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Necrotizing Enterocolitis

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Intravenous pentoxifylline is well tolerated in critically ill preterm infants with sepsis or necrotizing enterocolitis.

Simone S Schüller, Kristina Kempf, Lukas Unterasinger, Tobias Strunk, Angelika Berger,

Pentoxifylline (PTX) is a candidate adjuvant medication for the treatment of sepsis and necrotizing enterocolitis in preterm infants. There is only limited data on safety and compatibility with other commonly used intravenous medications. This retrospective single-center study of 198 preterm infants (September 2012-September 2018) was performed at a level IV ... Read more >>

Eur. J. Pediatr. (European Journal of Pediatrics)
[2020, :]

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Necrotizing Enterocolitis and Associated Mortality in Neonates With Congenital Heart Disease: A Multi-Institutional Study.

Joseph A Spinner, Shaine A Morris, Deipanjan Nandi, Andrew T Costarino, Bradley S Marino, Joseph W Rossano, Pirouz Shamszad,

OBJECTIVE:There are scarce data about the prevalence and mortality of necrotizing enterocolitis in neonates with congenital heart disease. The purpose of this study is to provide a multi-institutional description and comparison of the overall prevalence and mortality of necrotizing enterocolitis in neonates with congenital heart disease. DESIGN:Retrospective multi-institutional study. SETTING:The ... Read more >>

Pediatr Crit Care Med (Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies)
[2020, 21(3):228-234]

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Cronobacter sakazakii induces necrotizing enterocolitis by regulating NLRP3 inflammasome expression via TLR4.

Zhenhui Chen, Yiduo Zhang, Ruqin Lin, Xiaojing Meng, Wei Zhao, Wei Shen, Hongying Fan,

Introduction. Neonatal infection with Cronobacter sakazakii can cause severe intestinal damage and necrotizing enterocolitis (NEC). The inflammasome and Toll-like receptors mediate intestinal damage caused by other intestinal pathogens causing NEC, but the exact mechanism is unclear.Aim. We evaluated the molecular mechanisms underlying C. sakazakii-induced NEC.Methodology. The effects of C. sakazakii ... Read more >>

J. Med. Microbiol. (Journal of medical microbiology)
[2020, :]

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Necrotizing Enterocolitis: The Future.

Josef Neu,

Progress in our understanding of the pathophysiology, prevention and treatment of necrotizing enterocolitis (NEC) has been hampered for many reasons. Included among these is the fact that what we are calling "NEC" is likely to represent different disease processes, which need to be delineated before evaluating individual pathogenic mechanisms and ... Read more >>

Neonatology (Neonatology)
[2020, :1-5]

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Global Incidence of Necrotizing Enterocolitis: a Systematic Review and Incidence Meta-Analysis

Lukman Thalib, Amer Alsaied, Nazmul Islam,

<title>Abstract</title> <p> <bold>Background:</bold> Necrotizing Enterocolitis (NEC) is a major source of morbidity and mortality in the Neonatal Intensive Care Unit (NICU), yet the global incidence is not systematically evaluated. We conducted a systematic review and Meta-Analysis of cohort studies reporting the incidence of NEC in infants with Very ... Read more >>

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The human milk oligosaccharides 2'-fucosyllactose and 6'-sialyllactose protect against the development of necrotizing enterocolitis by inhibiting toll-like receptor 4 signaling.

Chhinder P Sodhi, Peter Wipf, Yukihiro Yamaguchi, William B Fulton, Mark Kovler, Diego F Niño, Qinjie Zhou, Emilyn Banfield, Adam D Werts, Mitchell R Ladd, Rachael H Buck, Karen C Goehring, Thomas Prindle, Sanxia Wang, Hongpeng Jia, Peng Lu, David J Hackam,

BACKGROUND:Necrotizing enterocolitis (NEC) develops through exaggerated toll-like receptor 4 (TLR4) signaling in the intestinal epithelium. Breast milk is rich in non-digestible oligosaccharides and prevents NEC through unclear mechanisms. We now hypothesize that the human milk oligosaccharides 2'-fucosyllactose (2'-FL) and 6'-sialyllactose (6'-SL) can reduce NEC through inhibition of TLR4 signaling. METHODS:NEC ... Read more >>

Pediatr. Res. (Pediatric research)
[2020, :]

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Necrotizing Enterocolitis: A Multi-omic Approach and the Role of the Microbiome.

Josef Neu,

Necrotizing enterocolitis (NEC) is a poorly defined disease that primarily affects preterm infants. There has not been much progress in the prevention or treatment of NEC since it became recognized as a common problem in preterm infants. Reasons for this lack of progress include the likelihood that different diseases are ... Read more >>

Dig. Dis. Sci. (Digestive diseases and sciences)
[2020, 65(3):789-796]

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Invited Commentary on "Safety and efficacy of Lactobacillus for preventing necrotizing enterocolitis in preterm infants: A systematic review and meta-analysis" (Int J Surg 2020; 76:79-87).

Henk-Jan Schuurman,

Int J Surg (International journal of surgery (London, England))
[2020, 77:30-31]

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Analysis of Disialyllacto-N-Tetraose (DSLNT) Content in Milk From Mothers of Preterm Infants.

Denise Hassinger, Dana M Clausen, Sarah Nitka, Aimee Herdt, Ian Griffin,

BACKGROUND:Human milk oligosaccharides (HMO) have been recognized for the protective effects they may elicit among high risk infants. One HMO, disialyllacto-N-tetraose (DSLNT), has been shown to reduce the risk for developing necrotizing enterocolitis in preterm infants. RESEARCH AIMS:To measure DSLNT content in the human milk from mothers of preterm infants, ... Read more >>

J Hum Lact (Journal of human lactation : official journal of International Lactation Consultant Association)
[2020, :890334420904041]

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Safety and efficacy of Lactobacillus for preventing necrotizing enterocolitis in preterm infants.

Dapeng Liu, Leipeng Shao, Yaodong Zhang, Wenqing Kang,

AIM:To evaluate the safety and efficacy of Lactobacillus for preventing necrotizing enterocolitis (NEC) in preterm infants. METHODS:We searched the Cochrane Library, PubMed, EMBASE, and Web of Science databases from inception to September 2019. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated to compare outcomes. We also performed a ... Read more >>

Int J Surg (International journal of surgery (London, England))
[2020, 76:79-87]

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ROCK1 Inhibitor Stabilizes E-cadherin and Improves Barrier Function in Experimental Necrotizing Enterocolitis.

Christie Buonpane, Carrie Y Yuan, Douglas R Wood, Guillermo Ares, Samuel C Klonoski, Catherine J Hunter,

Necrotizing enterocolitis (NEC) is a devastating gastrointestinal disease of newborns. Although incompletely understood, NEC is associated with intestinal barrier dysfunction. E-cadherin, an adherens junction, is a protein complex integral in maintaining normal barrier homeostasis. ROCK1 is a kinase that regulates the E-cadherin complex and p120-catenin is a subunit of the ... Read more >>

Am. J. Physiol. Gastrointest. Liver Physiol. (American journal of physiology. Gastrointestinal and liver physiology)
[2020, :]

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Normative Values for Potential Necrotizing Enterocolitis Biomarkers Across Gestational Ages

Darla Shores, Jennifer Fundora, Mitzi Go, Fauzia Shakeel, Sandra Brooks, Samuel Alaish, Jun Yang, Chhinder Sodhi, David Hackam, Allen Everett,

<title>Abstract</title> <p> Background: Necrotizing enterocolitis (NEC) is associated with significant morbidity and mortality. Serum biomarkers to aid diagnosis, such as intestinal fatty acid binding protein (IFABP) and calprotectin, are actively being investigated; however, the normative values of these markers among healthy premature and term infants remains unknown. Aims: ... Read more >>

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Trends in incidence and outcomes of necrotizing enterocolitis over the last 12 years: A multicenter cohort analysis.

Sam M Han, Charles R Hong, Jamie Knell, Erika M Edwards, Kate A Morrow, Roger F Soll, Biren P Modi, Jeffrey D Horbar, Tom Jaksic,

OBJECTIVE:We sought to describe changes in the incidence and mortality of necrotizing enterocolitis (NEC) and associated surgical management strategies for very low birth weight (VLBW) infants. METHODS:Data were prospectively collected on VLBW infants (≤1500 g or < 29 weeks) born 2006 to 2017 and admitted to 820 U.S. centers. NEC was defined by the presence ... Read more >>

J. Pediatr. Surg. (Journal of pediatric surgery)
[2020, :]

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Probiotics for Preterm Infants in India - Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Haribalakrishna Balasubramanian, Anitha Ananthan, Shripada Rao, Sanjay Patole,

The objective of the present study is to review current evidence from randomized controlled trials (RCTs) of probiotics for preterm infants in India. A systematic review of RCTs of probiotics for preterm infants in India was conducted using Cochrane methodology and PRISMA guidelines. Fixed effects model was used for meta-analysis. ... Read more >>

Indian J Pediatr (Indian journal of pediatrics)
[2020, :]

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Point-of-care ultrasound in the neonatal ICU.

Laura E Miller, Jason Z Stoller, María V Fraga,

PURPOSE OF REVIEW:Point-of-care ultrasound (POCUS) is an emerging clinical tool in the neonatal intensive care unit (NICU). Recent literature describing the use of POCUS for various applications in the NICU has garnered increased interest among neonatologists. RECENT FINDINGS:Diagnostic applications for POCUS in the NICU include the evaluation and serial monitoring ... Read more >>

Curr. Opin. Pediatr. (Current opinion in pediatrics)
[2020, 32(2):216-227]

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Gastric Residual to Predict Necrotizing Enterocolitis in Preterm Piglets As Models for Infants.

Susanne Soendergaard Kappel, Per Torp Sangild, Linda Hilsted, Bolette Hartmann, Thomas Thymann, Lise Aunsholt,

BACKGROUND:Necrotizing enterocolitis (NEC) is a serious intestinal inflammatory disease in preterm infants. High volume of gastric residual (GR) after oral feedings is often used as a predictor of NEC, but evidence is limited. Using NEC-sensitive preterm piglets as models, we hypothesized that GR mass and related plasma biomarkers predict early ... Read more >>

JPEN J Parenter Enteral Nutr (JPEN. Journal of parenteral and enteral nutrition)
[2020, :]

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Parent and Provider Perspectives on the Imprecise Label of "Human Milk Fortifier" in the NICU.

Jennifer Canvasser, Amy B Hair, Jae H Kim, Sarah N Taylor,

In the critical care of preterm infants, feeding is complex and potentially harmful to an immature gastrointestinal system. Parents have expressed the desire to be fully informed about what is being fed to their child, as this places them in the best position to nurture their child's health. In the ... Read more >>

Nutrients (Nutrients)
[2020, 12(3):]

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Epidemiology and microbiology of late-onset sepsis among preterm infants in China, 2015-2018: A cohort study.

Siyuan Jiang, Chuanzhong Yang, Changyi Yang, Weili Yan, Vibhuti Shah, Prakesh S Shah, Shoo K Lee, Yi Yang, Yun Cao, ,

OBJECTIVE:To describe the incidence, case-fatality rate and pathogen distribution of late-onset sepsis (LOS) among preterm infants in China and to investigate risk factors and short-term outcomes associated with LOS caused by Gram-positive bacteria, Gram-negative bacteria and fungi. METHODS:This cohort study included all infants born at <34 weeks' gestation and admitted ... Read more >>

Int. J. Infect. Dis. (International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases)
[2020, :]

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Neonatal necrotizing enterocolitis: a case series examining clinical diagnosis with discrepant versus concordant autopsy results.

Sarah L Lawrence, David Grynspan, Monica Chan, Julie Hurteau, C L Elizabeth Nizalik, Franco Momoli, Emanuela Ferretti,

OBJECTIVE:The objective of this study is to determine whether rapidity of death in necrotizing enterocolitis (NEC) increased odds of discordance between clinical and pathological diagnosis. STUDY DESIGN:Retrospective case-series study including preterm infants admitted to the NICU. RESULTS:Twenty-two infants met the selection criteria. Gross pathologic evidence of NEC was present in ... Read more >>

J Perinatol (Journal of perinatology : official journal of the California Perinatal Association)
[2020, :]

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A103 PROBIOTIC FORMULATIONS DIFFERENTIALLY AFFECT DISEASE OUTCOME IN A MOUSE MODEL OF NECROTIZING ENTEROCOLITIS.

S Robinson, H Zhu, Z Zhang, B Li, A Pierro, P M Sherman,

AbstractBackgroundNecrotizing enterocolitis (NEC) causes severe gastrointestinal disease in premature infants. A precise etiology is not yet known, but it is generally agreed that intestinal immaturity & alterations in the gut microbiota play key roles in NEC progression. There is growing interest in the clinical use of probiotics for the prevention ... Read more >>

J Can Assoc Gastroenterol (Journal of the Canadian Association of Gastroenterology)
[2020, 3(Suppl 1):119-120]

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Is Mother's Own Milk Lactoferrin Intake Associated with Reduced Neonatal Sepsis, Necrotizing Enterocolitis, and Death?

Theresa J Ochoa, Karina Mendoza, Cesar Carcamo, Jaime Zegarra, Sicilia Bellomo, Jan Jacobs, Veerle Cossey,

INTRODUCTION:Lactoferrin (LF) is a protective protein present in milk with anti-infective and immune-modulating properties. OBJECTIVES:The aim of this study was to determine the association of maternal LF intake and mother's own milk intake in the first 10 days of life on the prevention of late-onset sepsis (LOS), necrotizing enterocolitis (NEC), ... Read more >>

Neonatology (Neonatology)
[2020, :1-8]

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Influence of Patient Characteristics on Antibiotic Use Rates Among Preterm Infants.

Dustin D Flannery, Sagori Mukhopadhyay, Erik A Jensen, Jeffrey S Gerber, Molly R Passarella, Kevin Dysart, Zubair H Aghai, Jay Greenspan, Karen M Puopolo,

BACKGROUND:The antibiotic use rate (AUR) has emerged as a potential metric for neonatal antibiotic use, but reported center-level AURs are limited by differences in case mix. The objective of this study was to identify patient characteristics associated with AUR among a large cohort of preterm infants. METHODS:Retrospective observational study using ... Read more >>

J Pediatric Infect Dis Soc (Journal of the Pediatric Infectious Diseases Society)
[2020, :]

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An invited commentary on: "Safety and efficacy of Lactobacillus for preventing necrotizing enterocolitis in preterm infants: A systematic review and meta-analysis" [Int. J. Surg. (2020); Epub ahead of print].

Poramate Pitak-Arnnop,

Int J Surg (International journal of surgery (London, England))
[2020, 77:36-37]

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A Quality Improvement Initiative to Increase Mother's Own Milk Use in a Chinese Neonatal Intensive Care Unit.

Qi Zhou, Lan Zhang, Shoo K Lee, Chao Chen, Xiao-Jing Hu, Chan Liu, Yun Cao,

Background: To evaluate the efficacy of a multidisciplinary quality improvement intervention to promote mother's own milk feeding and reduce necrotizing enterocolitis (NEC) in very low-birth-weight infants. Materials and Methods: We conducted a pre (January 2014 to March 2015)-post (April 2015 to June 2016), nonrandomized, interventional cohort study of infants born ... Read more >>

Breastfeed Med (Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine)
[2020, :]

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Is Abdominal Sonography a Useful Adjunct to Abdominal Radiography in Evaluating Neonates with Suspected Necrotizing Enterocolitis?

Sarah A Tracy, Stefanie P Lazow, Ilse M Castro-Aragon, Alan M Fujii, Judy A Estroff, Richard B Parad, Steven J Staffa, David Zurakowski, Catherine Chen,

BACKGROUND:Abdominal sonography (AUS) is emerging as a potentially valuable adjunct to conventional abdominal radiography (AXR) in the setting of suspected necrotizing enterocolitis (NEC). We sought to evaluate concordance between AUS and AXR for signs of NEC to better understand the potential advantages and disadvantages of AUS. As a secondary aim, ... Read more >>

J. Am. Coll. Surg. (Journal of the American College of Surgeons)
[2020, :]

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