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Home parenteral nutrition

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https://www.readbyqxmd.com/read/28531419/current-practices-and-experience-of-transition-of-young-people-on-long-term-home-parenteral-nutrition-pn-to-adult-services-a-perspective-from-specialist-centres
#1
E Kyrana, S V Beath, S Gabe, M Small, S Hill
BACKGROUND: There has been an estimated fivefold increase in the number of children receiving parenteral nutrition (PN) at home in the past 10 years with some children approaching the age when they should be referred to adult services whilst still on treatment. Models of care for moving young people onto adult providers of PN at home are not yet well developed, and transition is a potentially dangerous time for young people with complex health needs. METHODS: A questionnaire to ascertain current experience and practices of transition in the context of home PN services was dispatched to 170 consultant gastroenterologists who were members of the British Association of Parenteral and Enteral Nutrition (BAPEN) and also to all 40 members of the Nutrition and IF working group of the British Society of Paediatric Gastroenterology and Nutrition (BSPGHAN)...
August 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28526379/the-polish-intestinal-failure-centres-consensus-on-the-use-of-teduglutide-for-the-treatment-of-short-bowel-syndrome
#2
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/28490244/-investigating-the-efficacy-of-nutrition-therapy-for-outpatients-with-inflammatory-bowel-disease
#3
Andrea Molnár, Ágnes Anna Csontos, Sarolta Dakó, Rita Hencz, Dániel Áron Anton, Erzsébet Pálfi, Pál Miheller
INTRODUCTION: Inflammatory bowel diseases can cause malnutrition (due to inflammatory cytokine production, catabolic states after surgery, restricted diet), which is difficult to treat by nutritional therapy. AIM: Investigating the efficacy of nutrition therapy. METHOD: Combined malnutrition risk screening (questionnaires and body composition analysis), at the beginning of the research and after a 1 year period. RESULTS: 205 patients were screened, 82 were malnourished...
May 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28489034/the-prevalence-of-vitamin-d-insufficiency-and-deficiency-and-their-relationship-with-bone-mineral-density-and-fracture-risk-in-adults-receiving-long-term-home-parenteral-nutrition
#4
Navaporn Napartivaumnuay, Leah Gramlich
It has been demonstrated that low bone mass and vitamin D deficiency occur in adult patients receiving home parenteral nutrition (HPN). The aim of this study is to determine the prevalence of vitamin D insufficiency and deficiency and its relationship with bone mineral density (BMD) and fracture risk in long-term HPN patients. Methods: A retrospective chart review of all 186 patients in the HPN registry followed by the Northern Alberta Home Parenteral Nutrition Program receiving HPN therapy >6 months with a 25 (OH) D level and BMD reported were studied...
May 10, 2017: Nutrients
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
#5
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
#6
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/28446383/development-and-validation-of-the-parenteral-nutrition-impact-questionnaire-pniq-a-patient-centric-outcome-measure-for-home-parenteral-nutrition
#7
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/28445171/identification-of-depressive-signs-in-patients-and-their-family-members-during-ipad-based-audiovisual-sessions
#8
Carol E Smith, Marilyn Werkowitch, Donna Macan Yadrich, Noreen Thompson, Eve-Lynn Nelson
Home parenteral nutrition requires a daily life-sustaining intravenous infusion over 12 hours. The daily intravenous infusion home care procedures are stringent, time-consuming tasks for patients and family caregivers who often experience depression. The purposes of this study were (1) to assess home parenteral nutrition patients and caregivers for depression and (2) to assess whether depressive signs can be seen during audiovisual discussion sessions using an Apple iPad Mini. In a clinical trial (N = 126), a subsample of 21 participants (16...
April 25, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28441092/self-evaluation-of-quality-of-life-among-patients-receiving-home-parenteral-nutrition-a-validation-study
#9
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/28358595/treatment-of-enterocutaneous-fistulas-then-and-now
#10
Luis Alfonso Ortiz, Bin Zhang, Maureen Walsh McCarthy, Haytham M A Kaafarani, Peter Fagenholz, David R King, Marc De Moya, George Velmahos, Daniel Dante Yeh
BACKGROUND: An enterocutaneous fistula (ECF) is an aberrant connection between the gastrointestinal tract and the skin or atmosphere (enteroatmospheric fistula [EAF]). Multimodal treatment includes surgical procedures, nutrition support, and wound care. We evaluated our practice and compared our outcomes with previous results published from our institution. MATERIALS AND METHODS: We performed a retrospective analysis of hospitalized ECF/EAF patients admitted between January 2011 and November 2015...
March 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28355492/longitudinal-bone-mineralization-assessment-in-children-treated-with-long-term-parenteral-nutrition-for-severe-intestinal-failure
#11
Pierre Poinsot, Perrine Geoffroy, Pierre Braillon, Angelique Denis, Irene Loras-Duclaux, Stéphanie Marotte, Stéphanie Boutroy, Justine Bacchetta, Sandrine Touzet, Alain Lachaux, Noel Peretti
BACKGROUND: Metabolic bone disease is common in children receiving home parenteral nutrition (HPN) for intestinal failure (IF). Long-term evolution of bone mass in pediatric IF is poorly documented. The aims of this study were (1) to determine the prevalence of low bone mass (LBM) in children receiving HPN for IF, (2) to evaluate the evolution of total bone mineral content (TBMC) during HPN with dual-energy x-ray absorptiometry (DXA), and (3) to identify related factors. METHODS: All children referred in our HPN center from 2004 to 2014 were eligible...
March 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28293969/teduglutide-for-treatment-of-adult-patients-with-short-bowel-syndrome
#12
Lore Billiauws, Julie Bataille, Vanessa Boehm, Olivier Corcos, Francisca Joly
The European Society for Clinical Nutrition has published recommendations on the 'definition and classification of intestinal failure (IF)'. Two criteria must be present: a 'decreased absorption of macronutrients and/or water and electrolytes due to a loss of gut function' and the 'need for parenteral support'. Home parenteral support (HPS) is the primary treatment for chronic IF but is associated with complications. Areas covered: The principal cause of chronic IF is short bowel syndrome (SBS). The aim of treatment is to maximize intestinal absorption and reduce or eliminate the need for HPS to achieve the best possible quality of life...
May 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28285209/acute-large-bowel-pseudo-obstruction-due-to-atrophic-visceral-myopathy-a-case-report
#13
Sean M Wrenn, Charles S Parsons, Michelle Yang, Ajai K Malhotra
PURPOSE: Atrophic visceral myopathy is a pathological diagnosis characterized by atrophy of the smooth muscle layers of the viscera with intact ganglia. Rarely, it can present acutely as an intestinal pseudo-obstruction. We describe a rare case report and explore how this diagnosis can be distinguished from other forms of intestinal obstruction. CASE DESCRIPTION: A 60-year-old male with a past medical history of hypothyroidism presented to the emergency department with a two-day history of worsening abdominal distention and pain associated with nausea and vomiting...
February 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28282321/intestinal-transplantation-a-review
#14
Larry Loo, Georgio Vrakas, Srikanth Reddy, Philip Allan
PURPOSE OF REVIEW: The purpose of this article is to review the existing literature on the current indications, surgical techniques, immunosuppressive therapy and outcomes following intestinal transplantation (ITx). RECENT FINDINGS: Over recent years, ITx has become a more common operation with approximately 2500 procedures carried out worldwide by 2014. It is reserved for patients with intestinal failure and who have developed complications of home parenteral nutrition or who have a high risk of dying from their underlying disease...
May 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28244719/thiamin-and-folic-acid-deficiency-accompanied-by-resistant-electrolyte-imbalance-in-the-re-feeding-syndrome-in-an-elderly-patient
#15
Sibel Ocak Serin, Gulsah Karaoren, Yildiz Okuturlar, Ethem Unal, Seda Ahci, Eda Karakoc, Sema Ucak Basat
INTRODUCTION: Re-feeding Syndrome (RS) is a deadly complication, which can be encountered during "refeeding" of malnourished patients. In these patients, thiamin deficiency may develop and "risk awareness" is the most significant factor in the management of these patients. In this case report, the treatment is presented of an elderly patient who was diagnosed with RS and followed-up in the intensive care unit (ICU) due to resistant fluidelectrolyte imbalance. CASE: An 87-year-old elderly woman was admitted to the hospital due to aspiration pneumonia...
March 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28244702/health-insurance-or-subsidy-has-universal-advantage-for-management-of-hospital-malnutrition-unrelated-to-gdp
#16
Stanislaw Klek, Michael Chourdakis, Dima Abdulqudos Abosaleh, Alejandra Amestoy, Hyun Wook Baik, Gertrudis Baptista, Rocco Barazzoni, Ryoji Fukushima, Josef Hartono, Ranil Jayawardena, Rafael Jimenez Garcia, Zeljko Krznaric, Ibolya Nyulasi, Gabriela Parallada, Eliza Mei Perez Francisco, Marina Panisic-Sekeljic, Mario Perman, Arina Prins, Isabel Martinez Del Rio Requejo, Ravinder Reddy, Pierre Singer, Marianna Sioson, Andrew Ukleja, Carla Vartanian, Nicolas Velasco Fuentes, Dan Linetzky Waitzberg, Steve Leonce Zoungrana, Aleksander Galas
BACKGROUND AND OBJECTIVES: Protein-energy and micronutrient malnutrition are global public health problems which, when not prevented and severe, require medical management by clinicians with nutrition expertise, preferably as a collectively skilled team, especially when disease-related. This study aimed to investigate barriers and facilitators of clinical nutrition services (CNS), especially the use of oral, enteral (EN) and parenteral (PN) nutrition in institutional and home settings...
March 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28185508/infusion-therapy
#17
Erin Dean
Essential facts Many patients admitted to hospital or receiving care in other settings, including their own homes, are recipients of one or more infusion therapies. Total parenteral nutrition, chemotherapy, parenteral antimicrobial therapy, pain relief and other infusion therapies are increasingly delivered in community settings. While the move away from hospital helps meet patients' lifestyles and clinical needs, it can have implications for patient care and safety.
February 10, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28158232/the-effects-of-hospice-shared-care-for-gastric-cancer-patients
#18
Kun-Siang Huang, Shih-Ho Wang, Seng-Kee Chuah, Kun-Ming Rau, Yu-Hung Lin, Meng-Che Hsieh, Li-Hsueh Shih, Yen-Hao Chen
BACKGROUND: Hospice care has been proved to result in changes to the medical behaviors of terminally ill patients. The aim of this study was to evaluate the effects and medical behavior changes of hospice-shared care intervention among terminally ill gastric cancer patients. METHODS: A total of 174 patients who died of gastric cancer between 2012 and 2014 were identified. These patients were divided into two groups: a hospice-shared care group (n = 93) and a control group (n = 81)...
2017: PloS One
https://www.readbyqxmd.com/read/28132623/infusion-therapy
#19
Erin Dean
Essential facts [Figure: see text] Many patients admitted to hospital or receiving care in other settings, including their own homes, are recipients of one or more infusion therapies. Total parenteral nutrition, chemotherapy, parenteral antimicrobial therapy, pain relief and other infusion therapies are increasingly delivered in community settings. While the move away from hospital helps meet patients' lifestyles and clinical needs, it can have implications for patient care and safety.
January 30, 2017: Nursing Management (Harrow)
https://www.readbyqxmd.com/read/28081385/catheter-related-bloodstream-infections-in-adults-receiving-home-parenteral-nutrition
#20
Siri Tribler, Christopher F Brandt, Mark Hvistendahl, Michael Staun, Per Brøbech, Claus E Moser, Palle B Jeppesen
BACKGROUND: A common complication in patients receiving home parenteral nutrition (HPN) is catheter-related bloodstream infections (CRBSIs). The CRBSI incidence has been advocated as an outcome parameter assessing the quality of care. This study aimed to illustrate how the use of different CRBSI definitions affects the reported incidence. MATERIALS AND METHODS: In an observational study based on the Copenhagen intestinal failure database, all clinically reported CRBSIs from 2002-2013 were compared with data from the affiliated microbiological database according to recommended CRBSI criteria...
January 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
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