A Review on Safety and Outcomes of Mucous Fistula Refeeding in Neonates

2020 ◽  
Author(s):  
Harmit Ghattaura ◽  
Manobi Borooah ◽  
Ingo Jester
Keyword(s):  
Weight Gain ◽  
English Language ◽  
Neonatal Period ◽  
Current Evidence ◽  
Large Prospective Study ◽  
International Consensus ◽  
Optimal Method ◽  
Major Complications ◽  
Study Population ◽  
Mucous Fistula

Abstract Introduction The utility of mucous fistula refeeding (MFR) in neonates with short bowel syndrome is widely debated. Our purpose is to review MFR and outline methods, reported complications, and clinical outcomes (survival, weight gain, dependence on parenteral nutrition [PN], and time to enteral autonomy). Materials and Methods We performed a MEDLINE literature search and reference review from January 1980 to May 2020 for terms (“mucous fistula re-feeding” or “enteral re-feeding”) and neonates. We included studies that utilized conventional MFR in the neonatal period. Non-English language articles were excluded. Results We identified 11 relevant articles. Internationally, there was no consensus on methods of MFR. A total of 197 neonates underwent MFR. Within a single study, four neonates developed major complications; however, the procedure was well tolerated without major complications in 10 of the 11 studies. A mortality of nine patients during MFR highlights the burden of disease within the study population; however, of these, only one was directly attributable to MFR. Minor complications were seldom quantified. Three studies demonstrated a higher rate of weight gain and shorter PN support versus controls. Neonates who underwent MFR had lower chance of anastomotic leak and quicker progression to full feed after reversal versus controls. The influence of microorganisms in MFR was only investigated in one study. Conclusion Current evidence suggests benefits of MFR; however, an international consensus is yet to be reached on the optimal method. A large prospective study investigating the influence of MFR on the enteric system is required.

scholarly journals A meta-analysis comparing short-term weight and cardiometabolic changes between olanzapine/samidorphan and olanzapine

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Manit Srisurapanont ◽  
Sirijit Suttajit ◽  
Surinporn Likhitsathian ◽  
Benchalak Maneeton ◽  
Narong Maneeton
Keyword(s):  
Weight Gain ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Dropout Rates ◽  
Lower Percentage ◽  
Current Evidence ◽  
Weight Changes ◽  
Short Term ◽  
Short Term Treatment

AbstractThis study compared weight and cardiometabolic changes after short-term treatment of olanzapine/samidorphan and olanzapine. Eligible criteria for an included trial were ≤ 24 weeks, randomized controlled trials (RCTs) that compared olanzapine/samidorphan and olanzapine treatments in patients/healthy volunteers and reported weight or cardiometabolic outcomes. Three databases were searched on October 31, 2020. Primary outcomes included weight changes and all-cause dropout rates. Standardized mean differences (SMDs) and risk ratios (RRs) were computed and pooled using a random-effect model. This meta-analysis included four RCTs (n = 1195). The heterogeneous data revealed that weight changes were not significantly different between olanzapine/samidorphan and olanzapine groups (4 RCTs, SDM = − 0.19, 95% CI − 0.45 to 0.07, I2 = 75%). The whole-sample, pooled RR of all-cause dropout rates (4 RCTs, RR = 1.02, 95% CI 0.84 to 1.23, I2 = 0%) was not significant different between olanzapine/samidorphan and olanzapine groups. A lower percentage of males and a lower initial body mass index were associated with the greater effect of samidorphan in preventing olanzapine-induced weight gain. Current evidence is insufficient to support the use of samidorphan to prevent olanzapine-induced weight gain and olanzapine-induced cardiometabolic abnormalities. Samidorphan is well accepted by olanzapine-treated patients.

scholarly journals Hormones in international meat production: biological, sociological and consumer issues

2002 ◽  
Vol 15 (2) ◽  
pp. 293-314 ◽  
Author(s):  
Hugh Galbraith
Keyword(s):  
Biological Activity ◽  
Adverse Effects ◽  
Good Practice ◽  
Current Status ◽  
Current Evidence ◽  
Meat Production ◽  
International Consensus ◽  
Free Radical Damage ◽  
Endogenous Production ◽  
Human Pathology

AbstractBeef and its products are an important source of nutrition in many human societies. Methods of production vary and include the use of hormonal compounds (‘hormones’) to increase growth and lean tissue with reduced fat deposition in cattle. The hormonal compounds are naturally occurring in animals or are synthetically produced xenobiotics and have oestrogenic (oestradiol-17β and its esters; zeranol), androgenic (testosterone and esters; trenbolone acetate) or progestogenic (progesterone; melengestrol acetate) activity. The use of hormones as production aids is permitted in North American countries but is no longer allowed in the European Union (EU), which also prohibits the importation of beef and its products derived from hormone-treated cattle. These actions have resulted in a trade dispute between the two trading blocs. The major concern for EU authorities is the possibility of adverse effects on human consumers of residues of hormones and metabolites. Methods used to assess possible adverse effects are typical of those used by international agencies to assess acceptability of chemicals in human food. These include analysis of quantities present in the context of known biological activity and digestive, absorptive, post-absorptive and excretory processes. Particular considerations include the low quantities of hormonal compounds consumed in meat products and their relationships to endogenous production particularly in prepubertal children, enterohepatic inactivation, cellular receptor- and non-receptor-mediated effects and potential for interference with growth, development and physiological function in consumers. There is particular concern about the role of oestradiol-17β as a carcinogen in certain tissues. Now subject to a ‘permanent’ EU ban, current evidence suggests that certain catechol metabolites may induce free-radical damage of DNA in cell and laboratory animal test systems. Classical oestrogen-receptor mediation is considered to stimulate proliferation in cells maintaining receptivity. Mathematical models describing quantitative relationships between consumption of small amounts of oestrogens in meat in addition to greater concentrations from endogenous production, chemical stoichiometry at cellular level and human pathology have not been developed. Such an approach will be necessary to establish ‘molecular materiality’ of the additional hormone intake as a component of relative risk assessment. The other hormones, although generally less well researched, are similarly subject to a range of tests to determine potentially adverse effects. The resulting limited international consensus relates to the application of the ‘precautionary principle’ and non-acceptance by the European Commission of the recommendations of the Codex Alimentarius Commission, which determined that meat from cattle, hormone-treated according to good practice, was safe for human consumers. The present review considers the hormone issue in the context of current international social methodology and regulation, recent advances in knowledge of biological activity of hormones and current status of science-based evaluation of food safety and risk for human consumers.

scholarly journals The role of telehealth during COVID-19 outbreak: A systematic review based on current evidence

2020 ◽  
Author(s):  
Elham Monaghesh ◽  
Alireza Hajizadeh
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Healthcare Providers ◽  
Physical Contact ◽  
Current Evidence ◽  
Health Providers ◽  
Search Results ◽  
Effective Option ◽  
Critical Appraisal Skills

Abstract Purpose The outbreak of coronavirus disease-19 (COVID-19) is a public health emergency of international concern. Telehealth is effective option to fight COVID-19 outbreak. The aim of this systematic review was to identify the role of telehealth services during COVID-19 outbreak.Methods This systematic review was conducted through searching five databases including PubMed, Scopus, Embase, Web of Science and Science direct. Inclusion criteria included studies clearly defined role of telehealth services in COVID-19 outbreak, published from December 31, 2019, written in English language and published in peer reviewed. Two reviewers independently assessed search results, extracted data, and assessed quality of included studies. Quality assessment was based on the Critical Appraisal Skills Program (CASP) checklist. Narrative synthesis was undertaken to summarize and report the findings.Results Eight studies met the inclusion out of the 142 search results. Currently, healthcare providers and patients who are self-isolating, telehealth is certainly appropriate to minimizing the risk of COVID-19 transmission. This solution has the potential to avoidance of direct physical contact, provide continuous care to the community and finally reduce morbidity and mortality in COVID-19 outbreak.Conclusions The use of telehealth improves the provision of health services. Therefore, telehealth should be an important tool in caring services while keeping patients and health providers safe as the COVID-19 outbreak.

Outcome of neonatal thrombocytopenia in tertiary care NICU

2020 ◽  
Vol 10 (3) ◽  
pp. 92-96
Author(s):  
Deepak Madhavi ◽  
Shamama Subuhi ◽  
Mohammed Zubai
Keyword(s):  
Risk Factor ◽  
Neonatal Intensive Care ◽  
Neonatal Period ◽  
Tertiary Care ◽  
Neonatal Intensive Care Units ◽  
Severe Thrombocytopenia ◽  
Maternal Risk ◽  
Intracranial Bleed ◽  
Study Population ◽  
Neonatal Thrombocytopenia

Thrombocytopenia is one of the commonest haematological disorders in the neonatal period, affecting up to a third of those admitted to neonatal intensive care units. It is well recognized that many fetomaternal and neonatal conditions are associated with thrombocytopenia. The majority of episodes of neonatal thrombocytopenia are relatively mild, self-limiting and of short duration but it may cause severe morbidity & mortality due to severe complication like IVH. Methods & material: 140 Newborn admitted in tertiary care NICU were selected to find out outcome and etiology of neonatal thrombocytopenia. Detail maternal history and neonatal physical examination done and Neonates were followed for outcome, relevant investigation done according to cases. Result: Out of 140 neonates 63 neonates had thrombocytopenia (45%).42.8% neonates were premature out of which 63.3% had thrombocytopenia. Other neonatal risk factor for thrombocytopenia are sepsis 38 (74.5%), SGA/IUGR 28(80%) and NEC 9(100%). Maternal risk factor for thrombocytopenia are eclampsia81.8% and infection during pregnancy 72.72%. 95.5 % of all study population were discharged.4.5 % cases of whole study population didn’t survive. 4.54% of mild, 9.09% of moderate and 60 % of severe thrombocytopenic babies didn’t survive. Conclusion: Bleeding manifestations i.e. mucosal, cutaneous and intracranial bleed were significantly associated with severe thrombocytopenia. 60% of mortality was found in severe thrombocytopenic group. Thus, severe thrombocytopenia was found to be a predictor of poor outcome in sick neonates of NICU.

Metabolic Consequences of Solid Organ Transplantation

2020 ◽  
Author(s):  
Mamatha Bhat ◽  
Shirine E Usmani ◽  
Amirhossein Azhie ◽  
Minna Woo
Keyword(s):  
Metabolic Disease ◽  
Weight Gain ◽  
Dietary Habits ◽  
Solid Organ Transplantation ◽  
Calcineurin Inhibitors ◽  
Metabolic Effects ◽  
Current Evidence ◽  
Solid Organ ◽  
Metabolic Complications ◽  
Nonalcoholic Fatty Liver

Abstract Metabolic complications affect over 50% of solid organ transplant recipients. These include posttransplant diabetes, nonalcoholic fatty liver disease, dyslipidemia, and obesity. Preexisting metabolic disease is further exacerbated with immunosuppression and posttransplant weight gain. Patients transition from a state of cachexia induced by end-organ disease to a pro-anabolic state after transplant due to weight gain, sedentary lifestyle, and suboptimal dietary habits in the setting of immunosuppression. Specific immunosuppressants have different metabolic effects, although all the foundation/maintenance immunosuppressants (calcineurin inhibitors, mTOR inhibitors) increase the risk of metabolic disease. In this comprehensive review, we summarize the emerging knowledge of the molecular pathogenesis of these different metabolic complications, and the potential genetic contribution (recipient +/− donor) to these conditions. These metabolic complications impact both graft and patient survival, particularly increasing the risk of cardiovascular and cancer-associated mortality. The current evidence for prevention and therapeutic management of posttransplant metabolic conditions is provided while highlighting gaps for future avenues in translational research.

Patient satisfaction of telephone or video interpreter services compared with in-person services: a systematic review

2018 ◽  
Vol 42 (2) ◽  
pp. 168 ◽  
Author(s):  
Corey Joseph ◽  
Marie Garruba ◽  
Angela Melder
Keyword(s):  
Patient Satisfaction ◽  
Consumer Satisfaction ◽  
English Language ◽  
Ad Hoc ◽  
A Priori ◽  
Current Evidence ◽  
Cochrane Library ◽  
Interpreter Services ◽  
Interpreter Service ◽  
Google Search

Objective This review was conducted to identify and synthesise the evidence around the use of telephone and video interpreter services compared with in-person services in healthcare. Methods A systematic search of articles published in the English language was conducted using PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Database of Abstracts of Reviews of Effects (DARE), Joanna Briggs, Google Scholar and Google. Search terms included ‘interpreter’, ‘patient satisfaction’, ‘consumer satisfaction’ and ‘client satisfaction’. Any study that did not compare in-person interpreter services with either telephone or video interpreter services was excluded from analysis. Studies were screened for inclusion or exclusion by two reviewers, using criteria established a priori. Data were extracted via a custom form and synthesised. Results The database search yielded 196 studies, eight of which were included in the present review. The search using an Internet search engine did not identify any relevant studies. Of the studies included, five used telephone and three used video interpreter services. All studies, except one, compared levels of satisfaction regarding in-person interpretation and telephone or video interpretation. One study compared satisfaction of two versions of video interpretation. There is evidence of higher satisfaction with hospital-trained interpreters compared with ad hoc (friend or family) or telephone interpreters. There is no difference in satisfaction between in-person interpreting, telephone interpreting or interpretation provided by the treating bilingual physician. Video interpreting has the same satisfaction as in-person interpreting, regardless of whether the patient and the physician are in the same room. Higher levels of satisfaction were reported for trained telephone interpreters than for in-person interpreters or an external telephone interpreter service. Conclusions Current evidence does not suggest there is one particular mode of interpreting that is superior to all others. This review is limited in its translational capacity given that most studies were from the US and in a Spanish-speaking cohort. What is known about the topic? Access to interpreters has been shown to positively affect patients who are not proficient in speaking the local language of the health service. What does this paper add? This paper adds to the literature by providing a comprehensive summary of patient satisfaction when engaging several different types of language interpreting services used in healthcare. What are the implications for practitioners? This review provides clear information for health services on the use of language interpreter services and patient satisfaction. The current body of evidence does not indicate a superior interpreting method when patient satisfaction is concerned.

Ramipril for the Prevention and Treatment of Cardiovascular Disease

2003 ◽  
Vol 37 (3) ◽  
pp. 412-419 ◽  
Author(s):  
April D Vuong ◽  
Laura G Annis
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Ace Inhibitors ◽  
English Language ◽  
Ace Inhibitor ◽  
Data Extraction ◽  
Left Ventricular ◽  
Current Evidence ◽  
Pubmed Database ◽  
Prevention And Treatment

OBJECTIVE: To evaluate the effectiveness of ramipril in the prevention and treatment of cardiovascular disease and determine its need for inclusion on a formulary. DATA SOURCES: A MEDLINE and PubMed database search was conducted (1987–May 2002). Only journals written in the English language were selected for review. DATA EXTRACTION AND STUDY SELECTION: Articles reporting the use of ramipril in humans were evaluated. Emphasis was placed on randomized, controlled trials assessing efficacy. DATA SYNTHESIS: Ramipril is an angiotensin-converting enzyme (ACE) inhibitor that exerts its effects through inhibition of the renin–angiotensin–aldosterone system. It exhibits a safety profile that is similar to that of other ACE inhibitors and is comparable in cost to the majority of the available agents. Clinical trials have proven the effectiveness of ACE inhibitors in the treatment of hypertension, heart failure, and nephropathy. Ramipril, however, is the only ACE inhibitor currently approved for the prevention of cardiovascular events in high-risk patients without evidence of left-ventricular dysfunction or heart failure, based on the results of the HOPE (Heart Outcomes Prevention Evaluation) trial. Whether this effect is specific to ramipril has yet to be proven. This article emphasizes the major trials involving ramipril including the AIRE (Acute Infarction Ramipril Efficacy), REIN (Ramipril Efficacy in Nephropathy), and HOPE trials. CONCLUSIONS: Although similar to other ACE inhibitors in many aspects, it cannot be assumed that the benefits shown with ramipril in the HOPE trial are a class effect. Ongoing trials should help to clarify this matter. Until this time, current evidence justifies the inclusion of ramipril on a formulary.

Assessing risk of neurodevelopmental disorders after birth with oxytocin: a systematic review and meta-analysis

2018 ◽  
Vol 49 (6) ◽  
pp. 881-890 ◽  
Author(s):  
Nicole N. Lønfeldt ◽  
Frank C. Verhulst ◽  
Katrine Strandberg-Larsen ◽  
Kerstin J. Plessen ◽  
Eli R. Lebowitz
Keyword(s):  
Cognitive Impairment ◽  
English Language ◽  
Psychiatric Symptoms ◽  
Meta Analysis ◽  
Evidence Base ◽  
Autism Spectrum ◽  
Risk Estimate ◽  
Current Evidence ◽  
Language Studies ◽  
Meta Analyses

AbstractExperts have raised concerns that oxytocin for labor induction and augmentation may have detrimental effects on the neurodevelopment of children. To investigate whether there is the reason for concern, we reviewed and evaluated the available evidence by searching databases with no language or date restrictions up to 9 September 2018. We included English-language studies reporting results on the association between perinatal oxytocin exposure and any cognitive impairment, psychiatric symptoms or disorders in childhood. We assessed the quality of studies using the Newcastle–Ottawa Quality Assessment Scales. Independent risk estimates were pooled using random-effects meta-analyses when at least two independent datasets provided data on the same symptom or disorder. Otherwise, we provided narrative summaries. Two studies examined cognitive impairment, one examined problem behavior, three examined attention-deficit/hyperactivity disorder (ADHD) and seven focused on autism spectrum disorders (ASD). We provided narrative summaries of the studies on cognitive impairment. For ADHD, the pooled risk estimate was 1.17; 95% confidence interval (CI) 0.77–1.78, based on a pooled sample size of 5 47 278 offspring. For ASD, the pooled risk estimate was 1.10; 95% CI 1.04–1.17, based on 8 87 470 offspring. Conclusions that perinatal oxytocin increases the risks of neurodevelopmental problems are premature. Observational studies of low to high quality comprise the evidence-base, and confounding, especially by the genetic or environmental vulnerability, remains an issue. Current evidence is insufficient to justify modifying obstetric guidelines for the use of oxytocin, which state that it should only be used when clinically indicated.

دور الإرشاد الوظيفي في دمج خريجي الجامعات الفلسطينية في سوق العمل

2018 ◽  
Vol 5 (1) ◽  
pp. 1-40
Keyword(s):  
Labor Market ◽  
Career Counseling ◽  
English Language ◽  
Training Programs ◽  
Counseling Services ◽  
University Graduates ◽  
Study Population ◽  
Palestinian Universities ◽  
Sample Method

تهدف الدراسة الحالية إلى التعرف على دور الإرشاد الوظيفي في دمج خريجي الجامعات الفلسطينية في سوق العمل، من خلال دراسة حالة مركز الإرشاد الوظيفي التابع للكلية الجامعية للعلوم التطبيقية بغزة، وتمثل مجتمع الدراسة في المستفيدين من خدمات المركز والمشاركين في(البرامج التدريبية، وورش العمل الإرشادية، وأيام التوظيف، ومعارض مشاريع الخريجين الإبداعية(، والبالغ عددهم (4423) مستفيد، وتم استخدام طريقة العينة العشوائية حيث بلغ عدد الاستبانات الموزعة (400) استبانة على مجتمع الدراسة، وكان عدد الاستبانات المستردة (356) استبانة بنسبة (89%)، واستخدم الباحثان المنهج الوصفي التحليلي والاستبانة كأداة للدراسة، وكذلك برنامج (SPSS) الإحصائي لتحليل البيانات واختبار صحة الفرضيات وللإجابة عن تساؤلات الدراسة. أظهرت نتائج الدراسة وجود علاقة بين الإرشاد الوظيفي والمتمثل بالخدمات المقدمة للخريجين من حيث (البرامج التدريبية، وورش العمل الإرشادية، وأيام التوظيف، ومعارض مشاريع الخريجين الإبداعية) وبين دمج خريجي الجامعات الفلسطينية في سوق العمل، بالإضافة لوجود أثر للإرشاد الوظيفي في دمج خريجي الجامعات الفلسطينية في سوق العمل، وقد بينت نتائج الدراسة أن خدمات الإرشاد الوظيفي المؤثرة على المتغير التابع “دمج خريجي الجامعات الفلسطينية في سوق العمل” هي (البرامج التدريبية، وأيام التوظيف، ومعارض مشاريع الخريجين الإبداعية)، أما ورش العمل الإرشادية فقد تبين أنّ تأثيرها ضعيف. وفي ضوء تلك النتائج خلصت الدراسة إلى عدة توصيات أهمها ضرورة تطوير مركز الإرشاد الوظيفي للخدمات المقدمة للخريجين بما يراعي الاحتياجات الفعلية لهم، ويساهم في رفع كفاءتهم وتعزيز فرص منافستهم في سوق العمل، وخاصة البرامج التدريبية بمجال المهارات الحاسوبية ومهارات اللغة الإنجليزية، وورش العمل الإرشادية المختصة بمجال رسم المسار المهني للخريجين. This study aimed at identifying the role of career counseling in the integration of Palestinian university graduates in the labor market. The Job Advisory Center at University College of Applied Sciences in Gaza has been taken as a case study. The study population included the beneficiaries of the services offered by the Center, and participants in its training programs, counseling workshops, recruitment days, and graduation projects exhibits. Those were 4423 participants. The study used the random sample method. The number of questionnaires distributed was 400 questionnaire forms. The number of questionnaires retrieved was356, with a return rate of 89%. The study adopted the descriptive analytical approach, and the questionnaire as a tool. The study used SPSS program for statistical data analysis and hypotheses testing, and to answer the questions of the study. The results of the study showed that there is a relationship between career counseling through the services offered to graduates in terms of training programs, counseling workshops, recruitment days, and creative graduation projects exhibits, and the integration of graduates of Palestinian universities into the labor market. There is also an impact of career counseling and the integration of graduates of Palestinian universities into the labor market. Results of the study also showed that the career counseling services that influence the dependent variable of “integration of graduates of Palestinian universities in the labor market” are training programs, recruitment days and exhibitions of creative graduates’ projects. The study found that there is an insignificant role of the counseling workshops in this regard. In light of these results, the study reached a set of recommendations. Most importantly, the study recommends the development of the services offered by the Job Advisory center to take into consideration the actual needs of graduates, and contribute to raising their competency and improving their chances of competition in the labor market. Development of training programs in computer skills and English language skills and counseling workshops in the field of career track construction are more essential in this regard.

Sign in / Sign up

Export Citation Format

Share Document