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  1. Article ; Online: Surgical considerations in the management of short bowel syndrome.

    Mercer, David F

    Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition

    2023  Volume 38 Suppl 1, Page(s) S88–S97

    Abstract: Patients with short bowel syndrome (SBS) are optimally managed in centers of expertise with dedicated multidisciplinary intestinal failure (IF) teams. Over the life of a patient with SBS, many different surgical concerns may arise requiring intervention. ...

    Abstract Patients with short bowel syndrome (SBS) are optimally managed in centers of expertise with dedicated multidisciplinary intestinal failure (IF) teams. Over the life of a patient with SBS, many different surgical concerns may arise requiring intervention. These can range from reasonably simple procedures, such as the creation or maintenance of gastrostomy tube and enterostomies, to complex reconstructions of multiple enterocutaneous fistulas or the performance of intestine-containing transplants. This review will cover the development of a surgeon's role on the IF team; common surgical issues arising in patients with SBS, with a focus on decision-making rather than technique; and, finally, a brief overview of transplantation and some related decision-making issues.
    MeSH term(s) Humans ; Short Bowel Syndrome/surgery ; Parenteral Nutrition/methods ; Intestines/surgery ; Intestinal Fistula/surgery ; Gastrostomy
    Language English
    Publishing date 2023-04-17
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 645074-x
    ISSN 1941-2452 ; 0884-5336
    ISSN (online) 1941-2452
    ISSN 0884-5336
    DOI 10.1002/ncp.10988
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  2. Article ; Online: Surgical considerations in the management of short bowel syndrome

    Mercer, David F.

    Nutrition in Clinical Practice. 2023 May, v. 38 Suppl S1 p.S88-S97

    2023  

    Abstract: Patients with short bowel syndrome (SBS) are optimally managed in centers of expertise with dedicated multidisciplinary intestinal failure (IF) teams. Over the life of a patient with SBS, many different surgical concerns may arise requiring intervention. ...

    Abstract Patients with short bowel syndrome (SBS) are optimally managed in centers of expertise with dedicated multidisciplinary intestinal failure (IF) teams. Over the life of a patient with SBS, many different surgical concerns may arise requiring intervention. These can range from reasonably simple procedures, such as the creation or maintenance of gastrostomy tube and enterostomies, to complex reconstructions of multiple enterocutaneous fistulas or the performance of intestine‐containing transplants. This review will cover the development of a surgeon's role on the IF team; common surgical issues arising in patients with SBS, with a focus on decision‐making rather than technique; and, finally, a brief overview of transplantation and some related decision‐making issues.
    Keywords decision making ; digestive system diseases ; enterostomy ; intestines ; nutrition ; patients
    Language English
    Dates of publication 2023-05
    Size p. S88-S97.
    Publishing place John Wiley & Sons, Ltd
    Document type Article ; Online
    Note REVIEW
    ZDB-ID 645074-x
    ISSN 1941-2452 ; 0884-5336
    ISSN (online) 1941-2452
    ISSN 0884-5336
    DOI 10.1002/ncp.10988
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  3. Article ; Online: Preventing central venous catheter complications in children using 4% tetrasodium EDTA locks: A small study with a big impact.

    Mercer, David F

    JPEN. Journal of parenteral and enteral nutrition

    2021  Volume 45, Issue 6, Page(s) 1134–1135

    MeSH term(s) Catheter-Related Infections/prevention & control ; Catheterization, Central Venous/adverse effects ; Central Venous Catheters/adverse effects ; Child ; Edetic Acid ; Humans ; Vascular Diseases
    Chemical Substances Edetic Acid (9G34HU7RV0)
    Language English
    Publishing date 2021-07-10
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 800861-9
    ISSN 1941-2444 ; 0148-6071
    ISSN (online) 1941-2444
    ISSN 0148-6071
    DOI 10.1002/jpen.2205
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  4. Article ; Online: Optimizing transition from pediatric to adult care in short bowel syndrome and intestinal failure.

    Kinberg, Sivan / Verma, Tanvi / Kaura, Deeksha / Mercer, David F

    JPEN. Journal of parenteral and enteral nutrition

    2023  Volume 47, Issue 6, Page(s) 718–728

    Abstract: As the majority of children with short bowel syndrome (SBS) and intestinal failure (IF) are now surviving into adulthood, there is a paradigm shift from short-term management to long-term outcomes and a growing need to focus on healthcare transition (HCT) ...

    Abstract As the majority of children with short bowel syndrome (SBS) and intestinal failure (IF) are now surviving into adulthood, there is a paradigm shift from short-term management to long-term outcomes and a growing need to focus on healthcare transition (HCT). It is imperative that adolescents and young adults with SBS and IF receive disease education, empowerment, and support as they navigate the transition from pediatric to adult care. Furthermore, both pediatric and adult healthcare providers who manage these patients should be aware of the challenges faced by this population, barriers to their HCT, and strategies to overcome them. This article reviews the literature on HCT in children with chronic illnesses, discusses barriers to HCT in SBS/IF, identifies the important constituents of the transition process in SBS/IF, and provides recommendations for the successful and smooth transition of the pediatric patient to the adult healthcare environment. Structured and multicomponent HCT programs should become the standard of care to ensure uninterrupted high-quality care across the life span for patients with SBS/IF.
    MeSH term(s) Adolescent ; Young Adult ; Humans ; Child ; Transition to Adult Care ; Short Bowel Syndrome/therapy ; Intestinal Failure ; Chronic Disease
    Language English
    Publishing date 2023-04-02
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 800861-9
    ISSN 1941-2444 ; 0148-6071
    ISSN (online) 1941-2444
    ISSN 0148-6071
    DOI 10.1002/jpen.2499
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  5. Article ; Online: Exploring the impact of pediatric short bowel syndrome on parent well-being using a disease-specific pilot survey.

    Neumann, Marie L / Allen, Jessica Y / Ladner, Amy / Kakani, Swapna / Weaver, Meaghann S / Mercer, David F

    Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition

    2023  Volume 39, Issue 1, Page(s) 154–167

    Abstract: Background: Children with short bowel syndrome (SBS) have complex care needs, most of which are met in the home by family caregivers who may experience a range of stressors unique to this experience. Prior research suggests that parents of children with ...

    Abstract Background: Children with short bowel syndrome (SBS) have complex care needs, most of which are met in the home by family caregivers who may experience a range of stressors unique to this experience. Prior research suggests that parents of children with SBS have poorer health-related quality of life than peers parenting children without health needs, but the mechanisms shaping parent outcomes are understudied.
    Methods: A pilot survey was developed using a community-driven research design to measure the impact of disease-specific items on parent-perceived well-being. The cross-sectional survey, which included both closed-ended and open-ended items, was distributed to a convenience sample of parents of children with SBS. Quantitative and qualitative data were integrated for a mixed-methods analysis of how individual items impacted parent well-being.
    Results: Twenty parents completed the survey. Sleep interruptions, lack of support and resources, and psychological stressors and their mental health implications were more frequently reported as stressors than logistics related to caregiving (e.g., managing therapies and preparing specialized meals).
    Conclusion: The impact of a child's SBS on parent well-being may stem mainly from three interconnected domains: poor sleep and its consequences, lack of access to support and resources, and a range of psychological stressors that affect parent mental health. Understanding the mechanisms through which SBS shapes parent well-being is a necessary first step for developing targeted interventions to support parents and provide family-centered care.
    MeSH term(s) Child ; Humans ; Quality of Life ; Short Bowel Syndrome/therapy ; Cross-Sectional Studies ; Parents ; Parenting/psychology
    Language English
    Publishing date 2023-05-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645074-x
    ISSN 1941-2452 ; 0884-5336
    ISSN (online) 1941-2452
    ISSN 0884-5336
    DOI 10.1002/ncp.11008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Fish oil emulsions in the management of intestinal failure-associated liver disease.

    Mercer, David F

    Journal of clinical gastroenterology

    2012  Volume 46, Issue 10, Page(s) 823–827

    Abstract: The role of parenteral lipid emulsions in the treatment of intestinal failure-associated liver disease (IFALD) is both topical and controversial. There is strong evidence supporting plant-based (soy, olive) lipid emulsions as a key cause for IFALD, ... ...

    Abstract The role of parenteral lipid emulsions in the treatment of intestinal failure-associated liver disease (IFALD) is both topical and controversial. There is strong evidence supporting plant-based (soy, olive) lipid emulsions as a key cause for IFALD, especially in neonates. As a result, alternate lipid formulations, most notably fish oil emulsions (FOE) have come into widespread use despite somewhat limited clinical data on their overall benefit and potential long-term consequences. This review examines putative mechanisms of action of FOE in reversing cholestasis associated with IFALD, and critically reviews published clinical studies of the use of FOE in pediatric patients with IFALD. From these works, it appears the mechanism of action of FOE is most likely related to the reduction of serum phytosterols associated with plant-based lipid emulsions rather than a specific positive benefit of the fish oils themselves. Although the use of FOE seems to correlate with a reduction in cholestasis, their actual individual benefit is not established, and data on long-term outcomes and safety are not yet available.
    MeSH term(s) Cholestasis/complications ; Cholestasis/drug therapy ; Fat Emulsions, Intravenous/adverse effects ; Fat Emulsions, Intravenous/therapeutic use ; Fish Oils/therapeutic use ; Humans ; Intestinal Diseases/complications ; Intestinal Diseases/physiopathology ; Liver Diseases/drug therapy ; Liver Diseases/etiology ; Olive Oil ; Parenteral Nutrition/adverse effects ; Plant Oils/adverse effects ; Soybean Oil/adverse effects
    Chemical Substances Fat Emulsions, Intravenous ; Fish Oils ; Olive Oil ; Plant Oils ; Soybean Oil (8001-22-7)
    Language English
    Publishing date 2012-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 448460-5
    ISSN 1539-2031 ; 0192-0790
    ISSN (online) 1539-2031
    ISSN 0192-0790
    DOI 10.1097/MCG.0b013e318261836d
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  7. Article ; Online: Hot topics in postsmall bowel transplantation: noninvasive graft monitoring including stool calprotectin and plasma citrulline.

    Mercer, David F

    Current opinion in organ transplantation

    2011  Volume 16, Issue 3, Page(s) 316–322

    Abstract: Purpose of review: Long-term success in intestinal transplantation could be significantly improved by the development of a reliable noninvasive marker of rejection, allowing early diagnosis and treatment without the need for repeated biopsy procedures.!# ...

    Abstract Purpose of review: Long-term success in intestinal transplantation could be significantly improved by the development of a reliable noninvasive marker of rejection, allowing early diagnosis and treatment without the need for repeated biopsy procedures.
    Recent findings: At present, no single test appears sufficiently reliable to replace the need for invasive testing. Falling plasma citrulline levels may correlate with mucosal damage already done, but do not appear to be specific for rejection or provide clinically useful prediction of an event in advance of its occurrence. Similarly, rising stool calprotectin levels are correlated with pathologic diagnosis of rejection, but do not appear to have sufficient predictive value. Both tests appear to be best described as exclusionary, in that if their values are 'normal', rejection is less likely, but each is hampered by wide variability within and between patients.
    Summary: These approaches and others are reviewed in an outline of the current progress towards developing a clinically useful noninvasive tool for graft monitoring.
    MeSH term(s) Biomarkers/metabolism ; Biopsy ; Citrulline/blood ; Early Diagnosis ; Feces/chemistry ; Graft Rejection/diagnosis ; Graft Rejection/etiology ; Graft Rejection/metabolism ; Graft Survival ; Humans ; Intestine, Small/metabolism ; Intestine, Small/transplantation ; Leukocyte L1 Antigen Complex/metabolism ; Organ Transplantation/adverse effects ; Predictive Value of Tests ; Reproducibility of Results ; Time Factors ; Treatment Outcome
    Chemical Substances Biomarkers ; Leukocyte L1 Antigen Complex ; Citrulline (29VT07BGDA)
    Language English
    Publishing date 2011-06
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1390429-2
    ISSN 1531-7013 ; 1087-2418
    ISSN (online) 1531-7013
    ISSN 1087-2418
    DOI 10.1097/MOT.0b013e3283467115
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  8. Article ; Online: Animal models for studying hepatitis C and alcohol effects on liver.

    Mercer, David F

    World journal of gastroenterology

    2011  Volume 17, Issue 20, Page(s) 2515–2519

    Abstract: Chronic consumption of ethanol has a dramatic effect on the clinical outcome of patients with hepatitis C virus (HCV) infection, but the mechanism linking these two pathologies is unknown. Presently, in vitro systems are limited in their ability to study ...

    Abstract Chronic consumption of ethanol has a dramatic effect on the clinical outcome of patients with hepatitis C virus (HCV) infection, but the mechanism linking these two pathologies is unknown. Presently, in vitro systems are limited in their ability to study the interaction between a productive wild-type HCV infection and chronic ethanol exposure. Mouse models are potentially very useful in dissecting elements of the HCV-ethanol relationship. Experiments in mice that transgenically express HCV proteins are outlined, as are experiments for the generation of mice with chimeric human livers. The latter models appear to have the most promise for accurately modeling the effects of chronic ethanol intake in HCV-infected human livers.
    MeSH term(s) Animals ; Chimera ; Comorbidity ; Disease Models, Animal ; Ethanol/pharmacology ; Hepatitis C/epidemiology ; Hepatitis C/physiopathology ; Humans ; Liver/drug effects ; Liver/physiopathology ; Liver/virology ; Liver Diseases, Alcoholic/epidemiology ; Liver Diseases, Alcoholic/physiopathology ; Mice ; Mice, Transgenic
    Chemical Substances Ethanol (3K9958V90M)
    Language English
    Publishing date 2011-04-29
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2185929-2
    ISSN 2219-2840 ; 1007-9327
    ISSN (online) 2219-2840
    ISSN 1007-9327
    DOI 10.3748/wjg.v17.i20.2515
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  9. Article ; Online: Case presentation and panel discussion: Transitions in care.

    Katz, Jennifer / Mercer, David F / Schuetz, Philipp / Mundi, Manpreet S / Pimiento, Jose / Morrison, Chet / Mechanick, Jeffrey I / Patel, Jayshil J

    JPEN. Journal of parenteral and enteral nutrition

    2022  Volume 47 Suppl 1, Page(s) S35–S37

    Abstract: There is evidence that significant quality problems arise as patients transitions in care from one setting to another. Attention to nutrition during transitions of care is important to avoid complication. During the American Society for Parenteral and ... ...

    Abstract There is evidence that significant quality problems arise as patients transitions in care from one setting to another. Attention to nutrition during transitions of care is important to avoid complication. During the American Society for Parenteral and Enteral Nutrition 2022 preconference course, nutrition during transition of care from pediatric to adult care, from the intensive care unit to the hospital floors and from the hospital to home was addressed.
    MeSH term(s) Adult ; Child ; Humans ; Transition to Adult Care ; Enteral Nutrition ; Parenteral Nutrition ; Intensive Care Units ; Nutritional Status
    Language English
    Publishing date 2022-12-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 800861-9
    ISSN 1941-2444 ; 0148-6071
    ISSN (online) 1941-2444
    ISSN 0148-6071
    DOI 10.1002/jpen.2438
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  10. Article ; Online: Characteristics of chronic intestinal failure in the USA based on analysis of claims data.

    Mundi, Manpreet S / Mercer, David F / Iyer, Kishore / Pfeffer, Daniel / Zimmermann, Lis B / Berner-Hansen, Mark / Bishop, Joan / Seidner, Douglas L

    JPEN. Journal of parenteral and enteral nutrition

    2022  Volume 46, Issue 7, Page(s) 1614–1622

    Abstract: Background: This study investigated the prevalence, characteristics, and management of patients with chronic intestinal failure (CIF) in the United States in 2012-2020, based on parenteral support (PS) prescription claims and healthcare utilization.: ... ...

    Abstract Background: This study investigated the prevalence, characteristics, and management of patients with chronic intestinal failure (CIF) in the United States in 2012-2020, based on parenteral support (PS) prescription claims and healthcare utilization.
    Methods: Patients with CIF were identified from the Integrated DataVerse® claims database if they had at least two PS prescriptions within 6 months and a relevant diagnosis. Analysis included prevalence and characteristics of patients with CIF, their travel distance to receive PS prescriptions, and the distribution of PS providers and their prescribing history.
    Results: Up to 24,048 patients with CIF were identified, equivalent to 75 patients per million. CIF affected people of all ages, being more prevalent in women than in men. Many providers signed PS orders for small patient groups over short time periods, whereas few providers signed PS orders for large patient groups long term, indicating a lack of centralization. The distribution of PS providers suggested a disparity in healthcare coverage in rural vs urban areas, leading to patients traveling considerable distances to receive PS prescriptions. This may be exacerbated by a decline of providers with expertise in CIF and nutrition.
    Conclusions: Healthcare disparities for patients with CIF have likely been obscured by the lack of CIF-specific diagnostic and procedure codes, obliging providers to code for their patients under other codes. Effective policy changes, including centralized care, revision of reimbursement models, and expansion of nutrition-focused education in addition to the newly introduced International Classification of Diseases codes, are needed to provide the best care for patients.
    MeSH term(s) Chronic Disease ; Female ; Humans ; Intestinal Diseases/epidemiology ; Intestinal Diseases/therapy ; Intestinal Failure ; Male ; Parenteral Nutrition ; Prevalence ; United States/epidemiology
    Language English
    Publishing date 2022-07-24
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 800861-9
    ISSN 1941-2444 ; 0148-6071
    ISSN (online) 1941-2444
    ISSN 0148-6071
    DOI 10.1002/jpen.2426
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