Experience with Fully Covered Self-Expandable Metal Stents for Esophageal Leakage in Children

2019 ◽  
Vol 232 (01) ◽  
pp. 13-19
Author(s):  
Bettina Lange ◽  
Süha Demirakca ◽  
Georg Kähler ◽  
Christel Weiß ◽  
Lucas Wessel ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Weight Gain ◽  
Preterm Infants ◽  
Relative Weight ◽  
Metal Stents ◽  
Single Application ◽  
Emergency Procedure ◽  
Previous Therapy ◽  
Age Related ◽  
Distal Migration

Abstract Background There is a lack of experience with fully covered self-expandable metal stents (SEMSs) for the treatment of esophageal leakage particularly in infants and neonates. Methods Eight patients (5M, 3F) with a median age of 17 months (range, 1–135 months) who underwent treatment with SEMSs for an anastomotic leakage or perforation of the esophagus were recruited to this retrospective study. Four children were born premature. In six patients the stents were placed primarily as an emergency procedure. Results Median duration of individual stent placement was 42 days (range, 13–72 days). Six out of eight patients (75%) were treated with one stent only. In three preterm infants who had their stents inserted within the first month relative weight gain was 17% compared with 2% in five patients who were treated later in life (p=0.0986). In four cases (50%) distal migration of the stent was observed. Seven out of eight patients (88%) had their leakage resolved after stent therapy. Conclusions Insertion of fully covered SEMSs is an alternative tool for the treatment of esophageal leakage in children and preterm infants, and successful with only one single application in selected cases. It can be used either following previous therapy or as part of an emergency procedure. Because of the absence of manufactured, age-related devices SEMSs that are originally designed for other organs can be applied.

scholarly journals Preterm Infants’ Weight Gain and Nutrition: Retrospective Study in a Top Indonesian Referral Hospital

2021 ◽  
Vol 4 (2) ◽  
pp. 212-218
Author(s):  
Dewi Irianti ◽  
Yeni Rustina ◽  
Defi Efendi
Keyword(s):  
Body Weight ◽  
Retrospective Study ◽  
Weight Gain ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Referral Hospital ◽  
Repeated Measure ◽  
Mother’S Own Milk ◽  
Record Review ◽  
National Referral Hospital

Background: Impairment of nutritional fulfillment is one of the problems that is often encountered in premature infants. Purpose: This study aims to determine the effect of the type of nutrition on the weight increase of premature babies.Methods: A retrospective study was conducted through a medical record review in a top national referral hospital, Indonesia. Total of 75 preterm infants divided into groups of 15 infants by nutrition type (100% BM, 75% BM, 50% BM, 25% BM, and 0% BM). Weight gain was assessed for 12 days through the patients’ medical records. Weighing observation was devided into four times: birth weight in day-1, day-4, day-8, and day-12. Subjects were recruited using consecutive sampling with the following criteria: preterm infants with chronological age > 7 days and weight > 1000 grams. Meanwhile, the exclusion criteria were preterm infants treated in the neonatal intensive care unit (NICU), preterm infants with medical diagnosis of hydrocephalus, sepsis, and congenital anomalies, conjoined twin babies. The general linear model-repeated measure was used to quantify the contrast of increases in infants’ body weight among groups for days 1-4; 4-8; and 8-12. Results: There were no significant differences between the five types of nutrients in terms of increase in the infants’ body weight in day 1-4 (p > 0,68); day 4-8 (p > 0,65); day 8-12 (p > 0,12). Conclusion: Although it not likely to accelerate the infant’s weight, mother’s own milk is still the first recommendation due to its immunity components, nutritional elements, and safety.

scholarly journals Digestive enzyme replacement relieves growth failure in preterm infants with poor exocrine pancreatic function: a retrospective case series

2021 ◽  
Author(s):  
Annette Münch ◽  
Christoph Bührer ◽  
Ann Carolin Longardt
Keyword(s):  
Weight Gain ◽  
Preterm Infants ◽  
Digestive Enzyme ◽  
Pancreatic Insufficiency ◽  
Growth Failure ◽  
Exocrine Pancreatic Function ◽  
Exocrine Pancreatic Insufficiency ◽  
Very Preterm Infants ◽  
Enzyme Replacement ◽  
Fecal Pancreatic Elastase

AbstractIn orally fed preterm infants, poor weight gain may be linked to low fecal pancreatic elastase-1 (FPE-1) activity, indicative of exocrine pancreatic insufficiency. The objective of this study was the retrospective assessment of the effect of exogenous digestive enzyme replacement by gavage in preterm infants with growth failure and low FPE-1 (<200 μg/g). We analyzed weight gain relative to baseline and caloric intake during 14-day periods before and after institution of digestive enzyme replacement containing 6000 U lipase and 240 U protease kg−1 d−1. Among 46 of 132 preterm infants < 1250g birth weight surviving to at least 14 days in whom FPE-1 was determined, 38 infants had low FPE-1 (< 200 μg/g), and 33 infants received exogenous digestive enzyme replacement. Average daily weight gain significantly increased from 14.4 [range 2.6–22.4] g kg−1 d−1 to 17.4 [8.4–29.0] g kg−1 d−1 (P = 0.001), as did weight gain per kcal, from 0.08 [0.02–0.13] g kcal−1 d−1 to 0.11 [0.05–0.18] g kcal−1 d−1.Conclusion: In preterm infants with signs and symptoms of exocrine pancreatic insufficiency, exogenous digestive enzyme replacement is associated with improved growth. What is Known:• Very preterm infants on full enteral nutrition may display growth failure linked to transient poor exocrine pancreatic function.• Porcine pancreatic enzymes covered with an acid-resistant coating are too large to pass the internal diameter of most gavage tubes used in very preterm infants.What is New:• Administration of a liquid formulation of acid-resistant microbial digestive enzymes in preterm infants with growth failure and low fecal pancreatic elastase-1 values was associated with improved weight gain.• Response to exogenous digestive enzyme replacement was associated with the prior extent of growth failure.

Effects of trenbolone acetate and testosterone on growth and on plasma concentrations of corticosterone and ACTH in rats

1990 ◽  
Vol 126 (3) ◽  
pp. 461-466 ◽  
Author(s):  
M. N. Sillence ◽  
R. G. Rodway
Keyword(s):  
Weight Gain ◽  
Growth Response ◽  
Plasma Concentrations ◽  
Female Rats ◽  
Male Rats ◽  
Adrenal Weight ◽  
Trenbolone Acetate ◽  
Male And Female Rats ◽  
Age Related ◽  
Old Rats

ABSTRACT The effects of trenbolone acetate (TBA) on growth and on plasma concentrations of corticosterone were examined in male and female rats. At 5 weeks of age, rats were injected with TBA (0·8 mg/kg) dissolved in peanut oil, or with oil alone, daily for 10 days. In female rats, TBA caused an increase in weight gain (20–38%), a reduction in adrenal weight (19%) and a reduction in plasma concentrations of corticosterone (55%). In contrast, TBA-treated male rats showed no significant increase in weight gain, no significant change in adrenal weight and no reduction in plasma concentrations of corticosterone. The mechanism by which adrenal activity was suppressed in TBA-treated female rats was examined and the response compared with that to testosterone. Female rats (8 weeks old) were injected daily either with oil vehicle, TBA (0·8 mg/kg) or testosterone propionate (0·8 mg/kg). Testosterone increased weight gain (24%), but the growth response to TBA treatment was significantly greater (97%). A reduction in plasma concentrations of corticosterone (45%) was again observed in response to TBA. However, testosterone increased plasma concentrations of corticosterone (52%) above those of control values. Neither androgen affected plasma concentrations of ACTH. Finally, the effects of TBA were examined in 6-week-old female rats, to characterize further the apparent age-related increase in responsiveness. The growth response of 6-week-old rats (60–74%) was intermediate between that seen in 5- and 8-week-old animals. It is concluded that part of the anabolic activity of TBA may be related to a reduction in circulating concentrations of corticosterone. The effect of TBA on corticosterone concentrations differs from that of the natural androgen, testosterone, and does not appear to be mediated by a reduction in plasma concentrations of ACTH. Journal of Endocrinology (1990) 126, 461–466

Fully covered, self-expandable metal stents for first-step endoscopic treatment of biliary leaks secondary to hepato-biliary surgery: A retrospective study

2013 ◽  
Vol 45 (5) ◽  
pp. 430-432 ◽  
Author(s):  
Benedetto Mangiavillano ◽  
Carmelo Luigiano ◽  
Ilaria Tarantino ◽  
Luca Barresi ◽  
Marco Dinelli ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Endoscopic Treatment ◽  
Metal Stents ◽  
Biliary Surgery

scholarly journals Age-related changes in factors associated with delayed extubation after general anesthesia: a retrospective study

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Naoya Kobayashi ◽  
Toshihiro Wagatsuma ◽  
Takuya Shiga ◽  
Hiroaki Toyama ◽  
Yutaka Ejima ◽  
...  
Keyword(s):  
Retrospective Study ◽  
General Anesthesia ◽  
Factors Associated ◽  
Age Related ◽  
Delayed Extubation ◽  
Age Related Changes

Abstract 13946: Sleep Problems on Simvastatin Differentially Predict Weight Change in Men

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Beatrice A Golomb ◽  
Hayley J Koslik ◽  
Alexis K Bui
Keyword(s):  
Young Adults ◽  
Weight Gain ◽  
Weight Change ◽  
Sleep Problems ◽  
Metabolic Effects ◽  
Muscle Loss ◽  
Relative Contribution ◽  
Age Related ◽  
Baseline Weight ◽  
Interaction Term

Background and Goal: Sleep problems were significantly increased on simvastatin ( simva ) (but not pravastatin) vs placebo in the UCSD Statin Study. Sleep problems on simva predicted glucose rise. Weight gain has also been reported as a statin side effect. We sought to capitalize on existing data to assess whether sleep problems on simva related to weight gain in men. Method: 442 men without known diabetes or CVD were randomized to simva 20mg or placebo for 6 mon. One hundred eighty and 186 completed single-item self-rating of change in sleep problems vs baseline ( Δslpprob ). Weight (lb) was measured at baseline and 6 mon. Missing 6 mon values were imputed. Analyses: A. Regressions stratified by treatment assessed prediction of weight change by Δslpprob, adjusted for baseline weight. B. Regressions assessed prediction of weight change by the interaction term of simva (vs placebo) x Δslpprob, adjusted for the components of the interaction and baseline weight. Since age-related muscle loss may complicate weight change in elderly; and young adults have low vulnerability to metabolic problems, analyses were repeated excluding these groups. Results: A. Increased sleep problems on simva predicted weight gain (significant), but on placebo predicted weight loss (nonsignificant). B. The Δslpprob x simva interaction term significantly predicted weight gain. When that was parceled out, simva, outside of the sleep relationship, negatively predicted weight change. Exclusion of young adults and elderly strengthened significance of findings (Table). Discussion: Sleep problems, which differentially arise on simva, differentially predict weight gain on simva. This expands the metabolic effects to which sleep problems on simva may contribute and might possibly favor mediation by sleep apnea (a reported complication of simva). Once the sleep problem effect is considered, simva use predicted weight loss . The relative contribution of fat vs muscle loss (vs other) requires exploration.

Gastric Lipolysis and Fat Absorption in Preterm Infants: Effect of Medium-Chain Triglyceride or Long-Chain Triglyceride-Containing Formulas

PEDIATRICS ◽  
1989 ◽  
Vol 83 (1) ◽  
pp. 86-92 ◽  
Author(s):  
Margit Hamosh ◽  
Joel Bitman ◽  
Teresa H. Liao ◽  
N. R. Mehta ◽  
R. J. Buczek ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Fatty Acid ◽  
Weight Gain ◽  
Preterm Infants ◽  
Lipase Activity ◽  
Medium Chain Triglyceride ◽  
Fat Absorption ◽  
Medium Chain ◽  
Long Chain ◽  
Long Chain Triglyceride

The extent of gastric lipolysis, fat absorption, and infant weight gain was studied in 12 preterm infants (gestational age 28.75 ± 0.50 weeks, postnatal age 6.08 ± 0.81 weeks) fed medium-chain triglyceride or long-chain triglyceride formula for 1 week in a crossover design. The former formula contained 42% of 8:0 and 10:0 and 19% of 12:0, 14:0, and 16:0; the latter formula contained only 7% of 8:0 and 10:0 and 46% of 12:0, 14:0, and 16:0. Gastric aspirates were obtained on the second and third day of formula feeding for quantitation of lipase activity and of the extent of gastric lipolysis. Fat balance studies were conducted during the last three days of each feeding regimen. The study showed that (1) there was marked hydrolysis of formula fat in the stomach during feeding of either medium-chain triglyceride formula or long-chain triglyceride formula (20% and 16%, respectively); (2) lipase activity in the gastric aspirates was less during feeding of medium-chain triglyceride formula than before the meal, which suggested stimulation of lipase secretion by long-chain fatty acid released from long-chain triglyceride formula fat or more rapid binding of lipase to ingested lipid in the medium-chain triglyceride formula; (3) fatty acid distribution in glycerides and free fatty acids showed preferential release of medium-chain (8:0, 10:0) and long-chain unsaturated (18:1, 18:2) fatty acids in the stomach. The low content of 8:0 and 10:0 in gastric triglyceride and free fatty acids suggested that medium-chain fatty acids were absorbed directly in the stomach. (4) fat balance studies showed almost identical absorption rates (84.6% ± 3.1% and 82.8% ± 4.0%) and weight gain (23.0 ± 1.5 g/d and 20.8 ± 1.8 g/d) during feeding of either medium-chain triglyceride or long-chain triglyceride formula. In this study, in which each infant was fed either formula alternately, it was shown that although the extent of fat digestion varied among infants, medium-chain and long-chain triglyceride were absorbed to the same extent by most infants.

Effect of Oral Motor Intervention on Oral Feeding in Preterm Infants: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-11
Author(s):  
Danna Chen ◽  
Zhen Yang ◽  
Chujie Chen ◽  
Pu Wang
Keyword(s):  
Weight Gain ◽  
Hospital Stay ◽  
Preterm Infants ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Oral Feeding ◽  
Transition Time ◽  
Cochrane Library ◽  
Oral Motor ◽  
Feeding Efficiency

Objective This review article aimed to explore the effect of oral motor intervention on oral feeding in preterm infants through a meta-analysis. Method Eligible studies were retrieved from four databases (PubMed, Embase, Cochrane Library, and Web of Science) up to July 2020 and screened based on established selection criteria. Thereafter, relevant data were extracted and heterogeneity tests were conducted to select appropriate effect models according to the chi-square test and I 2 statistics. Assessment of risk of bias was performed among the included studies. Finally, a meta-analysis was carried out to evaluate the effect of oral motor intervention in preterm infants according to four clinical indicators: transition time for oral feeding, length of hospital stay, feeding efficiency, and weight gain. Results Eighteen randomized controlled trials with 848 participants were selected to evaluate the effect of oral motor intervention on preterm infants. The meta-analysis results revealed that oral motor intervention could effectively reduce the transition time to full oral feeds and the length of hospital stay as well as increase feeding efficiency and weight gain. Conclusions Oral motor intervention was an effective way to improve oral feeding in preterm infants. It is worthy to be used widely in hospitals to improve the clinical outcomes of preterm infants and reduce the economic burdens of families and society. Future studies should seek to identify detailed intervention processes and intervention durations for clinical application.

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