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Pediatric intestinal failure (PIF) is a relatively rare disease entity which requires focused interdisciplinary care and specialized nutrition management. There has long been a lack of consensus in the definition of key terms related to PIF due to its rarity and plethora of small studies rather than large trials. As such, the American Society for Parenteral and Enteral Nutrition (ASPEN) Pediatric Intestinal Failure Section, composed of clinicians from a variety of disciplines caring for children with intestinal failure, is uniquely poised to provide insight into this definition void. This document is the product of an effort by the Section to create evidence-based consensus definitions, with the goal of allowing for appropriate comparisons between clinical studies and measurement of longterm patient outcomes. Selleck BSO inhibitor This manuscript was approved by the ASPEN Board of Directors. This article is protected by copyright. All rights reserved.

The aim of this study is to identify cutoff values for muscle ultrasound (US) to be used in Global Leadership Initiative on Malnutrition (GLIM) criteria, and to define the effect of reduced muscle mass assessment on malnutrition prevalence at hospital admission.

A total of 118 inpatients were enrolled in this cross-sectional study. Six different muscles were evaluated by US. Following defining thresholds for muscle US to predict low muscle mass measured by bioelectrical impedance analysis, malnutrition was diagnosed by GLIM criteria with seven approaches, including calf circumference, mid-upper arm circumference (MAC), handgrip strength (HGS), skeletal muscle index (SMI), rectus femoris (RF) muscle thickness, and cross-sectional area (CSA) in addition to without using the reduced muscle mass criterion.

The median age of patients was 64 (18-93) years, 55.9% were female. RF muscle thickness had moderate positive correlations with both HGS (r = 0.572) and SMI (r = 0.405). RF CSA had moderate correlation with HGS (r = 0.567) and low correlation with SMI (r = 0.389). The cutoff thresholds were 11.3 mm (area under the curve [AUC] = 0.835) and 17 mm (AUC = 0.737) for RF muscle thickness and 4 cm² (AUC = 0.937) and 7.2 cm² (AUC = 0.755) for RF CSA in females and males, respectively. Without using the reduced muscle mass criterion, malnutrition prevalence was 46.6%; otherwise, it ranged from 47.5% (using MAC) to 65.2% (using HGS).

Muscle US may be used in GLIM criteria. However, muscle US needs a standard measurement technique and specific cutoff values in future studies.

Muscle US may be used in GLIM criteria. However, muscle US needs a standard measurement technique and specific cutoff values in future studies.

Almost one in four lumpectomies fails to fully remove cancerous tissue from the breast, requiring reoperation. This high failure rate suggests that existing lumpectomy guidance methods are inadequate for allowing surgeons to consistently identify the proper volume of tissue for excision. Current guidance techniques either provide little information about the tumor position or require surgeons to frequently switch between making incisions and manually probing for a marker placed at the lesion site. This article explores the feasibility of thermo-acoustic ultrasound (TAUS) to enable hands-free localization of metallic biopsy markers throughout surgery, which would allow for continuous visualization of the lesion site in the breast without the interruption of surgery. In a TAUS-based localization system, microwave excitations would be transmitted into the breast, and the amplification in microwave absorption around the metallic markers would generate acoustic signals from the marker sites through the thermo-acy markers. With further development, TAUS opens new avenues to enable a more intuitive lumpectomy guidance system that could help to achieve better lumpectomy outcomes.

Native allergen extracts or chemically modified allergoids are routinely used to induce allergen tolerance in allergen-specific immunotherapy (AIT), although mechanistic side-by-side studies are rare. It is paramount to balance optimal dose and allergenicity to achieve efficacy warranting safety. AIT safety and efficacy could be addressed by allergen dose reduction and/or use of allergoids and immunostimulatory adjuvants, respectively. In this study, immunological effects of experimental house dust mite (HDM) AIT were investigated applying high-dose HDM extract and low-dose HDM allergoids with and without the adjuvants microcrystalline tyrosine (MCT) and monophosphoryl lipid A (MPL) in a murine model of HDM allergy.

Cellular, humoral, and clinical effects of the different AIT strategies were assessed applying a new experimental AIT model of murine allergic asthma based on physiological, adjuvant-free intranasal sensitization followed by subcutaneous AIT.

While low-dose allergoid and high-dose extract AI strategies to drive cellular tolerance and adjuvants to modulate humoral responses.

Treatment with glucagon-like peptide-2 (GLP-2) analogs improve intestinal adaptation in patients with short bowel syndrome associated intestinal failure (SBS-IF) and may reduce parenteral support (PS) requirements. Apraglutide is a novel, long-acting GLP-2 analog designed for once weekly dosing. This trial investigated the safety and efficacy of apraglutide in patients with SBS-IF.

In this placebo-controlled, double-blind, randomized, crossover phase 2 trial, eight adults with SBS-IF were treated with once weekly 5 mg apraglutide and placebo for four weeks, followed by once weekly 10 mg apraglutide for four weeks with a washout period of 6-10 weeks between treatments. Safety was the primary endpoint. Secondary endpoints included changes from baseline in urine volume output compared to placebo, assessed 48-hours before and after each treatment period.

Common treatment-related adverse events (AEs) were mild to moderate and included polyuria, decreased stoma output, stoma complications, decreased thirst and edema. No serious AEs were considered related to apraglutide treatment. The safety profile was comparable for the lower and higher dose. Treatment with once weekly 5 and 10 mg apraglutide significantly increased urine volume output by an adjusted mean of 714 mL/day (95% CI 490; 939; P<0.05) and 795 mL/day (95% CI 195; 1,394; P<0.05), respectively, compared to placebo, with no significant differences between doses.

Once weekly apraglutide was well-tolerated at both tested doses and significantly increased urine volume output, providing evidence for increased intestinal fluid absorption. A phase 3 trial is underway in adults with SBS-IF. This article is protected by copyright. All rights reserved.

Once weekly apraglutide was well-tolerated at both tested doses and significantly increased urine volume output, providing evidence for increased intestinal fluid absorption. A phase 3 trial is underway in adults with SBS-IF. This article is protected by copyright. All rights reserved.