1.
A combination of corticosteroid, sirolimus, and intradialytic parenteral nutrition in encapsulating peritoneal sclerosis: Case report and literature review.
Minetto Brabo, A, Soares Do Carmo Reis, N, Barretti, P, Ponce, D
Hemodialysis international. International Symposium on Home Hemodialysis. 2017;(3):307-311
Abstract
Encapsulating peritoneal sclerosis (EPS) is a rare complication of peritoneal dialysis that carries a high morbidity and mortality. Although its pathogenesis is still not clear, the "two hit theory" suggests that long term deterioration of the peritoneum combined with intraperitoneal inflammation is needed in the pathogenesis of EPS. To date, there is no proven effective therapy with an absence of randomized controlled trials. Individual case reports and small case series have reported on the use of tamoxifen and corticosteroids for medical management of EPS. Here, we present the first case of EPS treated successfully with a combination of sirolimus, low dose corticosteroid and intradialytic parenteral nutrition. A critical review of the relevant literature on this subject is also presented to determine the best approach.
2.
[Parenteral nutrition in treatment of patients with syndrome of short bowel].
Kostiuchenko, LN, Kuz'mina, TN, Ruchkina, IN
Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology. 2009;(6):98-102
Abstract
If the gut is too short parenteral feeding becomes the only option. As clinicians interested in this field, we must continue to inform others about what standarts may be set in different patients. Nowadays the enteral nutrition is also used in the scheem of the treatment such patients. We discuss about haw, where and in what compositions and regimens it may be recommended the nutritional support.
3.
Refeeding syndrome in cancer patients.
Marinella, MA
International journal of clinical practice. 2008;(3):460-5
Abstract
BACKGROUND Refeeding syndrome (RFS) is a common, yet underappreciated, constellation of electrolyte derangements that typically occurs in acutely ill, malnourished hospitalised patients who are administered glucose solutions or other forms of intravenous or enteral nutrition. DISCUSSION The hallmark of RFS is hypophosphataemia, but hypokalaemia and hypomagnesaemia are also common. Patients with various types of malignancies are at-risk for RFS, but very little exists in the oncologic literature about this disorder. CONCLUSIONS As RFS can have many adverse metabolic, cardiovascular, haematologic and neurologic complications, practicing oncologist needs to be aware of the pathophysiology, risk factors and clinical manifestations to promptly recognise this important, and potentially fatal, metabolic disorder.
4.
Wernicke's encephalopathy during parenteral nutrition.
Francini-Pesenti, F, Brocadello, F, Famengo, S, Nardi, M, Caregaro, L
JPEN. Journal of parenteral and enteral nutrition. 2007;(1):69-71
Abstract
BACKGROUND Thiamine deficiency in humans affects the cardiovascular, muscular, nervous, and gastrointestinal systems. Wernicke's encephalopathy is described in alcoholism, in hyperemesis gravidarum, and in prolonged IV feeding without vitamin supplementation. METHODS We report a case of a 66-year-old man undergoing surgery for acute necrotic-hemorrhagic pancreatitis, who presented a Wernicke's syndrome during parenteral nutrition (PN). After surgery, he was treated with infusion of industrial 3-compartment bags, without vitamin supplementation. On the seventh postoperative day, nausea and vomiting began, and 5 days later the patient showed diplopia, ataxia, general muscular stiffness, reduction of osteotendinous reflexes, confusional state, and thrombocytopenia. The magnetic resonance scan evidenced pathologic changes in the medial thalamus, in the third and fourth ventricular floor, in the cerebellar vermis, and in the periaqueductal gray substance. RESULTS All neurologic signs and platelet blood count gradually normalized after IV supplementation of thiamine, 100 mg daily. The magnetic resonance scan repeated 40 days after the first one was normal. CONCLUSIONS Our report points out the risk of incorrect procedures in management of industrial 3-compartment bags. Moreover, we suggest that thrombocytopenia may be related to thiamine deficiency.