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By Angel Flores
Agata Kantorowska, Julia C Wei, Ronald S Cohen, Ruth A Lawrence, Jeffrey B Gould, Henry C Lee
OBJECTIVES: To examine the availability of donor human milk (DHM) in a population-based cohort and assess whether the availability of DHM was associated with rates of breast milk feeding at NICU discharge and rates of necrotizing enterocolitis (NEC). METHODS: Individual patient clinical data for very low birth weight infants from the California Perinatal Quality Care Collaborative were linked to hospital-level data on DHM availability from the Mothers' Milk Bank of San José for 2007 to 2013...
March 2016: Pediatrics
Angelica Dessì, Roberta Pintus, Silvia Marras, Flaminia Cesare Marincola, Anna De Magistris, Vassilios Fanos
Necrotizing enterocolitis (NEC) is a serious inflammation of the bowel that most often affects premature infants. The exact cause of NEC is still poorly understood but investigators believe that these different factors can play an important role: prematurity and immaturity of the intestine of the preterm newborns, differences in the intestinal bacterial colonization and an abnormal immune response. Since the early symptoms of NEC are often rather non-specific, the diagnosis of NEC can be difficult. Therefore, the search for diagnostic biomarkers for NEC remains warranted...
October 2016: Expert Review of Molecular Diagnostics
Diego F Niño, Chhinder P Sodhi, David J Hackam
Necrotizing enterocolitis (NEC) is the most frequent and lethal disease of the gastrointestinal tract of preterm infants. At present, NEC is thought to develop in the premature host in the setting of bacterial colonization, often after administration of non-breast milk feeds, and disease onset is thought to be due in part to a baseline increased reactivity of the premature intestinal mucosa to microbial ligands as compared with the full-term intestinal mucosa. The increased reactivity leads to mucosal destruction and impaired mesenteric perfusion and partly reflects an increased expression of the bacterial receptor Toll-like receptor 4 (TLR4) in the premature gut, as well as other factors that predispose the intestine to a hyper-reactive state in response to colonizing microorganisms...
October 2016: Nature Reviews. Gastroenterology & Hepatology
Silvia Martini, Arianna Aceti, Mario Lima, Michela Maffi, Giacomo Faldella, Luigi Corvaglia
Necrotizing enterocolitis (NEC) is the most severe gastrointestinal complication of prematurity. Surgery, either peritoneal drainage placement or laparotomy with resection of the intestinal necrotic tracts, is the definitive treatment of perforated NEC; however, when clinical conditions contraindicate surgical approaches, little is known about medical treatments adjuvant or alternative to surgery. Octreotide is a synthetic somatostatin analog that inhibits pancreatic secretion and leads to splanchnic vasoconstriction...
August 2016: Pediatrics
Tim G J de Meij, Marc P C van der Schee, Daan J C Berkhout, Mirjam E van de Velde, Anna E Jansen, Boris W Kramer, Mirjam M van Weissenbruch, Anton H van Kaam, Peter Andriessen, Johannes B van Goudoever, Hendrik J Niemarkt, Nanne K H de Boer
OBJECTIVES: To test the hypothesis that fecal volatile organic compounds (VOCs) analysis by electronic nose (eNose) allows for early detection of necrotizing enterocolitis (NEC). STUDY DESIGN: In 3 neonatal intensive care units, fecal samples of infants born at gestational age ≤ 30 weeks were collected daily, up to the 28th day of life. Included infants were allocated in 3 subgroups: NEC, sepsis, and matched controls. Three time windows were defined: (1) T-5,-4 (5 and 4 days before diagnosis); (2) T-3,-2 (3 and 2 days before diagnosis); and (3) T-1,0 (day before and day of diagnosis)...
September 2015: Journal of Pediatrics
Dilek Dilli, Banu Aydin, Nurdan Dinlen Fettah, Elif Özyazıcı, Serdar Beken, Ayşegül Zenciroğlu, Nurullah Okumuş, Banu Mutlu Özyurt, Mehmet Şah İpek, Arzu Akdağ, Özden Turan, Şenol Bozdağ
OBJECTIVE: To test the efficacy of probiotic and prebiotic, alone or combined (synbiotic), on the prevention of necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants. STUDY DESIGN: A prospective, randomized, controlled trial was conducted at 5 neonatal intensive care units in Turkey. VLBW infants (n = 400) were assigned to a control group and 3 study groups that were given probiotic (Bifidobacterium lactis), prebiotic (inulin), or synbiotic (Bifidobacterium lactis plus inulin) added to breastmilk or formula for a maximum of 8 weeks before discharge or death...
March 2015: Journal of Pediatrics
Matthew J Bizzarro, Richard A Ehrenkranz, Patrick G Gallagher
OBJECTIVE: To determine the incidence, microbiology, risk factors, and outcomes related to bloodstream infections (BSIs) concurrent with the onset of necrotizing enterocolitis (NEC). STUDY DESIGN: We performed a retrospective review of all cases of NEC in a single center over 20 years. BSI was categorized as "NEC-associated" if it occurred within 72 hours of the diagnosis of NEC and "post-NEC" if it occurred >72 hours afterwards. Demographics, hospital course data, microbiologic data, and outcomes were compared via univariate and multivariate analyses...
January 2014: Journal of Pediatrics
Melissa A Hull, Jeremy G Fisher, Ivan M Gutierrez, Brian A Jones, Kuang Horng Kang, Michael Kenny, David Zurakowski, Biren P Modi, Jeffrey D Horbar, Tom Jaksic
BACKGROUND: Necrotizing enterocolitis (NEC) is a leading cause of death in very low birth weight (VLBW) neonates. The overall mortality of NEC is well documented. However, those requiring surgery appear to have increased mortality compared with those managed medically. The objective of this study was to establish national birth-weight-based benchmarks for the mortality of surgical NEC and describe the use and mortality of laparotomy vs peritoneal drainage. STUDY DESIGN: There were 655 US centers that prospectively evaluated 188,703 VLBW neonates (401 to 1,500 g) between 2006 and 2010...
June 2014: Journal of the American College of Surgeons
Hendrik J Niemarkt, Tim G J de Meij, Mirjam E van de Velde, Marc P van der Schee, Johannes B van Goudoever, Boris W Kramer, Peter Andriessen, Nanne K H de Boer
Necrotizing enterocolitis (NEC) remains one of the most frequent gastrointestinal diseases in the neonatal intensive care unit, with a continuing unacceptable high mortality and morbidity rates. Up to 20% to 40% of infants with NEC will need surgical intervention at some point. Although the exact pathophysiology is not yet elucidated, prematurity, use of formula feeding, and an altered intestinal microbiota are supposed to induce an inflammatory response of the immature intestine. The clinical picture of NEC has been well described...
February 2015: Inflammatory Bowel Diseases
Eddy W Y Ng, Terence C W Poon, Hugh S Lam, Hon M Cheung, Terence P Y Ma, Kathy Y Y Chan, Raymond P O Wong, Kam T Leung, Melody M T Lam, Karen Li, Pak C Ng
OBJECTIVES: To evaluate the use of gut barrier proteins, liver-fatty acid binding protein (L-FABP), intestinal-fatty acid binding protein (I-FABP), and trefoil factor 3 (TFF3), as biomarkers for differentiating necrotizing enterocolitis (NEC) from septicemic/control infants and to identify the most severely affected surgical NEC from nonsurgical NEC infants. BACKGROUND: Clinical features and routine radiologic investigations have low diagnostic utilities in identifying surgical NEC patients...
December 2013: Annals of Surgery
Nicolas de Prost, Emilie Sbidian, Olivier Chosidow, Christian Brun-Buisson, Roland Amathieu
No abstract text is available yet for this article.
August 2015: Intensive Care Medicine
Amy L Hammers, Luis Sanchez-Ramos, Andrew M Kaunitz
OBJECTIVE: The purpose of this study was to provide an updated summary of the literature regarding the effects of tocolysis with indomethacin on neonatal outcome by systematically reviewing previously and recently reported data. STUDY DESIGN: All previously reported studies pertaining to indomethacin tocolysis and neonatal outcomes along with recently reported data were identified with the use of electronic databases that had been supplemented with references that were cited in original studies and review articles...
April 2015: American Journal of Obstetrics and Gynecology
Fardou H Heida, Anne G J F van Zoonen, Jan B F Hulscher, Bastiaan J C Te Kiefte, Rianne Wessels, Elisabeth M W Kooi, Arend F Bos, Hermie J M Harmsen, Marcus C de Goffau
BACKGROUND: Anomalous intestinal microbiota development is supposedly associated with development of necrotizing enterocolitis (NEC). Our aim in this study was to identify the intestinal microbiota of patients at risk for NEC. METHODS: In a prospective trial that investigated prognostic factors for development of NEC in high-risk neonates (NTR4153), 11 NEC cases were gestational age/birthweight matched with controls (ratio of 1:2). Feces were collected twice a week...
April 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
M J Mϋller, T Paul, S Seeliger
Necrotizing enterocolitis (NEC) is the most common acquired disease of the gastrointestinal tract (GIT) in premature infants and newborns. It is defined as an ulcerative inflammation of the intestinal wall. The clinical signs of incipient NEC are often very discrete, and range from localized intestinal symptoms to generalized signs of sepsis. NEC is classified depending on its severity into disease states according to the modified Bell's Classification. Treatment of NEC ranges, depending on its severity, from a conservative therapeutic approach to surgery with resection of the affected parts of the intestine...
September 16, 2016: Journal of Neonatal-perinatal Medicine
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