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Gastrointestinal failure

Anna Tortora, Domenico La Sala, Mario Vitale
Reduced intestinal absorption of levothyroxine (LT4) is the most common cause of failure to achieve an adequate therapeutic target in hypothyroid patients under replacement therapy. We present the case of a 63-year-old woman with autoimmune hypothyroidism previously well-replaced with tablet LT4 who became unexpectedly no more euthyroid. At presentation, the patient reported the onset of acute gastrointestinal symptoms characterized by nausea, loss of appetite, flatulence, abdominal cramps and diarrhea, associated with increase of thyrotropin levels (TSH: 11 mIU/mL)...
March 21, 2019: Endocrinology, Diabetes & Metabolism Case Reports
Maribeth C Lovegrove, Deborah Dowell, Andrew I Geller, Sandra K Goring, Kathleen O Rose, Nina J Weidle, Daniel S Budnitz
OBJECTIVES: To estimate the number of US emergency department visits for prescription opioid harms by patient characteristics, intent, clinical manifestations, and active ingredient. METHODS: We used data from medical record-based surveillance from a nationally representative 60-hospital sample. RESULTS: Based on 7769 cases, there were 267 020 estimated emergency department visits annually (95% confidence interval [CI] = 209 833, 324 206) for prescription opioid harms from 2016 to 2017...
March 21, 2019: American Journal of Public Health
Sean Wharton, Revi Bonder, Aaron Jeffery, Rebecca A G Christensen
OBJECTIVE: To evaluate the evidence published from 2006 to 2016 on the effectiveness and safety of commonly used natural supplements for weight loss in individuals with obesity. METHODS: Amazon and Google were searched for names of mono-agent natural supplements marketed for weight loss and a list of the 10 supplements was created. Google Scholar, Pubmed, Science Direct, and the Cochrane Library were searched for articles that met inclusion. RESULTS: At least one article was published on the effectiveness or safety of bitter orange, capsinoid, carnitine, chromium picolinate, Coleus forskohlii, conjugated linoleic acid, glucomannan, green tea and psyllium for weight loss in populations with obesity from 2006 to 2016...
March 21, 2019: Critical Reviews in Food Science and Nutrition
Namkee G Choi, John E Sullivan, C Nathan Marti
Significant differences in health across racial/ethnic and socioeconomic groups in the US signal increasing numbers of low-income homebound older adults in a rapidly ageing society. The purpose of this study was to examine physical and psychiatric conditions and their association with incidence of self-reported falls and hospitalisations among largely low-income and racial/ethnic minority adults age 50+ (N = 2,224), clients from a home-delivered meals programme in Central Texas. Data came from comprehensive, in-home assessments done in 2017 by these older adults' case managers...
March 20, 2019: Health & Social Care in the Community
Jo Ellen Wilson, Leanne Boehm, Lauren R Samuels, Deborah Unger, Martha Leonard, Christianne Roumie, E Wesley Ely, Robert S Dittus, Sumi Misra, Jin H Han
OBJECTIVE: Many patients with advanced serious illness or at the end of life experience delirium, a potentially reversible form of acute brain dysfunction, which may impair ability to participate in medical decision-making and to engage with their loved ones. Screening for delirium provides an opportunity to address modifiable causes. Unfortunately, delirium remains underrecognized. The main objective of this pilot was to validate the brief Confusion Assessment Method (bCAM), a two-minute delirium-screening tool, in a veteran palliative care sample...
March 19, 2019: Palliative & Supportive Care
Dimosthenis Chrysikos, Theodore Troupis, John Tsiaoussis, Markos Sgantzos, Vasileios Bonatsos, Vasileios Karampelias, Theodoros Piperos, Vasileios Kalles, Panagiotis Theodoropoulos, Dimosthenis Kakaviatos, Ioannis Flessas, Euthumios Nikou, Theodoros Mariolis-Sapsakos
Superior mesenteric artery (SMA) or Wilkie's syndrome is a rare clinical entity of partial or complete duodenal obstruction. The pathogenic mechanism is an acute angulation of the SMA which leads to compression of the third part of the duodenum between the SMA and the aorta. This is commonly due to loss of fatty tissue as a result of a variety of debilitating conditions. Its treatment is initially conservative and in case of failure, surgical therapy is unavoidable. We present a case of a 68-year-old female patient who presented in our Department with symptoms of dehydration after persistent vomiting for months...
March 2019: Journal of Surgical Case Reports
Elisabeth Blüthner, Jan Bednarsch, Ulrich-Frank Pape, Mirjam Karber, Sebastian Maasberg, Undine A Gerlach, Andreas Pascher, Bertram Wiedenmann, Johann Pratschke, Martin Stockmann
BACKGROUND & AIMS: Intestinal failure associated liver disease (IFALD) is one of the leading complications and causes of deaths in adult patients receiving home parenteral nutrition for chronic intestinal failure (CIF). Early diagnosis of IFALD is key to alleviate the progression of hepatic dysfunction. The aim of this study was to evaluate the capability of noninvasive liver function tests. METHODS: 90 adult patients with CIF receiving long-term home parenteral nutrition were included in a prospective cross-sectional study at our department between 2014 and 2017...
March 5, 2019: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Eduardo A Manfredi, Marta Rivas
On November 27, 2008, a foodborne disease outbreak associated with the consumption of chicken salad occurred in a kindergarten in the District of Hurlingham, Province of Buenos Aires. Thirty-seven children and 10 adults with gastrointestinal symptoms were affected. Five children were hospitalized with signs of dehydration, one of them requiring intensive care. Staphylococcus aureus subsp. aureus was isolated from the mentioned food in 4 out of 5 stool specimens from the patients, and in 3 out of 5 food handlers (nose of food handler #1, hands of food handlers #2 and 3)...
March 15, 2019: Revista Argentina de Microbiología
Naomi Sugimura, Tsutomu Mizoshita, Tomoya Sugiyama, Shozo Togawa, Tomokatsu Miyaki, Taketo Suzuki, Satoshi Tanida, Hiromi Kataoka, Makoto Sasaki
BACKGROUND: Anti-tumor necrosis factor-α agents are important for managing refractory intestinal Behçet's disease. Few studies have reported the efficacy of anti-tumor necrosis factor-α monoclonal antibodies for intestinal Behçet's disease due to its rarity. AIMS: The aim was to examine the efficacy of anti-tumor necrosis factor-α antibodies for intestinal Behçet's disease in real-world practice. METHODS: This was a retrospective review of medical records at 4 hospitals in Japan...
February 19, 2019: Digestive and Liver Disease
David A Warrell
Louse-borne relapsing fever (LBRF) is an epidemic disease with a fascinating history from Hippocrates' times, through the 6th century 'Yellow Plague', to epidemics in Ireland, Scotland and England in the 19th century and two large Afro-Middle Eastern pandemics in the 20th century. An endemic focus persists in Ethiopia and adjacent territories in the Horn of Africa. Since 2015, awareness of LBRF in Europe, as a re-emerging disease, has been increased dramatically by the discovery of this infection in dozens of refugees arriving from Africa...
January 2019: Epidemiology and Infection
David H Ballard, Michael C Gates, Alireza Hamidian Jahromi, Daniel V Harper, Daniel V Do, Horacio B D'Agostino
PURPOSE: To evaluate outcomes of image-guided transrectal/transvaginal (TR/TV) drainage for symptomatic pelvic fluid collections (SPFCs). MATERIALS AND METHODS: Single-center retrospective study of 150 consecutive patients (36 males, 114 females, average age 41 years) who underwent attempted TR/TV drainages of SPFCs during an 11-year, 5-month period. All patients presented with pain and had SPFCs with rectal or vaginal contact on preceding diagnostic CT. Routine technique included Foley catheter insertion, image-guidance with ultrasound and fluoroscopy, 18 g/20 cm Chiba needles, and Seldinger technique for catheter insertion...
March 13, 2019: Abdominal Radiology
Andrew Mitchell, Alexandre Dugas
BACKGROUND: Malakoplakia is a chronic inflammatory disease characterized by tissue infiltrates of large granular macrophages containing distinctive intracytoplasmic inclusions termed Michaelis-Gutmann (MG) bodies. The genitourinary system is the most commonly involved site, followed by the gastrointestinal tract. Malakoplakia may occur as a complication of primary or secondary immunosuppression and, therefore, renal transplant recipients are at risk. The graft itself or extra-renal sites may be involved...
March 13, 2019: Diagnostic Pathology
Roos M Smits, Rebecca Mackenzie-Proctor, Anusch Yazdani, Marcin T Stankiewicz, Vanessa Jordan, Marian G Showell
BACKGROUND: The inability to have children affects 10% to 15% of couples worldwide. A male factor is estimated to account for up to half of the infertility cases with between 25% to 87% of male subfertility considered to be due to the effect of oxidative stress. Oral supplementation with antioxidants is thought to improve sperm quality by reducing oxidative damage. Antioxidants are widely available and inexpensive when compared to other fertility treatments, however most antioxidants are uncontrolled by regulation and the evidence for their effectiveness is uncertain...
March 14, 2019: Cochrane Database of Systematic Reviews
Silvia J Leon, Oksana Harasemiw, Navdeep Tangri
PURPOSE OF REVIEW: Although renin-angiotensin aldosterone system (RAAS) inhibitors have become the mainstay treatment for patients with chronic diseases, hyperkalemia is a major contributory deterrent to their use in patients with chronic kidney disease (CKD) and heart failure. For the first time in 50 years, two new therapies (patiromer and ZS-9) have recently emerged for the concomitant treatment of hyperkalemia in these patients. The objective of this review is to discuss the efficacy and safety of these new agents...
March 6, 2019: Current Opinion in Nephrology and Hypertension
Catalina Bazacliu, Josef Neu
Necrotizing enterocolitis (NEC) remains the most threatening gastrointestinal complication of prematurity leading to a high mortality, morbidity and cost. Common complications of NEC include neurodevelopmental delay, failure to thrive, gastrointestinal problems including strictures and adhesions, cholestasis, short bowel syndrome with or without intestinal failure that can be difficult to manage. Infants who develop NEC benefit from close follow-up for early diagnosis and treatment of complications. Those who present with severe complications such as intestinal failure benefit from a multidisciplinary approach involving careful assessment and treatment...
March 11, 2019: Current Pediatric Reviews
Moises Rodriguez-Gonzalez, Maria Isabel Sanchez-Codez, Manuel Lubian-Gutierrez, Ana Castellano-Martinez
BACKGROUND: Myocarditis is an important cause of morbidity and mortality in children, leading to long-term sequelae including chronic congestive heart failure, dilated cardiomyopathy, heart transplantation, and death. The initial diagnosis of myocarditis is usually based on clinical presentation, but this widely ranges from the severe sudden onset of a cardiogenic shock to asymptomatic patients. Early recognition is essential in order to monitor and start supportive treatment prior to the development of severe adverse events...
March 6, 2019: World Journal of Clinical Cases
Zhenzhen Yin, Jinqiang You, Youyou Wang, Jinlin Zhao, Shengpeng Jiang, Ximei Zhang, Peiguo Wang, Zhen Tao, Xin Wang, Zhiyong Yuan
Purpose: To determine the efficacy and late toxicities of moderate (2.5-4 Gy) hypofractionated radiotherapy (H-RT) in localized prostate cancer, a meta-analysis of published randomized clinical trials comparing moderate H-RT with conventional fractionated RT (C-RT) was performed. Materials and methods: Systematic search on published randomized clinical trials in English according to Cochrane review guidelines in databases of Pubmed, Embase, Cochrane, web of science, and Wiley Online Library was carried out...
2019: OncoTargets and Therapy
Peng Wu, Yuanguo Chen, Haibo Zhang, Chen Li
RATIONALE: Idiopathic hypereosinophilic syndrome (IHES) is a rare disease in which patients which present with eosinophilia-associated damage. Previous studies focused on organ damage from increased eosinophilic granulocytosis. We report IHES in a patient who presented with multiple organ damage (MOD). PATIENT CONCERNS: A 52-year-old male presented with MOD, including myocardial damage suggestive of myocardial infarction, cardiac tamponade, respiratory failure, skin damage, and gastrointestinal damage...
March 2019: Medicine (Baltimore)
Ulrich P Jorde, Aman M Shah, Daniel B Sims, Shivank Madan, Nida Siddiqi, Anne Luke, Omar Saeed, Snehal R Patel, Sandhya Murthy, Jooyoung Shin, Johanna Oviedo, Sade Watts, William Jakobleff, Stephen Forest, Sasa Vukelic, Dimitri Belov, Yoram Puius, Grace Minamoto, Victoria Muggia, Anthony Carlese, Sharon Leung, Marjan Rahmanian, Jonathan Leff, Daniel Goldstein
BACKGROUND: Continuous flow-left ventricular assist devices (CF-LVADS) have revolutionized the management of advanced heart failure. Device complications continue to limit survival, but enhanced management strategies have shown promise. This study compared outcomes for HeartmateII recipients before and after implementation of a multidisciplinary continuous support Heart Team (HTMCS) strategy. METHODS: Between 1/2012-12/2016, 124 consecutive patients underwent primary HeartmateII implantation at our institution...
March 7, 2019: Annals of Thoracic Surgery
Laila F Ibrahim, Sandy M Hopper, Francesca Orsini, Andrew J Daley, Franz E Babl, Penelope A Bryant
BACKGROUND: Outpatient parenteral antimicrobial therapy in children is common despite no evidence of its efficacy or safety from clinical trials. We aimed to compare the efficacy and safety of intravenous antibiotic therapy at home with that of standard treatment in hospital for children with moderate to severe cellulitis. METHODS: The Cellulitis at Home or Inpatient in Children from the Emergency Department (CHOICE) trial was a randomised, controlled, non-inferiority trial in children aged 6 months to 18 years who presented to the emergency department at The Royal Children's Hospital (Melbourne, VIC, Australia) with uncomplicated moderate to severe cellulitis...
March 7, 2019: Lancet Infectious Diseases
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