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necrotizing enterocolitis treatment

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https://www.readbyqxmd.com/read/28422949/heparin-binding-egf-like-growth-factor-promotes-neuronal-nitric-oxide-synthase-expression-and-protects-the-enteric-nervous-system-after-necrotizing-enterocolitis
#1
Yu Zhou, Yijie Wang, Jacob Olson, Jixin Yang, Gail E Besner
BACKGROUND: Neonatal necrotizing enterocolitis (NEC) is associated with alterations of the ENS, with loss of neuronal nitric oxide synthase (nNOS) expressing neurons in the intestine. The aims of this study were to investigate the roles of heparin binding EGF-like growth factor (HB-EGF) in neural stem cell (NSC) differentiation, nNOS expression, and effects on ENS integrity during experimental NEC. METHODS: The effects of HB-EGF on NSC differentiation and nNOS production were determined using cultured enteric NSC...
April 19, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28419427/how-i-manage-children-with-neutropenia
#2
REVIEW
David C Dale
Neutropenia, usually defined as a blood neutrophil count <1·5 × 10(9) /l, is a common medical problem for children and adults. There are many causes for neutropenia, and at each stage in life the clinical pattern of causes and consequences differs significantly. I recommend utilizing the age of the child and clinical observations for the preliminary diagnosis and primary management. In premature infants, neutropenia is quite common and contributes to the risk of sepsis with necrotizing enterocolitis...
April 17, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28410788/independence-of-gut-bacterial-content-and-neonatal-necrotizing-enterocolitis-severity
#3
Lauren K Barron, Barbara B Warner, Phillip I Tarr, William D Shannon, Elena Deych, Brad W Warner
INTRODUCTION: Necrotizing enterocolitis (NEC) is a common and devastating gastrointestinal disease of premature infants. NEC severity varies widely. Recent data have demonstrated a strong link between gut microbial dysbiosis and development of NEC. We tested the hypothesis that alterations in the gut microbiome at the time of diagnosis predict the severity of NEC. METHODS: We used prospectively collected fecal samples from very low birth weight infants who developed NEC, stratifying by NEC severity...
April 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28396025/prophylactic-indomethacin-compared-with-delayed-conservative-management-of-the-patent-ductus-arteriosus-in-extremely-preterm-infants-effects-on-neonatal-outcomes
#4
Melissa Liebowitz, Ronald I Clyman
OBJECTIVE: To determine whether prophylactic indomethacin (PINDO) has more or less morbidity than delayed conservative management of the moderate-to-large patent ductus arteriosus (PDA). STUDY DESIGN: We performed a prospective double cohort controlled study of infants delivered at ≤27(6/7) weeks gestation (n = 397). From January 2005 through April 2011, all infants were treated with PINDO (n = 247). From May 2011 through August 2016, no infant was treated with indomethacin until at least 8 postnatal days (conservative epoch, n = 150)...
April 7, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28377234/potential-biomarkers-for-effective-screening-of-neonatal-sepsis-infections-an-overview
#5
REVIEW
Nidhi Chauhan, Sukirti Tiwari, Utkarsh Jain
Neonatal sepsis, a clinical disorder developed by bacterial blood stream infections (BSI) in neonates, is one of the serious global public health problems that must be addressed. More than one million of the estimated global newborn deaths per year are occurred due to severe infections. The genesis of the infection is divided into early-onset sepsis (EOS) and late-onset sepsis (LOS) of the disease. The clinical complications of neonatal sepsis may be associated with bronchopulmonary dysplasia, ductus arteriosus and necrotizing enterocolitis...
April 1, 2017: Microbial Pathogenesis
https://www.readbyqxmd.com/read/28362356/severe-pneumonia-caused-by-influenza-a-h1n1-virus-successfully-managed-with-extracorporeal-life-support-in-a-comorbid-former-preterm-infant
#6
Genny Raffaeli, Giacomo Cavallaro, Lorenza Pugni, Ernesto Leva, Andrea Artoni, Simona Neri, Chiara Baracetti, Mauro Cotza, Valerio Gentilino, Leonardo Terranova, Susanna Esposito, Fabio Mosca
Influenza A (H1N1) virus infection is a global health burden, leading to significant pediatric morbidity and mortality. Prematurity, young age and comorbidities are important risk factors for unfavorable outcomes. Preventive strategies, such as healthcare workers and household contacts vaccination as well as the implementation of infection control practices during the epidemic season, are crucial to protect the most vulnerable populations. Early diagnosis, timely administration of antiviral drugs and supportive therapy are crucial to lead to a complete recovery...
March 31, 2017: International Journal of Environmental Research and Public Health
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
#7
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
#8
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
#9
MULTICENTER STUDY
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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