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https://www.readbyqxmd.com/read/29241163/diagnosis-and-management-of-necrotizing-enterocolitis-an-international-survey-of-neonatologists-and-pediatric-surgeons
#1
Mélanie Valpacos, Delphine Arni, Amy Keir, Ann Aspirot, James C H Wilde, Spencer Beasley, Daniele De Luca, Riccardo E Pfister, Oliver Karam
BACKGROUND: Necrotizing enterocolitis (NEC) is a serious complication of prematurity. Currently, there is limited evidence to guide investigation and treatment strategies. OBJECTIVES: To evaluate the parameters used to diagnose or exclude NEC, and to identify differences between neonatologists and pediatric surgeons. METHODS: A scenario-based survey was sent to neonatologists and pediatric surgeons. RESULTS: 173 physicians from 26 countries completed the survey (55% neonatologists and 45% pediatric surgeons)...
December 15, 2017: Neonatology
https://www.readbyqxmd.com/read/29234596/exploring-the-multiple-hit-hypothesis-of-preterm-white-matter-damage-using-diffusion-mri
#2
Madeleine L Barnett, Nora Tusor, Gareth Ball, Andrew Chew, Shona Falconer, Paul Aljabar, Jessica A Kimpton, Nigel Kennea, Mary Rutherford, A David Edwards, Serena J Counsell
Background: Preterm infants are at high risk of diffuse white matter injury and adverse neurodevelopmental outcome. The multiple hit hypothesis suggests that the risk of white matter injury increases with cumulative exposure to multiple perinatal risk factors. Our aim was to test this hypothesis in a large cohort of preterm infants using diffusion weighted magnetic resonance imaging (dMRI). Methods: We studied 491 infants (52% male) without focal destructive brain lesions born at < 34 weeks, who underwent structural and dMRI at a specialist Neonatal Imaging Centre...
2018: NeuroImage: Clinical
https://www.readbyqxmd.com/read/29228827/conservative-versus-active-management-in-hellp-syndrome-results-from-a-cohort-study
#3
Marie Cavaignac-Vitalis, Fabien Vidal, M D Caroline Simon-Toulza, Pierre Boulot, Paul Guerby, Elodie Chantalat, Parant M D Olivier
OBJECTIVE: HELLP syndrome exposes to severe maternal and fetal complications. Prompt delivery is thus recommended after 34 weeks of gestation, or earlier in case of nonreassuring maternofetal conditions. However, no consensus has been raised in the treatment of HELLP syndrome occurring before 34 weeks of gestation, when both maternal and fetal conditions are stable: it remains still unclear whether an active attitude should be prioritized over expectant management. Herein we aimed to compare mother and child outcomes according to the type of obstetrical management, either active or conservative...
December 11, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29223416/cost-variation-across-centers-for-the-norwood-operation
#4
Kimberly E McHugh, Sara K Pasquali, Matthew A Hall, Mark A Scheurer
BACKGROUND: The Norwood operation is associated with high health care utilization, and prior studies reported substantial variability in Norwood costs across centers. However, specific factors driving this cost variation are unclear. We assessed center variability in Norwood costs and underlying mechanisms in a multicenter cohort. METHODS: Clinical data from the Pediatric Heart Network Single Ventricle Reconstruction trial were linked with cost data from the Children's Hospital Association Inpatient Essentials database...
December 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29222137/benefits-of-probiotics-in-preterm-neonates-in-low-income-and-medium-income-countries-a-systematic-review-of-randomised-controlled-trials
#5
Girish Deshpande, Gayatri Jape, Shripada Rao, Sanjay Patole
OBJECTIVE: Although there is an overall reduction in underfive mortality rate, the progress in reducing neonatal mortality rate has been very slow. Over the last 20 years, preterm births have steadily increased in low-income and medium-income countries (LMICs) particularly in sub-Saharan Africa and South Asia. Preterm birth is associated with increased mortality and morbidity, particularly in LMICs. Based on systematic reviews of randomised controlled trials (RCTs), many neonatal units in high-income countries have adopted probiotics as standard of care for preterm neonates...
December 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/29218832/necrotizing-enterocolitis-in-the-setting-of-milk-allergy-after-pediatric-living-donor-liver-transplantation
#6
Soichi Narumoto, Seisuke Sakamoto, Hajime Uchida, Kengo Sasaki, Takanobu Shigeta, Akinari Fukuda, Shunsuke Nosaka, Rie Irie, Takako Yoshioka, Mureo Kasahara
NEC is an idiopathic intestinal mucosal injury that may progress to transmural bowel necrosis without mesenteric ischemia. NEC usually affects 7- to 10-day-old neonates following enteral feeding. A 10-month-old girl with no history of laparotomy underwent LDLT for acute liver failure. After starting enteral feeding on postoperative day 5, she developed abdominal distention. Diffuse PVG and PI were detected by radiologic modalities. Exploratory laparotomy revealed patchy necrosis of the intestine without perforation...
December 7, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29212397/growth-and-neurodevelopment-in-very-preterm-infants-receiving-a-high-enteral-volume-feeding-regimen-a-population-based-cohort-study
#7
Claus Klingenberg, Fredrik Kragh Muraas, Catherine Elde Isaksen, Tina Nilsen, Marte Torgersen, Cecilie Melum-Hansen
AIM: To evaluate a feeding regimen routinely providing > 180 ml/kg/d fortified human milk to very preterm infants and impact on in-hospital growth, osteopenia and neurodevelopment. METHOD: Retrospective population-based descriptive study of infants < 30-week gestation admitted within 24 h of birth and discharged during the 6-year period 2005 to 2010. Growth and neurodevelopment was assessed until 2 years corrected age, and cerebral palsy up to 4 years corrected age Results: Ninety-nine infants below 30-week gestation were admitted within 24 h of birth during the 6-year period, of which 84 (85%) survived to discharge...
December 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29210890/allergic-colitis-with-pneumatosis-intestinalis-in-an-infant
#8
Helena Liu, Troy W S Turner
Inflammatory causes of bloody diarrhea during infancy include necrotizing enterocolitis and allergic colitis, often due to cow's milk protein. We report this case of cow's milk protein allergy, managed successfully with elimination of dietary antigen, to highlight the unusual finding of pneumatosis intestinalis on abdominal x-ray, a radiographic hallmark associated with necrotizing enterocolitis. Detailed patient's history, clinical presentation, and physical examinations are discussed for cow's milk protein allergy and necrotizing enterocolitis...
November 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29208662/antenatal-corticosteroids-in-impending-preterm-deliveries-before-25-weeks-gestation
#9
Mangesh Deshmukh, Sanjay Patole
Antenatal corticosteroid (ANC) use before 25 weeks' gestation is controversial. Our previous systematic review (eight observational studies, n=10 109) showed that ANC exposure was associated with significantly reduced mortality and severe intraventricular haemorrhage (IVH)/periventricular leukomalacia (PVL) in neonates born <25 weeks. We update our review by adding data (n=3334) from a recent study. We used Cochrane methodology and summarised the results using GRADE (The Grading of Recommendations Assessment, Development and Evaluation) guidelines...
December 5, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29204140/comparative-outer-membrane-protein-analysis-of-high-and-low-invasive-strains-of-cronobacter-malonaticus
#10
Maha A Aldubyan, Ibtesam S Almami, Fatiha M Benslimane, Abdlrhman M Alsonosi, Stephen J Forsythe
Cronobacter are an important group of foodborne pathogens that has been linked to life-threatening infections in both infants and adults. The major infections associated with Cronobacter species are neonatal meningitis, necrotizing enterocolitis, and septicaemia. There are seven species in the Cronobacter genus, of which only three are of clinical importance; Cronobacter sakazakii, Cronobacter malonaticus, and Cronobacter turicensis. To date most studies have focussed on C. sakazakii as it is the major species associated with neonatal infections...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29199963/food-protein-induced-enterocolitis-syndrome-in-response-to-quail-s-egg-in-a-child-without-hen-s-egg-allergy
#11
M Akashi, S Sato
No abstract text is available yet for this article.
2017: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/29198543/exposure-to-gastric-acid-inhibitors-increases-the-risk-of-infection-in-preterm-very-low-birth-weight-infants-but-concomitant-administration-of-lactoferrin-counteracts-this-effect
#12
Paolo Manzoni, Ruben García Sánchez, Michael Meyer, Ilaria Stolfi, Lorenza Pugni, Hubert Messner, Silvia Cattani, Pasqua Maria Betta, Luigi Memo, Lidia Decembrino, Lina Bollani, Matteo Rinaldi, Maria Fioretti, Michele Quercia, Milena Maule, Elena Tavella, Alessandro Mussa, Chryssoula Tzialla, Nicola Laforgia, Fabio Mosca, Rosario Magaldi, Michael Mostert, Daniele Farina
OBJECTIVE: To investigate whether exposure to inhibitors of gastric acidity, such as H2 blockers or proton pump inhibitors, can independently increase the risk of infections in very low birth weight (VLBW) preterm infants in the neonatal intensive care unit. STUDY DESIGN: This is a secondary analysis of prospectively collected data from a multicenter, randomized controlled trial of bovine lactoferrin (BLF) supplementation (with or without the probiotic Lactobacillus rhamnosus GG) vs placebo in prevention of late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) in preterm infants...
November 30, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29198411/epileptic-spasms-secondary-to-acute-cerebral-and-cerebellar-encephalitis
#13
Tohru Okanishi, Ayataka Fujimoto, Risa Hashimoto, Mitsuyo Nishimura, Sotaro Kanai, Miho Ogawa, Takayuki Suzuki, Hirotaka Motoi, Yukitoshi Takahashi, Hideo Enoki
BACKGROUND: Patients with infection-related acute encephalitis sometimes develop epilepsy in the chronic phase of the disease. Patients with postencephalitic epilepsy usually develop partial seizures due to the lesions generated by the encephalitis. We report a case who developed late-onset epileptic spasms after acute cerebral and cerebellar encephalitis. CASE REPORT: A 5-year-old girl showed severe tremor, gait ataxia, partial or generalized tonic-clonic seizures, hyperactivity, and panic attacks after a mild enterocolitis...
November 29, 2017: Brain & Development
https://www.readbyqxmd.com/read/29197867/topical-coconut-oil-in-very-preterm-infants-an-open-label-randomised-controlled-trial
#14
Tobias Strunk, Sameer Pupala, Julie Hibbert, Dorota Doherty, Sanjay Patole
BACKGROUND: The immature fragile skin of preterm infants represents an inadequate protective barrier. The emollient and anti-infective properties of coconut oil make it a potentially beneficial topical agent for this population. OBJECTIVES: Our aim was to evaluate feasibility, safety, and the effects of topical coconut oil on skin condition in very preterm infants. METHODS: An open-label randomised controlled trial in preterm infants <30 weeks' gestation was conducted...
December 1, 2017: Neonatology
https://www.readbyqxmd.com/read/29196880/role-of-intestinal-hsp70-in-barrier-maintenance-contribution-of-milk-to-the-induction-of-hsp70-2
#15
Rebecca M Rentea, Yuee Guo, Xiaorong Zhu, Mark W Musch, Eugene B Chang, David M Gourlay, Jennifer L Liedel
BACKGROUND: Necrotizing enterocolitis (NEC) is a gastrointestinal disease of complex etiology resulting in devastating systemic inflammation and often death in premature newborns. We previously demonstrated that formula feeding inhibits ileal expression of heat shock protein-70 (Hsp70), a critical stress protein within the intestine. Barrier function for the premature intestine is critical. We sought to determine whether reduced Hsp70 protein expression increases neonatal intestinal permeability...
December 1, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/29196510/necrotizing-enterocolitis
#16
Barrie S Rich, Stephen E Dolgin
Necrotizing enterocolitis (NEC) is a frequently encountered condition in the premature neonate, which can have devastating effects. The signs and symptoms of NEC are variable and can be confused with those of sepsis. An abdominal radiograph is often obtained for diagnosis, and findings that indicate NEC include pneumatosis and portal venous gas. The treatment of NEC includes gastrointestinal rest, gastric decompression, broad-spectrum intravenous antibiotics, and systemic support. A finding of pneumoperitoneum signifies intestinal perforation, which requires surgical intervention...
December 2017: Pediatrics in Review
https://www.readbyqxmd.com/read/29190854/-clostridium-difficile-infection-epidemiology-clinical-presentation-therapy-and-prevention
#17
Magnus Kaffarnik, Caroline Isner, Uwe Hamsen
Clostridium difficile infections (CDI) are common causes of diarrhoea in hospitalised medical and surgical patients. Clinical presentation ranges from mild diarrhoea to pseudomembraneous enterocolitis of the colon and sometimes the small intestines, with development of a toxic megacolon. Recurrent infections are common. Early diagnosis is necessary because of high rates of complications and mortality. Knowledge of risk factors for the development of CDI is recommended. Early initiation of therapy is recommended to avoid complications and standard therapy is antibiotics, while therapy with monoclonal antibodies and vaccination is under research and development...
November 30, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29190848/temporal-relationship-of-onset-of-necrotizing-enterocolitis-and-introduction-of-enteric-feedings-and-powdered-milk-fortifier
#18
Yana Vaks, Krista L Birnie, Suzan L Carmichael, Tina Hernandez-Boussard, William E Benitz
No abstract text is available yet for this article.
November 30, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/29190745/colonization-with-escherichia-coli-ec-25-protects-neonatal-rats-from-necrotizing-enterocolitis
#19
Debi M Thomas, Brandon Bell, Stephanie Papillon, Patrick Delaplain, Joanna Lim, Jamie Golden, Jordan Bowling, Jin Wang, Larry Wang, Anatoly V Grishin, Henri R Ford
Necrotizing enterocolitis (NEC) is a significant cause of morbidity and mortality in premature infants; yet its pathogenesis remains poorly understood. To evaluate the role of intestinal bacteria in protection against NEC, we assessed the ability of naturally occurring intestinal colonizer E. coli EC25 to influence composition of intestinal microbiota and NEC pathology in the neonatal rat model. Experimental NEC was induced in neonatal rats by formula feeding/hypoxia, and graded histologically. Bacterial populations were characterized by plating on blood agar, scoring colony classes, and identifying each class by sequencing 16S rDNA...
2017: PloS One
https://www.readbyqxmd.com/read/29187842/low-microbial-diversity-and-abnormal-microbial-succession-is-associated-with-necrotizing-enterocolitis-in-preterm-infants
#20
Priscila T Dobbler, Renato S Procianoy, Volker Mai, Rita C Silveira, Andréa L Corso, Bruna S Rojas, Luiz F W Roesch
Despite increased efforts, the diverse etiologies of Necrotizing Enterocolitis (NEC) have remained largely elusive. Clinical predictors of NEC remain ill-defined and currently lack sufficient specificity. The development of a thorough understanding of initial gut microbiota colonization pattern in preterm infants might help to improve early detection or prediction of NEC and its associated morbidities. Here we compared the fecal microbiota successions, microbial diversity, abundance and structure of newborns that developed NEC with preterm controls...
2017: Frontiers in Microbiology
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