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delayed gastric emptying

Michael P Kuncewitch, Aaron U Blackham, Clancy J Clark, Rebecca M Dodson, Gregory B Russell, Edward A Levine, Perry Shen
Surgical site infection (SSI) and incisional hernia are common complications after major pancreatectomy. We investigated the effects of negative pressure wound therapy (NPWT) on short- and long-term wound outcomes in patients undergoing pancreatectomy. A randomized controlled trial comparing the effect of NPWT with standard surgical dressing (SSD) on wounds was performed in 265 patients undergoing open gastrointestinal resections from 2012 to 2016. We performed a subset analysis of 73 patients who underwent pancreatectomy...
January 1, 2019: American Surgeon
Anne-Charlotte Jarry, Nadir Merah, Fanta Cisse, Florence Cayetanot, Marie-Noëlle Fiamma, Alexandra Willemetz, Dalale Gueddouri, Besma Barka, Philippe Valet, Sandra Guilmeau, André Bado, Johanne Le Beyec, Laurence Bodineau, Maude Le Gall
The gut-brain peptide neuromedin U (NMU) decreases food intake and body weight and improves glucose tolerance. Here, we characterized NMU as an enteropeptide and determined how it impacts glucose excursion. NMU was expressed predominantly in the proximal small intestine, and its secretion was triggered by ingestion of a mixed meal. Although a single peripheral injection of NMU in C57BL/6NRj mice prevented the rise of glycemia upon an oral but not an intraperitoneal load of glucose, it unexpectedly prevented insulin secretion, only slightly improved peripheral insulin sensitivity, and barely reduced intestinal glucose absorption...
February 12, 2019: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Lei Huang, Jian-Qiang Wu, Bing Han, Zhi Wen, Pei-Rui Chen, Xiao-Kang Sun, Xiang-Dong Guo, Chang-Ming Zhao
BACKGROUND: The main clinical treatment for esophageal cancer is surgery. Since traditional open esophageal cancer resection has the disadvantages of large trauma, long recovery period, and high postoperative complication rate, its clinical application is gradually reduced. The current report of minimally invasive Ivor-Lewis esophagectomy (MIILE) is increasing. However, researchers found that patients with MIILE had a higher incidence of early delayed gastric emptying (DGE). AIM: To investigate the influencing factors of postoperative early DGE after MIILE...
February 6, 2019: World Journal of Clinical Cases
Tessa Heinonen, Suzie Ferrie, Clare Ferguson
BACKGROUND: Management of gut function in the intensive care unit (ICU) is often protocol-driven. Protocols for enteral feeding or bowel management are based on assumptions about what is 'normal' gastrointestinal motility during critical illness or in the early postoperative period, although 'normal' has not been well described in this group. OBJECTIVES: This study aimed to describe aspects of gut function based on an audit of current ICU patients. METHODS: A retrospective medical audit of 100 recent consecutive ICU patients was conducted to obtain data on gut function parameters in the critically ill or postoperative population...
February 7, 2019: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Sarah Turnipseed Edwards, Jose Cocjin, Stephanie Bolger Theut, Douglas Rivard, Ashley K Sherman, Craig A Friesen
BACKGROUND: In adults, there is a consensus for standards to diagnose gastroparesis utilizing a gastric emptying study as the key diagnostic modality but there is no consensus for a standard in pediatrics. Additionally, some cost savings might be achieved if symptoms could be utilized to predict patients with gastroparesis. The aims of the current study were to confirm the sensitivity of a 4 h study in the pediatric population and to assess whether the severity of symptoms were predictive of delayed gastric emptying...
February 11, 2019: BMC Gastroenterology
Ryan J Ellis, Aakash R Gupta, D Brock Hewitt, Ryan P Merkow, Mark E Cohen, Clifford Y Ko, Karl Y Bilimoria, David J Bentrem, Anthony D Yang
BACKGROUND AND OBJECTIVES: Delayed gastric emptying (DGE) occurs commonly following pancreaticoduodenectomy (PD), but the rate of DGE in the absence of other intra-abdominal complications is poorly understood. The objectives of this study were to define the incidence of DGE and identify risk factors for DGE in patients without pancreatic fistula or other intra-abdominal infections. METHODS: Retrospective cohort study utilizing the American College of Surgeons National Surgical Quality Improvement Program pancreatectomy variables to identify patients with DGE following PD without evidence of fistula or intra-abdominal infection...
February 8, 2019: Journal of Surgical Oncology
Lingling Liu, Fanbin Kong
Three types of nanocellulose (NC), namely cellulose nano-fibrils (CNF), TEMPO-oxidized CNF and cellulose nanocrystals (CNC), were studied in terms of their effects on in vitro digestion of whey protein isolate (WPI). The behavior of NC itself during digestion was monitored by particle size, confocal microscopy imaging, viscosity, and zeta potential. 1% CNF and 4% CNC significantly retarded free amino nitrogen (FAN) diffusion (23% and 50% respectively) mainly due to high viscosity. 4% CNC also significantly reduced %FAN release during intestinal digestion...
April 15, 2019: Carbohydrate Polymers
Thomas L Abell, Archana Kedar, Abigail Stocker, Karen Beatty, Lindsay McElmurray, Michael Hughes, Hani Rashed, William Kennedy, Gwen Wendelschafer-Crabb, Xiu Yang, Mostafa Fraig, Endashaw Omer, Ed Miller, Michael Griswold, Christina Pinkston
BACKGROUND AND AIMS: Factors underlying gastroparesis are not well defined, nor is the mechanism of action of gastric electrical stimulation (GES). We hypothesized that GES acts via several mechanisms related to underlying disordered pathophysiology. METHODS: We studied 43 consecutive eligible patients with gastroparetic symptoms, previously evaluated by two methods in each of five core areas: inflammatory, autonomic, enteric, electrophysiologic, and hormonal; and also categorized by GI symptoms, metabolic status, illness quantification, and gastric physiology...
January 31, 2019: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Nicole Villafane-Ferriol, Katherine A Baugh, Amy L McElhany, George Van Buren, Andrew Fang, Erisha K Tashakori, Jose E Mendez Reyes, Hop S Tran Cao, Eric J Silberfein, Nader Massarweh, Cary Hsu, Omar Barakat, Carl Schmidt, Nicholas J Zyromski, Mary Dillhoff, Joshua A Villarreal, William E Fisher
BACKGROUND: Early drain removal when postoperative day (POD) one drain fluid amylase (DFA) was ≤5000 U/L reduced complications in a previous randomized controlled trial. We hypothesized that most surgeons continue to remove drains late and this is associated with inferior outcomes. METHODS: We assessed the practice of surgeons in a prospectively maintained pancreas surgery registry to determine the association between timing of drain removal with demographics, comorbidities, and complications...
January 4, 2019: Journal of Surgical Research
Ryouichi Tomita, Takeo Azuhata, Shigeru Fujisaki, Yuko Takamoto, Kenichi Sakurai, Kayomi Kitada
To clarify the basis for postprandial abdominal fullness(PAF)in patients after pylorus-preserving gastrectomy(PPG), the authors investigated the relationship of PAF with postgastrectomy disorder(PGD)and gastric emptying function(GEF)in PPG patients. A total of 22 patients(14 men and 8 women, average age 64.8 years)were divided into 2 groups[Group A, PAF-positive(n=12); Group B, PAF-negative(n=10)]at 1 year after PPG for early gastric cancer. The relationships of PAF with PGD and GEF were examined. Length of the antral cuff(LAC)was significantly shorter in group A than in group B(p< 0...
December 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Christelle Beti, Bernd Stratmann, Georgy Bokman, Jens Dreier, Michael Hauber, Young Hee Lee-Barkey, Manfred Fischer, Cornelius Knabbe, Diethelm Tschoepe
The effect of the treatment with glucagon-like peptide (GLP)-1 receptor agonists on gastric emptying in patients with diabetes with and without gastroparesis is analysed. Patients with type 2 diabetes mellitus subjected to GLP-1 receptor agonist therapy with exenatide were examined before and shortly after initiation of treatment. Gastric half-emptying time was determined by 13 C-octanoic breath test; routine laboratory parameter as well as active GLP-1, ghrelin, leptin, insulin, proinsulin and C-peptide levels were determined in fasting state as well as postprandial secretion within 1 h after a standardised meal...
January 28, 2019: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
Daisuke Sato, Katsutaro Morino, Seiichiro Ogaku, Akiko Tsuji, Kimihiro Nishimura, Osamu Sekine, Satoshi Ugi, Hiroshi Maegawa
AIMS/INTRODUCTION: Preprandial metformin administration significantly reduces postprandial plasma triglyceride levels in animal studies by reducing intestinal absorption through delayed gastric emptying. However, this effect has not been shown in a clinical study. Therefore, we planned to investigate the efficacy of preprandial metformin administration on postprandial hypertriglyceridemia and the related gastrointestinal effects in patients with type 2 diabetes mellitus. MATERIALS AND METHODS: Eleven patients taking single-dose metformin at 500-1000 mg, with non-fasting plasma triglyceride levels of 150-1000 mg/dL were recruited at a single university hospital...
January 28, 2019: Journal of Diabetes Investigation
Rachel E Simpson, Mitchell L Fennerty, Cameron L Colgate, E Molly Kilbane, Eugene P Ceppa, Michael G House, Nicholas J Zyromski, Attila Nakeeb, C Max Schmidt
INTRODUCTION: Optimal pain control post-pancreatoduodenectomy is a challenge. Epidural analgesia (EDA) is increasingly utilized despite inherent risks and unclear effects on outcomes. METHODS: All pancreatoduodenectomies (PD) performed from 1/2013-12/2017 were included. Clinical parameters were obtained from retrospective review of a prospective clinical database, the ACS NSQIP prospective institutional database and medical record review. Chi-Square/Fisher's Exact and Independent-Samples t-Tests were used for univariable analyses; multivariable regression (MVR) was performed...
January 21, 2019: Journal of the American College of Surgeons
Maryam Rameshrad, Bibi Marjan Razavi, Gordon A A Ferns, Hossein Hosseinzadeh
OBJECTIVES: Despite advances in our understanding of metabolic syndrome (MetS) and the treatment of each of its components separately, currently there is no single therapy approved to manage it as a single condition. Since multi-drug treatment increases drug interactions, decreases patient compliance and increases health costs, it is important to introduce single therapies that improve all of the MetS components. EVIDENCE ACQUISITION: We conducted a PubMed, Scopus, Google Scholar, Web of Science, US FDA, utdo...
January 23, 2019: Daru: Journal of Faculty of Pharmacy, Tehran University of Medical Sciences
Rishabh Gulati, Sameen Khalid, Marissa Ashley Tafoya, Denis McCarthy
No abstract text is available yet for this article.
January 23, 2019: Digestive Diseases and Sciences
Lileswar Kaman, Karikal Chakarbathi, Ashish Gupta, Divya Dahiya, Kaptan Singh, Krishna Ramavath, Arunanshu Behera, Kamal Kajal
The numbers of patients undergoing pancreaticoduodenectomy are increasing and considerable percentage is elderly patients. Pancreaticoduodenectomy is a major and complicated surgery. The morbidity and mortality following pancreaticoduodenectomy have significantly reduced in recent times; it still remains unclear in elderly patients. Applications of Enhanced Recovery after Surgery protocol have contributed for this better outcome. In this retrospective study, patients who underwent pancreaticoduodenectomy with Enhanced Recovery after Surgery protocol were included and divided into two groups (< 60 years vs ≥ 60 years)...
January 23, 2019: Updates in Surgery
Ulla Klaiber, Pascal Probst, Felix J Hüttner, Thomas Bruckner, Oliver Strobel, Markus K Diener, André L Mihaljevic, Markus W Büchler, Thilo Hackert
BACKGROUND: The randomized controlled PROPP trial (DKRS00004191) showed that pylorus-resecting pancreatoduodenectomy (PR) is not superior to the pylorus-preserving procedure (PP) in terms of perioperative outcome, specifically in reduction of delayed gastric emptying. Non-superiority of PR was also confirmed in a recent meta-analysis of randomized controlled trials. However, long-term data on morbidity and quality of life after PP compared to PR are sparse. The aim of this study was to investigate long-term outcomes of patients included in the PROPP trial...
January 22, 2019: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Bo Broberg, Jan L Madsen, Stefan Fuglsang, Jens J Holst, Karl Bang Christensen, Casper Rydahl, Thomas Idorn, Bo Feldt-Rasmussen, Mads Hornum
BACKGROUND: Previous studies indicated delayed gastric emptying in patients with end-stage renal disease (ESRD) using indirect methods. The objective of the current study was to examine gastrointestinal motility using a direct method as well as the role of the incretin hormones and glucagon. METHODS: Patients on chronic hemodialysis and with either normal glucose tolerance, impaired glucose tolerance or type 2 diabetes, and healthy control subjects (N = 8, respectively) were studied...
January 22, 2019: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
E F Collares, L E A Troncon
Dipyrone (metamizole), acting through its main metabolites 4-methyl-amino-antipyrine and 4-amino-antipyrine, has established analgesic, antipyretic, and spasmolytic pharmacological effects, which are mediated by poorly known mechanisms. In rats, intravenously administered dipyrone delays gastric emptying (GE) of liquids with the participation of capsaicin-sensitive afferent fibers. This effect seems to be mediated by norepinephrine originating from the sympathetic nervous system but not from the superior celiac-mesenteric ganglion complex, which activates β2-adrenoceptors...
January 10, 2019: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Tarek Mazzawi, Emily Bartsch, Sara Benammi, Rosa Maria Carrasco Ferro, Ekaterina Nikitina, Nancy Nimer, Lara Jiménez Ortega, Charles Perrotte, Joäo Vitor Pithon, Safira Rosalina, Alexis Sharp, Reza Stevano, Jan Gunnar Hatlebakk, Trygve Hausken
Purpose: Delayed gastric emptying is present in patients with functional dyspepsia (FD), diabetes mellitus, and neurological diseases. Diet may affect gastric emptying symptoms in patients with FD. We sought to determine the extent to which gastric emptying and symptoms of dyspepsia are influenced by caloric content in healthy subjects using ultrasonography. Materials and Methods: 32 healthy volunteers were given 2 meals with different caloric content in random order...
January 2019: Ultrasound International Open
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