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enterocolitis necrotizing

Richard You Wu, Bo Li, Yuhki Koike, Pekka Määttänen, Hiromu Miyake, Marissa Cadete, Kathene C Johnson-Henry, Steven R Botts, Carol Lee, Thomas R Abrahamsson, Eva Landberg, Agostino Pierro, Philip M Sherman
SCOPE: Necrotizing enterocolitis (NEC) is a leading cause of morbidity and death in preterm infants, occurring more often in formula-fed than breastfed infants. Studies in both rats and humans show that human milk oligosaccharides (HMOs) lower the incidence of NEC, but the mechanism underlying such protection is currently unclear. METHODS AND RESULTS: Here by extracting HMOs from pooled human breastmilk, we investigated the impact of HMOs on the intestinal mucin levels in a murine model of NEC...
November 8, 2018: Molecular Nutrition & Food Research
Jayasree Nair, Rachel Longendyke, Satyan Lakshminrusimha
Necrotizing enterocolitis (NEC) is a devastating morbidity usually seen in preterm infants, with extremely preterm neonates (EPT ≤28 weeks) considered at highest risk. Moderately preterm infants (MPT 28-34 weeks) constitute a large percentage of NICU admissions. In our retrospective data analysis of NEC in a single regional perinatal center, NEC was observed in 10% of extremely EPT and 7% of MPT, but only 0.7% of late-preterm/term admissions. There was an inverse relationship between postnatal age at onset of NEC and gestational age at birth...
2018: BioMed Research International
Ulf Kessler, Eva-Maria Hau, Marcin Kordasz, Stephanie Haefeli, Catherine Tsai, Peter Klimek, Dietmar Cholewa, Mathias Nelle, Mladen Pavlovic, Steffen Berger
Background: Studies on the influence of congenital heart disease (CHD) on neonates with necrotizing enterocolitis (NEC) have produced varied results. We therefore examined the influence of CHD on NEC outcomes. Methods: We carried out a retrospective single-center study including infants with confirmed NEC, treated between 2004 and 2017. We excluded patients with isolated patent ductus arteriosus or pulmonary hypertension ( n = 45) and compared outcomes of patients with hemodynamically relevant CHD ( n = 38) and those without CHD ( n = 91)...
2018: Frontiers in Pediatrics
Elena Biagi, Arianna Aceti, Sara Quercia, Isadora Beghetti, Simone Rampelli, Silvia Turroni, Matteo Soverini, Angelo Vittorio Zambrini, Giacomo Faldella, Marco Candela, Luigi Corvaglia, Patrizia Brigidi
Mother's own milk represents the optimal source for preterm infant nutrition, as it promotes immune defenses and gastrointestinal function, protects against necrotizing enterocolitis, improves long-term clinical outcome and is hypothesized to drive gut microbiota assembly. Preterm infants at birth usually do not receive their mother's milk directly from the breast, because active suckling and coordination between suckling, swallowing and breathing do not develop until 32-34 weeks gestational age, but actual breastfeeding is usually possible as they grow older...
2018: Frontiers in Microbiology
Catalina Bazacliu, Josef Neu
NEC is a devastating disease that, once present, is very difficult to treat. In the absence of an etiologic treatment, preventive measures are required. Advances in decoding the pathophysiology of NEC are being made but a more comprehensive understanding is needed for the targeting of preventative strategies. A better definition of the disease as well as diagnostic criteria are needed to be able to specifically label a disease as NEC. Multiple environmental factors combined with host susceptibility appear to contribute to enhanced risks for developing this disease...
November 2, 2018: Current Pediatric Reviews
G De Bernardo, D Sordino, C De Chiara, M Riccitelli, F Esposito, M Giordano, A Tramontano
Necrotizing enterocolitis is the most common cause of the postnatal critical conditions and remains one of the dominant cause of newborns' death in Neonatal Intensive Care. The morbidity and mortality associated with necrotizing enterocolitis remains largely unchanged and the incidence of necrotizing enterocolitis continues to increase. There is no general agreement regarding the surgical treatment of the necrotizing enterocolitis. In this paper, we want to evaluate the results obtained in our centre from different types of necrotizing enterocolitis's surgical treatment and to analyse the role of traditional X-ray versus ultrasound doppler imaging in the evolutionary phases of necrotizing enterocolitis...
November 2, 2018: Current Pediatric Reviews
E Lorthe
OBJECTIVES: To synthetize the available evidence regarding the incidence and risk factors of preterm premature rupture of membranes (PPROM). To describe the evolution of pregnancy, neonatal outcomes and the prognosis of infants born in a context of PPROM, according to the existence of an associated intrauterine infection and to the latency duration. METHOD: Consultation of the Medline database, from 1980 to February 2018. RESULTS: PPROM before 37 and before 34 weeks' gestation occur in 2-3% and <1% of pregnancies, respectively (LE2)...
October 29, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Sara K Berkelhamer, Karen K Mestan, Robin Steinhorn
The past decade of neonatal care has been highlighted by increased survival rates in smaller and more premature infants. Despite reduction in mortality associated with extreme prematurity, long term pulmonary morbidities remain a concern, with growing recognition of the clinical burden attributable to infants with bronchopulmonary dysplasia (BPD)-associated pulmonary hypertension (PH). Recent publications shed light on the critical contributions of maternal placental pathology and compromised intrauterine growth to fetal pulmonary vascular development...
October 4, 2018: Seminars in Perinatology
Bo Li, Fang Zhou Yu, Adam Minich, Alison Hock, Carol Lee, Agostino Pierro
Maternal separation (MS) is a well-studied phenomenon thought to play a role in the pathogenesis of many diseases ranging from neuropsychiatric to early intestinal disorders such as necrotizing enterocolitis. The existing evidence suggests that MS initiates a variety of processes that in turn lead to early intestinal injury. Although there are many theories as to how MS alters normal physiological processes, the exact mechanism of action remains to be elucidated. This review aims to describe some of the pathological processes affecting the intestine that are caused by MS, including: (i) brain-gut axis, (ii) intestinal epithelial barrier function, (iii) microbiome, (iv) oxidative stress and endoplasmic reticulum stress, and (v) gut inflammation...
November 1, 2018: Canadian Journal of Physiology and Pharmacology
Bo Li, Carol Lee, Marissa Cadete, Hiromu Miyake, Dorothy Lee, Agostino Pierro
BACKGROUND: Adult intestinal organoids have been used to study ex vivo intestinal injury in adulthood. However, the neonatal intestinal epithelium has many unique features that are different from adult mature intestine. Establishing a neonatal ex vivo organoid model is essential to study the epithelial physiology in early postnatal development and to investigate derangements associated with disease processes during the neonatal period like necrotizing enterocolitis (NEC). METHODS: Fresh and frozen terminal ileum was harvested from mice pups on postnatal day 9...
October 31, 2018: Pediatric Surgery International
Abhishek Somasekhara Aradhya, Kanya Mukhopadhyay, Shiv Sajan Saini, Venkataseshan Sundaram, Sourabh Dutta, Praveen Kumar
BACKGROUND: Feed intolerance is common in growth-restricted infants with antenatal AREDF (absent or reverse end-diastolic flow) and presumed to be more severe in those with reverse end diastolic flow (REDF). Natural history of feeding in REDF is rarely reported in the literature. AIMS AND OBJECTIVES: To determine the incidence of feed intolerance and necrotizing enterocolitis (NEC) in neonates with antenatal REDF. DESIGN: Preterm inborn neonates with gestation <37 weeks with antenatal REDF diagnosed between January 2015 and September 2017 were included in this retrospective cohort study...
October 29, 2018: Journal of Maternal-fetal & Neonatal Medicine
Li Wang, Shen-Wang Ni, Ke-Ran Zhu, Deng-Yu Zhou, Yang Wang, Li-Li Wang
OBJECTIVE: To study the changes in C-reactive protein (CRP) and procalcitonin (PCT) levels in neonates with necrotizing enterocolitis (NEC) and their clinical significance. METHODS: According to the modified Bell's staging criteria, 142 neonates with NEC were divided into stage I group (n=40), stage II group (n=72), and stage III group (n=30). All the 18 neonates who underwent surgical treatment had stage III NEC, and among the 124 neonates who underwent conservative treatment, 12 had stage III NEC and the others had stage I or II NEC...
October 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Anders Brunse, Lena Martin, Torben Sølbeck Rasmussen, Lars Christensen, Malene Skovsted Cilieborg, Maria Wiese, Bekzod Khakimov, Robert Pieper, Dennis Sandris Nielsen, Per Torp Sangild, Thomas Thymann
This study examined gut colonization patterns and host responses to fecal microbiota transplantation (FMT) by different administration routes after preterm birth. In two separate experiments, cesarean-delivered, preterm pigs were administered combined oral + rectal, or exclusively rectal donor feces, and compared with saline controls. After 5 days, stomach and colon bacterial compositions were determined by 16S rRNA gene amplicon sequencing, and organic acid metabolites measured. Further, gut pathology, mucosa bacterial adherence, and goblet cell density were assessed...
October 26, 2018: ISME Journal
Joann Romano-Keeler, Meghan H Shilts, Andrey Tovchigrechko, Chunlin Wang, Robert M Brucker, Daniel J Moore, Christopher Fonnesbeck, Shufang Meng, Hernan Correa, Harold N Lovvorn, Yi-Wei Tang, Lora Hooper, Seth R Bordenstein, Suman R Das, Jörn-Hendrik Weitkamp
OBJECTIVE: Necrotizing enterocolitis (NEC) is the most common surgical emergency in preterm infants, and pathogenesis associates with changes in the fecal microbiome. As fecal samples incompletely represent microbial communities in intestinal mucosa, we sought to determine the NEC tissue-specific microbiome and assess its contribution to pathogenesis. DESIGN: We amplified and sequenced the V1-V3 hypervariable region of the bacterial 16S rRNA gene extracted from intestinal tissue and corresponding fecal samples from 12 surgical patients with NEC and 14 surgical patients without NEC...
2018: PloS One
Ghassan Nakib, Sameer Sajwani, Zahreddin Abusalah, Abdelazeim Abdallah, Nada Ibrahim, Aseel Fattah, Rossana Bussani, Valeria Calcaterra, Gloria Pelizzo
Insufficiency in mesenteric flow is a risk factor for the development of necrotizing enterocolitis (NEC). Recurrent episodes of supraventricular tachycardia (SVT) can lead to gut ischemia, with subsequent reperfusion injury. We present a term infant who developed NEC at 37 days of life after refractory SVT and reverted to sinus rhythm on day 23 and 25 of life. Resected stenotic ileum and transverse colon demonstrated inflammation with ischemia. This is the first case of NEC following SVT in a term infant without a congenital morphologic abnormality...
September 25, 2018: Pediatric Reports
Dale L Phelps, Kristi L Watterberg, Tracy L Nolen, Carol A Cole, C Michael Cotten, William Oh, Brenda B Poindexter, Kristin M Zaterka-Baxter, Abhik Das, Conra Backstrom Lacy, Ann Marie Scorsone, Michele C Walsh, Edward F Bell, Kathleen A Kennedy, Kurt Schibler, Gregory M Sokol, Matthew M Laughon, Satyanarayana Lakshminrusimha, William E Truog, Meena Garg, Waldemar A Carlo, Abbot R Laptook, Krisa P Van Meurs, David P Carlton, Amanda Graf, Sara B DeMauro, Luc P Brion, Seetha Shankaran, Faruk H Orge, Richard J Olson, Helen Mintz-Hittner, Michael B Yang, Kathryn M Haider, David K Wallace, Mina Chung, Denise Hug, Irena Tsui, Martin S Cogen, John P Donahue, Michael Gaynon, Amy K Hutchinson, Don L Bremer, Graham Quinn, Yu-Guang He, William R Lucas, Timothy W Winter, Stephen D Kicklighter, Kartik Kumar, Patricia R Chess, Tarah T Colaizy, Anna Marie Hibbs, Namasivayam Ambalavanan, Heidi M Harmon, Elisabeth C McGowan, Rosemary D Higgins
Importance: Previous studies of myo-inositol in preterm infants with respiratory distress found reduced severity of retinopathy of prematurity (ROP) and less frequent ROP, death, and intraventricular hemorrhage. However, no large trials have tested its efficacy or safety. Objective: To test the adverse events and efficacy of myo-inositol to reduce type 1 ROP among infants younger than 28 weeks' gestational age. Design, Setting, and Participants: Randomized clinical trial included 638 infants younger than 28 weeks' gestational age enrolled from 18 neonatal intensive care centers throughout the United States from April 17, 2014, to September 4, 2015; final date of follow-up was February 12, 2016...
October 23, 2018: JAMA: the Journal of the American Medical Association
Erik Wejryd, Magalí Martí, Giovanna Marchini, Anna Werme, Baldvin Jonsson, Eva Landberg, Thomas R Abrahamsson
Difference in human milk oligosaccharides (HMO) composition in breast milk may be one explanation why some preterm infants develop necrotizing enterocolitis (NEC) despite being fed exclusively with breast milk. The aim of this study was to measure the concentration of 15 dominant HMOs in breast milk during the neonatal period and investigate how their levels correlated to NEC, sepsis, and growth in extremely low birth weight (ELBW; <1000 g) infants who were exclusively fed with breast milk. Milk was collected from 91 mothers to 106 infants at 14 and 28 days and at postmenstrual week 36...
October 20, 2018: Nutrients
Eduardo Cuestas, Belén Aguilera, Manuel Cerutti, Alina Rizzotti
OBJECTIVE: To determine whether a sustained neonatal systemic inflammatory response was associated with poor postnatal growth among infants born very preterm during the first year of life. STUDY DESIGN: We studied prospectively 192 infants born preterm (birth weight ≤1.5 kg and gestational age ≤31 weeks). Weight, length, and head circumference were measured at birth, term, 4, and 12 months of corrected age. Serial C-reactive protein and procalcitonin were measured at 1, 3, 7, 14, and 28 days of age and averaged for each infant...
October 16, 2018: Journal of Pediatrics
Ronald I Clyman, Melissa Liebowitz, Joseph Kaempf, Omer Erdeve, Ali Bulbul, Stellan Håkansson, Johanna Lindqvist, Aijaz Farooqi, Anup Katheria, Jason Sauberan, Jaideep Singh, Kelly Nelson, Andrea Wickremasinghe, Lawrence Dong, Denise C Hassinger, Susan W Aucott, Madoka Hayashi, Anne Marie Heuchan, William A Carey, Matthew Derrick, Erika Fernandez, Meera Sankar, Tina Leone, Jorge Perez, Arturo Serize
OBJECTIVE: To compare early routine pharmacologic treatment of moderate-to-large patent ductus arteriosus (PDA) at the end of week 1 with a conservative approach that requires prespecified respiratory and hemodynamic criteria before treatment can be given. STUDY DESIGN: A total of 202 neonates of <28 weeks of gestation age (mean, 25.8 ± 1.1 weeks) with moderate-to-large PDA shunts were enrolled between age 6 and 14 days (mean, 8.1 ± 2.2 days) into an exploratory randomized controlled trial...
October 16, 2018: Journal of Pediatrics
Ahizechukwu C Eke, Jeanne Sheffield, Ernest M Graham
INTRODUCTION: To evaluate whether there are additional benefits of 17-hydroxyprogesterone caproate (17-OHPC) supplementation in preventing recurrent spontaneous preterm birth in women with a prophylactic cerclage. MATERIAL AND METHODS: Electronic databases (MEDLINE, Scopus, ClinicalTrials gov, PROSPERO, EMBASE, Scielo and the Cochrane Central Register of Controlled Trials) were searched for studies published before June 2018. Keywords included "preterm birth," "prophylactic cerclage," "history-indicated cerclage," "pregnancy" and "17-hydroxyprogesterone caproate...
October 19, 2018: Acta Obstetricia et Gynecologica Scandinavica
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