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Nutritional support and complications

Adem Bayraktar, Ali Fuat Kaan Gök, Selman Emiroğlu, Hüseyin Bakkaloğlu
BACKGROUND: Encapsulating peritoneal sclerosis (EPS) related to peritoneal dialysis (PD) has a vague etiology and high mortality. In this study, our aim was to determine treatment options for EPS cases. METHODS: A total of 169 patients underwent kidney transplantation from January 2008 to January 2018 and 119 patients from a cadaveric and 50 patients from a living donor. Twenty-one patients were undergoing PD before the transplantation. The mean PD time was 6.9 (IQR 3-14) years...
March 2019: Turkish Journal of Trauma & Emergency Surgery: TJTES
Choolwe Muzyamba
OBJECTIVE: While HIV research remains priority in Sub-Saharan Africa (SSA), most of the studies have traditionally been conducted in secure locations with little focus on internally displaced person (IDPs) and how they rely on locally available strategies for care and survival. Thus the aim of this study is to fill this gap by investigating the role of indigenous social relations (particularly, peer support) in the promotion of care among IDPs living with human immunodeficiency virus (HIV) in a conflict region known as Kabaré in the south Kivu province of Eastern Democratic Republic of the Congo...
March 12, 2019: BMC Research Notes
Scott R Coleman, Ming Chen, Srikant Patel, Hong Yan, Alan D Kaye, Marcus Zebrower, Julie A Gayle, Henry Liu, Richard D Urman
PURPOSE OF REVIEW: Enhanced recovery after surgery (ERAS) has become a widespread topic in perioperative medicine over the past 20 years. The goals of ERAS are to improve patient outcomes and perioperative experience, reduce length of hospital stay, minimize complications, and reduce cost. Interventions and factors before, during, and after surgery all potentially play a role with the cumulative effect being superior quality of patient care. RECENT FINDINGS: Preoperatively, patient and family education, optimization of nutritional status, and antibiotic prophylaxis all improve outcomes...
March 14, 2019: Current Pain and Headache Reports
Lon J Van Winkle, Rebecca Ryznar
Extracellular histones support rodent and human embryo development in at least two ways. First, these molecules in uterine secretions protect embryos from inflammation caused by pathogens that gain access to the reproductive tract. Also, histones in uterine secretions likely support penetration of the uterine epithelium by blastocysts during embryo implantation. Extracellular histones seem to preserve amino acid transport system B0,+ in blastocysts by inhibiting its activity. Preservation of system B0,+ is needed because, at the time of invasion of the uterine epithelium by motile trophoblasts, system B0,+ is likely reactivated to help remove tryptophan from the implantation chamber...
December 26, 2018: Biomolecular Concepts
Peter Declercq, Frank Van der Aa, Lutgart De Pourcq, Isabel Spriet
Background After radical cystectomy, delayed return of bowel function is relatively common. Although studies investigating on the best modality for delivering nutritional support to this patient group are limited, parenteral nutrition was standard of care in those patients at the urological ward of the University Hospitals Leuven. In 2015, we published the findings from our study conducted in patients undergoing elective regular radical cystectomy at the urological ward of the University Hospitals Leuven comparing the length of hospital stay in patients with early postoperative parenteral nutrition (n = 48) versus an immediate oral nutrition protocol (n = 46)...
March 12, 2019: International Journal of Clinical Pharmacy
Aurora Vincent, Raja Sawhney, Yadranko Ducic
Microvascular free tissue transfer is an indispensable reconstructive option in head and neck reconstruction. Flap failure is relatively rare, but it is nonetheless very morbid and psychologically devastating to patients when it does occur. Further, complications after free tissue transfer to the head and neck remain common. There are numerous ongoing debates about various facets of preoperative, intraoperative, and postoperative care of patients undergoing free flap reconstruction of the head and neck, all ultimately searching for the optimal treatment algorithm to further improve flap success, minimize complications, and maximize patient outcomes...
February 2019: Seminars in Plastic Surgery
Simona Salera, Gianluca Tadini, Donata Rossetti, Francesca Sofia Grassi, Paola Marchisio, Carlo Agostoni, Claudia Giavoli, Giulia Rodari, Sophie Guez
Inherited epidermolysis bullosa (EB) is a clinically and genetically heterogeneous group of rare diseases characterized by skin and mucous membrane fragility. EB primarily involves the skin and, in specific subtypes, the mucous membrane, resulting in complications which can strongly affect nutritional status (e.g. gastrointestinal complications, hand deformities, pain). The aims of nutritional support mainly include improving nutritional status, alleviating the stress of oral feeding and minimizing nutritional deficiencies, thus consequently improving growth, pubertal development, bowel function, immune status and wound healing...
February 21, 2019: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Kathleen H McGrath, Winita Hardikar
Children with cancer are at risk of malnutrition, which can impair critical childhood processes of growth and development and contribute to poor health outcomes. Enteral nutrition can effectively ameliorate malnutrition or weight loss in children with cancer; however, published nutrition support algorithms contain minimal specific information on gastrostomy tube use, and current literature is limited. Decisions about gastrostomy tube insertion in children with cancer can be challenging. Consideration of gastrostomy tube insertion is only appropriate in children with long-term dependence on enteral nutrition, particularly when nasogastric tube insertion is predicted or proven to be problematic...
March 11, 2019: Pediatric Blood & Cancer
Ying-Min Lin, Min Wang, Nuan-Xin Sun, Yan-Yan Liu, Teng-Fei Yin, Chen Chen
BACKGROUND: Malnutrition is very common in elderly patients admitted to the hospital. The aim of our study is to assess the nutritional status of elderly patients and the use of nutritional support in a tertiary care hospital in China and to analyze the impacts of nutritional status and nutritional support on clinical outcomes. METHODS: Statistical analysis was performed on a sample of 745 elderly patients in the geriatric medicine department of Qilu Hospital of Shandong University from March 2012 to March 2015...
2019: PloS One
A Yanni, D Dequanter, J R Lechien, I Loeb, A Rodriguez, R Javadian, M Van Gossum
INTRODUCTION: Head and neck cancer (HNC) patients often experience malnutrition before and during treatment. Prophylactic gastrostomy has emerged as an efficient tool for ensuring adequate nutrition. However, there is no suitable algorithm able to identify patients at high risk of malnutrition. The aim of this study was to describe the nutritional management, to assess the impact of prophylactic gastrostomy, and to identify predictors of malnutrition. METHODS: This retrospective study included 152 patients treated with surgery, radiotherapy, or chemotherapy for HNC...
March 4, 2019: European Annals of Otorhinolaryngology, Head and Neck Diseases
C Laivier, M-O Bleuze, P Hantson, J Devos
A 53-year-old man developed a Legionella pneumophila pneumonia complicated by rhabdomyolysis, acute kidney injury, and protracted ileus. Risk factors were smoking and chronic alcoholism, but the patient had no history of previous abdominal surgery. Hemodialysis was required for a period of 5 weeks with a full renal recovery. Pneumonia required respiratory support but for a limited period of 6 days. The protracted course of the ileus led to explorative laparotomy despite negative computed tomography findings...
2019: Case Reports in Critical Care
Amy J Zhang, Rachel M Nygaard, Frederick W Endorf, Sara A Hylwa
BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe mucocutaneous disorders. To date, relatively few studies have looked at institutional approaches to treatment of SJS/TEN, particularly with a focus on wound care. METHODS: A retrospective review was conducted on patients admitted to the Hennepin County Medical Center from 2007 to 2017 with a final diagnosis of SJS or TEN. Data were obtained for demographics, causative drug, hospital course, supportive care, medical management, complications, and disposition...
March 1, 2019: International Journal of Dermatology
J Oguma, S Ozawa, A Kazuno, M Yamamoto, Y Ninomiya, K Yatabe
Nononcological prognostic factors in superficial esophageal squamous cell carcinoma (SESCC) patients remain unclear. The aim of this study is to evaluate the relationship between sarcopenia and surgical outcome in patients with SESCC who had undergone definitive surgery. A total of 194 SESCC patients who had undergone thoracic esophagectomy with three-field lymphadenectomy without neoadjuvant therapy at Tokai University Hospital between January 2006 and December 2015 were analyzed retrospectively. Manual tracing using CT imaging was used to measure the cross-sectional areas of the skeletal muscle mass...
February 27, 2019: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Mario Kofler, Alois Josef Schiefecker, Maxime Gaasch, Barbara Sperner-Unterweger, Dietmar Fuchs, Ronny Beer, Boris Ferger, Verena Rass, Werner Hackl, Paul Rhomberg, Bettina Pfausler, Claudius Thomé, Erich Schmutzhard, Raimund Helbok
The amino-acids tryptophan, phenylalanine and tyrosine seem to play an important role in the pathophysiology of depressive disorders. We measured daily brain extracellular levels of these amino-acids using cerebral microdialysis (CMD) and high performance liquid chromatography in 26 consecutive subarachnoid hemorrhage (SAH) patients and associated them with the presence of depressive disorders. Patients were grouped as follows: medical history of depression (prior to SAH), antidepressant intake 12 months after SAH (but not before), or neither...
February 26, 2019: Scientific Reports
Craig M Riley, Frank C Sciurba
Importance: There are 30 million adults (12%) in the United States who have chronic obstructive pulmonary disease (COPD). Chronic obstructive pulmonary disease accounts for 3.2% of all physician office visits annually and is the fourth leading cause of death (126 000 deaths per year). Most patients are diagnosed by their primary care clinicians who must address the highly variable clinical features and responses to therapy. The diagnosis and treatment of COPD is rapidly changing, so understanding recent advances is important for the delivery of optimal patient care...
February 26, 2019: JAMA: the Journal of the American Medical Association
Chao Qu, Jingyu Cao, Kui Liu, Bin Tan, Chengzhan Zhu, Kun Li, Linlin Qu
INTRODUCTION: Crohn's disease (CD) is a chronic disease characterized by purulent inflammation involving any part of the gastrointestinal tract between the oral cavity and the anus. Although studies have reported various complications of CD, arterial thrombosis is extremely rare in these patients. We report a patient with CD presenting with extensive thrombosis of the extremities and mesenteric arteries. CASE PRESENTATION: A 41-year-old man presented to our hospital with a 2-month history of discomfort in the right upper abdomen, as well as arterial occlusive disease of the left lower extremity and ischemic contracture of the left upper limb for > 2 months...
February 22, 2019: Annals of Vascular Surgery
Augusto Lauro, Florence Lacaille
Short bowel syndrome (SBS) is a dramatic clinical condition in both children and adults; the residual bowel length is not sufficient to avoid intestinal failure, with subsequent malnutrition and growth retardation, and intravenous support is required to provide the nutrients normally coming from the intestine. Apart from the primary disease, the medical status can be worsened by complications of intestinal failure: if there are irreversible, the prognosis is poor unless a successful intestinal rehabilitation is achieved...
January 2019: Expert Review of Gastroenterology & Hepatology
Qing He, Ning-Ning Yang, Yong-Jiu Xie, Yong-Song Guan
INTRODUCTION: Presently, bariatric surgery is a widespread treatment for obesity and its co-morbidities. Comprehensive evidence from outcomes of bariatric surgery supported that the surgery is safe and effective. However, we should be aware of the multiple risks of bariatric surgery, especially the severe infection at the operation site. CASE PRESENTATION: A 30-year-old woman was hospitalized for anastomotic leakage with abscess after laparoscopic sleeve gastrectomy...
February 12, 2019: International Journal of Surgery Case Reports
Alfred Adiamah, Reesha Ranat, Dhanwant Gomez
BACKGROUND: The need for nutritional support following pancreaticoduodenectomy is well recognised due to the high prevalence of malnutrition, but the optimal delivery route is still debated. This meta-analysis evaluated postoperative outcomes in patients receiving enteral or parenteral nutrition. METHODS: EMBASE, MEDLINE and Cochrane databases were searched to identify randomised controlled trials comparing enteral and parenteral nutrition in patients undergoing pancreaticoduodenectomy...
February 14, 2019: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Sung Eun Choi, Seth A Berkowitz, John S Yudkin, Huseyin Naci, Sanjay Basu
BACKGROUND: Personalizing medical treatment often requires practitioners to compare multiple treatment options, assess a patient's unique risk and benefit from each option, and elicit a patient's preferences around treatment. We integrated these 3 considerations into a decision-modeling framework for the selection of second-line glycemic therapy for type 2 diabetes. METHODS: Based on multicriteria decision analysis, we developed a unified treatment decision support tool accounting for 3 factors: patient preferences, disease outcomes, and medication efficacy and safety profiles...
February 15, 2019: Medical Decision Making: An International Journal of the Society for Medical Decision Making
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