Current Status of Chronic Intestinal Failure Management in Adults.

Background: Chronic intestinal failure (CIF) is a heterogeneous disease that affects pediatric and adult populations worldwide and requires complex multidisciplinary management. In recent years, many advances in intravenous supplementation support, surgical techniques, pharmacological management, and intestinal transplants have been published. Based on these advances, international societies have published multiple recommendations and guidelines for the management of these patients.

Pathophysiology of ascites: The importance of the intestine. A surgical contribution to the understanding of a medical problem.

The understanding of the mechanisms for the development of ascites has evolved over the years, involving the liver, peritoneum, heart, and kidneys as key responsible for its formation. In this article, we review the pathophysiology of ascites formation, introducing the role of the intestine as a major responsible for ascites production through "a game changer" case.

Induction Versus Maintenance Immunosuppression After Intestinal Transplant: Determining Which Treatment Most Impacts Long-Term Patient And Graft Survival.

Objectives: Immunosuppressive strategies for intestinal transplant have changed over time. However, specific intestinal transplant-oriented protocols and reports on long-term maintenance regimens are scarce. Our objective was to evaluate the impact of 2 different initial immunosuppressive protocols based on thymoglobulin (group A) and basiliximab (anti-interleukin 2 antibody) (group B) and of changes to maintenance immunosuppression over long-term follow-up in intestinal transplant recipients.

Successful pregnancy in a patient with short bowel syndrome after surgical rehabilitation and sGLP-2 treatment: novel report on endogenous GLP-2 levels at delivery and during breastfeeding.

Pregnant patients with short bowel syndrome (SBS) and chronic intestinal failure (CIF) can successfully reach to term their pregnancies while on parenteral nutrition (PN) but with high rates of complications. The combination of rehabilitation surgery, combined with the use of novel treatment with enterohormones, especially semisynthetic glucagon-like peptide 2 (sGLP-2), has increased the chances to achieve intestinal sufficiency. Here, we report the case of a 33-year-old female with SBS/CIF (anatomy type 2), weaned off PN using sGLP-2 for 3.

Power Management Unit for Solar Energy Harvester Assisted Batteryless Wireless Sensor Node.

This work describes an energy-efficient monolithic Power Management Unit (PMU) that includes a charge pump adapted to photovoltaic cells with the capability of charging a large supply capacitor and managing the stored energy efficiently to provide the required supply voltage and power to low energy consumption wireless sensor nodes such as RFID sensor tags. The proposed system starts-up self-sufficiently with a light source luminosity equal to or higher than 500 lux using only a 1.42 cm solar cell and integrating an energy monitor that gives the ability to supply autonomous sensor nodes with discontinuous operation modes.

First registry of adult patients with chronic intestinal failure due to short bowel syndrome in Argentina: The RESTORE project.

Background: Short bowel syndrome (SBS) is considered a low prevalence disease. In Argentina, no registries are available on chronic intestinal failure (CIF) and SBS. This project was designed as the first national registry to report adult patients with this disease.

Autologous gastrointestinal reconstruction surgery for short bowel syndrome: the cornerstone for intestinal rehabilitation.

Purpose Of Review: Intestinal failure (IF) evolved from being the last recognized organ failure, to become one of the most progressive fields in terms of therapeutic alternatives and results. Short bowel syndrome (SBS) is the main cause of IF in adults and children. The use of surgery allowed patients with unfavorable anatomy type and length to be wean off parenteral nutrition.

Non-conventional vascular accesses for the management of superior vena cava syndrome in patients with Intestinal Failure. Case series and systematic review.

Background: Type III Intestinal Failure (IF) is a devastating clinical condition.characterized by the inability of the gut to absorb necessary macronutrients, and/or water and electrolytes, requiring Parenteral Nutrition (PN) as chronic therapy. Long-term PN may lead to life-threatening complications; the loss of central venous access (LCVA) is the most frequent and challenging.

Quality of life after intestinal transplantation.

Purpose Of Review: Intestinal transplantation (ITx) is the last therapeutic option in chronic intestinal failure (CIF) patients who develop life-threatening complication related to home parenteral nutrition (HPN). Improvement of quality of life (QoL) has been proposed as one of the nonconventional indications for ITx in these patients. This review aims to summarize the current evidence about QoL assessment in ITx recipients.

A 21 m Operation Range RFID Tag for "Pick to Light" Applications with a Photovoltaic Harvester.

In this paper, a novel Radio-Frequency Identification (RFID) tag for "pick to light" applications is presented. The proposed tag architecture shows the implementation of a novel voltage limiter and a supply voltage (VDD) monitoring circuit to guarantee a correct operation between the tag and the reader for the "pick to light" application. The feasibility to power the tag with different photovoltaic cells is also analyzed, showing the influence of the illuminance level (lx), type of source light (fluorescent, LED or halogen) and type of photovoltaic cell (photodiode or solar cell) on the amount of harvested energy.

Postsurgical Intestinal Rehabilitation Using Semisynthetic Glucagon-Like Peptide-2 Analogue (sGLP-2) at a Referral Center: Can Patients Achieve Parenteral Nutrition and sGLP-2 Independency?

Background: Teduglutide, a semisynthetic analogue of glucagon-like peptide-2 (sGLP-2), increases intestinal absorption of fluids and nutrients, reducing the need for parenteral nutrition (PN). This report aims to describe our experience with sGLP-2 in a cohort of adult patients with short-bowel syndrome.

Methods: This is a prospective observational study on adult patients initially evaluated in our specialized intestinal rehabilitation program that received sGLP-2 from June 2014 to March 2020.

Results of Surgical and Medical Rehabilitation for Adult Patients With Type III Intestinal Failure in a Comprehensive Unit Today: Building a New Model to Predict Parenteral Nutrition Independency.

Background: Short-bowel syndrome remains the primary cause of intestinal failure (IF) in adult patients. We aim to report the long-term results of medical and surgical rehabilitation in a cohort of patients with type III IF (III-IF) and develop a formula to predict parenteral nutrition (PN) independency.

Methods: We used a retrospective analysis of a prospective database for III-IF patients undergoing autologous gastrointestinal reconstruction surgery (AGIRS) from March 2006 to August 2018.

Use of Nonvascularized Abdominal Rectus Fascia After Liver, Small Bowel, and Multiorgan Transplantation: Long-Term Follow-up of a Single-Center Series.

Background: The abdominal wall may be severely compromised in the vast majority of intestinal and multiorgan transplant candidates, and sometimes as a consequence of complex liver transplantation. Multiple options have been described to overcome this problem, varying from component separation to the extreme need of performing an abdominal wall transplantation. The aim of the present paper is to report the largest and longest-term results of patients that received an abdominal rectus fascia (ARF) after liver, intestinal, or multiorgan transplantation at a single transplant center.

Long-Term Outcomes of Intestinal and Multivisceral Transplantation at a Single Center in Argentina.

Background: Intestinal failure (IF) patients received parenteral nutrition (PN) as the only available therapy until intestinal transplantation (ITx) evolved as an accepted treatment. The aim of this article is to report the long-term outcomes of a series of ITx performed in pediatric and adult patients at a single center 9 years after its creation.

Patients And Methods: This is a retrospective analysis of the ITx performed between May 2006 and January 2015.

0.5 V and 0.43 pJ/bit Capacitive Sensor Interface for Passive Wireless Sensor Systems.

This paper presents an ultra low-power and low-voltage pulse-width modulation based ratiometric capacitive sensor interface. The interface was designed and fabricated in a standard 90 nm CMOS 1P9M technology. The measurements show an effective resolution of 10 bits using 0.

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One of the greatest achievements in gastroenterology and surgery of the last 50 years has been the capability to transplant different abdominal organs of the digestive system separately or as a whole. The complexity of the intestinal transplantation demands a multidisciplinary team engaged in the management of patients with intestinal failure responsible for defining the need for nutritional support, rehabilitation, or intestinal transplantation. This team should include a basic research area to provide answers to unresolved clinical problems.

Immunosuppressive therapies after intestinal transplant modulate the expression of Th1 signature genes during acute cellular rejection. Implications in the search for rejection biomarkers.

Background And Aims: Acute cellular rejection (ACR) and infections are leading causes of graft loss and death in intestinal transplant patients. Our aim was to evaluate the impact of maintenance immunosuppressive therapies on the expression of pro-inflammatory mediators in small bowel at ACR diagnosis.

Materials And Methods: We analyzed expression levels of Th1-associated genes, IFNG, CXCL10, and CXCL11 by qPCR in 46 selected graft biopsies unequivocally assigned to mild ACR (n = 14) or normal histopathology and clinical condition (n = 32) from 15 patients receiving two different immunosuppressive (IS) schemes.

Serum albumin level during intestinal exfoliative rejection: a potential predictor of graft recovery and patient outcome.

Exfoliative rejection is a severe complication after intestinal transplant. The assessment of mucosa histology is restricted to the area reached by endoscopy. We aim to evaluate the serum albumin (SA) value as a parameter of graft damage and clinical prognosis in intestinal exfoliative rejection (ExR).

What is the normal small bowel length in humans? first donor-based cohort analysis.

Normal small bowel length (SBL) has been reported within a wide range, but never studied in a cohort of either pediatric or adult deceased donors. Between 5/2006 and 2/2011, SBL was measured in all grafts procured for intestinal transplantation at a single center and used for either isolated intestinal transplant (15) or multiorgan transplants (5) employing a standardized method. SBL was the only not significantly different variable among pediatric and adult donors divided by age 16.

Visceral Kaposi's sarcoma remission after intestinal transplant. First case report and systematic literature review.

Background: Kaposi's sarcoma (KS) is an infrequent vascular neoplasm commonly diagnosed as an isolated cutaneous lesion that can involve other organs. So far, there are no data in the literature about the development of KS after intestinal transplant.

Methods: In this study, the authors describe a case of "visceral KS" with pulmonary and intestinal involvement and perform a systematic literature review of case reports and single-center series identified in MEDLINE.

[Clinical features of adults younger and older than 50 years hospitalized with influenza A H1N1 2009 in a private hospital in Santiago, Chile].

Introduction: The new pandemic influenza A H1N1 2009 virus has shown a different clinical behavior in different age groups.

Objective: To describe the clinical features of adult patients hospitalized with influenza AH1N1 2009 and compare the clinical and demographic variables among adults < 50 years and over 50 years old.

Patients And Method: We included hospitalized patients between May 17 and July 17, 2009 confirmed by polymerase chain reaction (PCR) and/or rapid test for influenza A.

Evaluation of a noninvasive method for cardiac output measurement in critical care patients.

Objective: Thermodilution (TD) is the gold standard to monitor cardiac output (CO) in critical care. However, there is concern about the safety of right-ventricular catheterization. The CO(2) rebreathing technique allows noninvasive CO determination by means of the indirect Fick principle.

[Helicobacter pylori: cagA analysis and vacA genotyping in Chile. Detection of a s2/m1 strain].

Background: The genes cagA and vacA encode H pylori virulence factors.

Aim: To genotype these genes in H pylori strains isolated from patients with upper gastrointestinal symptoms.

Material And Methods: We studied 50 patients who underwent an upper gastrointestinal endoscopy, with positive culture for H pylori.