The challenges of managing and following-up a case of short bowel in eastern europe

Osakwe, H; Dragomir, Cristina; Nicolescu, Cristian; Boia, Eugen Sorin

doi:10.1016/j.ijscr.2016.07.041

Cited by 5 publications

(4 citation statements)

References 11 publications

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“…Further research across various regions has highlighted specific healthcare alterations during the pandemic period. A generalized reduction in the utilization of primary care services was observed, largely attributed to a lack of resources within healthcare systems [45][46][47]. This reduction was compounded by barriers both within the service provision and among the population.…”

Section: Discussionmentioning

confidence: 99%

Three-Year Analysis of the Rectal Cancer Care Trajectory after the COVID-19 Pandemic

Braicu,

Fulger,

Nelluri

et al. 2023

Diseases

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The global pandemic period from 2020 to 2022 caused important alterations in oncology care. This study aimed to describe the trends and variations in patient characteristics, comorbidities, and treatment approaches during this time in Romania. We conducted a retrospective database search to identify patients with rectal cancer who underwent surgical intervention between 2020 and 2022 and the year 2019, which served as a pre-pandemic period control. This study included 164 patients, with a yearly increase of approximately 10% in surgical interventions noted from 2020 (1709 interventions) to 2022 (2118 interventions), but an overall 34.4% decrease compared with the pre-pandemic period. Notable shifts were observed in the type of surgeries performed, with laparoscopic procedures doubling from 2020 (25%) to 2022 (47.5%), confirming the decrease in emergency presentations during the last year of the COVID-19 pandemic and a recovery to normality with planned, elective interventions. Elective interventions increased significantly in 2022 (79.7%) compared with the previous years (p = 0.043), with a concurrent rise in neoadjuvant therapy uptake in 2022 (35.6%). However, significant alterations in the TNM staging, from 12.5% stage IV cases in 2020 to 25.4% in 2022 (p = 0.039), indicated an increased diagnosis of advanced stages of rectal cancer as the years progressed. There was a significant difference in albumin levels over the years (p = 0.019) and in the American Society of Anesthesiology (ASA) scores (from 6.2% ASA stage IV in 2020 to 16.9% in 2022), denoting an increase in case complexity (p = 0.043). This study reveals a trend of increasing surgical interventions and the prevalence of more advanced stages of rectal cancer during the pandemic years. Despite the subtle fluctuations in various patient characteristics and treatment approaches, notable shifts were documented in the severity at diagnosis and surgery types, pointing toward more advanced disease presentations and changes in surgical strategies over the period studied. Nevertheless, the trends in ICU admission rates and mortality did not alter significantly during the pandemic period.

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Section: Discussionmentioning

confidence: 99%

Three-Year Analysis of the Rectal Cancer Care Trajectory after the COVID-19 Pandemic

Braicu,

Fulger,

Nelluri

et al. 2023

Diseases

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“…During enteral nutrition, some complications can occur, such as mechanical or digestive complications leading to the interruption of enteral nutrition; these can manifest as bilious vomiting, abdominal distension, and intestinal perforation [ 23 – 25 ]. Nevertheless, early postoperative enteral feeding did not increase the incidence of postoperative gastrointestinal complications [ 7 , 26 , 27 ]. Gastric residue should also be checked before each feeding [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…As such, these individuals require parenteral nutrition (PN) for survival. The subsequent nutritional, medical, and surgical aspects of care are complex [ 6 , 7 ]. The incidence is higher in premature infants with a gestational age of less than 37 weeks than in full-term infants [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Macronutrients Management for Growth in Neonates with Congenital Gastrointestinal Malformation

et al. 2022

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Background Congenital gastrointestinal (GI) malformations are developmental disorders that can result in secondary intestinal failure. Nutrient intakes must be adapted according to the newborn’s nutritional requirements based on frequent anthropometric and biochemical assessments. Deficiencies or excess of a macronutrient can hinder the growth of the newborn. Material/Methods To assess the clinical condition of newborns with GI malformations, together with the postoperative nutritional status of newborns who underwent surgery due to congenital GI malformations, we performed a case-control study. The study group comprised newborns with digestive malformations (n=51) and the control group consisted of newborns without digestive pathologies (n=102), matched by sex, gestational age, and weight at admission. Results Bivariate comparisons and multiple logistic regression analyses were performed. A P value <0.05 was considered to be statistically significant; these were observed in abdominal distension, gastric residue, and vomiting. The duration of hospitalization was shorter in the case group, as on average, they were transferred to the Pediatric Surgery Department on the 6 th day, where they further remained admitted to treat the underlying cause. Differences between groups in administration of breast milk versus formula were not statistically significant. Conclusions We concluded that the clinical examination had a major role in early detection of digestive malformations and in the effective management of specific necessary nutrition. Proper evaluation of when to start enteral feeding can help post-surgical cases to recover faster, minimizing complications. Further studies are required to assess how financial factors affect implementation of the standardized guidelines of nutrition in children and to find possible solutions to financial constraints.

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“…Recent advances in microbial sequencing and resistance pattern analysis offer new opportunities to understand the complex interplay between microbial species and drug resistance in acute cholangitis [21]. These technologies hold promise for the development of more targeted and effective treatment strategies, particularly in the context of post-cholecystectomy patients [22][23][24]. However, there remains a significant gap in comprehensive studies that integrate microbial species analysis with multidrug resistance patterns in this patient group.…”

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of Microbial Species and Multidrug Resistance Patterns in Acute Cholangitis Patients with Cholecystectomy: A Single-Center Study

Miutescu,

Vuletici,

Burciu

et al. 2024

Diseases

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This study aimed to compare microbial species and multidrug resistance patterns in acute cholangitis patients with and without a history of cholecystectomy, highlighting potential differences We hypothesized that post-cholecystectomy patients would exhibit distinct microbial spectra and resistance patterns. Conducted at a western Romanian hospital specializing in gastroenterology and hepatobiliary diseases from 2020 to 2023, this retrospective study included 488 acute cholangitis patients, divided into groups based on their cholecystectomy history. Bile and blood samples were analyzed for microbial identification and antibiotic susceptibility using VITEK®2. Positive biliary cultures were found in 66% of patients. The cholecystectomy group showed a higher prevalence of multidrug-resistant organisms, with 74.4% exhibiting resistance compared to 31.5% in the non-cholecystectomy group (p < 0.001). Notable microbial differences included higher occurrences of Escherichia coli (40.2%) and Enterococcus spp. (32.4%) in the cholecystectomy group. Resistance to Piperacillin/Tazobactam and Penems was significantly higher in this group, with odds ratios of 3.25 (p < 0.001) and 2.80 (p = 0.001), respectively, for the development of multidrug-resistant (MDR) bacterial species. The study confirmed our hypothesis, revealing distinct microbial profiles and a higher prevalence of multidrug resistance in acute cholangitis post-cholecystectomy patients. These findings underscore the need for tailored antibiotic strategies in managing acute cholangitis in this patient demographic.

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The challenges of managing and following-up a case of short bowel in eastern europe

Cited by 5 publications

References 11 publications

Three-Year Analysis of the Rectal Cancer Care Trajectory after the COVID-19 Pandemic

Three-Year Analysis of the Rectal Cancer Care Trajectory after the COVID-19 Pandemic

Macronutrients Management for Growth in Neonates with Congenital Gastrointestinal Malformation

Comparative Analysis of Microbial Species and Multidrug Resistance Patterns in Acute Cholangitis Patients with Cholecystectomy: A Single-Center Study

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