Browsing by Author "Plata, Clara"

Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    International Latin American Survey on Pediatric Intestinal Failure Team
    (2021) Spolidoro, Jose Vicente N.; Souza, Mirella C.; Goldani, Helena A. S.; Tanzi, Maria N.; Busoni, Veronica B.; Padilla, Maria del Carmen; Ramirez, Nelson E.; Cofre, Colomba; Valdivieso, Lidia P.; Saure, Carola; Jimenez-Arguedas, Gabriela; Mateus, Mikaelle S. M.; Serra, Roberta; Cuadros-Mendonza, Carlos; Rivera-Medina, Juan; Gattini, Daniela; dos Santos, Beatriz J.; Plata, Clara; Sandy, Natascha Silva
    There is little data on the experience of managing pediatric Intestinal Failure (IF) in Latin America. This study aimed to identify and describe the current organization and practices of the IF teams in Latin America and the Caribbean. An online survey was sent to inquire about the existence of IF teams that managed children on home parenteral nutrition (HPN). Our questionnaire was based on a previously published European study with a similar goal. Twenty-four centers with pediatric IF teams in eight countries completed the survey, representing a total number of 316 children on HPN. The median number of children on parenteral nutrition (PN) at home per team was 5.5 (range 1-50). Teams consisted of the following members: pediatric gastroenterologist and a pediatric surgeon in all teams, dietician (95.8%), nurse (91.7%), social worker (79.2%), pharmacist (70.8%), oral therapist (62.5%), psychologist (58.3%), and physiotherapist (45.8%). The majority of the centers followed international standards of care on vascular access, parenteral and enteral nutrition, and IF medical and surgical management, but a significant percentage reported inability to monitor micronutrients, like vitamins A (37.5%), E (41.7%), B1 (66.7%), B2 (62.5%), B6 (62.5%), active B12 (58.3%); and trace elements-including zinc (29.2%), aluminum (75%), copper (37.5%), chromium (58.3%), selenium (58.3%), and manganese (58.3%). Conclusion: There is wide variation in how IF teams are structured in Latin America-while many countries have well-established Intestinal rehabilitation programs, a few do not follow international standards. Many countries did not report having an IF team managing pediatric patients on HPN.
  • No Thumbnail Available
    Item
    Short bowel syndrome related intestinal failure outcomes in Latin America: Insights from the RESTORE Registry
    (2024) Rumbo, Carolina; Solar, Hector; Ortega, Mariana; Busoni, Veronica; de Barrio, Silvia; Martinuzzi, Andres; Martinez, Maria Ines; Plata, Clara; Donnadio, Luciana; Zuniga, Aurora Serralde; Saure, Carola; Perez, Claudia; Tanzi, Maria Noel; Consuelo, Alejandra; Becerra, Andres; Manzur, Alejandra; Moya, Diego Arenas; Rudi, Lorena; Moreira, Eduardo; Buncuga, Martin; Hodgson, Maria Isabel; Claria, Rodrigo Sanchez; Fernandez, Adriana; Gondolesi, Gabriel
    BackgroundShort bowel syndrome is considered a low prevalence disease. The scant information available about intestinal failure in Latin America was the driving force to expand this registry.MethodsA prospective, multicenter observational registry was created for patients with chronic intestinal failure short bowel at specialized centers in Latin America. Demographics, clinical characteristics, nutrition assessment, parenteral nutrition management, intestinal rehabilitation, related complications, clinical outcome, and survival were analyzed.ResultsFrom May 2020 to July 2023, 167 patients (115 adults, 52 children) from 20 centers were enrolled. For the adults, the mean age was 37.2 +/- 18 years, 48% were female, and the mean follow-up was 22.6 +/- 18.3 months. The main etiology was surgical resections (postsurgical complications: 37%; ischemia: 25%); the mean intestinal length was 73 +/- 55 cm. The complications were as follows: infections: 0.4/1000 catheter-days; thrombosis: 0.24/1000 catheter-days; liver disease: 2.6%. The outcomes were as follows: 28% were rehabilitated, 15% died, 9.6% were lost to follow-up, 0.9% underwent transplant, and 45.6% continued follow-up. For the children, the mean age 48 +/- 52 months, 48% were female, 52% were premature. The mean follow-up was 17.2 +/- 5.6 months; the mean remaining intestinal length was 38 +/- 45 cm. The leading etiologies were atresia (25%), NEC (23%), and gastroschisis (21%). The complication were as follows: infections: 2/1000 catheter-days; thrombosis: 2.22/1000 catheter-day; 25% developed liver disease. The outcomes were as follows: 7.7% died, 3.8% were rehabilitated, and 88.5% continued follow-up.ConclusionThe RESTORE amendment served as a registry and educational tool for the participating teams. The aspiration is to objectively show current aspects of intestinal failure in the region and carry them to international standards. Including all Latin American countries and etiologies of chronic intestinal failure besides short gut would serve to complete this registry.