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Bram P Raphael, Christina Hazenkamp, Mihail Samnaliev, Al Ozonoff
BACKGROUND: While previous literature suggests home parenteral nutrition (HPN) dependent children experience frequent complications like community acquired central line associated bloodstream infections (CLABSI), few studies have characterized the cost. OBJECTIVES: To evaluate institutional cost of community-acquired CLABSI in pediatric HPN patients. METHODS: This is a single center retrospective review of institutional costs for HPN patients with community-acquired CLABSI at a tertiary care children's hospital...
June 13, 2018: Journal of Pediatric Gastroenterology and Nutrition
Sang Gon Lee, Chang Hyun Kim, Si Woo Sung, Eun Seok Lee, Min Su Goh, Ho Yub Yoon, Myung Joo Kang, Sangkil Lee, Young Wook Choi
Background: To facilitate selective and enhanced drug delivery to hepsin (Hpn)-expressing cancer cells, RIPL peptide (IPLVVPLRRRRRRRRC, 16-mer)-conjugated nanostructured lipid carriers (RIPL-NLCs) were developed. Methods: NLCs were prepared using a solvent emulsification-evaporation method and the RIPL peptide was conjugated to the maleimide-derivatized NLCs via the thiol-maleimide reaction. Employing a fluorescent probe (DiI), in vitro target-selective intracellular uptake behaviors were observed using fluorescence microscopy and flow cytometry...
2018: International Journal of Nanomedicine
Liam Ennis, Joanne Ablett, Michael Taylor, Simon Lal
BACKGROUND & AIMS: People with chronic, type 3, intestinal failure often require long-term home parenteral nutrition (HPN). People receiving HPN have frequent interactions with their healthcare, due to the need for close monitoring and due to recurrent hospital admissions. Individuals' responses to, and interactions with, their health care service provides are poorly described. We conducted a service evaluation to explore people's experiences of HPN-related healthcare interactions in order to identify how service providers can best meet the individualised needs of patients...
August 2018: Clinical Nutrition ESPEN
Sylwia Osowska, Marek Kunecki, Jacek Sobocki, Joanna Tokarczyk, Krystyna Majewska, Mohamed Omidi, Marek Radkowski, Helena L Fisk, Philip C Calder
BACKGROUND: The effect of different lipid emulsions (LEs) within the parenteral nutrition (PN) regimen of adult home PN (HPN) patients is not clear. This study investigated the effect of changing adult HPN patients from a soybean oil based LE (Intralipid) to either a fish oil containing LE (providing n-3 fatty acids) (SMOFLipid) or an olive oil based LE (ClinOleic). METHODS: Thirty two adults receiving long-term HPN with Intralipid as the LE were transferred to receive either SMOFLipid (n = 13) or ClinOleic (n = 19) for 60 days...
June 6, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Zachary Saylor, Robert Maier
Nickel metabolism and trafficking in Helicobacter pylori is complex, perhaps more so than in any other pathogen. Along with nickel enzymes and their associated nickel-binding maturation machinery, H. pylori contains nickel storage proteins, Hpn and Hpnl. Through a combined crosslinking and enrichment approach, we show that Hpn/Hpnl interact with a wide array of partners; over 100 proteins were captured, including known nickel-enzyme maturation proteins, and other proteins outside known H. pylori nickel-associated proteins...
June 15, 2018: Microbiology
Yuji Mikata, Risa Ohnishi, Risa Nishijima, Arimasa Matsumoto, Hideo Konno
Dinuclear Zn2+ complexes with HTQHPN ( N,N,N' ,N'-tetrakis(2-quinolylmethyl)-2-hydroxy-1,3-propanediamine) derivatives have been prepared, and their pyrophosphate (PPi, P2 O7 4- ) sensing properties were examined. The ligand library includes six HTQHPN derivatives with electron-donating/withdrawing substituents, an extended aromatic ring, and six-membered chelates upon zinc binding. Complexation of ligand with 2 equiv of Zn2+ promotes small to moderate fluorescence enhancement around 380 nm, but in the cases of HTQHPN, HT(6-FQ)HPN ( N,N,N' ,N'-tetrakis(6-fluoro-2-quinolylmethyl)-2-hydroxy-1,3-propanediamine), and HT(8Q)HPN ( N,N,N' ,N'-tetrakis(8-quinolylmethyl)-2-hydroxy-1,3-propanediamine), subsequent addition of PPi induced a significant fluorescence increase around 450 nm...
June 15, 2018: Inorganic Chemistry
Jian Yang, Bingxu Chen, Xiaokang Liu, Wei Liu, Zhijun Li, Juncai Dong, Wenxing Chen, Wensheng Yan, Tao Yao, Xuezhi Duan, Yuen Wu, Yadong Li
Herein, we report amorphous phosphorus nitride imide nanotubes (HPN) as a novel substrate to stabilize single metal sites materials by its abundant dangling unsaturated P vacancies. The Ru single atom can be successfully anchored by the strong coordination interaction between the d orbitals of Ru and the lone pair electrons of nitrogen at the skeleton of the HPN matrix. The atomic dispersion of Ru atoms can be distinguished by the X-ray absorption fine structure measurement and spherical aberration correction electron microscopy...
June 13, 2018: Angewandte Chemie
Anna Simona Sasdelli, Federica Agostini, Caterina Pazzeschi, Mariacristina Guidetti, Simon Lal, Loris Pironi
BACKGROUND & AIMS: Intestinal failure associated liver disease (IFALD) has been defined using numerous criteria; however the clinical relevance of these criteria has never been compared. We therefore aimed to evaluate the prevalence, incidence, evolution of IFALD diagnosed by different criteria and to assess any clinical features that may be associated with its occurrence. METHODS: A cross sectional (CS) and retrospective study were carried out on adults on home parenteral nutrition (HPN) for chronic intestinal failure (CIF) managed at a single center...
May 8, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Sarah Kate Brown, Natalie Davies, Enda Smyth, Nicky Heather, Caroline Cole, Simon Charles Keys, Robert Mark Beattie, Akshay Batra
AIM: We performed this study to examine and understand the evolving demographics and changing outcomes of intestinal failure, and its implications for healthcare delivery. METHOD: We conducted a retrospective analysis of outcome data of children on home Parenteral Nutrition (HPN), over a 15 year period. RESULTS: 31 patients received HPN, 15 for short bowel syndrome (SBS), 8 neuromuscular disease (NMD) and 8 for other causes. The HPN prevalence increased from 1...
May 13, 2018: Acta Paediatrica
Zhi-Jun Zhang, Rui-Feng Cai, Jian-He Xu
A nitrilase from Hoeflea phototrophica DFL-43 (HpN) demonstrating excellent catalytic activity towards benzoylacetonitrile was identified from a nitrilase tool-box, which was developed previously in our laboratory for (R)-o-chloromandelic acid synthesis from o-chloromandelonitrile. The HpN was overexpressed in Escherichia coli BL21 (DE3), purified to homogeneity by nickel column affinity chromatography, and its biochemical properties were studied. The HpN was very stable at 30-40 °C, and highly active over a wide range of pH values (pH 6...
May 10, 2018: Applied Microbiology and Biotechnology
Bram P Raphael, Caitlin Schumann, Sara Garrity-Gentille, Jennifer McClelland, Carolyn Rosa, Christina Tascione, Mary Gallotto, Melissa Takvorian-Bené, Alexandra N Carey, Patrick McCarthy, Christopher Duggan, Al Ozonoff
BACKGROUND: Despite being less costly than prolonged hospitalization, home parenteral nutrition (HPN) is associated with high rates of post-discharge complications, including frequent readmissions and central line-associated bloodstream infections (CLABSIs). Telemedicine has been associated with improved outcomes and reduced healthcare utilization in other high-risk populations, but no studies to date have supported effectiveness of telemedicine in pediatric HPN. METHODS: We prospectively collected data on pediatric patients managed at a single HPN program who participated in postdischarge telemedicine visits from March 1, 2014 to March 30, 2016...
May 4, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Lynne Murphy, Penny Allen, Bettemarie Bond, Peggi Guenter
Home parenteral nutrition (HPN) has been considered a lifesaving intervention since the late 1960s for patients with gastrointestinal (GI) failure and other conditions that affect the GI tract who are well enough to be at home. Payment for this therapy under federal programs requires significant documentation and complex processes to qualify. Medicare parenteral nutrition policy, qualification processes and challenges, and advocacy supported by the American Society for Parenteral and Enteral Nutrition are reviewed with the goal of increasing clinician awareness of the complexity surrounding Medicare HPN reimbursement...
March 30, 2018: Nutrition in Clinical Practice
Bram P Raphael, Maria Jorina, Mary Gallotto, Glendalis Grullon, Meghan Dalton, Melissa Takvorian-Bené, Christina Tascione, Carolyn Rosa, Jennifer McClelland, Megan Gray, Alexis K Potemkin, Courtney Glavin, Kathleen M Gura, Margaret K Murphy, Kierrah Leger, Judith Mahoney, Jessica Kerr, Al Ozonoff, Christopher P Duggan
BACKGROUND: Home parenteral nutrition (HPN) is a life-sustaining therapy for short bowel syndrome (SBS) and other severe digestive diseases, but complications are common. We evaluated a predischarge HPN hands-on training course to reduce complications in children with SBS, including hospital readmissions. METHODS: We conducted a prospective, nonrandomized controlled research study between April 1, 2014, and April 30, 2017. Eligible participants were children aged <18 years old with SBS and anticipated HPN dependence duration ≥6 months...
March 30, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Alice Heaney, Stephen P McKenna, Jeanette Wilburn, Matthew Rouse, Michael Taylor, Sorrel Burden, Simon Lal
BACKGROUND & AIMS: Several studies have been published reporting on the impact of Home Parenteral Nutrition (HPN) on the lives of people with Type 3 Intestinal Failure. These studies focused on symptoms and functional limitations resulting from the treatment. The aim of this study was to determine how dependence on HPN affects individuals' ability to fulfil their human needs. METHODS: Unstructured qualitative interviews were conducted with people dependent on HPN, who were asked to explain how their lives were affected by the treatment...
April 2018: Clinical Nutrition ESPEN
Christina Wong, Beverley Lucas, Diana Wood
BACKGROUND & AIMS: Parenteral nutrition (PN) provides nourishment and hydration as an intravenous infusion to patients with intestinal failure (IF). The aim of the study is to generate theory that explains the experiences of adult patients living with home parenteral nutrition (HPN) and complex medication regimens. METHODS: A grounded theory methodology was used to explore the experiences of twelve patients receiving HPN. A semi-structured interview was conducted and recorded in each participant's home setting...
April 2018: Clinical Nutrition ESPEN
Miguel Camblor-Álvarez, María Julia Ocón-Bretón, Luis Miguel Luengo-Pérez, Juan Antonio Viruzuela, María José Sendrós-Maroño, Mercedes Cervera-Peris, Enrique Grande, Julia Álvarez-Hernández, Paula Jiménez-Fonseca
BACKGROUND: Malnutrition is a frequent medical problem of cancer patients that negatively impacts their quality of life. OBJECTIVE: To analyze and respond to different issues related to the nutritional management of cancer patients in the clinical setting. METHODS: A multidisciplinary group of experts in Medical Oncology, Pharmacy, and Nutrition developed a list of topics related to the nutritional status of cancer patients, which were grouped into three blocks: Nutritional support; Parenteral nutrition (PN); and Home PN (HPN) in cancer patients...
January 10, 2018: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
John Spiliotis, Nikolaos Kopanakis, Anastasia Prodromidou, Alexis Terras, Anastasia Polichronaki, Christina Koutikova, Anna Gogou, Christina Sidera, Elias Efstathiou
PURPOSE: Home parenteral nutrition (HPN) has been proposed as the treatment of choice in patients suffering from intestinal failure (IF) and has been claimed to improve survival and quality of life either in patients with benign disorders or even in those with malignancies. The purpose of the present analysis was to report characteristics and outcomes of adult patients with IF receiving HPN in Greece. METHODS: Patients that received HPN between 2011 and 2017 were included in this retrospective analysis...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Christopher Filtenborg Brandt, Siri Tribler, Mark Hvistendahl, Rahim M Naimi, Per Brøbech, Michael Staun, Palle Bekker Jeppesen
BACKGROUND/AIMS: Catheter-related complications (CRCs) cause mortality and morbidity in patients dependent on parenteral support at home (HPN) due to intestinal failure (IF). This study describes the incidences of CRCs in an adult IF cohort over 40 years. It illustrates the evolution and consequences of CRCs, their association to demographic characteristics, and potential risk factors in an effort to provide the rationale for preventive precautions to the relevant patients with IF at risk...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Sharon Carey, Michelle Kalachov, Lynn Jones, Cherry Koh
BACKGROUND AND AIM: The aims of this study were to establish consensus on service delivery models for management of Type III intestinal failure (IF) and home parenteral nutrition (HPN) within the Australian health-care system and to identify barriers and enablers in moving towards this ideal model. METHODS: A modified Delphi methodology was utilized to survey experts working in Type III IF HPN. The panel comprised physicians, dietitians, nurses, and pharmacists from 18 of the 20 adult Type III IF HPN centres across Australia...
February 27, 2018: Journal of Gastroenterology and Hepatology
Krista Murray, Shameer Mehta
Patients who experience intestinal failure as a result of advanced malignancy can be supported with parenteral nutrition in their own home (HPN). This article describes how to identify which cancer patients would benefit from this therapy and how to ensure it is safely and correctly administered in the home setting.
February 1, 2018: British Journal of Nursing: BJN
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