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necrotizing enterocolitis treatment

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https://www.readbyqxmd.com/read/29304519/effect-of-n-acetylserotonin-on-tlr-4-and-myd88-expression-during-intestinal-ischemia-reperfusion-in-a-rat-model
#1
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
https://www.readbyqxmd.com/read/29301419/antenatal-magnesium-sulfate-is-beneficial-or-harmful-in-very-preterm-and-extremely-preterm-neonates-a-new-insight
#2
Bhawan Garg
Magnesium sulfate (MgSO4) is drug of choice for both prevention of eclampsia in women with severe preeclampsia and treatment of eclampsia. Antenatal MgSO4 is now emerging as popular neuroprotective agent in preterm neonates. However, recent studies reported an association of antenatal MgSO4 with feed intolerance, necrotizing enterocolitis and spontaneous intestinal perforation in extremely preterm neonates. In this review article, we discuss both aspects of antenatal MgSO4 in preterm neonates.
January 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29298457/predictive-value-of-a-persistent-tachycardia-to-indicate-impending-perforation-in-necrotizing-enterocolitis
#3
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
https://www.readbyqxmd.com/read/29298438/influence-of-pco2-control-on-clinical-and-neurodevelopmental-outcomes-of-extremely-low-birth-weight-infants
#4
Ulrich H Thome, Jens Dreyhaupt, 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, Benjamin Ackermann, Roland Hentschel, Matthias Heckmann, Rolf Schlösser, Jochen Peters, Rainer Rossi, Wolfgang Rascher, Ralf Böttger, Jürgen Seidenberg, Gesine Hansen, Harald Bode, Maria Zernickel, Rainer Muche, Helmut D Hummler
BACKGROUND: Levels or fluctuations in the partial pressure of CO2 (PCO2) may affect outcomes for extremely low birth weight infants. OBJECTIVES: In an exploratory analysis of a randomized trial, we hypothesized that the PCO2 values achieved could be related to significant outcomes. METHODS: On each treatment day, infants were divided into 4 groups: relative hypocapnia, normocapnia, hypercapnia, or fluctuating PCO2. Ultimate assignment to a group for the purpose of this analysis was made according to the group in which an infant spent the most days...
January 4, 2018: Neonatology
https://www.readbyqxmd.com/read/29275819/stem-cell-therapy-in-necrotizing-enterocolitis-current-state-and-future-directions
#5
Natalie A Drucker, Christopher J McCulloh, Bo Li, Agostino Pierro, Gail E Besner, Troy A Markel
Stem cell therapy is a promising treatment modality for necrotizing enterocolitis. Among the many promising stem cells identified to date, it is likely that mesenchymal stem cells will be the most useful and practical cell-based therapies for this condition. Using acellular components such as exosomes or other paracrine mediators are promising as well. Multiple mechanisms are likely at play in the positive effects provided by these cells, and further research is underway to further elucidate these effects.
February 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29275818/neurodevelopmental-considerations-in-surgical-necrotizing-enterocolitis
#6
Jamie R Robinson, Clark Kennedy, Kyle J van Arendonk, Alyssa Green, Camilia R Martin, Martin L Blakely
The majority of surviving infants with surgical necrotizing enterocolitis (NEC) will have some degree of neurodevelopmental impairment. The impact of specific medial and surgical treatments for infants with severe NEC remains largely unknown but is being actively investigated. It is incumbent upon all providers caring for these infants to continue to focus on long term neurodevelopmental outcomes and to develop more widespread methods of neurodevelopmental assessment.
February 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29275812/development-of-the-necrotizing-enterocolitis-society-registry-and-biorepository
#7
Matthew W Ralls, Samir K Gadepalli, Karl G Sylvester, Misty Good
Necrotizing enterocolitis (NEC) is a devastating disease affecting premature infants. New advances in diagnostic and treatment options are desperately needed. Accordingly, the NEC Society initiated a research collaborative with a group of investigators dedicated to advancing the state of NEC-associated knowledge. Recent advances in high-content molecular interrogation and bio-computation (e.g., genomics, transcriptomics, proteomics, and metabolomics) can provide new insights from afflicted infants with NEC, however, individual centers do not have sufficient cases to conduct these studies independently...
February 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29260286/bowel-ultrasound-for-predicting-surgical-management-of-necrotizing-enterocolitis-a-systematic-review-and-meta-analysis
#8
Alain C Cuna, Nidhi Reddy, Amie L Robinson, Sherwin S Chan
BACKGROUND: Necrotizing enterocolitis (NEC) is a devastating inflammatory disease of the intestinal tract that represents a significant source of morbidity and mortality in preterm infants. Imaging of the abdomen is valuable for timely diagnosis and close monitoring of disease progression in NEC. Bowel ultrasound (US) is increasingly being recognized as an important imaging tool for evaluating NEC that provides additional detail than plain abdominal radiographs. OBJECTIVE: To identify bowel US findings associated with surgical management or death in infants with NEC...
December 19, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29259371/probiotics-for-gastrointestinal-disorders-proposed-recommendations-for-children-of-the-asia-pacific-region
#9
REVIEW
Donald Cameron, Quak Seng Hock, Musal Kadim, Neelam Mohan, Eell Ryoo, Bhupinder Sandhu, Yuichiro Yamashiro, Chen Jie, Hans Hoekstra, Alfredo Guarino
Recommendations for probiotics are available in several regions. This paper proposes recommendations for probiotics in pediatric gastrointestinal diseases in the Asia-Pacific region. Epidemiology and clinical patterns of intestinal diseases in Asia-Pacific countries were discussed. Evidence-based recommendations and randomized controlled trials in the region were revised. Cultural aspects, health management issues and economic factors were also considered. Final recommendations were approved by applying the Likert scale and rated using the GRADE system...
December 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29241163/diagnosis-and-management-of-necrotizing-enterocolitis-an-international-survey-of-neonatologists-and-pediatric-surgeons
#10
Mélanie Valpacos, Delphine Arni, Amy Keir, Ann Aspirot, James C H Wilde, Spencer Beasley, Daniele De Luca, Riccardo E Pfister, Oliver Karam
BACKGROUND: Necrotizing enterocolitis (NEC) is a serious complication of prematurity. Currently, there is limited evidence to guide investigation and treatment strategies. OBJECTIVES: To evaluate the parameters used to diagnose or exclude NEC, and to identify differences between neonatologists and pediatric surgeons. METHODS: A scenario-based survey was sent to neonatologists and pediatric surgeons. RESULTS: 173 physicians from 26 countries completed the survey (55% neonatologists and 45% pediatric surgeons)...
December 15, 2017: Neonatology
https://www.readbyqxmd.com/read/29228827/conservative-versus-active-management-in-hellp-syndrome-results-from-a-cohort-study
#11
Marie Cavaignac-Vitalis, Fabien Vidal, M D Caroline Simon-Toulza, Pierre Boulot, Paul Guerby, Elodie Chantalat, Parant M D Olivier
OBJECTIVE: HELLP syndrome exposes to severe maternal and fetal complications. Prompt delivery is thus recommended after 34 weeks of gestation, or earlier in case of nonreassuring maternofetal conditions. However, no consensus has been raised in the treatment of HELLP syndrome occurring before 34 weeks of gestation, when both maternal and fetal conditions are stable: it remains still unclear whether an active attitude should be prioritized over expectant management. Herein we aimed to compare mother and child outcomes according to the type of obstetrical management, either active or conservative...
December 11, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29198543/exposure-to-gastric-acid-inhibitors-increases-the-risk-of-infection-in-preterm-very-low-birth-weight-infants-but-concomitant-administration-of-lactoferrin-counteracts-this-effect
#12
Paolo Manzoni, Ruben García Sánchez, Michael Meyer, Ilaria Stolfi, Lorenza Pugni, Hubert Messner, Silvia Cattani, Pasqua Maria Betta, Luigi Memo, Lidia Decembrino, Lina Bollani, Matteo Rinaldi, Maria Fioretti, Michele Quercia, Milena Maule, Elena Tavella, Alessandro Mussa, Chryssoula Tzialla, Nicola Laforgia, Fabio Mosca, Rosario Magaldi, Michael Mostert, Daniele Farina
OBJECTIVE: To investigate whether exposure to inhibitors of gastric acidity, such as H2 blockers or proton pump inhibitors, can independently increase the risk of infections in very low birth weight (VLBW) preterm infants in the neonatal intensive care unit. STUDY DESIGN: This is a secondary analysis of prospectively collected data from a multicenter, randomized controlled trial of bovine lactoferrin (BLF) supplementation (with or without the probiotic Lactobacillus rhamnosus GG) vs placebo in prevention of late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) in preterm infants...
November 30, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29196510/necrotizing-enterocolitis
#13
Barrie S Rich, Stephen E Dolgin
Necrotizing enterocolitis (NEC) is a frequently encountered condition in the premature neonate, which can have devastating effects. The signs and symptoms of NEC are variable and can be confused with those of sepsis. An abdominal radiograph is often obtained for diagnosis, and findings that indicate NEC include pneumatosis and portal venous gas. The treatment of NEC includes gastrointestinal rest, gastric decompression, broad-spectrum intravenous antibiotics, and systemic support. A finding of pneumoperitoneum signifies intestinal perforation, which requires surgical intervention...
December 2017: Pediatrics in Review
https://www.readbyqxmd.com/read/29152325/changes-of-intestinal-microbiota-composition-and-diversity-in-very-low-birth-weight-infants-related-to-strategies-of-nec-prophylaxis-protocol-for-an-observational-multicentre-pilot-study
#14
Stefan Kurath-Koller, Christine Moissl-Eichinger, Gregor Gorkiewicz, Raimund Kraschl, Claudia Kanduth, Barbara Hopfer, Berndt Urlesberger, Bernhard Resch
Background: At the Division of Neonatology, Department of Paediatrics, Medical University Graz, a unique regimen of necrotizing enterocolitis (NEC) prophylaxis in preterm infants showing a < 1500 g birth weight (i.e. very low birth weight, VLBW) is used. The regimen includes oral antibiotic and antifungal therapy and probiotic preparations as well as a standardised feeding regimen. The incidence of NEC in preterm infants treated by this regimen has been shown to be lower, reflecting 0...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29113524/how-does-preeclampsia-affect-neonates-highlights-in-the-disease-s-immunity
#15
Lina R Marins, Leonardo B Anizelli, Mariana D Romanowski, Ana L Sarquis
INTRODUCTION: Preeclampsia (PE) is the primary obstetrical cause in one of the four perinatal deaths. Although the etiology and pathogenesis of preeclampsia is not fully known, a proinflammatory immune state prevails and can disrupt fetal hematopoiesis. Some of the effects on the newborn include neonatal thrombocytopenia, neutropenia, a reduction in T regulatory cells, and an increased cytotoxic natural killer cell profile. METHODS: Electronic databases were searched, and defined criteria were applied to select articles for review...
November 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29089704/neonatal-gastrointestinal-perforations-the-10-year-experience-of-a-reference-hospital
#16
Mehmet Saraç, Ünal Bakal, Mustafa Aydın, Tugay Tartar, Aysen Orman, Erdal Taşkın, Şenay Canpolat, Ahmet Kazez
The aim of this study was to present our experiences with, as well as the factors that affect, the treatment and outcome of patients with neonatal gastrointestinal perforations (GIPs). Thirty-eight newborn cases that were operated on for GIP in our hospital's tertiary newborn intensive care unit between January 2005 and December 2015 were retrospectively evaluated. The patients were divided into the two following groups: group 1, perforations related to necrotizing enterocolitis (NEC), and group 2, non-NEC perforations...
October 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29072164/effects-of-a-lipid-emulsion-containing-fish-oil-on-polyunsaturated-fatty-acid-profiles-growth-and-morbidities-in-extremely-premature-infants-a-randomized-controlled-trial
#17
Svetlana Najm, Chatarina Löfqvist, Gunnel Hellgren, Eva Engström, Pia Lundgren, Anna-Lena Hård, Alexandre Lapillonne, Karin Sävman, Anders K Nilsson, Mats X Andersson, Lois E H Smith, Ann Hellström
BACKGROUND & AIMS: The purpose of the study was to compare the effects of the parenteral emulsion SMOFlipid®, with 15% fish oil, with Clinoleic® on retinopathy of prematurity (ROP) and other morbidities and growth, and to compare their impact on longitudinal serum levels of fatty acids. Retinopathy of prematurity, other morbidity and growth were correlated with each parenteral lipid supplement. METHODS: Ninety infants born at gestational age <28 weeks were randomized to treatment with SMOFlipid® or Clinoleic®...
August 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29044351/surgical-management-of-necrotizing-enterocolitis-in-an-incredibly-low-birth-weight-infant-and-review-of-the-literature
#18
A Zangari, C Noviello, S Nobile, G Cobellis, C Gulia, R Piergentili, S Gigli, V Carnielli
Survival of preterm infants have dramatically improved over the last decades. Nonetheless, infants born preterm remain vulnerable to many complications, including necrotizing enterocolitis (NEC). The severity of the disease and the mortality rate are directly correlated with decreasing gestational age and birth weight. Despite surgical treatment mortality rate remains very high in extremely premature infants, especially in newborns at the lowest limit of viability. Survival of infants of birth weight (BW) below 750 g has been increasingly reported in recent years, however the overall mortality in extremely low "BW" infants (ELBW) requiring surgery for NEC has not decreased over the past years...
September 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28985839/peritoneal-drainage-is-associated-with-higher-survival-rates-for-necrotizing-enterocolitis-in-premature-extremely-low-birth-weight-infants
#19
COMPARATIVE STUDY
Jun Tashiro, Amy E Wagenaar, Eduardo A Perez, Juan E Sola
BACKGROUND: To evaluate peritoneal drainage (PD) and laparotomy ± resection/ostomy (LAP) as initial approaches to the surgical management of necrotizing enterocolitis (NEC) in premature, extremely low birth weight (ELBW) infants. METHODS: Kids' Inpatient Database (2003-2012) was searched for cases of NEC (International Classification of Diseases, ninth revision, Clinical Modification [ICD-9-CM] 777.5x) in premature (<37 weeks), extremely low birth weight (<1000 g) infants...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28984754/late-presentation-of-necrotizing-enterocolitis-associated-with-rotavirus-infection-in-a-term-infant-with-hyperinsulinism-on-octreotide-therapy-a-case-report
#20
Abdulaziz A Alsaedi, Ayman A Bakkar, Naglaa M Kamal, Jwaher M Althobiti
RATIONALE: Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in infancy that can cause permanent brain damage. Consequently, optimal management is extremely important. Current pharmacologic and surgical treatment were available that included diazoxide and octreotides. PATIENT CONCERNS: A 4 month old Saudi male patient diagnosed at our hospital as CHI, treated with near total pancreatectomy and octreotide therapy of 30 mcg/kg/day presented with severe abdominal distension, vomiting and bloody diarrhea...
October 2017: Medicine (Baltimore)
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