Abstract:
GOALS:To describe the epidemiology and microbiologic characteristics of bloodstream infections (BSIs) in patients receiving long-term total parenteral nutrition (TPN). BACKGROUND:Home TPN therapy has been reported as a risk factor for BSI. However, little knowledge exists regarding the epidemiology of BSIs in this patient group. STUDY:A descriptive, observational epidemiologic study of patients receiving long-term TPN from January 1981 to July 2005 was performed. Variables analyzed include age, gender, time of follow-up, number of BSIs, microbiologic characteristics, underlying disease necessitating long-term TPN, catheter type, complications related to TPN, and clinical outcome. RESULTS:Forty-seven patients receiving long-term TPN were evaluated. The most frequent indication for long-term TPN was ischemic bowel disease (25.5%). The mean duration of follow-up was 4.5 years. Thirty-eight patients (80.9%) developed 248 BSIs while receiving TPN. More than 1 BSI episode occurred in 78.9% of these patients, and 23.8% of BSI episodes were polymicrobial. The most prevalent pathogen was coagulase negative staphylococci (33.5%). The most frequent complication among patients with BSI was central venous thrombosis (44.7%). Five patients were intravenous drug users. There were 11 deaths among the patients on long-term TPN, 4 of these were related to infection and 4 were related to intravenous drug use. CONCLUSIONS:The incidence of BSI is high, and a significant proportion of BSIs in long-term TPN patients are polymicrobial and due to multidrug-resistant bacteria and fungi. Careful management of the infusion line is required and interventions are needed to reduce the risk of catheter-related infections in this population.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Marra AR,Opilla M,Edmond MB,Kirby DFdoi
10.1097/01.mcg.0000212606.13348.f7subject
Has Abstractpub_date
2007-01-01 00:00:00pages
19-28issue
1eissn
0192-0790issn
1539-2031pii
00004836-200701000-00004journal_volume
41pub_type
杂志文章abstract::Five patients with hepatorenal syndrome were treated with the orally active angiotensin-converting enzyme inhibitor captopril (25 or 50 mg 6 hourly) for up to 48 hours. Only one patient showed a significant increase in urinary sodium concentration (from less than 10 to 70 mmol/liter), but without associated diuresis; ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198508000-00018
更新日期:1985-08-01 00:00:00
abstract::Inflammatory bowel disease (IBD) commonly affects women of childbearing age, leading to concerns about the effects of the disease on fertility and pregnancy, the effect of pregnancy on the disease, and the diagnosis and treatment of IBD in the pregnancy women. The literature regarding these issues is reviewed, and a r...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-198206000-00008
更新日期:1982-06-01 00:00:00
abstract::A 41-year-old man with human immunodeficiency virus (HIV) (CD4 count, 446/mm3) developed a protracted course of abdominal pain, weight loss, and increasing liver function tests after undergoing a metronidazole treatment regimen for Giardia enteritis. Three months later, endoscopic retrograde cholangiography (ERCP) sho...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200108000-00018
更新日期:2001-08-01 00:00:00
abstract::Sucralfate binds to duodenal and gastric ulcers and to gastric erosions produced by ethanol and anti-inflammatory drugs. The affinity of sucralfate for defective mucosa is explained by the drug's viscous adhesiveness and the formation of polyvalent bridges between the negatively charged sucralfate polyanions and posit...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract::Hereditary hemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu disease, is an hereditary disorder that results in fibrovascular dysplasia with the development of telangiectasias and arteriovenous malformations. It predominantly involves the skin, mucous membranes, viscera, lungs, and brain. Hereditary he...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-200302000-00013
更新日期:2003-02-01 00:00:00
abstract::We have found 20 cases of ectopic gastric mucosa in the proximal esophagus. Five patients had symptoms, usually a burning sensation in the neck and/or dysphagia. We report the results of immunoperoxidase staining of this tissue for gastrin, somatostatin, vasoactive intestinal peptide, and bombesin. In 85% of biopsy sp...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198610000-00003
更新日期:1986-10-01 00:00:00
abstract::The ultrastructure of microvessels in the gastric mucosa of patients with atrophic gastritis was investigated. In the gastric mucosa of atrophic gastritis, the endothelial cells of microvessels were irregularly swollen and subendothelial spaces were enlarged. The basement membrane underlying the endothelium was thicke...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199312001-00017
更新日期:1993-01-01 00:00:00
abstract::The fear of cancer has evoked calls for intensive surveillance programs in Barrett's esophagus. Two evolving issues are fueling this fire: (a) the rising risk of adenocarcinoma of the esophagus over the past 20 years and (b) the coincidental increase in the recognized prevalence of Barrett's esophagus in the general p...
journal_title:Journal of clinical gastroenterology
pub_type: 社论
doi:10.1097/00004836-199609000-00002
更新日期:1996-09-01 00:00:00
abstract::Gastroesophageal reflux disease, especially when refractory to standard therapy, remains a significant clinical problem. Although symptom pathogenesis in erosive reflux disease is relatively easy to understand, it is less clear how exposure of the macroscopically normal mucosa in nonerosive reflux disease (NERD) is ab...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0b013e318299f181
更新日期:2014-01-01 00:00:00
abstract::Gastroesophageal varices are a direct consequence of portal hypertension. Nonselective beta-adrenergic blockers decrease portal pressure and are effective in preventing variceal hemorrhage. However, a large multicenter placebo-controlled trial demonstrates that nonselective beta-adrenergic blockers are not effective i...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/MCG.0b013e318157c63d
更新日期:2007-11-01 00:00:00
abstract:GOAL:To prospectively assess the utility of multidetector row computed tomography angiography (MDCTA) in the diagnosis of active gastrointestinal bleeding (GIB). BACKGROUND:MDCTA is a relatively recent advance in CT scanning technology enabling excellent vascular visualization and detection of various vascular abnorma...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e31823337ee
更新日期:2012-01-01 00:00:00
abstract::It is becoming increasingly recognized that purely clinical endpoints may not be sufficient in the treatment of patients with inflammatory bowel disease. As such, mucosal disease assessment has become a prominent component of the majority of recent clinical trials in Crohn's disease and ulcerative colitis. There is mo...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0b013e3182732ff5
更新日期:2013-03-01 00:00:00
abstract::A 61-year-old man developed obstructive jaundice and had ultrasonographic and cholangiopancreatographic findings consistent with carcinoma of the pancreas. However, pathologically the obstruction proved to be from heterotopic pancreatic tissue compressing the common bile duct. This patient and eight previously reporte...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198304000-00014
更新日期:1983-04-01 00:00:00
abstract::We report the development of ulcerative colitis (UC) and Crohn's disease (CD) Health Status Scales that improve on existing inflammatory bowel disease (IBD) activity measures by their added association with health status. We surveyed 991 members of the Crohn's and Colitis Foundation of America (CCFA) and analyzed the ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199209000-00005
更新日期:1992-09-01 00:00:00
abstract::Brunner's gland hamartomas are rare benign duodenal tumors often discovered incidentally during endoscopy or on an upper gastrointestinal series. These tumors arise mainly in the duodenal bulb and can present with gastrointestinal bleeding or symptoms of intestinal obstruction. When symptomatic, surgical or endoscopic...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199812000-00017
更新日期:1998-12-01 00:00:00
abstract::Liver transplantation (LT) for alcoholic cirrhosis remains controversial. This controversy surrounding LT in alcoholics focuses on the risk of alcohol recidivism and on potential noncompliance with the immunosuppressive regimen, both of which result in graft failure. Our study examined alcohol recidivism after LT by m...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199804000-00011
更新日期:1998-04-01 00:00:00
abstract::Carcinoid metastases in the liver are typically solid, hypervascular lesions. We report 3 cases of cystic carcinoid tumors in the liver with radiographic findings. Two were metastatic from primary carcinoid tumors of the small intestine and one was not associated with any extra hepatic lesion at presentation or during...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3181da7714
更新日期:2010-11-01 00:00:00
abstract::A randomized trial with a blind observer compared the efficacy of an emulsion containing micronized sucralfate (1 g four times daily) and ranitidine (150 mg twice daily) in the short-term healing of peptic ulcer. Patients with a minimum ulcer size of 5 mm located in the duodenal bulb, the pyloric canal, or in the prep...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004836-198808000-00006
更新日期:1988-08-01 00:00:00
abstract:BACKGROUND:Although the diagnostic process in celiac disease (CeD) has been addressed in several international guidelines, little is known about the actual proceeding in current clinical practice. This study investigated the initial presentation, the diagnostic process, follow-up evaluations, and adherence to a gluten-...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000676
更新日期:2018-01-01 00:00:00
abstract::The tissue distribution of a previously identified M(r) 40 K epithelial autoantigen in ulcerative colitis was examined in situ in the fetal tissue by immunocytochemical method, using an immunoglobulin M (IgM) monoclonal antibody (7E12H12). Fetal-autopsy tissue from 9 to 19 weeks of development (11-21 gestational weeks...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199212000-00009
更新日期:1992-12-01 00:00:00
abstract:BACKGROUND:After radiation treatment of head and neck cancer, placement of gastrostomy feeding tubes can be technically difficult. The practice of placing tubes before treatment is probably justified if the tube is used for more than 4 weeks and if complications are infrequent. The aim of this study was to determine th...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200109000-00009
更新日期:2001-09-01 00:00:00
abstract::Diverticular disease of the colon is quite common in developed countries, and its prevalence increases with age. Although present in perhaps two thirds of the elderly population, the large majority of patients will remain entirely asymptomatic. Nonetheless, an estimated 20% of those affected may manifest clinical illn...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-199910000-00004
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND AND AIMS:This study evaluated the clinical significance of subclinical ascites in patients with hepatitis B virus-related cirrhosis treated with lamivudine (LMV) or entecavir (ETV). METHODS:This multicenter retrospective study involved 8 hospitals. Patients were classified by degree of ascites: (1) no ascit...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,多中心研究
doi:10.1097/MCG.0000000000000529
更新日期:2016-09-01 00:00:00
abstract::This study evaluates the clinical usefulness of titers of antibody to Helicobacter pylori (Hp) in a urine-based enzyme-linked immunosorbent assay (URINELISA; Otsuka Pharmaceutical, Tokushima, Japan) by comparing values of serum antibody to Hp in an already commercialized kit in a population of 250 asymptomatic individ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200304000-00010
更新日期:2003-04-01 00:00:00
abstract::Portal hypertension, a consequence of end-stage liver disease and liver cirrhosis can lead to significant morbidity and mortality for patients through abnormal fluid accumulation as well as the formation of portosystemic shunts and varices. Treatment of the sequelae of portal hypertension can be achieved through endov...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0000000000001180
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Iron deficiency anemia (IDA) may be the sole manifestation of celiac disease. The role of routine small bowel biopsies obtained during endoscopy in the evaluation of IDA is unclear. This study assessed the usefulness of routine small bowel biopsies in patients presenting with IDA. STUDY:Evaluation of 103 co...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/01.mcg.0000139034.38568.51
更新日期:2004-10-01 00:00:00
abstract::The practice of gastroenterology is undergoing sweeping changes that demand improvements in efficiency and effectiveness within the practice and ambulatory endoscopy centers. This article discusses core principles of practice and endoscopic ambulatory surgery center function and management that lead to the improvement...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e318046ef80
更新日期:2007-04-01 00:00:00
abstract::Twenty consecutive patients with first-time presentation of suspected inflammatory bowel disease underwent both endoscopy with biopsy and magnetic resonance imaging (MRI) within a 3-day period; the relative abilities of endoscopy and MRI to distinguish ulcerative colitis (UC) from Crohn's disease (CD) and to determine...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章
doi:10.1097/00004836-199407000-00009
更新日期:1994-07-01 00:00:00
abstract:GOALS:To evaluate the effects of probucol, an agent with strong antioxidant properties, in reversing biochemical changes in nonalcoholic steatohepatitis (NASH). BACKGROUND:There is currently no well-established medical treatment of NASH. It is believed that oxidative stress plays a major role in hepatic damage in thes...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章
doi:10.1097/00004836-200303000-00015
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND AND AIMS:Human enteric antimicrobial peptides composed predominantly of human enteric α-defensins (HD5 and HD6) are important in the mucosal antimicrobial barrier. Previous studies have identified that genetic variations at rs2066844, rs2066845, rs2066847 are associated with diminished enteric α-defensins in...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000001146
更新日期:2020-07-01 00:00:00