Database : MEDLINE
Search on : Short and Bowel and Syndrome [Words]
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[PMID]: 29273999
[Au] Autor:Hofker TO; Kaijser MA; Nieuwenhuijs VB; Lange JFM; Hofker HS
[Ad] Address:Department of Surgery, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands.
[Ti] Title:Distal Duodenogastrostomy or Proximal Jejunogastrostomy in the Management of Ultra-Short Bowel.
[So] Source:J Gastrointest Surg;22(3):538-543, 2018 Mar.
[Is] ISSN:1873-4626
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Inflammatory bowel disease, vascular disease, volvulus, adhesions, or abdominal trauma may necessitate extensive small-bowel resection resulting in an ultra-short distal duodenal or jejunal stump. If this distal duodenal or short jejunal stump is too short for stoma creation and bowel continuity restoration is hazardous or not possible at all, a distal duodenogastrostomy or proximal jejunogastrostomy in combination with drainage of the stomach is an option to prevent stump leakage. Although successful, this distal duodenogastrostomy has been described only in very few patients and in older records. We reintroduced this technique and describe a recent series of patients that confirms its usefulness in certain conditions. The technique of the distal duodenogastrostomy or proximal jejunogastrostomy with gastric drainage was used for the management of the difficult distal duodenum stump in five critically ill patients undergoing extensive bowel resection. Four patients with small-bowel ischemia and one patient suffering from perforating Crohn's disease and small-bowel volvulus were treated  successfully. The gastrostomies were subsequently converted to a duodenotransversostomy (in two patients) or the patients underwent small-bowel transplantation (two patients). One patient still has a jejunogastrostomy just after the duodenal-jejunal transition. In all five patients, the distal duodenogastrostomy or proximal jejunogastrostomy in combination with gastric drainage functioned well up to restoration of bowel continuity. In one patient, distal duodenogastrostomy and transabdominal gastric drainage functioned well for 5 years. No anastomotic leakage occurred. This procedure provides a feasible solution for an ultra-short bowel at emergency laparotomy. It enhances the surgical armamentarium and provides treatment options for these patients that were perhaps previously deemed unsalvageable.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Data-Review
[do] DOI:10.1007/s11605-017-3654-0

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[PMID]: 29231018
[Au] Autor:Li R; Li CT; Zhao SM; Li HX; Li L; Wu RG; Zhang CC; Sun HY
[Ad] Address:Department of Forensic Medicine, Zhongshan Medical College, Sun Yat-sen University, Guangzhou 510089, China.
[Ti] Title:[Full Sibling Identification by IBS Scoring Method and Establishment of the Query Table of Its Critical Value].
[So] Source:Fa Yi Xue Za Zhi;33(2):136-140, 2017 Apr.
[Is] ISSN:1004-5619
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVES: To establish a query table of IBS critical value and identification power for the detection systems with different numbers of STR loci under different false judgment standards. METHODS: Samples of 267 pairs of full siblings and 360 pairs of unrelated individuals were collected and 19 autosomal STR loci were genotyped by Golden ye™ 20A system. The full siblings were determined using IBS scoring method according to the 'Regulation for biological full sibling testing'. The critical values and identification power for the detection systems with different numbers of STR loci under different false judgment standards were calculated by theoretical methods. RESULTS: According to the formal IBS scoring criteria, the identification power of full siblings and unrelated individuals was 0.764 0 and the rate of false judgment was 0. The results of theoretical calculation were consistent with that of sample observation. The query table of IBS critical value for identification of full sibling detection systems with different numbers of STR loci was successfully established. CONCLUSIONS: The IBS scoring method defined by the regulation has high detection efficiency and low false judgment rate, which provides a relatively conservative result. The query table of IBS critical value for identification of full sibling detection systems with different numbers of STR loci provides an important reference data for the result judgment of full sibling testing and owns a considerable practical value.
[Mh] MeSH terms primary: Irritable Bowel Syndrome/genetics
Siblings
[Mh] MeSH terms secundary: Alleles
Genotype
Humans
Reproducibility of Results
Research Design
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[Js] Journal subset:IM
[Da] Date of entry for processing:171213
[St] Status:MEDLINE
[do] DOI:10.3969/j.issn.1004-5619.2017.02.006

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[PMID]: 29509291
[Au] Autor:Parreiras-E-Silva LT; de Araújo IM; Elias J; Nogueira-Barbosa MH; Suen VMM; Marchini JS; Bonella J; Nahas AK; Salmon CEG; de Paula FJA
[Ad] Address:Department of Internal Medicine, Ribeirao Preto Medical School, University of São Paulo (USP), São Paulo, Brazil.
[Ti] Title:Short bowel syndrome: influence of nutritional therapy and incretin GLP1 on bone marrow adipose tissue.
[So] Source:Ann N Y Acad Sci;, 2018 Mar 06.
[Is] ISSN:1749-6632
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Energy deprivation leads to a decrease in white adipose tissue and bone mineral density (BMD), while simultaneously inducing the expansion of marrow adipose tissue (MAT). In short bowel syndrome (SBS), parenteral nutrition mitigates the deterioration of nutritional status, including decreases in MAT. Osteoporosis is, however, a frequent complication of SBS. The objective of our study here was to evaluate the association of fat deposit sites (subcutaneous and visceral adipose tissues: intrahepatic lipid (IHL) and MAT) and the incretin glucagon-like peptide 1 (GLP1) with BMD in individuals with SBS. MAT was negatively correlated with lumbar spine BMD in normal individuals, but not in those in the SBS group, who otherwise showed a positive correlation between MAT and GLP1. In addition, in individuals with SBS, IHL was negatively associated with lumbar spine BMD and positively associated with C-terminal telopeptide of type 1 collagen (a serum biomarker of bone turnover). Caloric maintenance in individuals with SBS, therefore, seems to positively affect the relationship between MAT and BMD, which may be modulated, at least in part, by GLP1.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher
[do] DOI:10.1111/nyas.13657

  4 / 6966 MEDLINE  
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[PMID]: 29505155
[Au] Autor:Smith A; Feuling MB; Larson-Nath C; Karls C; Van Hoorn M; Walia CLS; Leon C; Danner E; Opichka P; Duesing L; Martinez A; Goday PS
[Ad] Address:Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA.
[Ti] Title:Laboratory Monitoring of Children on Home Parenteral Nutrition: A Prospective Study.
[So] Source:JPEN J Parenter Enteral Nutr;42(1):148-155, 2018 Jan.
[Is] ISSN:1941-2444
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: The primary hypothesis of this article is that a team approach in creating a protocolized laboratory monitoring schedule for home parenteral nutrition (PN) patients improves patient safety by decreasing the occurrence of nutrition deficiencies and is cost-effective. METHODS: In this prospective cohort study of home PN patients, each patient followed an established protocol of laboratory monitoring and weekly review by an interdisciplinary team of dietitians, nurses, and physicians. Data collected included anthropometric measurements, laboratory results, deviations from laboratory protocols, laboratory charges, PN shortage information, and means of ameliorating such shortages. Cost-effectiveness analysis was only performed for nonmicronutrient laboratory tests. RESULTS: Fifteen children (male, n = 6) with a median age of 59 months (range, 19-216) were included in this study. Primary diagnoses included short bowel syndrome (47%) and intestinal pseudo-obstruction (40%). Patients received PN mixtures from 6 different infusion companies and experienced 60 different shortages in the PN formulation requiring adjustments or substitutions (mean, 4 shortages per patient). All patients had appropriate growth and complete micronutrient monitoring. No patient experienced any clinical symptoms due to shortages. The median number of laboratory draws/patient per month was 2.9 preprotocol compared with 1.14 postprotocol (P = .003). The median per patient per month charges were $2014 (interquartile range [IQR], 1471-2780) preprotocol compared with $792 (IQR, 435-1140) postprotocol (P = .002). CONCLUSIONS: A structured team approach to laboratory monitoring of home PN patients can simplify PN management, significantly decrease monthly laboratory costs, and lead to fewer laboratory draws while improving micronutrient monitoring and preventing deficiencies.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:In-Data-Review
[do] DOI:10.1177/0148607116673184

  5 / 6966 MEDLINE  
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[PMID]: 29505151
[Au] Autor:Lam K; Schwartz L; Batisti J; Iyer KR
[Ad] Address:Mount Sinai Medical Center, New York, NY, USA.
[Ti] Title:Single-Center Experience with the Use of Teduglutide in Adult Patients with Short Bowel Syndrome.
[So] Source:JPEN J Parenter Enteral Nutr;42(1):225-230, 2018 Jan.
[Is] ISSN:1941-2444
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Teduglutide is a glucagon-like peptide 2 (GLP-2) analog that has been approved for the treatment of adult short bowel syndrome (SBS)-associated intestinal failure (IF; SBS-IF). Teduglutide increases villus height and crypt depth in the small bowel mucosa, promoting nutrition absorption and enteral independence from parenteral nutrition (PN). We aim to report our single-center experience with teduglutide in adult patients with SBS to provide real-world context to its use. METHOD: We conducted a retrospective analysis on patients managed within our tertiary-level intestinal rehabilitation program to identify patients with SBS-IF treated with teduglutide from 2009-2015. The current report includes all patients at our center who had any exposure to teduglutide, including those who received commercial drug after approval by the Food and Drug Administration (FDA) and outside the scope of clinical trials. RESULTS: A total of 18 patients were treated with teduglutide. Eleven patients (61%) achieved complete enteral independence from PN and/or intravenous fluids (IV) at a median time of 10 months (range: 3-36 months). PN/IV volume requirement was reduced in all patients except two. Ten of the 11 patients (91%) who achieved enteral autonomy had colon. All patients off PN/IV required additional oral vitamins and electrolyte supplementations. CONCLUSION: Our preliminary experience is consistent with prior reports of successful partial or complete weaning from PN/IV with teduglutide treatment in adult patients with SBS. The presence of colon appears to be favorable in obtaining enteral independence from PN/IV, regardless of residual small bowel length. Patients on teduglutide may remain at high risk of micronutrient deficiencies.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:In-Data-Review
[do] DOI:10.1002/jpen.1011

  6 / 6966 MEDLINE  
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[PMID]: 29505150
[Au] Autor:Brandt CF; Tribler S; Hvistendahl M; Naimi RM; Brøbech P; Staun M; Jeppesen PB
[Ad] Address:Department of Medical Gastroenterology CA 2-12-1, Copenhagen University Hospital, Copenhagen, Denmark.
[Ti] Title:Home Parenteral Nutrition in Adult Patients With Chronic Intestinal Failure: Catheter-Related Complications Over 4 Decades at the Main Danish Tertiary Referral Center.
[So] Source:JPEN J Parenter Enteral Nutr;42(1):95-103, 2018 Jan.
[Is] ISSN:1941-2444
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract: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. METHODS: All patients with IF discharged with HPN from 1970-2010 were included. Patient and treatment characteristics were extracted from the Copenhagen IF database. The incidences were given per 1000 central venous catheter (CVC) days. RESULTS: The 1715 CRCs occurred in 70% of the 508 patients with IF (56% of the 2191 CVCs). The incidence of catheter-related bloodstream infections (CRBSIs) was 1.43. Higher age, HPN administration by community home nurses, and prior CRBSIs significantly raised the hazard for CRBSIs. In the 1970s, catheters were generally replaced following CRBSIs, whereas catheter salvage was the norm in the 2000s. The incidences of mechanical complications, tunnel infections, and catheter-related venous thromboses were 0.80, 0.25, and 0.11, respectively. The overall CRC incidence was 2.58, decreasing the first 3 decades but peaking in the last (2.84). The deaths related to CRCs were low (0.018). CONCLUSION: Even in an experienced IF center of excellence, the incidence of CRCs increased over the 4 decades. This increase could be explained by the expansion of the indication of HPN to a more elderly and frail patient population.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:In-Data-Review
[do] DOI:10.1177/0148607116678766

  7 / 6966 MEDLINE  
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[PMID]: 29505141
[Au] Autor:Fullerton BS; Velazco CS; Hong CR; Carey AN; Jaksic T
[Ad] Address:Center for Advanced Intestinal Rehabilitation, Boston Children's Hospital, Boston, MA, USA.
[Ti] Title:High Rates of Positive Severe Combined Immunodeficiency Screening Among Newborns with Severe Intestinal Failure.
[So] Source:JPEN J Parenter Enteral Nutr;42(1):239-246, 2018 Jan.
[Is] ISSN:1941-2444
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: Severe combined immunodeficiency (SCID) screening by T-cell receptor excision circles (TREC) has been part of Massachusetts routine newborn screening since 2009. Tetratricopeptide repeat domain 7A gene (TTC7A) mutations responsible for hereditary multiple intestinal atresia with combined immunodeficiency (MIA-CID) were also recently identified. We reviewed newborn SCID screening among infants with intestinal failure and correlated results with patient characteristics and outcomes. METHODS: Records of infants with severe intestinal failure and available newborn screen results treated at a single center 2009-2016 were reviewed retrospectively. Patients with 1 or more positive SCID screens (<252 TREC copies/µL) were compared with those without positive screens. TREC copies/µL were compared with population norms. RESULTS: Of 70 included infants, 34% had newborn screens with TREC <252 copies/µL, compared with 0.3% of the general population; TREC levels for the cohort were lower than the general population (p<0.001). Of those with positive screens, 42% had prior or subsequent negative screening, 8% had no further workup, and 50% had flow cytometry showing: severe T-cell lymphopenia (absolute CD3+ <1500 cells/mcL) in 8, 3 of whom had TTC7A mutation-associated MIA-CID. Four had CD3+ >1500 cells/mcL. MIA-CID patients had the lowest serum citrulline in the cohort; 4 of the 8 patients with CD3+ <1500 cells/mcL on flow cytometry had newborn screening notable for severe hypocitrullinemia (<3 µM). CONCLUSION: Infants with intestinal failure have lower TREC copies/µL than the general population; one-third had levels concerning for SCID, and 11% were diagnosed with severe T-cell lymphopenia. The clinical implications and etiology of this phenomenon remain unknown, but may be related to hypocitrullinemia.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:In-Data-Review
[do] DOI:10.1002/jpen.1013

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[PMID]: 29499845
[Au] Autor:McLaughlin CM; Bennett M; Channabasappa N; Journeycake J; Piper HG
[Ad] Address:Department of Surgery, Baylor University Medical Center, Dallas, TX, United States.
[Ti] Title:Anticoagulation results in increased line salvage for children with intestinal failure and central venous thrombosis.
[So] Source:J Pediatr Surg;, 2018 Feb 07.
[Is] ISSN:1531-5037
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: The purpose of this study was to investigate whether anticoagulation (AC) results in thrombus resolution and increased line longevity in children with intestinal failure (IF) and catheter-associated central venous thrombosis (CVT). METHODS: A retrospective, single institution review was performed of children with IF who were dependent on parenteral nutrition with known CVT between 2006 and 2017. Frequency of catheter-related complications including infection, occlusion, and breakage were compared 18months prior to and after starting AC. Thrombus resolution during anticoagulation was also determined. Data were analyzed using Poisson regression. p-Values <0.05 were considered significant. RESULTS: Eighteen children had ≥1 CVT, with the subclavian vein most commonly thrombosed (44%). All children were treated with low molecular weight heparin, and 6 patients (33%) had clot resolution on re-imaging while receiving AC. Bloodstream infections decreased from 7.9 to 4.4 per 1000 catheter days during AC (p=0.01), and the number of infections requiring catheter replacement decreased from 3.0 to 1.0 per 1000 catheter days (p=0.01). There were no significant differences in line occlusions or breakages. CONCLUSION: Anticoagulation for children with intestinal failure and central venous thrombosis may prevent thrombus propagation, and decrease blood stream infections and line replacements. Further research is needed to determine optimal dosing and duration of therapy. LEVEL OF EVIDENCE: III; Retrospective Comparative Study.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:Publisher

  9 / 6966 MEDLINE  
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[PMID]: 29499441
[Au] Autor:Hu H; You X; Ye J
[Ad] Address:Department of Neurology, Beijing Jishuitan Hospital, Beijing, China. Electronic address: hhtsd@163.com.
[Ti] Title:Short transverse myelitis in Chinese patients with neuromyelitis optica spectrum disorders.
[So] Source:Mult Scler Relat Disord;21:78-83, 2018 Feb 19.
[Is] ISSN:2211-0356
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND: Short transverse myelitis (STM) is considered uncommon in neuromyelitis optica spectrum disorders (NMOSD). Poor recognition of STM occurring in NMOSD may lead to increased delay in diagnosis and appropriate treatment. OBJECTIVES: The aim of this study was to assess the frequency and characteristics of STM in Chinese patients with NMOSD. METHODS: We enrolled 91 patients with NMOSD based on the 2015 International Consensus Diagnostic Criteria for NMOSD. The patients were divided into STM group and longitudinally extensive transverse myelitis (LETM) group according to the length of initial spinal cord lesions at the initial myelitis manifestation of NMOSD. RESULTS: Initial STM was observed in 18 patients (18/91, 19.8%). The STM episode was the first manifestation of NMOSD in 9 patients (50%) and preceded by optic neuritis in 3 patients (16.7%), area postrema syndrome in 5(27.8%) and brainstem syndrome in 1(5.6%). Compared to the NMOSD patients with an initial LETM, patients with STM suffered less motor and bowel or bladder disability, had minor EDSS at clinical onset, but suffered earlier relapse (P<.05). Thirteen patients had single short spinal lesion (13/18, 72.2%) and 5 patients had two short lesions. Of the 23 STM lesions, 4 lesions spanned 2.5 vertebral segments, 12 showed a length of continuous 2 vertebral segments, 7 were confined to single vertebral segment. The lesions on axial imaging involved the central grey matter in 61.1% (11/18) patients with STM and in 95.9%(70/73)patients with LETM (P<.05). Both the patients with STM(50%)and LETM (34.2%) had brain lesions. CONCLUSIONS: Initial STM does not exclude consideration of NMOSD diagnosis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[St] Status:Publisher

  10 / 6966 MEDLINE  
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[PMID]: 29202475
[Au] Autor:Drucker DJ; Habener JF; Holst JJ
[Ad] Address:Lunenfeld-Tanenbaum Research Institute, Mt. Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
[Ti] Title:Discovery, characterization, and clinical development of the glucagon-like peptides.
[So] Source:J Clin Invest;127(12):4217-4227, 2017 Dec 01.
[Is] ISSN:1558-8238
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The discovery, characterization, and clinical development of glucagon-like-peptide-1 (GLP-1) spans more than 30 years and includes contributions from multiple investigators, science recognized by the 2017 Harrington Award Prize for Innovation in Medicine. Herein, we provide perspectives on the historical events and key experimental findings establishing the biology of GLP-1 as an insulin-stimulating glucoregulatory hormone. Important attributes of GLP-1 action and enteroendocrine science are reviewed, with emphasis on mechanistic advances and clinical proof-of-concept studies. The discovery that GLP-2 promotes mucosal growth in the intestine is described, and key findings from both preclinical studies and the GLP-2 clinical development program for short bowel syndrome (SBS) are reviewed. Finally, we summarize recent progress in GLP biology, highlighting emerging concepts and scientific insights with translational relevance.
[Mh] MeSH terms primary: Drug Discovery
Glucagon-Like Peptide 1/pharmacology
Glucagon-Like Peptide 2/pharmacology
[Mh] MeSH terms secundary: Animals
Diabetes Mellitus, Type 2/drug therapy
Glucagon-Like Peptide-1 Receptor/agonists
Glucagon-Like Peptide-1 Receptor/physiology
Humans
Short Bowel Syndrome/drug therapy
Structure-Activity Relationship
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Nm] Name of substance:0 (Glucagon-Like Peptide 2); 0 (Glucagon-Like Peptide-1 Receptor); 89750-14-1 (Glucagon-Like Peptide 1)
[Em] Entry month:1712
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:171205
[St] Status:MEDLINE


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