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necrotizing enterocolitis treatment

Chengzhi Fang, Lili Xie, Chunmei Liu, Chunhua Fu, Wei Ye, Hong Liu, Binghong Zhang
Neonatal necrotizing enterocolitis (NEC) is a severe acquired disease that predominantly affects the small intestine of neonates. NEC is caused by a combination of metabolic products, dysfunctions of the blood vessels, mucus and other unknown factors. Berberine may induce beneficial effects on necrotic and cardiovascular diseases due to its anti-inflammatory and anti-apoptotic effects on epithelial cells. In the present study, the therapeutic effects of berberine were investigated and the potential mechanisms by which it functions within a neonatal NEC mouse model were analyzed...
April 2018: Experimental and Therapeutic Medicine
Annika Mutanen, Agostino Pierro, Augusto Zani
Necrotizing enterocolitis (NEC) is a devastating condition that mainly affects premature infants. Advanced cases of NEC require surgical treatment, which in up to 70% of infants is associated with significant perioperative morbidity including anastomosis- or enterostomy-related complications, sepsis, peritonitis, and wound infections. Moreover, the perioperative complications may compromise the long-term gastrointestinal and neurodevelopmental outcome of patients requiring surgery for NEC.
March 13, 2018: European Journal of Pediatric Surgery
Deonne Dersch-Mills, Belal Alshaikh, Amuchou S Soraisham, Albert Akierman, Kamran Yusuf
Background: There is no injectable ibuprofen product marketed to treat patent ductus arteriosus (PDA) in newborns in Canada. The authors' institution has used ibuprofen arginine in the past. In the absence of published evidence supporting use of this salt form of ibuprofen for neonatal PDA, a retrospective analysis was undertaken. Objective: To compare the effectiveness and adverse effects of ibuprofen arginine, ibuprofen tromethamine, and indomethacin in the treatment of PDA...
January 2018: Canadian Journal of Hospital Pharmacy
Wei-Cheng Lu, Xu Zheng, Jin-Fu Liu, Wen-Chuan Wu, Xing-Yue Chen, Hai-Bo Wei, Chun-Lei Li, Ming-Jing Lin
OBJECTIVE: To study the effect of Bifidobacterium on the expression of β-defensin-2 (BD-2) in intestinal tissue of neonatal rats with necrotizing enterocolitis (NEC). METHODS: A total of 40 rats were randomly divided into four groups: normal control, Bifidobacterium control, NEC model, and Bifidobacterium treatment, with 10 rats in each group. A rat model of NEC was induced by hypoxia, cold stimulation, and artificial feeding. The rats in the Bifidobacterium control and Bifidobacterium treatment groups were given Bifidobacterium via the gastric tube after cold stimulation once a day for three consecutive days...
March 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Ariel A Salas, Peng Li, Kelli Parks, Charitharth V Lal, Camilia R Martin, Waldemar A Carlo
Background: Due to insufficient evidence, extremely preterm infants (≤28 wk of gestation) rarely receive early progressive feeding (small increments of feeding volumes between 1 and 4 d after birth). We hypothesized that early progressive feeding increases the number of full enteral feeding days in the first month after birth. Objective: The aim of this study was to determine the feasibility and efficacy of early progressive feeding in extremely preterm infants...
February 24, 2018: American Journal of Clinical Nutrition
Siva Prasad Vyasam, Thangaraj Abiramalatha, Nalapalu Srinivasan Hema, Niranjan Thomas
BACKGROUND: Cytomegalovirus (CMV) enterocolitis is rare in term neonates. CASE CHARACTERISTICS: A term newborn with persistent pneumonia from birth developed enterocolitis on day 18 of life. OUTCOME: Polymerase chain reaction (PCR) for CMV DNA was positive in urine sample. Antiviral therapy for six weeks resulted in successful treatment without any stricture formation. MESSAGE: CMV enterocolitis should be considered as a differential diagnosis in atypical cases of necrotizing enterocolitis in neonates...
February 15, 2018: Indian Pediatrics
Charlotte S Schömig, Marie-Ève Robinson, Julia E von Oettingen
Congenital hypothyroidism requires prompt treatment to prevent adverse health outcomes. Poor intestinal levothyroxine absorption can complicate management. We present a case of a term female newborn with necrotizing enterocolitis (NEC) requiring subtotal ileum resection. Congenital hypothyroidism was diagnosed by newborn screening. Treatment was complicated by intestinal malabsorption of levothyroxine. Intravenous levothyroxine substitution restored euthyroidism and supraphysiologic PO doses subsequently maintained a euthyroid state...
2018: Endocrinology, Diabetes & Metabolism Case Reports
Daniel Johannes Cornelis Berkhout, Hendrik Johannes Niemarkt, Nanne Klaas de Boer, Marc Alexander Benninga, Timotheüs Gualtherus Jacob de Meij
Although the exact pathophysiological mechanisms of both necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) in preterm infants are yet to be elucidated, evidence is emerging that the gut microbiota plays a key role in their pathophysiology. Areas covered: In this review, initial microbial colonization and factors influencing microbiota composition are discussed. For both NEC and LOS, an overview of studies investigating preclinical alterations in gut microbiota composition and fecal volatile organic compounds (VOCs) is provided...
February 28, 2018: Expert Review of Gastroenterology & Hepatology
Letizia Capasso, Angela C Borrelli, Maria R Pirozzi, Laura Bucci, Roberta Albachiara, Teresa Ferrara, Francesco Raimondi
BACKGROUND: Immunoglobulin supplementation is a debated strategy in fighting sepsis. We evaluated a polyclonal IgM and IgA enriched immunoglobulin (IgMeIVIG) preparation in reducing the short term mortality in extremely low birth weight neonates (ELBW) with proven infection. METHODS: ELBW infants born from January 2008 to December 2014 were eligible for this retrospective casecontrol analysis if they were symptomatic and had a positive blood culture after 72hours of life...
February 19, 2018: Minerva Pediatrica
James M Edwards, Laura E Edwards, Geeta K Swamy, Chad A Grotegut
OBJECTIVE: We examined the effects of magnesium sulfate on non-neurologic neonatal outcomes with respect to cord blood magnesium level. STUDY DESIGN: We conducted a secondary analysis of the Maternal-Fetal Medicine Units Beneficial Effects of Antenatal Magnesium (MFMU BEAM) trial comparing the upper and lower quintiles of cord blood magnesium level. Outcomes included cerebral palsy (CP), necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), and assessments of mental and motor disability...
February 12, 2018: American Journal of Perinatology
Karien E A Hack, Marijn E M S Vereycken, Helen L Torrance, Corine Koopman-Esseboom, Jan B Derks
INTRODUCTIO: The aim of this study was to compare pregnancy outcomes in twin pregnancies after ACand spontaneous conception, according to chorionicity. MATERIAL AND METHODS: Retrospective cohort study of 1305 twin pregnancies between 1995 and 2015. All spontaneous (n=731) and assisted conception conceived twin pregnancies (n=574) with antenatal care and delivery in University Medical Center Utrecht, The Netherlands, a tertiary obstetric care center were studied according to chorionicity...
February 11, 2018: Acta Obstetricia et Gynecologica Scandinavica
Xin Gan, Juan Li
Necrotizing enterocolitis (NEC) is a catastrophic disease caused by a variety of factors in neonates, especially preterm infants. Severe NEC has a high fatality rate, and most survivors may face short- and long-term adverse prognosis. Risk factors for NEC include preterm birth, non-breastfeeding, microbial abnormalities in the digestive tract, and ischemia-reperfusion injury. High-resolution abdominal ultrasound helps with the early diagnosis of NEC. The preventive measures for NEC include protecting the intestinal mucosa through nutritional intervention, interfering with intestinal injury signals, changing intestinal microflora, and performing early minimal enteral nutrition...
February 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Yingwang Ye, Na Ling, Jina Gao, Maofeng Zhang, Xiyan Zhang, Liaowang Tong, Dexin Ou, Yaping Wang, Jumei Zhang, Qingping Wu
Cronobacter sakazakii is associated with severe infections including sepsis, neonatal meningitis, and necrotizing enterocolitis. Antibiotic resistance in Cronobacter species has been documented in recent years, but the genes involved in resistance in Cronobacter strains are poorly understood. In this study, we determined the role of outer membrane protein W (OmpW) on survival rates, morphologic changes, and biofilm formation between wild type (WT) and an OmpW mutant strain (ΔOmpW) under neomycin sulfate stress...
February 7, 2018: Journal of Dairy Science
Antje Allendorf, Ruth Dewitz, Joy Weber, Shahrzad Bakthiar, Rolf Schloesser, Udo Rolle
PURPOSE: Necrotizing enterocolitis (NEC) in very low birth weight infants is a risk factor for developmental delay. To our knowledge, there are no studies published investigating the neurodevelopmental outcome of patients with NEC comparing surgically treated and conservatively treated patients versus match paired controls. The aim of this retrospective case control study was to measure the neurodevelopmental outcome of patients with NEC who were treated surgically or conservatively METHODS: All patients were identified, who have been diagnosed with NEC (ICD-10 code, P77) born between 2006 and 2013...
January 31, 2018: Journal of Pediatric Surgery
Xiaoyu Pan, Desheng Gong, Duc Ninh Nguyen, Xinxin Zhang, Qi Hu, Hanlin Lu, Merete Fredholm, Per T Sangild, Fei Gao
Epigenetic regulation may play an important role in mediating microbe-host interactions and adaptation of intestinal gene expression to bacterial colonization just after birth. This is particularly important after preterm birth because the immature intestine is hypersensitive to invading bacteria. We compared the intestinal DNA methylome and microbiome between conventional (CON) and antibiotics-treated (AB) preterm pigs, used as a model for preterm infants. Oral AB treatment reduced bacterial density (∼100-fold), diversity and fermentation, improved the resistance to necrotizing enterocolitis (NEC) and changed the genome-wide DNA methylation in the distal small intestine...
January 19, 2018: DNA Research: An International Journal for Rapid Publication of Reports on Genes and Genomes
Leena B Mithal, Ram Yogev, Hannah L Palac, Daniel Kaminsky, Ilan Gur, Karen K Mestan
BACKGROUND: Nonspecific clinical signs and suboptimal diagnostic tests limit accurate identification of late onset sepsis (LOS) and necrotizing enterocolitis (NEC) in premature infants, resulting in significant morbidity and antibiotic overuse. An infant's systemic inflammatory response may be identified earlier than clinical suspicion through analysis of multiple vital signs by a computerized algorithm (RALIS). AIM: To evaluate the revised RALIS algorithm for detection of LOS and NEC in preterm infants...
January 16, 2018: Early Human Development
Soo Jung Kang, Young Sun Cho, Seo Jung Hwang, Hyo Jin Kim
Background: To evaluate the outcomes of left ventricular (LV) function according to treatment response for a hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. Methods: Echocardiograms of 21 preterm infants born at gestational age < 31 weeks obtained at term-equivalent age were retrospectively studied. Among preterm infants with a hsPDA, 9 underwent ligation after failure of pharmacological closure (ligation group) and 6 experienced successful pharmacological closure (medication group)...
December 2017: Journal of Cardiovascular Ultrasound
Igor Sukhotnik, Yoav Ben Shahar, Salim Halabi, Nir Bitterman, Tatiana Dorfman, Yulia Pollak, Arnold Coran, Arie Bitterman
BACKGROUND:  Accumulating evidence indicates that changes in intestinal toll-like receptors (TLRs) precede histological injury in a rodent model of necrotizing enterocolitis. N-acetylserotonin (NAS) is a naturally occurring chemical intermediate in the biosynthesis of melatonin. A recent study has shown that treatment with NAS prevents gut mucosal damage and inhibits programmed cell death following intestinal ischemia-reperfusion (IR). The objective of this study was to determine the effects of NAS on TLR-4, myeloid differentiation factor 88 (Myd88), and TNF-α receptor-associated factor 6 (TRAF6) expression in intestinal mucosa following intestinal IR in a rat...
January 5, 2018: European Journal of Pediatric Surgery
Bhawan Deep Garg
AIMS: To evaluate whether antenatal MgSO4 is beneficial or harmful in very preterm and extremely preterm neonates. MATERIALS AND METHODS: We retrieved published literature through searches of PubMed or Medline, CINAHL, and the Cochrane Library. Results were restricted to systematic reviews, meta-analysis, randomized controlled trials (RCTs), and relevant observational studies. RESULTS: Evidence revealed that antenatal MgSO4 has neuroprotective role in preterm neonates and it decreased the risk of cerebral palsy and gross motor dysfunction...
January 17, 2018: Journal of Maternal-fetal & Neonatal Medicine
Francisca van der Schyff, Jan Henrik Raynor Becker
INTRODUCTION:  Necrotizing enterocolitis (NEC) is a devastating disease of infancy. Full-thickness bowel wall necrosis may lead to perforation, peritonitis, and death. Timeous clinical diagnosis of impending perforation is imperative. OBJECTIVE:  The objective of this study was to determine whether a persistent tachycardia in an infant with proven NEC is indicative of full-thickness bowel wall necrosis and therefore impending perforation. STUDY DESIGN:  This study was conducted at the University of Pretoria academic hospitals...
January 3, 2018: American Journal of Perinatology
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