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Necrotising enterocolitis

Anne Synnes, Thuy Mai Luu, Diane Moddemann, Paige Church, David Lee, Michael Vincer, Marilyn Ballantyne, Annette Majnemer, Dianne Creighton, Junmin Yang, Reginald Sauve, Saroj Saigal, Prakesh Shah, Shoo K Lee
OBJECTIVES: Identify determinants of neurodevelopmental outcome in preterm children. METHODS: Prospective national cohort study of children born between 2009 and 2011 at <29 weeks gestational age, admitted to one of 28 Canadian neonatal intensive care units and assessed at a Canadian Neonatal Follow-up Network site at 21 months corrected age for cerebral palsy (CP), visual, hearing and developmental status using the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III)...
October 6, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Vidya Ramasamy, Harvey Teo, Victor Samuel Rajadurai, Suresh Chandran
A female preterm infant was born to a non-consanguineous couple at 35 weeks of gestation. On day 8 of life, while on full feeds, she developed prolonged apnoea and bradycardia, requiring respiratory support. Her abdomen was soft with unremarkable serial abdominal X-rays. Her septic screen was negative. Metabolic acidosis was worsening despite treatment. Echocardiography showed evidence of high pulmonary pressures. With further deterioration, an ultrasound scan of the abdomen was requested in view of the rising suspicion of abdominal pathology in the absence of sepsis and metabolic disorders...
2016: BMJ Case Reports
Katherine L Brown, Christina Pagel, Rhian Brimmell, Kate Bull, Peter Davis, Rodney C Franklin, Aparna Hoskote, Natasha Khan, Warren Rodrigues, Sara Thorne, Liz Smith, Linda Chigaru, Martin Utley, Jo Wray, Victor Tsang, Andrew Mclean
BACKGROUND: Morbidity is defined as a state of being unhealthy or of experiencing an aspect of health that is "generally bad for you", and postoperative morbidity linked to paediatric cardiac surgery encompasses a range of conditions that may impact the patient and are potential targets for quality assurance. METHODS: As part of a wider study, a multi-disciplinary group of professionals aimed to define a list of morbidities linked to paediatric cardiac surgery that was prioritised by a panel reflecting the views of both professionals from a range of disciplines and settings as well as parents and patients...
September 29, 2016: Cardiology in the Young
Nor Rosidah Ibrahim, Tan Hooi Kheng, Ariffin Nasir, Noraida Ramli, Jimmy Lee Kok Foo, Sharifah Huda Syed Alwi, Hans Van Rostenberghe
OBJECTIVE: To determine whether feeding with 2-hourly or 3-hourly feeding interval reduces the time to achieve full enteral feeding and to compare their outcome in very low birthweight preterm infants. DESIGN: Parallel-group randomised controlled trial with a 1:1 allocation ratio. SETTING: Two regional tertiary neonatal intensive care units. PATIENTS: 150 preterm infants less than 35 weeks gestation with birth weight between 1...
September 26, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Tanjina Chowdhury, Muhammad Manajjir Ali, Muhammad Monir Hossain, Jugindra Singh, Abu Noyeem Muhammad Yousuf, Fatema Yasmin, Fazle Rabbi Chowdhury
OBJECTIVE: To evaluate the efficacy of orally administered probiotics in preventing necrotizing enterocolitis (NEC) in preterm very low birth weight (VLBW) infants. STUDY DESIGN: Arandomized double blind controlled trial. PLACE AND DURATION OF STUDY: The Paediatrics Department of Sylhet M.A.G. Osmani Medical College Hospital, Sylhet Bangladesh, from July 2012 to June 2015. METHODOLOGY: Preterm (28 - 33 weeks gestation) VLBW (birth weight 1000 - 1499 g) neonates were enrolled...
September 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Tevfik Solakoglu, Sevil O Sari, Huseyin Koseoglu, Murat Basaran, Mustafa Akar, Semnur Buyukasik, Osman Ersoy
Hepatic portal venous gas (HPVG) is a rare radiologic finding that is usually precipitated by intestinal ischaemia, intra-abdominal abscesses, necrotising enterocolitis, abdominal trauma, infectious enteritis, and inflammatory bowel disease. In this study, we present a case of HPVG in a 66-year-old female patient who underwent colonoscopy for evaluation of haematochezia and a review of the literature focused on HPVG following colonoscopy.
September 2016: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
Meryem Kurek Eken, Abdülhamit Tüten, Enis Özkaya, Güner Karatekin, Ateş Karateke
OBJECTIVE: To assess the predictors of outcome in terms of length of stay in the neonatal intensive care unit (NICU) and survival of neonates from women with preterm premature rupture of membranes (PPROM). METHODS: A population-based retrospective study including three hundred thirty-one singleton pregnant women with PPROM at 24-34 gestational weeks between January 2013 and December 2015 was conducted. Gestational age at delivery, birth weight, route of delivery, newborn gender, maternal age,oligohydramnios, premature retinopathy (ROP), necrotising enterocolitis (NEC), sepsis, fetal growth retardation (FGR), intracranial hemorrhagia (ICH), bronchopulmonary dysplasia (BPD), respiratory distress syndrome (RDS), primary pulmonary hypertension (PPH), congenital cardiac disease (CCD), patent ductus arteriosus (PDA), use of cortisol (betamethasone) and maternal complications including gestational diabetes, preeclampsia, and chorioamnionitis were used to predict neonatal outcomes in terms of length of stay in the NICU and survival...
September 14, 2016: Journal of Maternal-fetal & Neonatal Medicine
Misty Good, Chhinder P Sodhi, Yukihiro Yamaguchi, Hongpeng Jia, Peng Lu, William B Fulton, Laura Y Martin, Thomas Prindle, Diego F Nino, Qinjie Zhou, Congrong Ma, John A Ozolek, Rachael H Buck, Karen C Goehring, David J Hackam
Necrotising enterocolitis (NEC) is a common disease in premature infants characterised by intestinal ischaemia and necrosis. The only effective preventative strategy against NEC is the administration of breast milk, although the protective mechanisms remain unknown. We hypothesise that an abundant human milk oligosaccharide (HMO) in breast milk, 2'-fucosyllactose (2'FL), protects against NEC by enhancing intestinal mucosal blood flow, and we sought to determine the mechanisms underlying this protection. Administration of HMO-2'FL protected against NEC in neonatal wild-type mice, resulted in a decrease in pro-inflammatory markers and preserved the small intestinal mucosal architecture...
October 2016: British Journal of Nutrition
Kate Costeloe, Ursula Bowler, Peter Brocklehurst, Pollyanna Hardy, Paul Heal, Edmund Juszczak, Andy King, Nicola Panton, Fiona Stacey, Angela Whiley, Mark Wilks, Michael R Millar
BACKGROUND: Necrotising enterocolitis (NEC) and late-onset sepsis remain important causes of death and morbidity in preterm babies. Probiotic administration might strengthen intestinal barrier function and provide protection; this is supported by published meta-analyses, but there is a lack of large well-designed trials. OBJECTIVE: To test the use of the probiotic Bifidobacterium breve strain BBG-001 to prevent NEC, late-onset sepsis and death in preterm babies while monitoring probiotic colonisation of participants...
August 2016: Health Technology Assessment: HTA
Carlo Caffarelli, Francesca Santamaria, Dora Di Mauro, Carla Mastrorilli, Virginia Mirra, Sergio Bernasconi
This review focuses key advances in different pediatric fields that were published in Italian Journal of Pediatrics and in international journals in 2015. Weaning studies continue to show promise for preventing food allergy. New diagnostic tools are available for identifying the allergic origin of allergic-like symptoms. Advances have been reported in obesity, short stature and autoimmune endocrine disorders. New molecules are offered to reduce weight gain and insulin-resistance in obese children. Regional investigations may provide suggestions for preventing short stature...
August 27, 2016: Italian Journal of Pediatrics
Eog van Vliet, G H Dijkema, E Schuit, K Y Heida, C Roos, Jam van der Post, E C Parry, L McCowan, D J Lyell, Y Y El-Sayed, D B Carr, A L Clark, Z A Mahdy, M Uma, N C Sayin, G F Varol, B W Mol, M A Oudijk
BACKGROUND: Preterm birth is the leading cause of neonatal mortality and morbidity in developed countries. Whether continued tocolysis after 48 hours of rescue tocolysis improves neonatal outcome is unproven. OBJECTIVES: To evaluate the effectiveness of maintenance tocolytic therapy with oral nifedipine on the reduction of adverse neonatal outcomes and the prolongation of pregnancy by performing an individual patient data meta-analysis (IPDMA). SEARCH STRATEGY: We searched PubMed, Embase, and Cochrane databases for randomised controlled trials of maintenance tocolysis therapy with nifedipine in preterm labour...
October 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Noor Samuels, Rob van de Graaf, Jasper V Been, Rogier C J de Jonge, Lidwien M Hanff, René M H Wijnen, René F Kornelisse, Irwin K M Reiss, Marijn J Vermeulen
Evidence on the clinical effectiveness of probiotics in the prevention of necrotising enterocolitis (NEC) in preterm infants is conflicting and cohort studies lacked adjustment for time trend and feeding type. This study investigated the association between the introduction of routine probiotics (Lactobacillus acidophilus and Bifidobacterium bifidum; Infloran(®)) on the primary outcome 'NEC or death'. Preterm infants (gestational age <32 weeks or birth weight <1500 gram) admitted before (Jan 2008-Sep 2012; n = 1288) and after (Oct 2012-Dec 2014; n = 673) introduction of probiotics were compared...
2016: Scientific Reports
Rosemarie Anne Boland, Peter Graham Davis, Jennifer Anne Dawson, Lex William Doyle
OBJECTIVES: To compare mortality and serious morbidity rates between outborn and inborn livebirths at 22-27 weeks' gestation. DESIGN: Population-based cohort study. SETTING: Victoria, Australia. PATIENTS: Livebirths at 22-27 weeks' gestation free of major malformations in 2010-2011. INTERVENTIONS: Outcome data for outborn (born outside a tertiary perinatal centre) infants compared with inborn (born in a tertiary perinatal centre) infants were analysed by logistic regression, adjusted for gestational age, birth weight and sex...
August 16, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Rangmar Goelz, Klaus Hamprecht, Karin Klingel, Christian F Poets
To review the relevant literature on cytomegalovirus-(CMV-)related intestinal problems in neonates, supplemented by two own cases of volvulus, a PubMed search and separate additional searches with characterizing terms were performed. 46 hits were found, 15 of which had to be excluded because they did not report clinical cases, yielding a total of 47 infants. Symptoms in both preterm and term infants with proven postnatal infection (n=16) included abdominal distension, bloody diarrhoea, necrotising enterocolitis (NEC) with perforation and intestinal stricture, with lethal outcome in 3 patients...
October 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
S M Juhl, M L Hansen, G Fonnest, M Gormsen, I D Lambaek, G Greisen
AIM: Necrotising enterocolitis contributes considerably to the mortality of preterm infants, but most questions remain unsolved after decades of extensive research. This Danish study investigated the validity of necrotising enterocolitis diagnoses at discharge according to Bell's staging system. METHODS: We conducted a retrospective single-centre cohort study of 714 preterm infants with a gestational age of less than 30 weeks born in 2006-2013. The infants were diagnosed with necrotising enterocolitis according to Bell's stages 2-3 at discharge and in retrospect by an expert panel, which served as our gold standard...
August 10, 2016: Acta Paediatrica
Ahmed Hosni Morsi, Hossam Rashad Omar, Ahmed Osama, Ahmed Refaat Khodary
BACKGROUND: Neonatal pneumoperitoneum is attributed, in most of the reported cases, to necrotising enterocolitis (NEC). There are also other causes leading to free intraperitoneal air. The aim of this study is to describe the clinical spectrum, causes, management and outcome of neonates admitted with pneumoperitoneum in the paediatric surgery unit of a university hospital. SUBJECTS AND METHODS: This retrospective study included neonates having radiographic evidences of pneumoperitoneum from 2012 to the end of 2014...
July 2016: African Journal of Paediatric Surgery: AJPS
Souvik Mitra, Ivan D Florez, Maria E Tamayo, Dagfinn Aune, Lawrence Mbuagbaw, Areti-Angeliki Veroniki, Lehana Thabane
INTRODUCTION: Management of patent ductus arteriosus (PDA) in preterm infants is one of the most controversial topics in neonatal medicine. The availability of different pharmacotherapeutic options often poses a practical challenge to the practising neonatologist as to which one to choose as a therapeutic option. Our objectives are to determine the relative merits of the available pharmacotherapeutic options for the management of PDA. METHODS AND ANALYSIS: We will conduct a systematic review of all randomised controlled trials evaluating the use of intravenous or oral: indomethacin, ibuprofen and acetaminophen for the treatment of PDA in preterm infants...
July 25, 2016: BMJ Open
Joseph B Cantey, Phillip S Wozniak, Jessica E Pruszynski, Pablo J Sánchez
BACKGROUND: Antibiotics are used frequently in the neonatal intensive care unit. We aimed to inform antibiotic stewardship strategies in a level 3 neonatal intensive care unit by surveillance and assessment of all antibiotic use during a 14-month period, identifying scenarios where antibiotic use can be reduced, and implementing interventions while monitoring safety. METHODS: The SCOUT study is an observational study in the level 3 neonatal intensive care unit at Parkland Hospital, Dallas, TX, USA...
October 2016: Lancet Infectious Diseases
Malene S Cilieborg, Stine B Bering, Mette V Østergaard, Michael L Jensen, Łukasz Krych, David S Newburg, Per T Sangild
Human milk decreases the risk of necrotising enterocolitis (NEC), a severe gastrointestinal disease that occurs in 5-10 % of preterm infants. The prebiotic and immune-modulatory effects of milk oligosaccharides may contribute to this protection. Preterm pigs were used to test whether infant formula enriched with α1,2-fucosyllactose (2'-FL, the most abundant oligosaccharide in human milk) would benefit gut microbial colonisation and NEC resistance after preterm birth. Caesarean-delivered preterm pigs were fed formula (Controls, n 17) or formula with 5 g/l 2'-FL (2'-FL, n 16) for 5 d; eight 2'-FL pigs (50 %) and twelve Controls (71 %) developed NEC, with no difference in lesion scores (P=0·35); 2'-FL pigs tended to have less anaerobic bacteria in caecal contents (P=0·22), but no difference in gut microbiota between groups were observed by fluorescence in situ hybridisation and 454 pyrosequencing...
September 2016: British Journal of Nutrition
Tomás Sánchez-Tamayo, María Gracia Espinosa Fernández, Laura Affumicato, María González López, Verónica Fernández Romero, María Concepción Moreno Algarra, Enrique Salguero García
INTRODUCTION: An unexpected increase in the incidence of necrotising enterocolitis (NEC) cases was observed in our hospital. Just in case, our feeding policy could be responsible, it was decided to conduct a systematic review and develop a clinical guideline regarding enteral nutrition of very low birth weight infants (VLBW). OBJECTIVE: To assess the impact of the new feeding protocol in the incidence of NEC. METHOD: A "before" (2011) and "after" (May 2012 - April 2013) study was performed on the new feeding protocol...
July 18, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
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