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necrotising enterocolitis

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https://www.readbyqxmd.com/read/28211086/variation-of-the-rates-of-necrotising-enterocolitis-in-the-neonatal-networks-in-england
#1
Nicholas T Longford
Necrotising enterocolitis is an oft-fatal disease of the intestinal tract in neonates born prematurely and with low birthweight. We study the variation of its rates across the neonatal networks (groups of hospital-based neonatal care units) in England. We illustrate the problematic nature of hypothesis testing for a key decision, which an analysis is meant to inform, and apply an approach based on decision theory. We emphasise the role of sensitivity analysis in dealing with the ambiguity encountered in the process of eliciting information about the perspective of the client or sponsor for whom the analysis is conducted...
February 17, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/28209998/cervical-pessary-for-prevention-of-preterm-birth-a-meta-analysis
#2
Xin-Hang Jin, Dan Li, Li-Li Huang
To investigate the efficacy of cervical pessary placement in preventing preterm birth and perinatal morbidity and mortality in asymptomatic women with a singleton pregnancy and a short cervix, we searched literature in relevant databases. The meta-analysis of the 3 included trials (1412 women) showed cervical pessary placement did not reduce the risk of spontaneous preterm birth <34 weeks in these women (risk ratio (RR), 0.71; 95% confidence interval (CI), 0.21-2.43, P = 0.59; I(2) = 90%). The sensitivity analyses by excluding one trial at one time showed the same results...
February 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28158932/the-association-of-neonatal-morbidity-with-long-term-neurological-outcome-in-infants-who-were-growth-restricted-and-preterm-at-birth-secondary-analyses-from-truffle-trial-of-randomized-umbilical-and-fetal-flow-in-europe
#3
A G Van Wassenaer-Leemhuis, N Marlow, C Lees, H Wolf
OBJECTIVE: To study the relationship between neonatal morbidity (NNM) and two-year neurodevelopmental impairment (NDI) in surviving children after early fetal growth restriction (FGR). DESIGN: Secondary analysis of a European randomised trial (TRUFFLE) of delivery for very preterm fetuses dependent on venous Doppler or cardiotocographic criteria. SETTING: Tertiary perinatal centres, participants in TRUFFLE. POPULATION: 402 surviving children after early FGR...
February 3, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28146296/nasal-intermittent-positive-pressure-ventilation-nippv-versus-nasal-continuous-positive-airway-pressure-ncpap-for-preterm-neonates-after-extubation
#4
REVIEW
Brigitte Lemyre, Peter G Davis, Antonio G De Paoli, Haresh Kirpalani
BACKGROUND: Previous randomised trials and meta-analyses have shown that nasal continuous positive airway pressure (NCPAP) is a useful method for providing respiratory support after extubation. However, this treatment sometimes 'fails' in infants, and they may require endotracheal re-intubation with its attendant risks and expense. Nasal intermittent positive pressure ventilation (NIPPV) can augment NCPAP by delivering ventilator breaths via nasal prongs. Older children and adults with chronic respiratory failure benefit from NIPPV, and the technique has been applied to neonates...
February 1, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28129748/the-speed-of-increasing-milk-feeds-a-randomised-controlled-trial
#5
Jane Abbott, Janet Berrington, Ursula Bowler, Elaine Boyle, Jon Dorling, Nicholas Embleton, Edmund Juszczak, Alison Leaf, Louise Linsell, Samantha Johnson, Kenny McCormick, William McGuire, Tracy Roberts, Ben Stenson
BACKGROUND: In the UK, 1-2% of infants are born very preterm (<32 weeks of gestation) or have very low birth weight (<1500 g). Very preterm infants are initially unable to be fed nutritional volumes of milk and therefore require intravenous nutrition. Milk feeding strategies influence several long and short term health outcomes including growth, survival, infection (associated with intravenous nutrition) and necrotising enterocolitis (NEC); with both infection and NEC being key predictive factors of long term disability...
January 28, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28128874/policy-of-feeding-very-preterm-infants-with-their-mother-s-own-fresh-expressed-milk-was-associated-with-a-reduced-risk-of-bronchopulmonary-dysplasia
#6
Odile Dicky, Virginie Ehlinger, Nathalie Montjaux, Gisèle Gremmo-Féger, Jacques Sizun, Jean-Christophe Rozé, Catherine Arnaud, Charlotte Casper
AIM: Since 2005, the French food safety agency has recommended that very preterm or low birth weight babies should be fed with pasteurised, expressed breast milk and feeding policies on this vary widely in French neonatal units. We investigated the differences between using a mother's expressed milk, in fresh or pasteurised forms, for very preterm infants. METHODS: This observational multicentre study analysed data on 926 very preterm infants: 636 from neonatal units who used the mother's own fresh milk and 290 who used the mother's milk after pasteurisation...
January 27, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28128518/maternal-and-neonatal-outcomes-in-women-with-severe-early-onset-pre-eclampsia-before-26-weeks-of-gestation-a-case-series
#7
M F van Oostwaard, L van Eerden, M W de Laat, J J Duvekot, Jjhm Erwich, Kwm Bloemenkamp, A C Bolte, Jpf Bosma, S V Koenen, R F Kornelisse, B Rethans, P van Runnard Heimel, Hcj Scheepers, W Ganzevoort, Bwj Mol, C J de Groot, Ipm Gaugler-Senden
OBJECTIVE: To describe the maternal and neonatal outcomes and prolongation of pregnancies with severe early onset pre-eclampsia before 26 weeks of gestation. DESIGN: Nationwide case series. SETTING: All Dutch tertiary perinatal care centres. POPULATION: All women diagnosed with severe pre-eclampsia who delivered between 22 and 26 weeks of gestation in a tertiary perinatal care centre in the Netherlands, between 2008 and 2014...
January 27, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28128283/a-uk-wide-cohort-study-describing-management-and-outcomes-for-infants-with-surgical-necrotising-enterocolitis
#8
Benjamin Allin, Anna-May Long, Amit Gupta, Marian Knight, Kokila Lakhoo
The Royal College of Surgeons have proposed using outcomes from necrotising enterocolitis (NEC) surgery for revalidation of neonatal surgeons. The aim of this study was therefore to calculate the number of infants in the UK/Ireland with surgical NEC and describe outcomes that could be used for national benchmarking and counselling of parents. A prospective nationwide cohort study of every infant requiring surgical intervention for NEC in the UK was conducted between 01/03/13 and 28/02/14. Primary outcome was mortality at 28-days...
January 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28114736/cromolyn-sodium-for-the-prevention-of-chronic-lung-disease-in-preterm-infants
#9
REVIEW
Geraldine Ng, Arne Ohlsson
BACKGROUND: This is an update of a review last published by Cochrane in June 2012 entitled "Cromolyn sodium for the prevention of chronic lung disease in preterm infants", which included two studies. This 2016 update identified no further studies.Chronic lung disease (CLD) frequently occurs in preterm infants and has a multifactorial aetiology including inflammation. Cromolyn sodium is a mast cell stabiliser that inhibits neutrophil activation and neutrophil chemotaxis and therefore may have a role in the prevention of CLD...
January 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28102115/can-probiotics-modulate-human-disease-by-impacting-intestinal-barrier-function
#10
Peter A Bron, Michiel Kleerebezem, Robert-Jan Brummer, Patrice D Cani, Annick Mercenier, Thomas T MacDonald, Clara L Garcia-Ródenas, Jerry M Wells
Intestinal barrier integrity is a prerequisite for homeostasis of mucosal function, which is balanced to maximise absorptive capacity, while maintaining efficient defensive reactions against chemical and microbial challenges. Evidence is mounting that disruption of epithelial barrier integrity is one of the major aetiological factors associated with several gastrointestinal diseases, including infection by pathogens, obesity and diabetes, necrotising enterocolitis, irritable bowel syndrome and inflammatory bowel disease...
January 2017: British Journal of Nutrition
https://www.readbyqxmd.com/read/28087725/neurodevelopmental-outcomes-of-extremely-low-birthweight-infants-randomised-to-different-pco2-targets-the-phelbi-follow-up-study
#11
Ulrich H Thome, Orsolya Genzel-Boroviczeny, Bettina Bohnhorst, Manuel Schmid, Hans Fuchs, Oliver Rohde, Stefan Avenarius, Hans-Georg Topf, Andrea Zimmermann, Dirk Faas, Katharina Timme, Barbara Kleinlein, Horst Buxmann, Wilfried Schenk, Hugo Segerer, Norbert Teig, Annett Bläser, Roland Hentschel, Matthias Heckmann, Rolf Schlösser, Jochen Peters, Rainer Rossi, Wolfgang Rascher, Ralf Böttger, Jürgen Seidenberg, Gesine Hansen, Maria Zernickel, Harald Bode, Jens Dreyhaupt, Rainer Muche, Helmut D Hummler
BACKGROUND: Tolerating higher partial pressures of carbon dioxide (PCO2) in mechanically ventilated extremely low birthweight infants to reduce ventilator-induced lung injury may have long-term neurodevelopmental side effects. This study analyses the results of neurodevelopmental follow-up of infants enrolled in a randomised multicentre trial. METHODS: Infants (n=359) between 400 and 1000 g birth weight and 23 0/7-28 6/7 weeks gestational age who required endotracheal intubation and mechanical ventilation within 24 hours of birth were randomly assigned to high PCO2 or to a control group with mildly elevated PCO2 targets...
January 13, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28050900/planned-early-birth-versus-expectant-management-waiting-for-prelabour-rupture-of-membranes-at-term-37-weeks-or-more
#12
REVIEW
Philippa Middleton, Emily Shepherd, Vicki Flenady, Rosemary D McBain, Caroline A Crowther
BACKGROUND: Prelabour rupture of membranes (PROM) at term is managed expectantly or by planned early birth. It is not clear if waiting for birth to occur spontaneously is better than intervening, e.g. by inducing labour. OBJECTIVES: The objective of this review is to assess the effects of planned early birth (immediate intervention or intervention within 24 hours) when compared with expectant management (no planned intervention within 24 hours) for women with term PROM on maternal, fetal and neonatal outcomes...
January 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28046187/development-of-a-gestational-age-specific-case-definition-for-neonatal-necrotizing-enterocolitis
#13
Cheryl Battersby, Nick Longford, Kate Costeloe, Neena Modi
Importance: Necrotizing enterocolitis (NEC) is a major cause of neonatal morbidity and mortality. Preventive and therapeutic research, surveillance, and quality improvement initiatives are hindered by variations in case definitions. Objective: To develop a gestational age (GA)-specific case definition for NEC. Design, Setting, and Participants: We conducted a prospective 34-month population study using clinician-recorded findings from the UK National Neonatal Research Database between December 2011 and September 2014 across all 163 neonatal units in England...
January 3, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28034304/temporal-bacterial-and-metabolic-development-of-the-preterm-gut-reveals-specific-signatures-in-health-and-disease
#14
Christopher J Stewart, Nicholas D Embleton, Emma C L Marrs, Daniel P Smith, Andrew Nelson, Bashir Abdulkadir, Tom Skeath, Joseph F Petrosino, John D Perry, Janet E Berrington, Stephen P Cummings
BACKGROUND: The preterm microbiome is crucial to gut health and may contribute to necrotising enterocolitis (NEC), which represents the most significant pathology affecting preterm infants. From a cohort of 318 infants, <32 weeks gestation, we selected 7 infants who developed NEC (defined rigorously) and 28 matched controls. We performed detailed temporal bacterial (n = 641) and metabolomic (n = 75) profiling of the gut microbiome throughout the disease. RESULTS: A core community of Klebsiella, Escherichia, Staphyloccocus, and Enterococcus was present in all samples...
December 29, 2016: Microbiome
https://www.readbyqxmd.com/read/28028291/contaminated-milk-is-a-common-cause-of-necrotising-enterocolitis-a-hypothesis
#15
N Y Boo
Necrotising enterocolitis (NEC) is the most commonly acquired gastrointestinal disease of neonates, particularly the very preterm (gestation <32 weeks) and/or very low birth weight (<1500g). It is associated with high morbidity and mortality. Despite improvement in neonatal care and increased use of expressed breast milk (EBM), the incidence remains high in many neonatal intensive care units (NICU), and even shows increasing trend in some countries. Numerous studies have pointed to the infective nature of NEC...
December 2016: Malaysian Journal of Pathology
https://www.readbyqxmd.com/read/28008787/a-review-of-dose-responses-of-probiotics-in-human-studies
#16
A C Ouwehand
The probiotic definition requires the administration of an 'adequate amount' in order to obtain a health benefit. What that amount should be is not indicated. Here, an overview is given of studies that investigated the dose-response relation of probiotics in human interventions. Studies were divided in; meta-analyses, meta-analyses on specific probiotic strains, and studies testing two or more doses of a probiotic (combination) in the same study. Meta-analyses on the effect of probiotics on antibiotic associated diarrhoea (AAD) suggest a dose-response effect; for Clostridium difficile-associated diarrhoea on the other hand no dose-response was observed...
December 23, 2016: Beneficial Microbes
https://www.readbyqxmd.com/read/27990166/morbidity-and-mortality-in-preterm-infants-following-antacid-use-a-retrospective-audit
#17
Natasha Singh, Aparna Dhayade, Abdel-Latif Mohamed, Tejasvi Vasant Chaudhari
Background and Objectives. Antacids are often prescribed to preterm infants due to misdiagnosis of gastro-oesophageal reflux. This suppresses gastric acidity, a major defence mechanism against infection. This study aims to determine if ranitidine and omeprazole use in very low birth weight (VLBW) neonates, <1500 grams, is associated with increased risk of late onset sepsis, necrotising enterocolitis (NEC), and mortality. Methods. Retrospective analysis was conducted on neonates, <1500 grams, born and admitted into the Neonatal Intensive Care Unit at The Canberra Hospital during the period from January 2008 to December 2012...
2016: International Journal of Pediatrics
https://www.readbyqxmd.com/read/27960245/bronchodilators-for-the-prevention-and-treatment-of-chronic-lung-disease-in-preterm-infants
#18
REVIEW
Geraldine Ng, Orlando da Silva, Arne Ohlsson
BACKGROUND: Chronic lung disease (CLD) occurs frequently in preterm infants. Bronchodilators have the potential effect of dilating small airways with muscle hypertrophy. Increased compliance and tidal volume and decreased pulmonary resistance have been documented with the use of bronchodilators in infants with CLD. Therefore, bronchodilators might have a role in the prevention and treatment of CLD. OBJECTIVES: To determine the effect of bronchodilators given as prophylaxis or as treatment for CLD on mortality and other complications of preterm birth in infants at risk for or identified as having CLD...
14, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27935107/surgical-findings-during-exploratory-laparotomy-are-closely-related-to-mortality-in-premature-infants-with-necrotising-enterocolitis
#19
M L Hansen, S M Juhl, G Fonnest, G Greisen
AIM: This study investigated whether a correlation existed between surgical findings during the first laparotomy for necrotising enterocolitis (NEC) and death and, or, disease progression. METHODS: We included infants admitted within one day of birth to our tertiary neonatal department at Rigshospitalet, Denmark, from 2006 to 2015, who underwent a laparotomy for acute NEC. They were classified according to the locality and extent of intestinal necrosis by a paediatric surgeon, based on the surgical findings...
December 9, 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/27909996/modelling-the-cost-effectiveness-of-human-milk-and-breastfeeding-in-preterm-infants-in-the-united-kingdom
#20
James Mahon, Lindsay Claxton, Hannah Wood
OBJECTIVES: To estimate the cost savings and health benefits in the UK NHS that could be achieved if human milk usage in the NICU was increased. METHODS: A systematic review established the disease areas with the strong sources of evidence of the short, medium and long-term benefits of human milk for preterm infants as opposed to the use of formula milk. The analysis assessed the economic impact of reducing rates of necrotising enterocolitis, sepsis, sudden infant death syndrome, leukaemia, otitis media, obesity and neurodevelopmental impairment...
December 2016: Health Economics Review
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