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Necrotizing enterocolitis in preterm infant

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https://www.readbyqxmd.com/read/28096129/current-knowledge-of-necrotizing-enterocolitis-in-preterm-infants-and-the-impact-of-different-types-of-enteral-nutrition-products
#1
REVIEW
Jocelyn Shulhan, Bryan Dicken, Lisa Hartling, Bodil Mk Larsen
Preterm infants are extremely vulnerable to a range of morbidities and mortality. Underdeveloped cardiac, respiratory, gastrointestinal, and immune systems in the preterm period increase the risk of necrotizing enterocolitis (NEC), a serious disease of the gut. NEC affects 5-12% of very-low birth-weight infants, leads to surgery in 20-40% of cases, and is fatal in 25-50% of cases. There are multiple factors that may contribute to NEC, but the exact cause is not yet fully understood. Severe cases can result in intestinal resection or death, and the health care costs average >$300,000/infant when surgical management is required...
January 2017: Advances in Nutrition
https://www.readbyqxmd.com/read/28056921/bifidobacterium-adolescentis-protects-against-necrotizing-enterocolitis-and-upregulates-tollip-and-sigirr-in-premature-neonatal-rats
#2
Wenshen Wu, Yanli Wang, Jingjing Zou, Fang Long, Huiheng Yan, Lijuan Zeng, Yunbin Chen
BACKGROUND: Necrotizing enterocolitis (NEC) is a serious gastrointestinal disorder that is often seen in premature infants. Probiotics decrease the risk of NEC; however, the mechanism by which probiotics work is not clear. The goal of this study was to evaluate the preventive effect of Bifidobacterium adolescentis in an NEC rat model. METHODS: Sprague-Dawley neonatal rats were obtained by caesarean section after 20-21 d gestation and randomly divided into the following 3 groups: dam fed (DF), formula fed (FF), and formula + B...
January 5, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28045982/fecal-bile-salts-and-the-development-of-necrotizing-enterocolitis-in-preterm-infants
#3
Christian V Hulzebos, Anne G J F van Zoonen, Jan B F Hulscher, Trijntje E Schat, Elisabeth M W Kooi, Martijn Koehorst, Renze Boverhof, Paul F M Krabbe, Albert K Groen, Henkjan J Verkade
BACKGROUND: Intestinal bile salts (BSs) may be implicated in NEC development. We hypothesized that fecal BS levels are higher in preterm infants at risk for NEC. METHODS: We compared the composition and concentration of fecal BSs in ten preterm infants who developed NEC (Bell's Stage ≥ II) with twenty matched control infants without NEC. Conjugated and unconjugated fecal BSs were measured after birth (T1) and twice prior to NEC (T2, T3). Data are presented as medians and interquartile ranges...
2017: PloS One
https://www.readbyqxmd.com/read/28034306/influence-of-maternal-breast-milk-ingestion-on-acquisition-of-the-intestinal-microbiome-in-preterm-infants
#4
Katherine E Gregory, Buck S Samuel, Pearl Houghteling, Guru Shan, Frederick M Ausubel, Ruslan I Sadreyev, W Allan Walker
BACKGROUND: The initial acquisition and early development of the intestinal microbiome during infancy are important to human health across the lifespan. Mode of birth, antibiotic administration, environment of care, and nutrition have all been shown to play a role in the assembly of the intestinal microbiome during early life. For preterm infants, who are disproportionately at risk of inflammatory intestinal disease (i.e., necrotizing enterocolitis), a unique set of clinical factors influence the establishment of the microbiome...
December 30, 2016: Microbiome
https://www.readbyqxmd.com/read/28030867/medications-that-increase-osmolality-and-compromise-the-safety-of-enteral-feeding-in-preterm-infants
#5
Suresh Chandran, Mei Chien Chua, Wanyun Lin, Jia Min Wong, Seyed Ehsan Saffari, Victor Samuel Rajadurai
BACKGROUND: Medications added to preterm milk feeds have the potential to raise osmolality, causing feed intolerance and necrotizing enterocolitis. OBJECTIVE: The aim of this study was to evaluate changes in the osmolality of milk feeds and water with 14 medications and the diluent amounts required to keep the osmolality below the safety threshold of ≤450 mOsm/kg. Changes in the osmolality of milk with medications while on continuous infusion over 2 and 4 h were determined...
December 29, 2016: Neonatology
https://www.readbyqxmd.com/read/28013313/increased-intestinal-inflammation-and-digestive-dysfunction-in-preterm-pigs-with-severe-necrotizing-enterocolitis
#6
Ann Cathrine F Støy, Peter M H Heegaard, Kerstin Skovgaard, Stine B Bering, Mette Bjerre, Per T Sangild
BACKGROUND: The risk factors for necrotizing enterocolitis (NEC) are well known, but the factors involved in the different NEC presentations remain unclear. OBJECTIVES: We hypothesized that digestive dysfunction and intestinal inflammation are mainly affected by severe NEC lesions. METHODS: In 48 preterm pigs, the association between the macroscopic NEC score (range 1-6) and the expression of 48 genes related to inflammation, morphological, and digestive parameters in the distal small intestine was investigated...
December 24, 2016: Neonatology
https://www.readbyqxmd.com/read/28002310/committee-opinion-no-684-delayed-umbilical-cord-clamping-after-birth
#7
(no author information available yet)
Delayed umbilical cord clamping appears to be beneficial for term and preterm infants. In term infants, delayed umbilical cord clamping increases hemoglobin levels at birth and improves iron stores in the first several months of life, which may have a favorable effect on developmental outcomes. There is a small increase in jaundice that requires phototherapy in this group of infants. Consequently, health care providers adopting delayed umbilical cord clamping in term infants should ensure that mechanisms are in place to monitor for and treat neonatal jaundice...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28002305/committee-opinion-no-684-summary-delayed-umbilical-cord-clamping-after-birth
#8
(no author information available yet)
Delayed umbilical cord clamping appears to be beneficial for term and preterm infants. In term infants, delayed umbilical cord clamping increases hemoglobin levels at birth and improves iron stores in the first several months of life, which may have a favorable effect on developmental outcomes. There is a small increase in jaundice that requires phototherapy in this group of infants. Consequently, health care providers adopting delayed umbilical cord clamping in term infants should ensure that mechanisms are in place to monitor for and treat neonatal jaundice...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28001143/vital-signs-and-their-cross-correlation-in-sepsis-and-nec-a-study-of-1-065-very-low-birth-weight-infants-in-two-nicus
#9
Karen D Fairchild, Douglas E Lake, John Kattwinkel, J Randall Moorman, David A Bateman, Philip G Grieve, Joseph R Isler, Rakesh Sahni
BACKGROUND: Subtle changes in vital signs and their interactions occur in preterm infants prior to overt deterioration from late-onset septicemia (LOS) or necrotizing enterocolitis (NEC). Optimizing predictive algorithms may lead to earlier treatment. METHODS: For 1,065 very-low-birth-weight (VLBW) infants in two neonatal intensive care units (NICUs), mean, SD, and cross-correlation of respiratory rate, heart rate (HR), and oxygen saturation (SpO2) were analyzed hourly (131 infant-years' data)...
December 21, 2016: Pediatric Research
https://www.readbyqxmd.com/read/27992937/parenteral-fish-oil-lipid-emulsions-in-the-prevention-of-severe-retinopathy-of-prematurity-a-systematic-review-and-meta-analysis
#10
Sakeer Vayalthrikkovil, Rani A Bashir, Yacov Rabi, Harish Amin, Jill-Marie Spence, Helen Lee Robertson, Abhay Lodha
Objective Omega-3 fatty acids are vital for brain and retinal maturation. It is not clear if early use of ω-3 fatty acids in the form of fish-oil lipid emulsions (FLEs) prevents retinopathy of prematurity (ROP) in preterm infants. The aim of this meta-analysis is to evaluate whether early administration of parenteral FLEs reduces ROP requiring laser therapy or severe ROP ≥stage 3 in preterm infants. Methods A literature search was performed to identify studies comparing parenteral FLEs with soybean-based lipid emulsions (SLEs) in preventing ROP...
December 19, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27986328/pathogenesis-of-nec-impact-of-an-altered-intestinal-microbiome
#11
REVIEW
Josef Neu, Mohan Pammi
Necrotizing enterocolitis (NEC), a disease most commonly seen in preterm infants, often presents without warning and is associated with very high mortality and morbidity. Progress in the prevention and treatment of NEC has been slow. In this article, we will discuss some of the reasons as to why this progress has been slow. We will describe some of the factors that appear to be highly associated and important components in the pathophysiology of NEC. We will discuss the intestinal microbial environment of the fetus as well as the preterm infant and how interaction of dysbiosis with an immature gastrointestinal tract combined with dietary factors play a role in the pathogenesis of NEC...
December 13, 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/27936476/necrotizing-enterocolitis-and-growth-in-preterm-infants-fed-predominantly-maternal-milk-pasteurized-donor-milk-or-preterm-formula-a-retrospective-study
#12
Paula M Sisk, Tinisha M Lambeth, Mario A Rojas, Teisha Lightbourne, Maria Barahona, Evelyn Anthony, Sam T Auringer
Objective To evaluate the association between necrotizing enterocolitis (NEC), growth, and feeding. Methods This is a retrospective study of 551 infants (birth weight ≤ 1,500 g, ≤32 weeks' gestation). NEC, Bell's stage ≥ 2, was confirmed by independent review of sentinel radiographs. Feeding type was defined as ≥ 50% maternal milk (MM), pasteurized donor human milk (PDHM), or preterm formula (PF). Demographic and clinical characteristics including growth were compared between the three groups...
December 9, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27923478/increased-incidence-of-necrotizing-enterocolitis-in-the-netherlands-after-implementation-of-the-new-dutch-guideline-for-active-treatment-in-extremely-preterm-infants-results-from-three-academic-referral-centers
#13
Fardou H Heida, Lisanne Stolwijk, Marie-Louise H J Loos, Stannie J van den Ende, Wes Onland, Frank A M van den Dungen, Elisabeth M W Kooi, Arend F Bos, Jan B F Hulscher, Roel Bakx
INTRODUCTION: Necrotizing enterocolitis (NEC) is a severe inflammatory disease, mostly occurring in preterm infants. The Dutch guidelines for active treatment of extremely preterm infants changed in 2006 from 26+0 to 25+0weeks of gestation, and in 2010 to 24+0 of gestation. We aimed to gain insight into the incidence, clinical outcomes and treatment strategies, in three academic referral centers in the Netherlands over the last nine years. METHODS: We performed a multicenter retrospective cohort study of all patients with NEC (Bell stage ≥2a) in three academic referral centers diagnosed between 2005 and 2013...
February 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27921445/risk-of-neonatal-and-childhood-morbidity-among-preterm-infants-exposed-to-marijuana
#14
Sarah K Dotters-Katz, Marcela C Smid, Tracy A Manuck, Torri D Metz
BACKGROUND: Limited data exist regarding the neonatal and neurodevelopmental outcomes of infants exposed to marijuana (MJ) in-utero, particularly among preterm infants. We hypothesized that MJ-exposed preterm infants would have worse neonatal and childhood developmental outcomes compared to MJ-unexposed infants. METHODS: Secondary analysis of multicenter randomized-controlled trial of antenatal magnesium sulfate for prevention of cerebral palsy was conducted. Singleton non-anomalous infants delivered <35 weeks exposed to MJ in-utero were compared to MJ-unexposed...
December 6, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27914140/comparison-of-the-mortality-and-in-hospital-outcomes-of-preterm-infants-treated-with-ibuprofen-for-patent-ductus-arteriosus-with-or-without-clinical-symptoms-attributable-to-the-patent-ductus-arteriosus-at-the-time-of-ibuprofen-treatment
#15
Hani Yoo, Jin A Lee, Sohee Oh, Young Hwa Jung, Jin A Sohn, Seung Han Shin, Chang Won Choi, Ee Kyung Kim, Han Suk Kim, Beyong Il Kim
The aim of this study was to assess the differences in the mortality and in-hospital outcomes of preterm infants with < 28 weeks of gestation who received ibuprofen treatment according to the presence of clinical symptoms (any of oliguria, hypotension, or moderate to severe respiratory difficulty) attributable to hemodynamically-significant patent ductus arteriosus (hsPDA) at the time of first ibuprofen treatment. In total, 91 infants born from April 2010 to March 2015 were included. Fourteen infants (15...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27904587/inhaled-nitric-oxide-in-preterm-infants-an-updated-meta-analysis
#16
REVIEW
Yang Yang, Yun Feng, Xiao-Guang Zhou, Jing-Jing Pan, Xiao-Yu Zhou
BACKGROUND: In the past several years, randomized controlled trials (RCTs) have indicated that inhaled nitric oxide (iNO) can potentially lower for both the incidence of bronchopulmonary dysplasia (BPD) and mortality in affected infants. Other research has, however, disagreed with these findings. MATERIALS AND METHODS: We performed an updated meta analysis of all relevant RCTs to assess the benefits of iNO in preterm infants by searching PubMed, EMBASE, Cochrane databases, Wanfang, VIP, and CNKI databases for English and Chinese references...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27902668/pneumatosis-intestinalis-due-to-child-abuse
#17
Stephanie Anne Deutsch, Cindy W Christian
Pneumatosis intestinalis (PI) and the presence of portal venous gas (PVG) are commonly considered pathognomonic for necrotizing enterocolitis in the neonatal period; however, these 2 radiographic findings have been documented in all age groups in a variety of clinical settings and medical conditions including respiratory, cardiac, rheumatologic, gastrointestinal disorders, and traumatic injury. In children, intramural dissection of intestinal gas in the absence of clinical symptoms suggestive of necrotizing enterocolitis should raise concern for a traumatic etiology, including injuries sustained from child physical abuse...
November 29, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27889684/human-milk-oligosaccharide-effects-on-intestinal-function-and-inflammation-after-preterm-birth-in-pigs
#18
Stine O Rasmussen, Lena Martin, Mette V Østergaard, Silvia Rudloff, Michael Roggenbuck, Duc Ninh Nguyen, Per T Sangild, Stine B Bering
: Human milk oligosaccharides (HMOs) may mediate prebiotic and anti-inflammatory effects in newborns. This is particularly important for preterm infants who are highly susceptible to intestinal dysfunction and necrotizing enterocolitis (NEC). We hypothesized that HMO supplementation of infant formula (IF) improves intestinal function, bacterial colonization and NEC resistance immediately after preterm birth, as tested in a preterm pig model. Mixtures of HMOs were investigated in intestinal epithelial cells and in preterm pigs (n=112) fed IF supplemented without (CON) or with a mixture of four HMOs (4-HMO) or >25 HMOs (25-HMO, 5-10 g/L given for 5 or 11 days)...
November 4, 2016: Journal of Nutritional Biochemistry
https://www.readbyqxmd.com/read/27843009/cerebellar-microstructural-organization-is-altered-by-complications-of-premature-birth-a-case-control-study
#19
Marie Brossard-Racine, Andrea Poretti, Jonathan Murnick, Marine Bouyssi-Kobar, Robert McCarter, Adre J du Plessis, Catherine Limperopoulos
OBJECTIVES: To compare regional cerebellar microstructure, as measured by diffusion tensor imaging (DTI), between preterm infants at term-equivalent age and healthy term-born control neonates, and to explore associations between DTI findings and clinical risk factors. STUDY DESIGN: In this case-control study, DTI studies were performed in 73 premature infants born ≤32 weeks and ≤1500 g birth weight and 73 full-term-born controls from healthy pregnancies. Using a region of interest approach, fractional anisotropy (FA) and mean diffusivity (MD) were extracted in 7 cerebellar regions including the anterior vermis, the right/left superior cerebellar peduncles, the middle cerebellar peduncle, and the dentate nuclei...
November 8, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27836421/human-milk-is-the-feeding-strategy-to-prevent-necrotizing-enterocolitis
#20
REVIEW
Diana Maffei, Richard J Schanler
Human milk is the preferred diet for preterm infants as it protects against a multitude of NICU challenges, specifically necrotizing enterocolitis. Infants who receive greater than 50% of mother's own milk (MOM) in the 2 weeks after birth have a significantly decreased risk of NEC. An additional factor in the recent declining rates of NEC is the increased utilization of donor human milk (DHM). This creates a bridge until MOM is readily available, thus decreasing the exposure to cow milk protein. Preterm infants are susceptible to NEC due to the immaturity of their gastrointestinal and immune systems...
November 8, 2016: Seminars in Perinatology
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