scholarly journals Amylase quantification in the terminal Ileum following formation of an Ileostomy

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
D. A. Clark ◽  
T. Cuda ◽  
C. Pretorius ◽  
A. Edmundson ◽  
M. Solomon ◽  
...  
Keyword(s):  
Cohort Study ◽  
Small Intestine ◽  
Healthy Volunteers ◽  
Sample Size ◽  
Terminal Ileum ◽  
Pancreatic Surgery ◽  
Reference Range ◽  
Validation Cohort ◽  
Physiological Activity ◽  
Testing Methodology

Abstract Amylase is elevated in the foregut and has been used to confirm anastomotic integrity after pancreatic surgery. The physiological activity of pancreatic enzymes in the ileum has been studied in healthy volunteers but not quantitated with the simple and readily available amylase measurements employed with serum tests. We aim to quantitate the levels of amylase in the terminal ileum. This was a prospective, non-randomised, non-blinded, consecutive cohort study conducted at the Royal Brisbane and Women’s Hospital. Consecutive patients undergoing routine surgery with an ileostomy were invited to participate in the study. Ileostomy effluent was collected and analysed daily for the first 5 post-operative days. This validation cohort included 8 males and 3 females, with a mean age of 49 years. Median daily amylase levels ranged from 4470 U/L to 23,000 U/L, with no specimens falling within the laboratory serum reference range of 40 to 130 U/L. Two specimens were not available on day one post-operative due to complete ileus. The sample size of 11 patients is small but was considered sufficient given that 55 effluent specimens were anticipated for analysis. Amylase levels remain highly elevated as the enzyme transits through the length of the small intestine and measured in the terminal ileum, and can be readily quantitated by the existing testing methodology routinely available.

scholarly journals Plasma vanin-1 as a novel biomarker of sepsis for trauma patients: a prospective multicenter cohort study

2020 ◽  
Author(s):  
Hongxiang Lu ◽  
Anqiang Zhang ◽  
Dalin Wen ◽  
Juan Du ◽  
Jianhui Sun ◽  
...  
Keyword(s):  
Cohort Study ◽  
Healthy Volunteers ◽  
Validation Cohort ◽  
Characteristic Curve ◽  
External Validation ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Enzyme Linked Immunosorbent Assay ◽  
Trauma Patients ◽  
Potential Biomarker

Abstract BackgroudVanin-1 plays a pivotal role in oxidative stress and the inflammatory response. However, its relationship with traumatic sepsis remains unknown. The aim of our study was to evaluate whether plasma vanin-1 expression can be used to predict traumatic sepsis in an early time.MethodsIn this three-stage prospective cohort study, severe trauma patients admitted to two hospitals from January 2015 to October 2018 were enrolled. Clinical data during hospitalization and APACHE II score were collected. Plasma vanin-1 levels were measured by enzyme linked immunosorbent assay. The associations among variables and traumatic sepsis were identified by logistic regression model. The receiver-operating characteristic curve was analyzed to evaluate the diagnostic efficiency of the selected factors.ResultsA total of 426 trauma patients (22 patients in the discovery cohort, 283 patients in the internal test cohort, and 121 patients in the external validation cohort) and 16 healthy volunteers were enrolled. The plasma vanin-1 level of trauma patients was significantly higher than that of healthy volunteers (P < 0.05), and sepsis patients had higher plasma vanin-1 than non-sepsis patients in the discovery trauma cohort (P < 0.05). In the internal test cohort, plasma vanin-1 levels at day 1 after trauma were significantly associated with the incidence of sepsis (OR = 3.92, 95% CI = 2.68–5.72, P = 1.62⊆10− 12). As a predictive biomarker, vanin-1 obtained a better area under the curve (AUC) (0.82, 95% CI = 0.77–0.87) than C-reaction protein (CRP) (0.62, 95% CI = 0.56–0.68, P < 0.0001), procalciton in (PCT) (0.66, 95% CI = 0.60–0.71, P < 0.0001), and Acute Physiology and Chronic Health Evaluation II (APACHE II) (0.71, 95% CI = 0.65–0.76, P = 6.70⊆10− 3). In addition, the clinical relevance between plasma vanin-1 and traumatic sepsis was validated in the external validation cohort (OR = 4.26, 95% CI = 2.22–8.17, P = 1.28⊆10− 5). The AUC of vanin-1 was 0.83 (95% CI = 0.75–0.89), which was better than that of CRP, PCT, and APACHE II.ConclusionsOur study demonstrated that plasma vanin-1 increased among trauma patients and was independently associated with the risk of sepsis. Vanin-1 might be a potential biomarker for the early prediction of traumatic sepsis.Trial registrationClinicaltrials.gov Identifier NCT01713205. Registered 24 October 2012.

Robotic hepatobiliary and pancreatic surgery: a cohort study

2011 ◽  
Vol 18 (4) ◽  
pp. 471-480 ◽  
Author(s):  
Oliver C. Y. Chan ◽  
Chung Ngai Tang ◽  
Eric C. H. Lai ◽  
George P. C. Yang ◽  
Michael K. W. Li
Keyword(s):  
Cohort Study ◽  
Pancreatic Surgery ◽  
Hepatobiliary And Pancreatic Surgery

Surgery: Small Intestine Terminal Ileum—Resection

2015 ◽  
pp. 147-165
Author(s):  
S. K. Sharma ◽  
J. W. Milsom
Keyword(s):  
Small Intestine ◽  
Terminal Ileum

scholarly journals The effect of drying and ensiling grass on its digestion in sheep

1971 ◽  
Vol 26 (2) ◽  
pp. 123-134 ◽  
Author(s):  
D. E. Beever ◽  
D. J. Thomson ◽  
E. Pfeffer ◽  
D. G. Armstrong
Keyword(s):  
Small Intestine ◽  
Digestive Tract ◽  
Terminal Ileum ◽  
Water Soluble ◽  
Soluble Carbohydrate ◽  
Proximal Duodenum ◽  
Fresh Frozen ◽  
Gross Energy ◽  
Water Soluble Carbohydrate

1. The effect of drying and ensiling ryegrass on the site of digestion of the energy andcarbohydrate fractions was studied in sheep fitted with rumen cannulas and re-entrant can-nulas in the proximal duodenum and terminal ileum.2. The sheep were given fresh (frozen) grass, dried grass, wilted and unwilted silage pre-pared from herbage harvested from the same sward. The grass diets were offered twice dailyto each animal and paper impregnated with chromium sesquioxide was administered twicedaily into the rumen. Twenty-four hour collections of duodenal and ileal digesta, adjusted togive 100 yo recovery of Cr2O3, were analysed to determine the extent of digestion in the fore-stomachs, the small intestine and the caecum and colon.3. Total digestibility of the gross energy was similar for the fresh grass, dried grass andwilted silage diets (67·4,68·1 and67·5 %)but higher for the unwilted silage (72·0 %, P < 0·01).There was an increased flow of energy into the small intestine when the sheep were given driedgrass and unwilted silage. The proportion of the apparently digested energy lost within thesmall intestine was greater when the dried grass was given (302 yo) than when the fresh grasswas given (23·6 yo).4. Drying or ensiling of wilted material affected digestion neither in the entire alimentarytract nor in the different sections of the tract, of some carbohydrate fractions. About 97 yo ofthe digested water-soluble carbohydrate, over 90 yo of the digested cellulose and over 70 yo ofthe digested hemicellulose were digested before reaching the small intestine. The increasedamount of energy entering the duodenum of the sheep given the dried grass was notaccounted for by changes in the fate of these carbohydrate fractions in the digestive tract. Withunwilted silage, digestibilities of the cellulose and hemicellulose fractions were higher, andlower proportions of the digested carbohydrates were lost before the small intestine.

ISARIC-4C Mortality Score overestimates risk of death due to COVID-19 in Australian ICU patients: a validation cohort study

2021 ◽  
Vol 23 (4) ◽  
pp. 403-413
Author(s):  
Matthew Durie ◽  
◽  
Ary Serpa Neto ◽  
Aidan Burrell ◽  
D Jamie Cooper ◽  
...  
Keyword(s):  
Cohort Study ◽  
Validation Cohort ◽  
Icu Patients ◽  
Risk Of Death

scholarly journals Experiences with the Kono-S anastomosis in Crohn’s disease of the terminal ileum—a cohort study

2020 ◽  
Author(s):  
K. Horisberger ◽  
D. L. Birrer ◽  
A. Rickenbacher ◽  
M. Turina
Keyword(s):  
Cohort Study ◽  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Terminal Ileum ◽  
Ileocecal Resection ◽  
Anastomotic Recurrence ◽  
Short Term ◽  
Recurrence Rates

Abstract Purpose The most frequent long-term complication after ileocecal resection in Crohn’s disease is anastomotic recurrence and subsequent stenosis. Recurrence typically begins at the site of the anastomosis, raising the question of whether the surgical technique of the anastomosis could affect recurrence rates. Kono-S anastomosis is a hand-sewn antimesenteric functional end-to-end anastomosis that offers a wide lumen that is well accessible for endoscopic dilatation. The purpose of our study is to review the rate of postoperative complications almost 2 years after the introduction of this technique. Materials and methods This is a prospective single-center cohort study of all consecutive patients with Crohn’s disease undergoing ileocecal resection. Patients’ characteristics as well as specific data for the surgical procedure and short-term outcome were evaluated. Results Thirty patients were operated for Crohn’s disease of the terminal ileum (n = 24) or anastomotic recurrence (n = 6). Postoperative complications with a Clavien-Dindo Score ≥ IIIb were observed in three patients. One patient showed a hemorrhage and underwent surgical hemostasis. Two patients developed anastomotic leakage; in both cases, ileostomy was created after resection of the anastomosis. The median hospital stay was 9 days (IQR 7–12). A comparison with a historic group of conventionally operated patients of our hospital revealed no differences in short-term results except for the duration of surgery. Conclusion The Kono-S anastomosis is associated with acceptable short-term results, complications, and recurrence rates comparable with the established anastomotic techniques. Longer operation times are observed, but the few published studies concerning long-term recurrence are promising.

scholarly journals Risk stratification model for in-hospital death in patients undergoing percutaneous coronary intervention: a nationwide retrospective cohort study in Japan

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e026683 ◽  
Author(s):  
Taku Inohara ◽  
Shun Kohsaka ◽  
Kyohei Yamaji ◽  
Hideki Ishii ◽  
Tetsuya Amano ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cohort Study ◽  
Risk Stratification ◽  
Hospital Mortality ◽  
Retrospective Cohort ◽  
Validation Cohort ◽  
Coronary Intervention ◽  
Hospital Death ◽  
Risk Models ◽  
Percutaneous Coronary

ObjectivesTo provide an accurate adjustment for mortality in a benchmark, developing a risk prediction model from its own dataset is mandatory. We aimed to develop and validate a risk model predicting in-hospital mortality in a broad spectrum of Japanese patients after percutaneous coronary intervention (PCI).DesignA retrospective cohort study was conducted.SettingThe Japanese-PCI (J-PCI) registry includes a nationally representative retrospective sample of patients who underwent PCI and covers approximately 88% of all PCIs in Japan.ParticipantsOverall, 669 181 patients who underwent PCI between January 2014 and December 2016 in 1018 institutes.Main outcome measuresIn-hospital death.ResultsThe study population (n=669 181; mean (SD) age, 70.1(11.0) years; women, 24.0%) was divided into two groups: 50% of the sample was used for model derivation (n=334 591), while the remaining 50% was used for model validation (n=334 590). Using the derivation cohort, both ‘full’ and ‘preprocedure’ risk models were developed using logistic regression analysis. Using the validation cohort, the developed risk models were internally validated. The in-hospital mortality rate was 0.7%. The preprocedure model included age, sex, clinical presentation, previous PCI, previous coronary artery bypass grafting, hypertension, dyslipidaemia, smoking, renal dysfunction, dialysis, peripheral vascular disease, previous heart failure and cardiogenic shock. Angiographic information, such as the number of diseased vessel and location of the target lesion, was also included in the full model. Both models performed well in the entire validation cohort (C-indexes: 0.929 and 0.926 for full and preprocedure models, respectively) and among prespecified subgroups with good calibration, although both models underestimated the risk of mortality in high-risk patients with the elective procedure.ConclusionsThese simple models from a nationwide J-PCI registry, which is easily applicable in clinical practice and readily available directly at the patients’ presentation, are valid tools for preprocedural risk stratification of patients undergoing PCI in contemporary Japanese practice.

scholarly journals Pharmacokinetics of omega-3 fatty acids in patients with severe sepsis compared with healthy volunteers: A prospective cohort study

2020 ◽  
Vol 39 (3) ◽  
pp. 958-965 ◽  
Author(s):  
Radhika Parikh ◽  
Jason H.T. Bates ◽  
Matthew E. Poynter ◽  
Benjamin T. Suratt ◽  
Polly E. Parsons ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Severe Sepsis ◽  
Cohort Study ◽  
Healthy Volunteers ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Omega 3 Fatty Acids ◽  
Omega 3
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