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Necrotizing enterocolitis

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https://www.readbyqxmd.com/read/28104319/the-mexican-consensus-on-probiotics-in-gastroenterology
#1
M A Valdovinos, E Montijo, A T Abreu, S Heller, A González-Garay, D Bacarreza, M Bielsa-Fernández, M C Bojórquez-Ramos, F Bosques-Padilla, A I Burguete-García, R Carmona-Sánchez, A Consuelo-Sánchez, E Coss-Adame, J A Chávez-Barrera, M de Ariño, J Flores-Calderón, O Gómez-Escudero, M S González-Huezo, M E Icaza-Chávez, A Larrosa-Haro, M Morales-Arámbula, C Murata, J A Ramírez-Mayans, J M Remes-Troche, T Rizo-Robles, M Peláez-Luna, E M Toro-Monjaraz, A Torre, M E Urquidi-Rivera, R Vázquez, J K Yamamoto-Furusho, F Guarner
INTRODUCTION: Probiotics are frequently prescribed in clinical practice. Their efficacy in treating gastrointestinal disorders is supported by a significant number of clinical trials. However, the correct prescription of these agents is hampered due to a lack of knowledge of the scientific evidence and to the different presentations and microbial compositions of the probiotics that are currently available. AIM: To provide the clinician with a consensus review of probiotics and recommendations for their use in gastroenterology...
January 16, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28099974/temporary-vacuum-assisted-closure-of-the-open-abdomen-in-neonates
#2
Kengo Hattori, Alp Numanoglu, Sharon Cox
Introduction The need for open abdomen in the treatment of severely ill neonates will increase in time as more complex abdominal procedures are undertaken. However, the experience of temporary closure of an open abdomen using vacuum-assisted closure (VAC) system is still relatively limited in premature and term neonates. The aim of this study is to describe and review our experience in the use of temporary VAC of the open abdomen for neonates with varying pathological processes. Materials and Methods A retrospective folder review of all neonates treated with VAC for open abdomen over the study period of 2010 to 2014 at our institution was performed...
January 18, 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28096129/current-knowledge-of-necrotizing-enterocolitis-in-preterm-infants-and-the-impact-of-different-types-of-enteral-nutrition-products
#3
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/28092913/umbilical-venous-catheter-malposition-is-associated-with-necrotizing-enterocolitis-in-premature-infants
#4
Mustafa Sulemanji, Khashayar Vakili, David Zurakowski, Wayne Tworetzky, Steven J Fishman, Heung Bae Kim
OBJECTIVE: The etiology of necrotizing enterocolitis (NEC) remains elusive despite known associations with several factors, including intestinal ischemia related to the effects of umbilical arterial catheterization on the mesenteric circulation. However, the role of the mesenteric venous circulation has yet to be studied as a potential cause of NEC. We examined the association between umbilical venous catheter (UVC) position and the development of NEC in premature infants. DESIGN: A prospective cohort study was performed to examine the effect of UVC on portosystemic shunting via the ductus venosus (DV) and its potential role in NEC...
January 17, 2017: Neonatology
https://www.readbyqxmd.com/read/28088292/human-fetal-intestinal-epithelial-cells-metabolize-and-incorporate-branched-chain-fatty-acids-in-a-structure-specific-manner
#5
Lei Liu, Zhen Wang, Hui Gyu Park, Chuang Xu, Peter Lawrence, Xueli Su, Vasuki Wijendran, W Allan Walker, Kumar S D Kothapalli, J Thomas Brenna
BACKGROUND: Branched chain fatty acids (BCFA) are constituents of gastrointestinal (GI) tract in healthy newborn human infants, reduce the incidence of necrotizing enterocolitis (NEC) in a neonatal rat model, and are incorporated into small intestine cellular lipids in vivo. We hypothesize that BCFA are taken up, metabolized and incorporated into human fetal cells in vitro. METHODS: Human H4 cells, a fetal non-transformed primary small intestine cell line, were incubated with albumin-bound non-esterified anteiso-17:0, iso-16:0, iso-18:0 and/or iso-20:0, and FA profiles in lipid fractions were analyzed...
January 2017: Prostaglandins, Leukotrienes, and Essential Fatty Acids
https://www.readbyqxmd.com/read/28079865/differences-in-mortality-characteristics-in-neonates-with-down-s-syndrome
#6
C L Cua, U Haque, S Santoro, L Nicholson, C H Backes
OBJECTIVE: Neonates with Down's syndrome (nDS) may have multiple medical issues that place them at increased risk for mortality during the newborn period. Goal of this study was to determine if there are differences in baseline characteristics, medical complications or procedures performed during hospitalization between nDS who survived versus those who died during initial hospitalization. STUDY DESIGN: Data from 2000 to 2014 were reviewed using the Pediatric Health Information Systems (PHIS) database on all DS patients admitted to the hospital <30 days postnatal life...
January 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28068438/variation-in-performance-of-neonatal-intensive-care-units-in-the-united-states
#7
Jeffrey D Horbar, Erika M Edwards, Lucy T Greenberg, Kate A Morrow, Roger F Soll, Madge E Buus-Frank, Jeffrey S Buzas
Importance: Hospitals use rates from the best quartile or decile as benchmarks for quality improvement aims, but to what extent these aims are achievable is uncertain. Objective: To determine the proportion of neonatal intensive care units (NICUs) in 2014 that achieved rates for death and major morbidities as low as the shrunken adjusted rates from the best quartile and decile in 2005 and the time it took to achieve those rates. Design, Setting, and Participants: A total of 408 164 infants with a birth weight of 501 to 1500 g born from January 1, 2005, to December 31, 2014, and cared for at 756 Vermont Oxford Network member NICUs in the United States were evaluated...
January 9, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28060152/an-elevated-low-cardiac-output-syndrome-score-is-associated-with-morbidity-in-infants-after-congenital-heart-surgery
#8
Kalia P Ulate, Ofer Yanay, Howard Jeffries, Harris Baden, Jane L Di Gennaro, Jerry Zimmerman
OBJECTIVES: To evaluate an empirically derived Low Cardiac Output Syndrome Score as a clinical assessment tool for the presence and severity of Low Cardiac Output Syndrome and to examine its association with clinical outcomes in infants who underwent surgical repair or palliation of congenital heart defects. DESIGN: Prospective observational cohort study. SETTING: Cardiac ICU at Seattle Children's Hospital. PATIENTS: Infants undergoing surgical repair or palliation of congenital heart defects...
January 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28056921/bifidobacterium-adolescentis-protects-against-necrotizing-enterocolitis-and-upregulates-tollip-and-sigirr-in-premature-neonatal-rats
#9
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/28053670/the-complete-genome-sequence-of-cronobacter-sakazakii-atcc-29544-t-a-food-borne-pathogen-isolated-from-a-child-s-throat
#10
Seongok Kim, You-Tae Kim, Hyunjin Yoon, Ju-Hoon Lee, Sangryeol Ryu
BACKGROUND: Cronobacter sakazakii is an emerging opportunistic pathogen that is associated with rare but life-threatening cases of severe diseases: meningitis, necrotizing enterocolitis, and sepsis in premature and full-term infants. However, the pathogenesis mechanism of this pathogen remains largely unknown. To determine its pathogenesis at the genomic level, the genome of C. sakazakii ATCC 29544(T) was completely sequenced and analyzed. RESULTS: The genomic DNA, containing a circular chromosome and three plasmids, is composed of 4,511,265 bp with a GC content of 56...
2017: Gut Pathogens
https://www.readbyqxmd.com/read/28048964/variability-in-antibiotic-regimens-for-surgical-necrotizing-enterocolitis-highlights-the-need-for-new-guidelines
#11
Brian P Blackwood, Catherine J Hunter, Julia Grabowski
BACKGROUND: Necrotizing enterocolitis or NEC is the most common gastrointestinal emergency in the newborn. The etiology of NEC remains unknown, and treatment consists of antibiotic therapy and supportive care with the addition of surgical intervention as necessary. Unlike most surgical diseases, clear guidelines for the type and duration of peri-operative antibiotic therapy have not been established. Our aim was to review the antibiotic regimen(s) applied to surgical patients with NEC within a single neonatal intensive care unit (NICU) and to evaluate outcomes and help develop guidelines for antibiotic administration in this patient population...
January 3, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28046187/development-of-a-gestational-age-specific-case-definition-for-neonatal-necrotizing-enterocolitis
#12
Cheryl Battersby, Nick Longford, Kate Costeloe, Neena Modi
Importance: Necrotizing enterocolitis (NEC) is a major cause of neonatal morbidity and mortality. Preventive and therapeutic research, surveillance, and quality improvement initiatives are hindered by variations in case definitions. Objective: To develop a gestational age (GA)-specific case definition for NEC. Design, Setting, and Participants: We conducted a prospective 34-month population study using clinician-recorded findings from the UK National Neonatal Research Database between December 2011 and September 2014 across all 163 neonatal units in England...
January 3, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28045982/fecal-bile-salts-and-the-development-of-necrotizing-enterocolitis-in-preterm-infants
#13
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/28045772/nutritional-practices-and-growth-in-premature-infants-after-surgical-necrotizing-enterocolitis
#14
Grace C Lin, Daniel T Robinson, Steven Olsen, Kristina M Reber, Mohannad Moallem, Robert DiGeronimo, Cecilia Mulroy, Ankur Datta, Karna Murthy
OBJECTIVE: To describe the nutritional provisions received by infants with surgical NEC and the associated effects on short-term growth. STUDY DESIGN: Through the Children's Hospitals Neonatal Database we identified infants born ≤32 weeks' gestation with surgical NEC from 5 regional neonatal intensive care units over 4 years. Excluded infants had isolated intestinal perforation and died <14 days post-operatively. Infants were stratified by their median parenteral protein dose (low (LP) or high (HP) protein) over the first post-operative week...
December 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28034306/influence-of-maternal-breast-milk-ingestion-on-acquisition-of-the-intestinal-microbiome-in-preterm-infants
#15
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/28033074/preoperative-feeding-neonates-with-cardiac-disease
#16
Carly J Scahill, Eric M Graham, Andrew M Atz, Scott M Bradley, Minoo N Kavarana, Sinai C Zyblewski
BACKGROUND: The potential for necrotizing enterocolitis (NEC) in neonates requiring cardiac surgery has contributed largely to wide feeding practice variations and a hesitation to initiate enteral feeding during the preoperative period, specifically those patients with hypoplastic left heart syndrome. METHODS: A retrospective chart review of neonates undergoing cardiac surgery at a single institution between July 2011 and July 2013 was performed. The primary objective of this study was to determine if preoperative feeding was associated with NEC in neonates requiring cardiac surgery...
January 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28030867/medications-that-increase-osmolality-and-compromise-the-safety-of-enteral-feeding-in-preterm-infants
#17
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/28029463/-tocolysis-for-preterm-labor-without-premature-preterm-rupture-of-membranes
#18
M Doret, G Kayem
OBJECTIVES: To propose guidelines for clinical practice for tocolysis in preterm labor without premature preterm rupture of the membranes (PPROM). MATERIALS AND METHODS: Bibliographic searches were performed in the Medline and Cochrane databases and gynecologist and obstetricians' international society guidelines. It is important to note that most studies included women in preterm labour with and without PPROM. RESULTS: Compared with placebo, tocolytics are not associated with a reduction in neonatal mortality or morbidity (LE2)...
October 28, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28018154/antenatal-escitalopram-use-and-necrotizing-enterocolitis-in-a-newborn-a-case-report
#19
Nilima Jawale, Alok Bhutada, Shantanu Rastogi
The increased use of antidepressants during pregnancy has been associated with adverse effects in the newborn. We report a case of antenatal escitalopram use associated with necrotizing enterocolitis in a healthy term baby. We further discuss possible mechanisms that may explain this association. With increasing evidence of association of necrotizing enterocolitis with maternal exposure to antidepressants, more studies to find out causality and methods to predict babies at risk and their prudent management are needed...
November 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28013313/increased-intestinal-inflammation-and-digestive-dysfunction-in-preterm-pigs-with-severe-necrotizing-enterocolitis
#20
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
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