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Necrotizing enterocolitis

T Schmitz
OBJECTIVE: To evaluate short- and long-term benefits and risks associated with antenatal administration of a single course of corticosteroids and the related strategies: multiple and rescue courses. METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: Antenatal administration of a single course of corticosteroids before 34 weeks of gestation is associated in the neonatal period with a significant reduction of respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC) and death (LE1), and in possibly childhood with a reduction of cerebral palsy and increased psychomotor development index and intact survival (LE3)...
October 21, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Joseph Y Ting, Anne Synnes, Ashley Roberts, Akhil Deshpandey, Kimberly Dow, Eugene W Yoon, Kyong-Soon Lee, Simon Dobson, Shoo K Lee, Prakesh S Shah
Importance: Excessive antibiotic use has been associated with altered bacterial colonization and may result in antibiotic resistance, fungemia, necrotizing enterocolitis (NEC), and mortality. Exploring the association between antibiotic exposure and neonatal outcomes other than infection-related morbidities may provide insight on the importance of rational antibiotic use, especially in the setting of culture-negative neonatal sepsis. Objective: To evaluate the trend of antibiotic use among all hospitalized very low-birth-weight (VLBW) infants across Canada and the association between antibiotic use rates (AURs) and mortality and morbidity among neonates without culture-proven sepsis or NEC...
October 24, 2016: JAMA Pediatrics
P Deltell Colomer, N Albertos Mira-Marcelí, N Gallego Mellado, M E Kuan Argüello, M F Bordallo Vázquez, J Mira Navarro, J Gonzálvez Piñera
INTRODUCTION: In more than 50% of the necrotizing enterocolitis that underwent surgery will require an ileostomy. The optimal time to reestablish intestinal transit still is a controversial subject. Many times ileostomies cause medical issues that require early intestinal reconstruction. Our objective is to compare the early closure against late close, being the shift point 35 days according to other published research. MATERIAL AND METHODS: Retrospective study off all patients that in the last 10 years have had an episode of necrotizing enterocolitis which required an intestinal derivation like ileostomy...
January 15, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
John Slattery, Derrick F MacFabe, Richard E Frye
Recent studies have highlighted the fact that the enteric microbiome, the trillions of microbes that inhabit the human digestive tract, has a significant effect on health and disease. Methods for manipulating the enteric microbiome, particularly through probiotics and microbial ecosystem transplantation, have undergone some study in clinical trials. We review some of the evidence for microbiome alteration in relation to childhood disease and discuss the clinical trials that have examined the manipulation of the microbiome in an effort to prevent or treat childhood disease with a primary focus on probiotics, prebiotics, and/or synbiotics (ie, probiotics + prebiotics)...
2016: Clinical Medicine Insights. Pediatrics
Sonja C Sawh, Santosh Deshpande, Sandy Jansen, Christopher J Reynaert, Philip M Jones
CONTEXT: Necrotizing enterocolitis (NEC) is the most frequent gastrointestinal emergency in neonates. The microbiome of the preterm gut may regulate the integrity of the intestinal mucosa. Probiotics may positively contribute to mucosal integrity, potentially reducing the risk of NEC in neonates. OBJECTIVE: To perform an updated systematic review and meta-analysis on the efficacy and safety of probiotics for the prevention of NEC in premature infants. DATA SOURCES: Structured searches were performed in: Medline, Embase, and the Cochrane Central Register of Controlled Trials (all via Ovid, from 2013 to January 2015)...
2016: PeerJ
Sheila M Gephart, Michelle Fleiner, Amy Kijewski
BACKGROUND: Necrotizing enterocolitis (NEC) can become severe quickly, making early recognition a priority and understanding the occurrence of abdominal and clinical signs of impending NEC important. PURPOSE: The purpose of this study was to examine relationships of abdominal signs up to 36 hours before diagnosis of NEC within subgroups treated medically, surgically, or those who died. METHODS: A 3-site, descriptive correlational case-control design with retrospective data collection was used matching each NEC case to 2 controls (N = 132)...
October 14, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Jing-Ran Ma, Dan-Hua Wang
Breastfeeding is well-known for its benefits of preventing communicable and non-communicable diseases. Human breastmilk consists not only of nutrients, but also of bioactive substances. What's more, the epigenetic effects of human breast milk may also play an important role. Alterations in the epigenetic regulation of genes may lead to profound changes in phenotype. Clarifying the role of human breast milk on genetic expression can potentially benefit the infant's health and his later life. This review article makes a brief summary of the epigenetic mechanism of breast milk, and its epigenetic effects on neonatal necrotizing enterocolitis, infectious diseases, metabolism syndrome, cognitive function and anaphylactic diseases...
October 2016: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Birju A Shah, Alison Migliori, Itsuka Kurihara, Surendra Sharma, Yow-Pin Lim, James Padbury
OBJECTIVE: To examine circulating levels of inter-alpha inhibitor protein (IaIp) in infants with necrotizing enterocolitis (NEC), spontaneous intestinal perforation (SIP), and matched controls to assess the diagnostic accuracy of IaIp to differentiate NEC from SIP and to compare receiver operating characteristics of IaIp for NEC with C-reactive protein (CRP). STUDY DESIGN: A prospective, nested case-control study of infants with feeding intolerance was carried out...
October 10, 2016: Journal of Pediatrics
Stephanie Prescott, Jessica Keim-Malpass
BACKGROUND: The incidence of hemodynamically significant patent ductus arteriosus (hsPDA) increases with decreasing gestational age and is associated with many common morbidities of extreme prematurity. Controversies remain surrounding the definition of hsPDA, the population of infants requiring treatment, the appropriate timing and method of treatment, and the outcomes associated with PDA and its therapies. PURPOSE: This integrative literature review focuses on diagnostic and treatment recommendations derived from the highest levels of evidence...
October 8, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Soo-Hong Kim, Yong-Hoon Cho, Hae-Young Kim
PURPOSE: Spontaneous colon perforations are usually encountered as necrotizing enterocolitis in the neonatal period, but occur rarely in infants and children without pathological conditions. This study was conducted to describe its clinical implication beyond the neonatal period. METHODS: Cases of spontaneous colon perforation confirmed after the operation were reviewed retrospectively and the clinicopathological characteristics were analyzed. Clinical data were compared according to the presence of pneumoperitoneum as initial findings...
September 2016: Pediatric Gastroenterology, Hepatology & Nutrition
Jens Henrichs, Viki Verfaille, Laura Viester, Myrte Westerneng, Bert Molewijk, Arie Franx, Henriette van der Horst, Judith E Bosmans, Ank de Jonge, Petra Jellema
BACKGROUND: Intrauterine growth retardation (IUGR) is a major risk factor for perinatal mortality and morbidity. Thus, there is a compelling need to introduce sensitive measures to detect IUGR fetuses. Routine third trimester ultrasonography is increasingly used to detect IUGR. However, we lack evidence for its clinical effectiveness and cost-effectiveness and information on ethical considerations of additional third trimester ultrasonography. This nationwide stepped wedge cluster-randomized trial examines the (cost-)effectiveness of routine third trimester ultrasonography in reducing severe adverse perinatal outcome through subsequent protocolized management...
October 13, 2016: BMC Pregnancy and Childbirth
Y Yang, J-J Pan, X-G Zhou, X-Y Zhou, R Cheng, Y-H Hu
OBJECTIVE: The application of intravenous immune globulin (IVIG) has been recommended for treating hemolysis in neonates for several years. But in clinical work, more than one study reported that IVIG treatment maybe increased the risk of NEC in hemolytic patients. In light of this situation, we performed this meta-analysis. MATERIALS AND METHODS: We searched in PubMed, Embase, Cochrane databases for English references, and in Wanfang, VIP, Cnki databases for Chinese references (all last launched on 2015/12/18)...
September 2016: European Review for Medical and Pharmacological Sciences
Liran Hiersch, Mayan Eitan, Eran Ashwal, Boaz Weisz, Benny Chayen, Shlomo Lipitz, Yoav Yinon
OBJECTIVE: To estimate the risk for twin anemia-polycythemia sequence (TAPS) and adverse perinatal outcome in monochorionic diamniotic (MCDA) twin pregnancies with amniotic fluid discordance (AFD). METHODS: Retrospective cohort study of 34 MCDA pregnancies with AFD (intertwin difference of ≥3 cm in maximal vertical pocket measurement) without meeting the criteria for twin to twin transfusion syndrome (TTTS) or selective intrauterine growth restriction (sIUGR)...
October 12, 2016: Prenatal Diagnosis
Manuela Molinaro, Massimo Aiazzi, Antonio La Torre, Elisabetta Cini, Roberto Banfi
Preterm infants are at high risk of neonatal sepsis. We report a case of a preterm infant under prophylaxis with Lactobacillus Rhamnosus for necrotizing enterocolitis; the child develops neonatal sepsis by Lactobacillus Rhamnosus. The infection is improved after probiotic withdrawal and had complete remission after 20 days of specific antibiotic therapy.
September 2016: Recenti Progressi in Medicina
Sanjay Chawla, Girija Natarajan, Seetha Shankaran, Athina Pappas, Barbara J Stoll, Waldemar A Carlo, Shampa Saha, Abhik Das, Abbot R Laptook, Rosemary D Higgins
Importance: Many premature infants are born without exposure to antenatal steroids (ANS) or with incomplete courses. This study evaluates the dose-dependent effect of ANS on rates of neonatal morbidities and early childhood neurodevelopmental outcomes of extremely premature infants. Objective: To compare rates of neonatal morbidities and 18- to 22-month neurodevelopmental outcomes of extremely premature infants exposed to no ANS or partial or complete courses of ANS...
October 10, 2016: JAMA Pediatrics
Laura Martínez-Rodríguez, Javier Estañ, Jose D Bermudez, Agustin Molina, Veronica Hortelano, Cecilia Martinez-Costa
No abstract text is available yet for this article.
October 7, 2016: Early Human Development
Sarah A Moore, Prashant Nighot, Cynthia Reyes, Manmeet Rawat, Jason McKee, David Lemon, Joshua Hanson, Thomas Y Ma
BACKGROUND: Intestinal barrier dysfunction has been implicated in necrotizing enterocolitis (NEC), but has not been directly measured in human NEC. METHODS: Small intestines removed during surgery were immediately mounted in an Ussing chamber. mRNA expression of tight junction (TJ) proteins was measured with RT-PCR. RESULTS: Fifteen infants were included, 5 with NEC and 10 with other diagnoses. Average transepithelial resistance (TER) was 11...
September 15, 2016: Journal of Pediatric Surgery
Mustafa Kemal Avsar, Tolga Demir, Cem Celiksular, Cenap Zeybek
BACKGROUND: PDA(Patent ductus arteriosus) is a common and clinically important condition which is presented with a number of hemodynamic and respiratory problems such as intraventricular hemorrhage, pulmonary hemorrhage and necrotizing enterocolitis due to increased pulmonary blood flow and stealing from systemic circulation. The incidence of PDA among the infants that were born before the 28th gestational week is as high as 70 %; and spontaneous closure rates in very-low-birth-weight premature neonates(VLBWPN) is around 34 %...
October 4, 2016: Journal of Cardiothoracic Surgery
Delphine Arni, Oliver Karam, Isabelle Vidal, Peter C Rimensberger, Sylviane Hanquinet, Barbara E Wildhaber
Background Management of children with necrotizing enterocolitis (NEC) remains challenging. Various scores try to facilitate therapeutic decision-making. We aim to assess the agreement of three scores intending to predict the need for surgery and/or mortality in our patient cohort, and analyze agreement between the different scores. Methods This study is a retrospective analysis of patients with NEC Bell's stage II and III, managed in a single institution (1991-2011). Three existing scores (Metabolic Derangement Acuity score, NEC score, Detroit score) were calculated individually for each patient...
October 5, 2016: European Journal of Pediatric Surgery
Crista A Hopp, Ida Sue Baron
OBJECTIVE: Children delivered at the edge of viability are at greatest risk of medical and neuropsychological disability, their adverse outcomes overshadowing extremely preterm survivors with more optimal outcomes. We aimed to describe an exceptionally early-born extremely preterm (EEEP) preschooler whose neurobiological, familial, and socioeconomic factors likely influenced her unexpected cognitive resilience. METHOD: Baby G was a 3-years 10-months-old, English-speaking, Caucasian, singleton girl born weighing 435 g at 22(5/7) weeks' gestation to well-educated married parents...
October 5, 2016: Clinical Neuropsychologist
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