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Aspiration is the leading cause of pneumonia in the intensive care unit and the most serious complication of enteral tube feeding (ETF). Although aspiration is common, the clinical consequences are variable because of differences in nature of the aspirated material and individual host responses. A number of defense mechanisms normally present in the upper(More)
The gastrointestinal tract constitutes one of the largest sites of exposure to the outside environment. The function of the gastrointestinal tract in monitoring and sealing the host interior from intruders is called the gut barrier. A variety of specific and nonspecific mechanisms are in operation to establish the host barrier; these include luminal(More)
BACKGROUND Recurrent acute pancreatitis (RAP) and chronic pancreatitis (CP) are complex syndromes associated with numerous etiologies, clinical variables and complications. We developed the North American Pancreatitis Study 2 (NAPS2) to be sufficiently powered to understand the complex environmental, metabolic and genetic mechanisms underlying RAP and CP.(More)
CONTEXT In some adult patients with chronic intractable diarrhea, the diagnosis remains elusive even after detailed evaluations, and colonic or duodenal biopsy specimens may appear unremarkable on routine hematoxylin-eosin staining. OBJECTIVES To assess the concentration of mast cells in colonic or duodenal biopsy specimens by immunohistochemical analysis(More)
The benefits of dietary fiber on inflammatory bowel disease may be related to the fermentative production of butyrate in the colon, which appears to decrease the inflammatory response. The benefits of dietary fiber against colon cancer may be related to both fermentative and non-fermentative processes, although poorly fermentable fibers appear more(More)
BACKGROUND Mast cells have a primary role in atopy. Mast cells may play a unique role in a subgroup of patients with irritable bowel syndrome (IBS). This observation suggests a link between atopic disorders and IBS. OBJECTIVE To determine whether there is an association between atopic disorders and IBS. METHODS We undertook a prospective study using(More)
OBJECTIVE To determine whether replacement of human albumin will improve a patient's prognosis. DESIGN A randomized, double-blind, controlled study in which 25 g of human albumin vs. placebo was administered intravenously daily. SETTING A university-affiliated hospital. PATIENTS Thirty-six patients with hypoalbuminemia (serum albumin of <2.5 g/dL),(More)
OBJECTIVE The role of fiber in tube feeding products has not clearly been defined. While some studies suggest that fiber can increase stool weight and bowel transit time in acutely ill patients, there is less information in stable patients receiving chronic enteral nutritional support. DESIGN Using a crossover study design, we investigated the effect of(More)
OBJECTIVES Currently, there is no scoring system for predicting severity in acute pancreatitis in children. Our intent was to evaluate the performance of existing scoring systems in children, to develop a system for children, and to examine the etiology of acute pancreatitis in children. METHODS A chart review of children with acute pancreatitis was(More)
OBJECTIVES Diarrhea is a complication of enteral feeding, occurring in up to 68% of critically ill patients. We hypothesized that prolonged fasting results in abnormal bile acid homeostasis. Subsequent enteral feeding then causes a relative luminal excess of bile acids, which leads to choleretic diarrhea. Hence, diarrhea induced by enteral feeding should(More)