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necrotizing enterocolitis treatment

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https://www.readbyqxmd.com/read/28315470/the-nitric-oxide-synthase-2-pathway-is-targeted-by-both-pro-and-anti-inflammatory-treatments-in-the-immature-human-intestine
#1
Emanuela Ferretti, Eric Tremblay, Marie-Pier Thibault, David Grynspan, Karolina M Burghardt, Marcos Bettolli, Corentin Babakissa, Emile Levy, Jean-François Beaulieu
BACKGROUND AND AIM: NO synthase 2 (NOS2) was recently identified as one the most overexpressed genes in intestinal samples of premature infants with necrotizing enterocolitis (NEC). NOS2 is widely implicated in the processes of epithelial cell injury/apoptosis and host immune defense but its specific role in inflammation of the immature human intestinal mucosa remains unclear. Interestingly, factors that prevent NEC such as epidermal growth factor (EGF) attenuate the inflammatory response in the mid-gestation human small intestine using serum-free organ culture while drugs that are associated with NEC occurrence such as the non-steroidal anti-inflammatory drug, indomethacin (INDO), exert multiple detrimental effects on the immature human intestine...
March 14, 2017: Nitric Oxide: Biology and Chemistry
https://www.readbyqxmd.com/read/28278201/the-symbiotic-bacterial-surface-factor-polysaccharide-a-on-bacteroides-fragilis-inhibits-il-1%C3%AE-induced-inflammation-in-human-fetal-enterocytes-via-toll-receptors-2-and-4
#2
Fei Jiang, Di Meng, Meiqian Weng, Weishu Zhu, Wenxue Wu, Dennis Kasper, W Allan Walker
Colonizing bacteria interacting with the immature, unlike the mature, human intestine favors inflammation over immune homeostasis. As a result, ten percent of premature infants under 1500 grams weight develop an inflammatory necrosis of the intestine after birth, e.g., necrotizing enterocolitis (NEC). NEC is a major health problem in this population causing extensive morbidity and mortality and an enormous expenditure of health care dollars. NEC can be prevented by giving preterm infants their mother's expressed breast milk or ingesting selective probiotic organisms...
2017: PloS One
https://www.readbyqxmd.com/read/28272242/predictive-factors-and-clinical-practice-profile-for-strictures-post-necrotising-enterocolitis
#3
Han Zhang, Jiaping Chen, Yan Wang, Chun Deng, Lei Li, Chunbao Guo
Intestinal stricture is a severe and common complication of necrotizing enterocolitis (NEC), causing severe and prolonged morbidity. Our goal was to investigate the clinical predictors for strictures developing after NEC and evaluate the management outcome of the post-NEC strictures to better orient their medicosurgical care.A total of 188 patients diagnosed with NEC with identical treatment protocols throughout the period under study were retrospectively reviewed from 4 academic neonatal centers between from January 1, 2011, and October 31, 2016...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28264088/association-of-patent-ductus-arteriosus-ligation-with-death-or-neurodevelopmental-impairment-among-extremely-preterm-infants
#4
Dany E Weisz, Lucia Mirea, Erin Rosenberg, Maximus Jang, Linh Ly, Paige T Church, Edmond Kelly, S Joseph Kim, Amish Jain, Patrick J McNamara, Prakesh S Shah
Importance: Observational studies have associated patent ductus arteriosus (PDA) ligation among preterm infants with adverse neonatal outcomes and neurodevelopmental impairment in early childhood, with a resultant secular trend away from surgical treatment. However, to our knowledge, studies have inadequately addressed sources of residual bias, including survival bias and major neonatal morbidities arising before exposure to ligation. Objective: Evaluate the association between PDA ligation vs medical management and neonatal and neurodevelopmental outcomes...
March 6, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28209955/-the-complications-of-intestinal-stoma-in-children
#5
S V Minaev, N I Bykov, A V Isaeva, A V Kachanov, E A Tovkan, N V Filip'yeva, I N Gerasimenko
AIM: To investigate the complications of intestinal stoma in children and to develop measures for decrease of their incidence. MATERIAL AND METHODS: The study included 152 children with congenital and acquired gastrointestinal pathology requiring surgical treatment with the imposition of intestinal stoma. Atresia of intestinal tube was observed in 28 (18.4%) children, meconium ileus - in 10 (6.6%) cases, Hirschsprung's disease - in 11 (7.2%)cases, anorectal malformations - in 39 (25...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28196391/pentoxifylline-treatment-of-very-low-birth-weight-neonates-with-nosocomial-sepsis
#6
Şahin Hamilçıkan, Emrah Can, Övgü Büke, Meltem Erol, Özlem Bostan Gayret
Objective The objective of this study was to assess the result of intravenous pentoxifylline as an adjunct to antibiotic therapy on mortality and morbidity in very low birth weight (VLBW) preterm neonates with nosocomial sepsis. Methods For the 18 VLBW preterm neonates, as an adjunct therapy to antibiotics regimens, pentoxifylline (5 mg/kg/h for 6 hours) was administered to premature infants with sepsis on 3 successive days. Clinical and laboratory parameters were recorded before and after treatment. Results Following pentoxifylline therapy, the immature-to-total neutrophil ratio and C-reactive protein (CRP) levels were significantly decreased, while the blood pH and base excess were significantly increased (p < 0...
February 14, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28188037/determinants-of-outcomes-in-patients-with-simple-gastroschisis
#7
Fouad Youssef, Jean-Martin Laberge, Pramod Puligandla, Sherif Emil
PURPOSE: We analyzed the determinants of outcomes in simple gastroschisis (GS) not complicated by intestinal atresia, perforation, or necrosis. METHODS: All simple GS patients enrolled in a national prospective registry from 2005 to 2013 were studied. Patients below the median for total parenteral nutrition (TPN) duration (26days) and hospital stay (34days) were compared to those above. Univariate and multivariate logistic and linear regression analyses were employed using maternal, patient, postnatal, and treatment variables...
January 28, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28188035/breast-milk-derived-exosomes-promote-intestinal-epithelial-cell-growth
#8
Alison Hock, Hiromu Miyake, Bo Li, Carol Lee, Leonardo Ermini, Yuhki Koike, Yong Chen, Pekka Määttänen, Augusto Zani, Agostino Pierro
BACKGROUND: Breast milk administration prevents necrotizing enterocolitis (NEC). However, the mechanism remains unclear. Exosomes are cell-derived vesicles highly present in human milk and regulate intercellular signaling, inflammation, and immune response. We hypothesized that milk-derived exosomes beneficially affect intestinal epithelial cells. METHODS: Rat milk was collected, and exosomes were isolated using ExoQuick reagent and visualized by Nanoparticle Tracking Analysis...
January 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28176308/fluid-restriction-for-treatment-of-preterm-infants-with-chronic-lung-disease
#9
REVIEW
Keith J Barrington, Etienne Fortin-Pellerin, Thomas Pennaforte
BACKGROUND: Fluid restriction is often recommended as part of the management of infants with early or established bronchopulmonary dysplasia (BPD). OBJECTIVES: To determine whether fluid restriction as part of the therapeutic intervention for early or established BPD improves clinical outcomes. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1) in the Cochrane Library (searched 16 February 2016), MEDLINE via PubMed (1966 to 16 February 2016), Embase (1980 to 16 February 2016), and CINAHL (1982 to 16 February 2016)...
February 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28167131/erythropoietin-induced-cytoprotection-in-intestinal-epithelial-cells-is-linked-to-system-xc
#10
Colin Martin, Mikita Patel, Miguel Melendez-Ferro, Brian Sims
Necrotizing enterocolitis is a common but serious complication among premature babies. Currently, there are limited treatment options. These include intensive supportive care and surgical intervention. In this study, we hypothesize that erythropoietin (Epo) could be protective against cell necrosis by increasing the levels of glutathione. This can be regulated by increasing the activity of system xC(-). This was demonstrated using intestinal epithelial cells (IEC-6) as a model system. S4-CPG and sulfasalazine pharmacologically inhibit xCT, which induced cell death...
March 15, 2017: Experimental Cell Research
https://www.readbyqxmd.com/read/28164853/impact-of-antibiotics-on-necrotizing-enterocolitis-and-antibiotic-associated-diarrhea
#11
REVIEW
Michael A Silverman, Liza Konnikova, Jeffrey S Gerber
Antibiotic treatment alters the composition and metabolic function of the intestinal microbiota. These alterations may contribute to the pathogenesis of necrotizing enterocolitis (NEC) and antibiotic-associated diarrhea (AAD). Recent studies are beginning to unravel the contribution of specific groups of microbes and their metabolic pathways to these diseases. Probiotics or other microbiota-targeted therapies may provide effect strategies to prevent and treat NEC and AAD.
March 2017: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/28150915/multicenter-retrospective-study-on-management-and-outcome-of-newborns-affected-by-surgical-necrotizing-enterocolitis
#12
Silvana Federici, Lorenzo DE Biagi, Simona Straziuso, Ernesto Leva, Giulia Brisighelli, Girolamo Mattioli, Luca Pio, Pietro Bagolan, Giorgia Totonelli, Bruno Noccioli, Elisa Severi, Pierluigi Lelli Chiesa, Gabriele Lisi, Antonino Tramontano, Carolina DE Chiara, Carmine Del Rossi, Giovanni Casadio, Mario Messina, Rossella Angotti, Antonino Appignani, Mirko Bertozzi, Fabio Rossi, Valeria Gabriele, Andrea Franchella, Veronica Zocca
BACKGROUND: Necrotizing enterocolitis (NEC) is the most common surgical emergency in newborns and it is still a leading cause of death despite the improvements reached in the management of the critically ill neonate. The purpose of this study was to evaluate risks factors, surgical treatments and outcome of surgical NEC. METHODS: We retrospectively evaluated a multicentric group of 184 patients with surgical NEC over a period of 5 years (2008-2012). Indications to operation were modified NEC Bell stages IIIA or IIIB...
February 1, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28148237/morbidity-and-mortality-among-very-preterm-singletons-following-fertility-treatment-in-australia-and-new-zealand-a-population-cohort-study
#13
Alex Y Wang, Abrar A Chughtai, Kei Lui, Elizabeth A Sullivan
BACKGROUND: Due to high rates of multiple birth and preterm birth following fertility treatment, the rates of mortality and morbidity among births following fertility treatment were higher than those conceived spontaneously. However, it is unclear whether the rates of adverse neonatal outcomes remain higher for very preterm (<32 weeks gestational age) singletons born after fertility treatment. This study aims to compare adverse neonatal outcomes among very preterm singletons born after fertility treatment including assisted reproductive technology (ART) hyper-ovulution (HO) and artificial insemination (AI) to those following spontaneous conception...
February 2, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28141547/efficacy-of-and-potential-morbidities-associated-with-the-use-of-antacid-medications-in-preterm-neonates
#14
Uday P Patil, Sean M Bailey, Elena V Wachtel, Evan Orosz, Rebecca Zarchin, Pradeep V Mally
OBJECTIVES: Antacid medications are frequently administered to preterm infants. These medications can change gastric pH levels and can affect regular gastrointestinal function and gut micro-bacterial flora. We hypothesized that preterm infants exposed to antacid medications are at a greater risk of necrotizing enterocolitis (NEC) and sepsis, and set out to determine any association, as well as to assess the clinical efficacy of these medications. MATERIALS AND METHODS: Retrospective chart review of preterm infants ≤30 weeks' gestational age or birth weight ≤1250 g over a 2-year period at New York University Langone Medical Center...
January 31, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28104319/the-mexican-consensus-on-probiotics-in-gastroenterology
#15
M A Valdovinos, E Montijo, A T Abreu, S Heller, A González-Garay, D Bacarreza, M Bielsa-Fernández, M C Bojórquez-Ramos, F Bosques-Padilla, A I Burguete-García, R Carmona-Sánchez, A Consuelo-Sánchez, E Coss-Adame, J A Chávez-Barrera, M de Ariño, J Flores-Calderón, O Gómez-Escudero, M S González-Huezo, M E Icaza-Chávez, A Larrosa-Haro, M Morales-Arámbula, C Murata, J A Ramírez-Mayans, J M Remes-Troche, T Rizo-Robles, M Peláez-Luna, E M Toro-Monjaraz, A Torre, M E Urquidi-Rivera, R Vázquez, J K Yamamoto-Furusho, F Guarner
INTRODUCTION: Probiotics are frequently prescribed in clinical practice. Their efficacy in treating gastrointestinal disorders is supported by a significant number of clinical trials. However, the correct prescription of these agents is hampered due to a lack of knowledge of the scientific evidence and to the different presentations and microbial compositions of the probiotics that are currently available. AIM: To provide the clinician with a consensus review of probiotics and recommendations for their use in gastroenterology...
January 16, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28099974/temporary-vacuum-assisted-closure-of-the-open-abdomen-in-neonates
#16
Kengo Hattori, Alp Numanoglu, Sharon Cox
Introduction The need for open abdomen in the treatment of severely ill neonates will increase in time as more complex abdominal procedures are undertaken. However, the experience of temporary closure of an open abdomen using vacuum-assisted closure (VAC) system is still relatively limited in premature and term neonates. The aim of this study is to describe and review our experience in the use of temporary VAC of the open abdomen for neonates with varying pathological processes. Materials and Methods A retrospective folder review of all neonates treated with VAC for open abdomen over the study period of 2010 to 2014 at our institution was performed...
January 18, 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28056921/bifidobacterium-adolescentis-protects-against-necrotizing-enterocolitis-and-upregulates-tollip-and-sigirr-in-premature-neonatal-rats
#17
Wenshen Wu, Yanli Wang, Jingjing Zou, Fang Long, Huiheng Yan, Lijuan Zeng, Yunbin Chen
BACKGROUND: Necrotizing enterocolitis (NEC) is a serious gastrointestinal disorder that is often seen in premature infants. Probiotics decrease the risk of NEC; however, the mechanism by which probiotics work is not clear. The goal of this study was to evaluate the preventive effect of Bifidobacterium adolescentis in an NEC rat model. METHODS: Sprague-Dawley neonatal rats were obtained by caesarean section after 20-21 d gestation and randomly divided into the following 3 groups: dam fed (DF), formula fed (FF), and formula + B...
January 5, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28048964/variability-in-antibiotic-regimens-for-surgical-necrotizing-enterocolitis-highlights-the-need-for-new-guidelines
#18
Brian P Blackwood, Catherine J Hunter, Julia Grabowski
BACKGROUND: Necrotizing enterocolitis or NEC is the most common gastrointestinal emergency in the newborn. The etiology of NEC remains unknown, and treatment consists of antibiotic therapy and supportive care with the addition of surgical intervention as necessary. Unlike most surgical diseases, clear guidelines for the type and duration of peri-operative antibiotic therapy have not been established. Our aim was to review the antibiotic regimen(s) applied to surgical patients with NEC within a single neonatal intensive care unit (NICU) and to evaluate outcomes and help develop guidelines for antibiotic administration in this patient population...
February 2017: Surgical Infections
https://www.readbyqxmd.com/read/28029463/-tocolysis-for-preterm-labor-without-premature-preterm-rupture-of-membranes
#19
M Doret, G Kayem
OBJECTIVES: To propose guidelines for clinical practice for tocolysis in preterm labor without premature preterm rupture of the membranes (PPROM). MATERIALS AND METHODS: Bibliographic searches were performed in the Medline and Cochrane databases and gynecologist and obstetricians' international society guidelines. It is important to note that most studies included women in preterm labour with and without PPROM. RESULTS: Compared with placebo, tocolytics are not associated with a reduction in neonatal mortality or morbidity (LE2)...
October 28, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28001143/vital-signs-and-their-cross-correlation-in-sepsis-and-nec-a-study-of-1-065-very-low-birth-weight-infants-in-two-nicus
#20
Karen D Fairchild, Douglas E Lake, John Kattwinkel, J Randall Moorman, David A Bateman, Philip G Grieve, Joseph R Isler, Rakesh Sahni
BACKGROUND: Subtle changes in vital signs and their interactions occur in preterm infants prior to overt deterioration from late-onset septicemia (LOS) or necrotizing enterocolitis (NEC). Optimizing predictive algorithms may lead to earlier treatment. METHODS: For 1,065 very-low-birth-weight (VLBW) infants in two neonatal intensive care units (NICUs), mean, SD, and cross-correlation of respiratory rate, heart rate (HR), and oxygen saturation (SpO2) were analyzed hourly (131 infant-years' data)...
February 2017: Pediatric Research
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