Article
Nutrition & Dietetics
Annika Mutanen, Helene Engstrand Lilja, Tomas Wester, Heimir Norrby, Helena Borg, Sara Persson, Kristin Bjornland, Anne Charlotte Brun, Lovisa Telborn, Pernilla Stenstrom, Mikko P. Pakarinen
Summary: This multicenter study aimed to assess key outcomes and clinical prognostic factors in a recent Nordic pediatric SBS-IF population. The results showed that despite multidisciplinary management, septic complications and intestinal failure associated liver disease (IFALD) are still associated with a low mortality rate.
CLINICAL NUTRITION
(2023)
Article
Nutrition & Dietetics
Maja Kopczynska, Gordon Carlson, Antje Teubner, Arun Abraham, Michael Taylor, Sorrel T. Burden, Christian L. Hvas, Peter Jepsen, Simon Lal
Summary: This study compares outcomes and surgical decision-making in patients with short bowel syndrome (SBS) and fistulas. The authors found that patients who underwent reconstructive surgery had higher rates of nutritional autonomy, while older patients with higher comorbidity index were less likely to achieve cessation of home parenteral nutrition (HPN). There were no differences in long-term nutritional and survival outcomes or surgical decisions between patients with SBS and fistulas, or between enterocutaneous and enteroatmospheric fistulas.
Article
Nutrition & Dietetics
Roxana Fatemizadeh, Laura Gollins, Joseph Hagan, Anne Debuyserie, Kristi King, Adam M. Vogel, Kristin L. Van Buren, Amy B. Hair, Muralidhar H. Premkumar
Summary: This study aimed to describe the long-term outcomes and predictive factors of neonatal-onset intestinal failure (IF) due to surgical short bowel syndrome (SBS). Results showed a high survival rate (96%) and achievement of enteral autonomy (85%). Residual bowel length (RBL) was correlated with achievement of enteral autonomy, while delay in achieving enteral autonomy was associated with absence of ileocecal valve and bloodstream infections.
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION
(2022)
Article
Pediatrics
Mercedes Bell, Conrad R. Cole, Nellie Hansen, Andrea F. Duncan, Susan R. Hintz, Ira Adams-Chapman
Summary: The study revealed that preterm infants with SBS had worse neurodevelopmental and growth outcomes compared to those without SBS, indicating an increased risk of moderate-severe neurodevelopmental impairment.
JOURNAL OF PEDIATRICS
(2021)
Article
Pediatrics
Carlos Zozaya, Jyotsna Shah, Agostino Pierro, Augusto Zani, Anne Synnes, Shoo Lee, Prakesh S. Shah
Summary: The study evaluated neurodevelopment and growth in extremely preterm infants, finding that spontaneous intestinal perforation, necrotizing enterocolitis, or any bowel perforation are risk factors for death or significant neurodevelopmental impairment in these infants.
JOURNAL OF PEDIATRIC SURGERY
(2021)
Article
Nutrition & Dietetics
Brune de Dreuille, Alexandre Nuzzo, Julie Bataille, Charlotte Mailhat, Lore Billiauws, Maude Le Gall, Francisca Joly
Summary: This real-life study aimed to evaluate the efficacy and outcomes of Teduglutide in the treatment of short-bowel-syndrome (SBS)-associated chronic intestinal failure (CIF). Among the 331 SBS-CIF patients included in the study, 56 patients (16.9% of the cohort) were treated with Teduglutide, resulting in a 60% reduction in parenteral support (PS) volume, and a treatment retention rate of over 80% at 2 years.
Article
Pediatrics
Shan He, Gang Liu, Xueping Zhu
Summary: This study demonstrates the beneficial effects of human breast milk-derived exosomes in preventing necrotizing enterocolitis by reducing inflammation and injury, and restoring intestinal tight-junction proteins.
PEDIATRIC RESEARCH
(2021)
Review
Gastroenterology & Hepatology
Ayseguel Aksan, Karima Farrag, Irina Blumenstein, Oliver Schroeder, Axel U. Dignass, Juergen Stein
Summary: Chronic intestinal failure, a rare complication of Crohn's disease, can greatly impact quality of life and treatment options include home-based parenteral nutrition and intravenous infusion. However, 60% of patients may need lifelong reliance on parenteral nutrition, and promising new drugs have brought new dimensions to therapy.
WORLD JOURNAL OF GASTROENTEROLOGY
(2021)
Review
Nutrition & Dietetics
Maria Giovanna Puoti, Jutta Koglmeier
Summary: This paper discusses the nutritional strategies available for clinicians caring for pediatric patients with short bowel syndrome. The research found that there is currently no consensus on the best way to feed these patients, and there are significant variations in practice between different centers. Therefore, more research is needed to establish common treatment protocols.
Article
Pediatrics
Si Chen, Xiuman Xiao, Su Lin, Jianghu Zhu, Lidan Liang, Minli Zhu, Zuqin Yang, Shangqin Chen, Zhenlang Lin, Yanli Liu
Summary: Children with NEC have a higher risk of neurodevelopmental delay compared to the control group, and early aEEG examination shows high specificity and PPV in predicting neurodevelopmental delays.
Review
Gastroenterology & Hepatology
Mark Radetic, Amir Kamel, Mark Lahey, Michelle Brown, Anil Sharma
Summary: Short bowel syndrome requires different management strategies, and long-term use of parenteral nutrition can help regain bowel function. However, some patients may still require more aggressive treatment.
DIGESTIVE DISEASES AND SCIENCES
(2023)
Review
Nutrition & Dietetics
Laura Moschino, Miriam Duci, Francesco Fascetti Leon, Luca Bonadies, Elena Priante, Eugenio Baraldi, Giovanna Verlato
Summary: NEC, a serious gastrointestinal disease in neonates, leads to SBS and requires early prevention. Nutritional practices are crucial for preventing NEC and supporting growth and intestinal function in preterm infants.
Article
Nutrition & Dietetics
Tierah Hinchliffe, Mirielle L. Pauline, Pamela R. Wizzard, Juan Jovel, Patrick N. Nation, Paul W. Wales, Karen L. Madsen, Justine M. Turner
Summary: This study investigated the safety and feasibility of fecal microbial transplant (FMT) to alter intestinal microbial composition in neonatal piglets with short-bowel syndrome (SBS). The results showed that FMT treatment induced transient changes to the intestinal microbiota in SBS piglets, but these changes did not persist long-term. Furthermore, FMT treatment did not increase the risk of sepsis or mortality in SBS piglets.
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION
(2022)
Article
Immunology
Xiao-Lin Yan, Xiao-Chen Liu, Yu-Ni Zhang, Ting-Ting Du, Qing Ai, Xiong Gao, Jing-Li Yang, Lei Bao, Lu-Quan Li
Summary: This study found that succinate plays an important role in the pathogenesis and severity of necrotizing enterocolitis, and the activation of the HIF-1α signaling pathway may lead to disease progression.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2022)
Review
Nutrition & Dietetics
Keqin Liu, Adila Abudusalamu, Jixin Yang, Yanwei Su
Summary: This review aimed to evaluate the effects of early enteral feeding on health outcomes in preterm infants. Nine systematic reviews were included, showing that early enteral feeding may improve weight gain, reduce feed intolerance, shorten feeding duration, decrease hospital stay, lower the incidence of necrotizing enterocolitis and mortality risk. However, the certainty of evidence was generally low, indicating a need for further research to assess long-term outcomes.
EUROPEAN JOURNAL OF CLINICAL NUTRITION
(2023)
Article
Nutrition & Dietetics
Arjuna Srikrishnaraj, Kathryn Chambers, Courtney South, Megan Arppe Robertson, Laura Vresk, Anna Tedesco-Bruce, Beth Haliburton, Dianna Yanchis, Christina Belza, Jordan Zietsma, Joanna Benec, Megan Carricato, Penni Kean, Yaron Avitzur, Paul W. Wales, Debra Harrison, Glenda Courtney-Martin
Summary: This study found that trace elements chromium and manganese in parenteral nutrition solutions were contaminated at higher levels than ordered concentrations. Chromium contamination exceeded the recommended intake for patients aged 0-12 months. Manganese contamination accounted for all the manganese in PN admixtures.
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION
(2021)
Article
Nutrition & Dietetics
Jill Quirt, Christina Belza, Nikhil Pai, Rose-Frances Clause, Filip Markovic, Sylvia Wong-Sterling, Yaron Avitzur, Paul W. Wales
Summary: This retrospective cohort study of 20 pediatric patients with intestinal failure (IF) found that 4% tetrasodium ethylenediaminetetraacetic acid (EDTA) solution was effective in reducing central line-associated bloodstream infections (CLABSIs) and line occlusions. Data showed no infections in the 12 months post-therapy and a significant decrease in occlusive episodes after starting EDTA therapy. These preliminary findings suggest the efficacy of 4% tetrasodium EDTA in reducing CLABSIs and catheter occlusions in pediatric patients with long-term central-access.
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION
(2021)
Article
Pediatrics
Iyad Faden, Yaron Avitzur, Oussama Abla, Dimitri A. Parra
Summary: This case report discusses a four-year-old boy diagnosed with LCH involving the liver, requiring a liver transplant. Six months post-transplant, recurrence of the primary disease led to biliary dilatation. Imaging showed strictures mimicking primary sclerosing cholangitis, ultimately resulting in biliary-enteric anastomosis stenosis and the need for re-transplantation.
PEDIATRIC TRANSPLANTATION
(2021)
Article
Nutrition & Dietetics
Dianna Yanchis, Christina Belza, Debra Harrison, Sylvia Wong-Sterling, Penni Kean, Stephanie So, Catherine Patterson, Paul W. Wales, Yaron Avitzur, Glenda Courtney-Martin
Summary: This study investigated the body composition of pediatric patients with intestinal failure who had normal growth, revealing that despite normal height and weight z-scores, these patients are at risk for abnormal body composition. Routine assessment of body composition is recommended for children with intestinal failure to guide nutrition interventions.
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION
(2022)
Article
Nutrition & Dietetics
Christina Belza, Catherine Patterson, Emily Ghent, Yaron Avitzur, Wendy J. Ungar, Darcy Fehlings, Robyn Stremler, Paul W. Wales
Summary: This qualitative study examined the experiences of family caregivers of children with intestinal failure (IF), and found that caring for a child with IF has a significant impact on caregivers and their families, affecting various aspects of their lives. The findings of this study align with the biopsychosocial model, emphasizing the need for multifaceted assessment and supports for caregivers.
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION
(2022)
Article
Pediatrics
Christina Belza, Wendy J. Ungar, Yaron Avitzur, Robyn Stremler, Darcy Fehlings, Paul W. Wales
Summary: Caregivers of children with intestinal failure receiving long-term PN spend a significant amount of time providing care, particularly in administering PN and caring for the central venous catheter.
JOURNAL OF PEDIATRICS
(2022)
Article
Surgery
Amin J. Roberts, Paul W. Wales, Sue Beath, Helen M. Evans, Jonathan Hind, David Mercer, Theodoric Wong, Jason Yap, Christina Belza, Yaron Avitzur
Summary: This study validates the Toronto criteria for selecting pediatric patients for intestinal transplantation, which include >= 2 ICU admissions, persistent CB >= 75 mu mol/L, and loss of >= 3 CVC sites.
AMERICAN JOURNAL OF TRANSPLANTATION
(2022)
Article
Immunology
Kumar Subramanian, Saikat Paul, Andrew Libby, Jordan Patterson, Adam Arterbery, James Knight, Christopher Castaldi, Guilin Wang, Yaron Avitzur, Mercedes Martinez, Steve Lobritto, Yanhong Deng, Gan Geliang, Alexander Kroemer, Thomas Fishbein, Andrew Mason, Margarita Dominguez-Villar, Malaiyalam Mariappan, Udeme D. Ekong
Summary: It has been observed that patients with de novo autoimmune hepatitis and autoimmune hepatitis have an increased expression of human endogenous retrovirus 1 (HERV1-env) proteins in regulatory T cells (Tregs). This leads to endoplasmic reticulum (ER) stress, which activates the unfolded protein response (UPR) through the IRE1, ATF6, and PERK branches. Coimmunoprecipitation studies show an interaction between HERV1-env proteins and the ATF6 branch. Activated ATF6a activates the expression of RORC and STAT3 by binding to promoter sequences and induces IL-17A production. Silencing HERV1-env restores Treg suppressive function. These findings highlight the importance of ER stress and UPR activation in driving Treg plasticity.
JOURNAL OF IMMUNOLOGY
(2023)
Article
Nutrition & Dietetics
Christina Belza, Yaron Avitzur, Wendy J. Ungar, Robyn Stremler, Darcy Fehlings, Paul W. Wales
Summary: This study examined the burden on caregivers of children with intestinal failure receiving long-term parenteral nutrition. The results showed that these caregivers experience increased stress, anxiety, and depression, as well as decreased health-related quality of life.
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION
(2023)
Review
Nutrition & Dietetics
Christina Belza, Paul W. W. Wales
Summary: Intestinal failure (IF) is a complex medical condition caused by various disorders, leading to the inability of the gut in absorbing fluids and nutrients properly. Intestinal rehabilitation advancements have improved the survival rates of IF patients. However, there are important differences between children and adults in terms of etiology, potential complications, and medical/surgical management. This review aims to highlight these similarities and differences for future directions in managing pediatric patients who will transition into adulthood.
NUTRITION IN CLINICAL PRACTICE
(2023)
Article
Nutrition & Dietetics
Dianna Yanchis, Stephanie So, Catherine Patterson, Christina Belza, Elizabeth Garofalo, Sylvia Wong-Sterling, Carina Silva, Yaron Avitzur, Paul W. Wales, Jessie M. Hulst, Dehan Kong, Libai Xuyx, Glenda Courtney-Martin
Summary: This study compared the accuracy of bioelectrical impedance analysis (BIA) and skinfold measurements with dual energy x-ray absorptiometry (DXA) in assessing body composition in children with intestinal failure. The results showed that BIA is an acceptable clinical tool for assessing body composition in pediatric intestinal failure.
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION
(2023)
Article
Nutrition & Dietetics
Christina Belza, Glenda Courtney-Martin, Sylvia Wong-Sterling, Elizabeth Garofalo, Carina Silva, Dianna Yanchis, Yaron Avitzur, Paul W. Wales
Summary: This study aimed to determine the prevalence of essential fatty acid deficiency (EFAD) in patients with intestinal failure (IF) who are receiving parenteral nutrition (PN) without lipid restriction. The results suggest that there is no concern for EFAD when using mixed oil intravenous lipid emulsion (MO ILE) in children receiving PN for IF.
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION
(2023)
Article
Nutrition & Dietetics
Daniela Gattini, Han Yan, Christina Belza, Yaron Avitzur, Paul W. Wales
Summary: This study assessed the incremental costs and health outcomes of using 4% tetrasodium ethylenediaminetetraacetic acid (EDTA) compared with taurolidine and heparin lock in children with intestinal failure. The results showed that 4% tetrasodium EDTA was more effective and less expensive, resulting in cost savings and additional quality-adjusted life-years (QALYs). It was considered the optimal strategy in terms of cost-effectiveness.
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION
(2023)
Article
Pediatrics
Christina Belza, Eyal Cohen, Julia Orkin, Nora Fayed, Nathalie Major, Samantha Quartarone, Myla Moretti
Summary: This study aims to describe the out-of-pocket expenses incurred by caregivers of children with medical complexity and identify factors associated with increased expenditures. The study found that caregivers have a significant financial burden and need to pay for a variety of expenses, including childcare, travel to appointments, hospitalizations, and device costs.
PAEDIATRICS & CHILD HEALTH
(2023)