Translating plasma citrulline concentration in clinical practice: Role of cross-sectional assessment in adult patients with short bowel syndrome.

Background: Cross-sectional plasma citrulline concentration (CIT) is considered a marker of enterocyte mass. The role of CIT in clinical practice in patients with short bowel syndrome (SBS) is not clearly defined.

Aim: To assess the accuracy of CIT to discriminate SBS from healthy controls (HC) and SBS with intestinal failure (SBS-IF), requiring intravenous supplementation (IVS), from SBS with intestinal insufficiency (SBS-II).

The gut microbiota in adults with chronic intestinal failure.

Objective: Fecal microbiota was investigated in adult patients with chronic intestinal failure (CIF) due to short bowel syndrome (SBS) with jejunocolonic anastomosis (SBS-2). Few or no data are available on SBS with jejunostomy (SBS-1) and CIF due to intestinal dysmotility (DYS) or mucosal disease (MD). We profiled the fecal microbiota of various pathophysiological mechanisms of CIF.

Non-interventional, 5-year retrospective data of home parenteral nutrition in patients with benign chronic intestinal failure: Analysis of an Italian nurse registry (SERECARE II).

Objective: This study is an assessment of home parenteral nutrition service performance and safety and efficacy outcomes in patients with benign chronic intestinal failure.

Methods: This is a retrospective, non-interventional, and multicenter study. Data were collected by trained nurses and recorded in a dedicated registry (SERECARE).

Candidacy of adult patients with short bowel syndrome for treatment with glucagon-like peptide-2 analogues: A systematic analysis of a single centre cohort.

Background And Aims: The glucagon-like peptide-2 (GLP-2) analogue, teduglutide, allows to reduce the intravenous supplementation (IVS) dependency of patients with short bowel syndrome and intestinal failure (SBS-IF). The rate of candidacy of SBS-IF patients for the treatment is unknown. The candidacy for teduglutide treatment of our patient cohort was investigated by a systematic analysis.

Outcome of kidney function in adults on long-term home parenteral nutrition for chronic intestinal failure.

Objective: The aim of this study was to evaluate kidney function outcome in adults on home parenteral nutrition (HPN) for chronic intestinal failure using the newly recommended equations for estimated glomerular filtration rate (eGFR) assessment in clinical practice.

Methods: This was an observational study with 72 patients. Clinical and biochemical parameters were collected at initiation of HPN (retrospective baseline [BL]), at inclusion in the study (cross-sectional [CS]), and at the end of a 30-mo prospective follow-up (Fup).

Assessment of Intestinal Failure Associated Liver Disease according to different diagnostic criteria.

Background & Aims: Intestinal failure associated liver disease (IFALD) has been defined using numerous criteria; however the clinical relevance of these criteria has never been compared. We therefore aimed to evaluate the prevalence, incidence, evolution of IFALD diagnosed by different criteria and to assess any clinical features that may be associated with its occurrence.

Methods: A cross sectional (CS) and retrospective study were carried out on adults on home parenteral nutrition (HPN) for chronic intestinal failure (CIF) managed at a single center.

Functional lipidomics in patients on home parenteral nutrition: Effect of lipid emulsions.

Aim: To investigate the fatty acid-based functional lipidomics of patients on long-term home parenteral nutrition receiving different intravenous lipid emulsions.

Methods: A cross-sectional comparative study was carried out on 3 groups of adults on home parenteral nutrition (HPN), receiving an HPN admixture containing an olive-soybean oil-based intravenous lipid emulsion (IVLE) (OO-IVLE; = 15), a soybean- medium-chain triacylglycerol-olive-fish oil-based IVLE (SMOF-IVLE; = 8) or HPN without IVLE (No-IVLE; = 8) and 42 healthy controls (HCs). The inclusion criteria were: duration of HPN ≥ 3 mo, current HPN admixtures ≥ 2 mo and HPN infusions ≥ 2/wk.

Plasma citrulline after small bowel transplantation: effect of time from transplantation, acute cellular rejection, and renal failure.

Background: Plasma citrulline concentration (CIT) depends on its synthesis by enterocytes and its catabolism by renal tubules. To evaluate CIT applicability as a marker of acute cellular rejection (ACR) after intestinal transplantation (ITx), CIT was investigated according to time from ITx, episodes of ACR, and creatinine clearance (CrCl).

Methods: Twenty-four adult ITx recipients were prospectively studied.

Iodine status in intestinal failure in adults.

Purpose Of Review: The aim of this work is to review the recent findings on iodine nutrition in adults with intestinal failure.

Recent Findings: Patients with intestinal failure who require long-term parenteral nutrition are potentially at risk for trace element deficiencies. It was considered that iodine deficiency was unlikely to occur in adults on parenteral nutrition, even if iodine is not added to parenteral nutrition, because of iodine absorption from iodine-containing antiseptics, to presence of iodine as contaminant in parenteral nutrition products and to absorption of dietary iodine, in patients eating and having a functioning duodenum.

Intravenous lipids in home parenteral nutrition.

Intravenous lipid emulsions (IVLEs) are an important component of the nutritional admixtures for patients on long-term home parenteral nutrition (HPN) for chronic intestinal failure (CIF). IVLEs are primarily used as a source of energy and essential fatty acids, and the content of polyunsaturated fatty acids (PUFAs) is the most important characteristic of IVLEs. IVLEs rich in n-6 PUFAs may have a pro-inflammatory effect, whereas those rich in n-3 PUFAs may exert an anti-inflammatory effect.

Iodine nutrition in adults on long-term home parenteral nutrition.

Objective: The aim of this study was to evaluate iodine nutrition in adults on long-term home parenteral nutrition (HPN) and to compare it with iodine supplemented with PN, categorized as below or according to the European Society for Clinical Nutrition and Metabolism guidelines (ESPEN-GL) recommendation.

Methods: Iodine nutrition was evaluated retrospectively in 31 stable adults on long-term HPN. We analyzed urinary iodine concentration (UIC) and serum thyroid-stimulating hormone (TSH).

Renal function in patients on long-term home parenteral nutrition and in intestinal transplant recipients.

Objective: A decrease of renal function was described in patients on long-term home parenteral nutrition (HPN) for benign intestinal failure. The risk for chronic renal failure (CRF) due to frequent episodes of dehydration despite optimal HPN, is an indication for intestinal transplantation (ITx). ITx is the solid organ transplant at highest risk for developing CRF.

The complex relationship between magnesium and serum parathyroid hormone: a study in patients with chronic intestinal failure.

In this study we compared the content of muscle free [Mg2+] assessed by 31P MRS to that of serum total Mg assessed by routine colorimetric assays in 15 patients affected by Chronic Intestinal Failure (CIF) on long-term Home Parenteral Nutrition (HPN) or who had undergone isolated intestinal transplantation. We also investigated in the same cohort of patients the relationship of muscle free [Mg2+] and serum total Mg with parathyroid hormone (PTH) serum content. All patients showed a normal cytosolic free [Mg2+] in the calf muscle despite about half of them having a content of total serum [Mg] below or at the lower edge of the boundary limits.

[Home parenteral nutrition and intestinal transplantation in the intestinal failure].

Home parenteral nutrition is the primary treatment for intestinal failure. Intestinal transplantation is indicated when home parenteral nutrition fails or when there is a risk of death because of underlying disease. Survival after transplantation is related to the appropriateness of the indication and the timing of listing for transplantation.

Vitamin A and vitamin E isoforms stability and peroxidation potential of all-in-one admixtures for parenteral nutrition.

Background: In all-in-one admixtures (AIOs), vitamins can be degraded and lipid can be peroxidized by light exposure, oxygen action, and multiple chemical interactions.

Aim: We investigated the impact of three commercial lipid emulsions and two multivitamin preparations on vitamin A and vitamin E chemical stability and lipid peroxidation potential of AIOs.

Methods: A soybean oil (Soy), soybean/medium-chain triacylglycerol oil (MCT), and olive/soybean oil (Olive)-based emulsion (all 20%), and a lyophilized (Lyo) and emulsified (Emu) multivitamin compounds, were tested.

Endogenous ethanol production in a patient with chronic intestinal pseudo-obstruction and small intestinal bacterial overgrowth.

The case of the gastrointestinal production of ethanol from Candida albicans and Saccharomyces cerevisiae in a Caucasian man with chronic intestinal pseudo-obstruction is reported. The patient, who declared to have always abstained from alcohol, was hospitalized for abdominal pain, belching and mental confusion. The laboratory findings showed the presence of ethanol in the blood.

Peroxidation potential of lipid emulsions after compounding in all-in-one solutions.

Objectives: We investigated the peroxidation potential of fat emulsions in all-in-one solutions (AIOs).

Methods: Three 20% emulsions were compared: soybean oil (SO; 60% polyunsaturated fatty acids [PUFAs], alpha-tocopherol:PUFAs = 0.44), soybean plus medium-chain triacylglycerol (SO-MCT; 31% PUFAs, alpha-tocopherol:PUFAs = 0.