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pediatric nutrition support

Wednesday Marie A Sevilla, Barbara McElhanon
Enteral nutrition is delivered via the gastrointestinal tract when oral intake is not sufficient to maintain nutrition status. There is evidence that long-term home enteral nutrition (HEN) can be advantageous to pediatric patients by improving quality of life and function. Data from pediatric patients receiving either nasogastric tube or gastrostomy tube feeds indicate good outcomes in terms of maintaining and improving nutrition status as evidenced by anthropometric measurements. As the number of pediatric patients requiring HEN increases, development of an effective program to allow smooth transition to the home is necessary...
October 18, 2016: Nutrition in Clinical Practice
Pilar Anton-Martin, Michael Papacostas, Elisabeth Lee, Paul A Nakonezny, Michael L Green
BACKGROUND: Malnutrition is associated with an increased risk of mortality in patients admitted to the intensive care unit. Children requiring extracorporeal membrane oxygenation (ECMO) support represent an extremely ill subset of this population. There is a lack of data on the impact of nutrition state on survival in this cohort. We examined the association between being underweight and in-hospital mortality among children supported with ECMO. MATERIALS AND METHODS: This article reports on an observational retrospective cohort study performed among neonatal and pediatric patients supported with ECMO in a tertiary children's hospital from May 1996 through June 2013...
October 13, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Ruba A Abdelhadi, Katina Rahe, Beth Lyman
Enteral nutrition (EN) support has proven to be a nutrition intervention that can provide full or partial calories to promote growth and development in infants and children. To supply these nutrients, an enteral access device is required, and the use of these devices is growing. Placement of the proper device for the patient need, along with appropriate care and monitoring, is required for individualized patient management. When complications arise, early identification and management can prevent more serious morbidity...
October 13, 2016: Nutrition in Clinical Practice
G Di Nardo, C Di Lorenzo, A Lauro, V Stanghellini, N Thapar, T B Karunaratne, U Volta, R De Giorgio
BACKGROUND: Chronic intestinal pseudo-obstruction (CIPO) represents the most severe form of gastrointestinal dysmotility with debilitating and potentially lethal consequences. Symptoms can be non-specific, and result in this condition being diagnosed incorrectly or too late with consequences for morbidity and even mortality. PURPOSE: The present article aims to provide pediatric and adult gastroenterologists with an up to date review about clinical features, diagnosis and therapeutic options for CIPO...
September 29, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Patricia Daly, Thaddeus Pace, Judith Berg, Usha Menon, Laura A Szalacha
UNLABELLED: While pediatric anti-obesity lifestyle interventions have received considerable attention, few show sustained impact on body mass index (BMI). Using the Information-Motivation-Behavioral Skills Theory as a framework, we examined the effects of a satiety-focused mindful eating intervention (MEI) on BMI, weight and mindful awareness. METHOD: HASH(0x3a90188) DESIGN AND SETTING: Utilizing a two-group, repeated measures design, 37 adolescent females with a BMI >90th percentile, recruited from a public high school in a Latino community in the Southwestern United States, were randomized 2:1, one third to the group receiving a 6-week MEI and two thirds to the comparison group (CG) receiving the usual care (nutrition and exercise information)...
October 2016: Complementary Therapies in Medicine
Victoria J Forster, Frederik W van Delft, Susan F Baird, Shona Mair, Roderick Skinner, Christina Halsey
PURPOSE: Methotrexate administration is associated with frequent adverse neurological events during treatment for childhood acute lymphoblastic leukemia. Here, we present evidence to support the role of common drug interactions and low vitamin B12 levels in potentiating methotrexate neurotoxicity. METHODS: We review the published evidence and highlight key potential drug interactions as well as present clinical evidence of severe methotrexate neurotoxicity in conjunction with nitrous oxide anesthesia and measurements of vitamin B12 levels among pediatric leukemia patients during therapy...
September 22, 2016: Cancer Chemotherapy and Pharmacology
Damayanti Rusli Sjarif, Klara Yuliarti, Luh Karunia Wahyuni, Tjhin Wiguna, Titis Prawitasari, Yoga Devaera, Henni Wahyu Triyuniati, Andika Afriansyah
BACKGROUND: Sixty percent of the 10.9 million under-5 deaths every year are related to malnutrition. More than two thirds of malnutrition is caused by inappropriate infant feeding practice. Only 35 % of mothers worldwide provide 4 months of exclusive breast-feeding, while complementary feeding is often untimely, nutritionally inadequate, hygienically poor, and improperly delivered. The existing pediatric nutrition module in our institution does not include proper delivery of food that involves oral-motor skills and feeding behavior...
2016: BMC Medical Education
Timothy A Simeone, Stephanie A Matthews, Kaeli K Samson, Kristina A Simeone
The ketogenic diet (KD) is an effective therapy primarily used in pediatric patients whom are refractory to current anti-seizure medications. The mechanism of the KD is not completely understood, but is thought to involve anti-inflammatory and anti-oxidant processes. The nutritionally-regulated transcription factor peroxisome proliferator activated receptor gamma, PPARγ, regulates genes involved in anti-inflammatory and anti-oxidant pathways. Moreover, endogenous ligands of PPARγ include fatty acids suggesting a potential role in the effects of the KD...
August 12, 2016: Experimental Neurology
M Petrea Cober
To accommodate small fluid volumes, repackaging of intravenous fat emulsions (IVFEs) is frequently performed in institutions providing parenteral nutrition to neonates and smaller pediatric patients. However, some consider this an unsafe practice. Concerns for potential administration errors leading to an overdose of IVFEs are weighed against the potential for microbial contamination from the repackaging process. The clinician providing pediatric nutrition support should tailor repackaging practices to ensure patient safety and quality...
October 2016: Nutrition in Clinical Practice
Mona Sajeev, Jennifer Cohen, Claire E Wakefield, Joanna E Fardell, Richard J Cohn
BACKGROUND: Despite the importance of nutrition support in preventing malnutrition in pediatric oncology, the decision to initiate and choose which nutrition support method is most appropriate can be difficult for parents and healthcare professionals. Decision aids are decision-focused patient information materials. They can improve knowledge, reduce decisional conflict, improve patients' risk perception, and increase patient participation in the decision-making process. They have never been evaluated for pediatric oncology nutrition decisions...
August 8, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Jennifer S LeBovidge, Wendy Elverson, Karol G Timmons, Elena B Hawryluk, Corinna Rea, Margaret Lee, Lynda C Schneider
Atopic dermatitis (AD) is the most common pediatric skin disease. AD has a significant effect on patient and family quality of life caused by intense pruritus, sleep disruption, dietary and nutritional concerns, and psychological stress associated with the disease and its management. Multidisciplinary approaches to AD care have been developed in appreciation of the complex interplay among biological, psychological, behavioral, and dietary factors that affect disease control and the wide range of knowledge, skills, and support that patients and families require to effectively manage and cope with this condition...
August 2016: Journal of Allergy and Clinical Immunology
Alejandro A Floh, Julie Slicker, Steven M Schwartz
OBJECTIVES: The objectives of this review are to discuss the challenges of delivering adequate nutrition to children with congenital heart disease, including pre- and postoperative factors and the role of enteral and parenteral nutrition, as well as the evidence supporting current practices. DATA SOURCE: MEDLINE and PubMed. CONCLUSION: Providing adequate nutritional support is paramount for critically ill infants with congenital heart disease, a population at particular risk for malnutrition...
August 2016: Pediatric Critical Care Medicine
Esraa S Al-Tawil, Alanoud M Almuhareb, Hamdy M Amin
BACKGROUND/AIM: Parenteral nutrition (PN) is a lifesaving therapy for patients with many severe conditions, including intestinal failure. Some patients require long-term PN therapy, which makes home parenteral nutrition (HPN) an attractive option to improve the quality of life. Among the most common and serious complications observed in these patients are catheter-related blood stream infections (CRBSIs). The aim of our study is to determine the frequency of CRBSI among patients receiving long-term HPN...
July 2016: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
John T Wright, Malavika P Tampi, Laurel Graham, Cameron Estrich, James J Crall, Margherita Fontana, E Jane Gillette, Brian B Nový, Vineet Dhar, Kevin Donly, Edmond R Hewlett, Rocio B Quinonez, Jeffrey Chaffin, Matt Crespin, Timothy Iafolla, Mark D Siegal, Alonso Carrasco-Labra
BACKGROUND: National Health and Nutrition Examination Survey 2011-2012 data indicated that, in the United States, nearly one-fourth of children and over one-half of adolescents experienced dental caries in their permanent teeth. The purpose of this review was to summarize the available clinical evidence regarding the effect of dental sealants for the prevention and management of pit-and-fissure occlusal carious lesions in primary and permanent molars, compared with a control without sealants, with fluoride varnishes, or with other head-to head comparisons...
August 2016: Journal of the American Dental Association
Jina Kim, Zhifei Sun, Brian R Englum, Alexander C Allori, Obinna O Adibe, Henry E Rice, Elisabeth T Tracy
PURPOSE: Concerns have been raised about the use of laparoscopic surgery (LS) in infants with congenital heart disease (CHD) due to their unique physiology. Prior studies on the safety and effectiveness of laparoscopy in children with CHD are limited in scope and cohort size. MATERIALS AND METHODS: We identified children <1 year of age with CHD who underwent abdominal surgery in the 2012-2013 American College of Surgeons National Surgical Quality Improvement Project Pediatric database...
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Seema Rajani, Hien Q Huynh, Leanne Shirton, Cheryl Kluthe, Donald Spady, Connie Prosser, Jon Meddings, Gwen R Rempel, Rabindranath Persad, Justine M Turner
Background. The European Society for Pediatric Gastroenterology, Hepatology and Nutrition endorses serological diagnosis (SD) for pediatric celiac disease (CD). The objective of this study was to pilot SD and to prospectively evaluate gastrointestinal permeability and mucosal inflammation at diagnosis and after one year on the gluten-free diet (GFD). We hypothesized that SD would be associated with similar short term outcomes as ED. Method. Children, 3-17 years of age, referred for possible CD were eligible for SD given aTTG level ≥200 U/mL, confirmed by repeat aTTG and HLA haplotypes...
2016: Canadian Journal of Gastroenterology & Hepatology
Corinne A Muirhead, Jillian N Sanford, Benjamin G McCullar, Dawn Nolt, Kelvin D MacDonald
Cystic fibrosis (CF) is a chronic disorder characterized by acute pulmonary exacerbations that comprise increased cough, chest congestion, increased mucus production, shortness of breath, weight loss, and fatigue. Typically, severe episodes are treated in the inpatient setting and include intravenous antimicrobials, airway clearance therapy, and nutritional support. Children with less-severe findings can often be managed as outpatients with oral antimicrobials and increased airway clearance therapy at home without visiting the specialty CF center to begin treatment...
2016: Clinical Medicine Insights. Pediatrics
Lisa A Joss-Moore, Synneva J Hagen-Lillevik, Calan Yost, Jennifer Jewell, Robert D Wilkinson, Sydney Bowen, Mar Janna Dahl, Li Dong, Zhengming Wang, Angela P Presson, Chong Zhang, Donald M Null, Bradley A Yoder, Kurt H Albertine
BACKGROUND: Preterm birth and respiratory support with invasive mechanical ventilation frequently leads to bronchopulmonary dysplasia (BPD). A hallmark feature of BPD is alveolar simplification. For our preterm lamb model of BPD, invasive mechanical ventilation is associated with postnatal feeding intolerance (reduced nutrition) and sedation. In contrast, preterm lambs managed by non-invasive support (NIS) have normal alveolar formation, appropriate postnatal nutrition, and require little sedation...
July 18, 2016: Pediatric Research
Sari Bar, Ruth Milanaik, Andrew Adesman
PURPOSE OF REVIEW: The American Academy of Pediatrics recommends exclusive breastfeeding for the first 6 months of an infant#$#apos;s life, with continuation of breastfeeding for at least a year or as mutually desired by mother and child. A robust body of research literature documenting the short-term medical, developmental, and emotional benefits of breastfeeding for infants and toddlers supports this position. This article reviews the neurodevelopmental benefits of breastfeeding as it relates to preschool and school-age children, with particular emphasis on cognitive development, attention-deficit/hyperactivity disorder, and autism spectrum disorder...
August 2016: Current Opinion in Pediatrics
Enid E Martinez, Nilesh M Mehta
PURPOSE OF REVIEW: Nutritional status and nutrient delivery during critical illness impact clinical outcomes. We have reviewed recent studies that may guide best practices regarding nutrition therapy in critically ill children. RECENT FINDINGS: Malnutrition is prevalent in the pediatric ICU population, and is associated with worse outcomes. Nutrition support teams, dedicated dietitians, and educational programs facilitate surveillance for existing malnutrition and nutrition risk, but specific tools for the pediatric ICU population are lacking...
August 2016: Current Opinion in Critical Care
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