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https://www.readbyqxmd.com/read/29413206/gastrointestinal-motility-problems-in-critically-ill-patients
#1
REVIEW
Christine Frazer, Leslie Hussey, Mary Bemker
Gastrointestinal (GI) motility problems are common complications in critical care patients. GI problems contribute to an increased risk of morbidity and mortality. Toxic megacolon (TM) is a type of acquired megacolon categorized as a medical emergency and includes severe inflammation affecting all layers of the colon wall. The high incidence of GI complications in critically ill patients requires the critical care nurse to provide close monitoring of patients at risk and an acute awareness of the causation, signs and symptoms, and treatment of various GI motility disorders, including gastroparesis, ileus, and TM...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29393463/bmp4-knockdown-of-ncscs-leads-to-aganglionosis-in-the-middle-embryonic-stage
#2
Hong-Bo Li, Xian-Qing Jin, Xin Jin, Zheng-Hua Guo, Xiong-Hui Ding, Quan Wang, Rui-Zhuo Liu
Transplacental bone morphogenetic protein (BMP)4 RNA interference (RNAi) is a technique used to knockdown genes in embryos. BMP4 are essential for the development of nervous system in the differentiation of neural crest stem cells (NCSCs). The failure of differentiation and migration of NCSCs may lead to aganglionosis. In the present study, pregnant mice were divided into three groups: Ringer's group, pSES group and RNAi‑BMP4 group. In order to silence the BMP4 gene in the first generation (F1), 11.5 day pregnant mice were injected with the small interfering RNA BMP4 plasmid, pSES or Ringer's solution via the tail vein...
January 30, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29385992/symptoms-and-diagnostic-criteria-of-acquired-megacolon-a-systematic-literature-review
#3
Tahleesa Cuda, Ronny Gunnarsson, Alan de Costa
BACKGROUND: Acquired Megacolon (AMC) is a condition involving persistent dilatation and lengthening of the colon in the absence of organic disease. Diagnosis depends on subjective radiological, endoscopic or surgical findings in the context of a suggestive clinical presentation. This review sets out to investigate diagnostic criteria of AMC. METHODS: The literature was searched using the databases - PubMed, Medline via OvidSP, ClinicalKey, Informit and the Cochrane Library...
January 31, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29305432/a-case-of-sigmoid-volvulus
#4
Aikaterini Leventi, Thomas Frederick James Clifford, Amy Arnold, Charles H Knowles, Joanne E Martin
CLINICAL PRESENTATION: A 53-year-old man was admitted with a 2-week history of bowel obstruction on a background of gradually worsening dyspeptic symptoms associated with vomiting and weight loss. He was under regular gastroenterology review for Barrett's oesophagus and had a recent endoscopic diagnosis of megaduodenum (mainly D1 dilatation) confirmed by barium study (figure 1). He was also known to have bladder emptying problems and an enlarged bladder. His mother died at age 28 due to 'megacolon', and he has a monozygotic twin brother with Barrett's oesophagus...
January 5, 2018: Gut
https://www.readbyqxmd.com/read/29280111/-choice-of-surgical-procedures-and-control-of-surgical-risks-in-chronic-constipation
#5
Jinke Sui, Wei Zhang
Surgery, as one of the methods for the treatment of chronic constipation, is the final choice after the failure of non-surgical treatment with its specific particularity. The history of surgical treatment of chronic constipation is complex and tortuous. How to select operation among many kinds of surgery, and control risk is difficult for clinician. The choice of surgical procedure depends mainly on the patient's conditions, the objective examination basis and the experience of physician teams. Based on the previous reports and the team's experience, this paper discusses the choice of surgical treatment for the following types of chronic constipation: (1) Slow transit constipation: subtotal colorectal resection plus ileorectal anastomosis or ascending colon rectum anastomosis is widely used at present in the domestic, and its efficacy is quite good...
December 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29276421/adaptive-returns-of-deficient-systemic-plasma-immunoglobulin-g-levels-as-rehabilitation-biomarker-after-emergency-colectomy-for-fulminant-ulcerative-colitis
#6
Alexander T Hawkins, Jun W Um, Amosy E M'Koma
Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) is the standard surgical treatment for ulcerative colitis (UC). Emergency colectomies are performed for fulminant colitis (ie, toxic megacolon, profuse bleeding, perforation, or sepsis). The RPC and IPAA involve manipulation of the proximal ileum, which may influence the essential physiological function of gut-associated lymphoid tissues. Circulating plasma immunoglobulin G (p-IgG) deficiency is observed in patients with fulminant UC...
2017: Clinical Medicine Insights. Gastroenterology
https://www.readbyqxmd.com/read/29273940/investigation-of-clostridium-difficile-ribotypes-in-symptomatic-patients-of-a-german-pediatric-oncology-center
#7
Arne Simon, Markus Mock, Norbert Graf, Lutz von Müller
In a German pediatric oncology unit, the attending physicians diagnosed 27 cases of Clostridium difficile-associated disease (CDI) from January 01, 2010 to October 31, 2013. This refers to a CDI incidence density of 2.0/1000 inpatient days. According to the hospital hygiene standard, symptomatic patients with CDI were kept in contact isolation. Most patients (median age 8.2 years) suffered from acute lymphoblastic leukemia; 88.9% were treated with broad-spectrum antibiotics during the preceding 4 weeks. 29...
December 22, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29212105/-german-society-of-gastroenterology-digestive-and-metabolic-diseases-dgvs-position-statement-on-endoscopic-decompression-in-acute-ileus
#8
Martin Götz, Georg Braun, Ralf Jakobs, Helmut Messmann, Eduard F Stange, Markus M Lerch
In patients with ileus with dilated intestine in imaging studies, endoscopic decompression appears a feasible option. However, its use is often uncritical and without scientific evidence. Before considering endoscopic intervention, CT-imaging should differentiate between mechanical obstruction and paralytic ileus/intestinal pseudo-obstruction. Tumor diagnosis and localisation are essential because the latter determines the choice of the decompression procedure. Coecal dilatation of more than 12 cm indicates an increased risk of perforation...
December 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29190854/-clostridium-difficile-infection-epidemiology-clinical-presentation-therapy-and-prevention
#9
Magnus Kaffarnik, Caroline Isner, Uwe Hamsen
Clostridium difficile infections (CDI) are common causes of diarrhoea in hospitalised medical and surgical patients. Clinical presentation ranges from mild diarrhoea to pseudomembraneous enterocolitis of the colon and sometimes the small intestines, with development of a toxic megacolon. Recurrent infections are common. Early diagnosis is necessary because of high rates of complications and mortality. Knowledge of risk factors for the development of CDI is recommended. Early initiation of therapy is recommended to avoid complications and standard therapy is antibiotics, while therapy with monoclonal antibodies and vaccination is under research and development...
November 30, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29186093/-rehbein-procedure-for-secondary-megacolon-in-children
#10
R Sh Polukhov
AIM: To evaluate the results of Rehbein procedure with extraperitoneal colorectal anastomosis combined with complex conservative treatment in children with secondary megacolon due to chronic constipation. MATERIAL AND METHODS: We carried out surgical interventions in 78 children aged 7-12 years with chronic colostasis resistant to conservative treatment. All patients underwent clinical, laboratory and instrumental examination. All patients were divided into 3 groups depending on type of surgery: group I - colon resection followed by intraperitoneal colorectal anastomosis (28 patients), group II - open Rehbein procedure (29 patients), group III - laparoscopic Rehbein procedure (21 patients)...
2017: Khirurgiia
https://www.readbyqxmd.com/read/29165757/clinical-effects-of-ascending-colon-patching-ileorectal-heart-shaped-anastomosis-on-total-colonic-aganglionosis
#11
S-X Li, H-W Zhang, H Cao, H-X Zou, Y-Y Yin, F Sui, X Zhang
OBJECTIVE: We studied the clinical effects of ascending colon patching ileorectal heart-shaped anastomosis in treating total colonic aganglionosis. PATIENTS AND METHODS: From June 2006 to June 2013, 15 children with severe abdominal distension, low small intestine obstruction and intestinal perforation in the neonatal period, were enrolled in this study. In phase I, patients received emergency terminal ileum stoma plus multi-site colonic biopsy and 6 to 12 months later, ascending colon patching ileorectal heart-shaped anastomosis was conducted in phase II...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29152528/x-linked-lissencephaly-with-absent-corpus-callosum-and-abnormal-genitalia-an-evolving-multisystem-syndrome-with-severe-congenital-intestinal-diarrhea-disease
#12
David Coman, Tom Fullston, Cheryl Shoubridge, Richard Leventer, Flora Wong, Simon Nazaretian, Ian Simpson, Josef Gecz, George McGillivray
X-linked lissencephaly with abnormal genitalia is a rare and devastating syndrome. The authors present an infant with a multisystem phenotype where the intestinal manifestations were as life limiting as the central nervous system features. Severe chronic diarrhea resulted in failure to thrive, dehydration, electrolyte derangements, long-term hospitalization, and prompted transition to palliative care. Other multisystem manifestations included megacolon, colitis, pancreatic insufficiency hypothalamic dysfunction, hypothyroidism, and hypophosphatasia...
January 2017: Child Neurology Open
https://www.readbyqxmd.com/read/29065705/effects-of-a-probiotic-slab51%C3%A2-on-clinical-and-histologic-variables-and-microbiota-of-cats-with-chronic-constipation-megacolon-a-pilot-study
#13
G Rossi, A Jergens, M Cerquetella, S Berardi, E Di Cicco, G Bassotti, G Pengo, J S Suchodolski
Chronic constipation (CC) and idiopathic megacolon (IMC) occur frequently in cats. The aim of the study was to investigate the effects of a multi-strain probiotic (SLAB51™) in constipated cats (n=7) and in patients with megacolon and constipation (n=3). Ten pet cats with a diagnosis of chronic constipation, non-responsive to medical management received orally 2×10(11) bacteria daily for 90 days. For microbiota analysis, selected bacterial groups were analysed by qPCR. Histological samples in megacolons were evaluated for interstitial cells of Cajal (ICC), enteric neurons, and neuronal apoptosis...
October 25, 2017: Beneficial Microbes
https://www.readbyqxmd.com/read/29018144/ogilvie-s-syndrome-treated-with-an-emergency-laparotomy-right-hemicolectomy-and-end-ileostomy
#14
Andrew James Robinson, John-Patrick Quigley, Athene Banks, Martin Farmer
Acute colonic pseudo-obstruction (ACPO), or Ogilvie's syndrome, is a rare clinical entity in which there is massive non-toxic colonic dilatation in the absence of a mechanically obstructing lesion. It is an important yet poorly recognised cause of surgical morbidity and mortality occurring typically in elderly patients with multiple comorbidities. ACPO can often be reversed conservatively with colonoscopic or nasogastric decompression. Surgical intervention is seldom necessary. We present a case of Ogilvie's syndrome in which a healthy 76-year-old man developed life-threatening pseudo-obstruction following rib polytrauma after a mechanical fall...
October 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28991144/colon-sparing-surgery-for-clostridium-difficile
#15
David N Naumann, Aneel Bhangu, Douglas M Bowley
There has been recent evidence from a large multi-center study sponsored by the Eastern Association for the Surgery of Trauma that colon-sparing surgery reduces mortality for patients with severe Clostridium difficile associated disease (CDAD) when compared to total colectomy. Amoebic colitis shares many pathologic and clinical features to CDAD, such as worsening diarrhoea, patchy colonic ulceration and necrosis, toxic megacolon, pseudomembranous colitis, perforation, and death. However, published research regarding amoebic colitis is sparse...
October 4, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28951427/an-unexpected-complication-following-uterine-artery-embolisation
#16
Sarah Peters, Michelle Wise, Brendan Buckley
A 35-year-old nulliparous woman underwent uterine artery embolisation (UAE) for heavy menstrual bleeding and anaemia due to fibroids, refractive to medical and surgical treatment.Bilateral UAE was performed after cephazolin prophylaxis and analgesia. Postoperatively, pain and abdominal bloating were prominent. Symptoms were initially treated as postembolisation syndrome, and analgesia was escalated. By the third day, pain was worsening and the woman developed marked tachypnoea and tachycardia, with raised inflammatory markers and lactate...
September 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28912906/constipation-is-related-to-small-bowel-disturbance-rather-than-colonic-enlargement-in-acquired-chagasic-megacolon
#17
Mauro Bafutto, Alejandro Ostermayer Luquetti, Salustiano Gabriel Neto, Felix Andre Sanches Penhavel, Enio Chaves Oliveira
BACKGROUND: Constipation is the main symptom of acquired chagasic megacolon. However, a number of patients with Chagas disease without colon involvement also have the same complain. This study evaluated the role of small bowel in constipated patients with Chagas disease with and without megacolon. METHODS: Orocecal transit time (OCTT) and oral glucose tolerance test (OGTT) in constipated non-chagasic and chagasic patients with and without megacolon were performed...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28906293/frequency-and-variables-associated-with-fasting-orders-in-inpatients-with-ulcerative-colitis-the-audit-of-diet-orders-ulcerative-colitis-adore-uc-study
#18
Zane R Gallinger, Amir Rumman, Kevin Pivovarov, Kyle J Fortinsky, A Hillary Steinhart, Adam V Weizman
INTRODUCTION: Current clinical practice guidelines suggest that patients with ulcerative colitis (UC) hospitalized because of a disease flare should be offered a normal diet, unless such a diet is not tolerated. Studies of hospitalized patients have demonstrated iatrogenic malnutrition from unjustified or inappropriate nil per os (NPO) or clear liquid diet (CLD) orders. In this study, we aim to characterize the burden of this problem in hospitalized patients with UC. METHODS: We conducted a retrospective cohort study of all patients with UC admitted to the gastroenterology service or the general internal medicine service at a tertiary, academic hospital between January 2009 and December 2014, with a length of stay between 2 and 30 days...
October 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28876575/neonatal-surgery-a-study-of-two-years-at-nelson-mandela-academic-hospital-mthatha-eastern-cape
#19
A Delgado, A Cejas, D Bangasa
BACKGROUND: Advances in diagnostic techniques and perioperative care have greatly improved the outcome of neonatal surgery. Despite this, disparity still exists in the outcome of neonatal surgery between developed and developing countries. METHOD: We performed a prospective study of neonates admitted and treated due to surgical congenital diseases and other conditions in our hospital from April 2015 to April 2017. RESULTS: There were 19 (28,7%) females and 47 (70,3%) males in this group...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876561/predictors-of-emergency-colectomy-in-patients-admitted-with-acute-severe-ulcerative-colitis
#20
N N Mokhele, S R Thomson, G A Watermeyer
BACKGROUND: Acute Severe Ulcerative Colitis (ASUC) is a life-threatening condition which requires urgent and aggressive medical therapy to reduce mortality, morbidity and avoid surgery. To facilitate this process, it is essential to identify patients at high risk of poor outcomes and emergency colectomy. Numerous such risk factors have been described in Western literature, however there is no local data addressing this issue. As such it is unclear if these predictors are applicable in our setting...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
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