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enterocolitis necrotizing

Renée R C E Schreurs, Martin E Baumdick, Adrian F Sagebiel, Max Kaufmann, Michal Mokry, Paul L Klarenbeek, Nicola Schaltenberg, Fenja L Steinert, Jorik M van Rijn, Agata Drewniak, Sarah-May M L The, Roel Bakx, Joep P M Derikx, Niek de Vries, Willemijn E Corpeleijn, Steven T Pals, Nicola Gagliani, Manuel A Friese, Sabine Middendorp, Edward E S Nieuwenhuis, Konrad Reinshagen, Teunis B H Geijtenbeek, Johannes B van Goudoever, Madeleine J Bunders
Although the fetal immune system is considered tolerogenic, preterm infants can suffer from severe intestinal inflammation, including necrotizing enterocolitis (NEC). Here, we demonstrate that human fetal intestines predominantly contain tumor necrosis factor-α (TNF-α)+ CD4+ CD69+ T effector memory (Tem) cells. Single-cell RNA sequencing of fetal intestinal CD4+ T cells showed a T helper 1 phenotype and expression of genes mediating epithelial growth and cell cycling. Organoid co-cultures revealed a dose-dependent, TNF-α-mediated effect of fetal intestinal CD4+ T cells on intestinal stem cell (ISC) development, in which low T cell numbers supported epithelial development, whereas high numbers abrogated ISC proliferation...
February 5, 2019: Immunity
Michel Hosny, Jacques Yaacoub Bou Khalil, Aurelia Caputo, Rita Abou Abdallah, Anthony Levasseur, Philippe Colson, Nadim Cassir, Bernard La Scola
The association between Clostridium species identification from stool samples in preterm neonates and the occurrence of necrotizing enterocolitis has been increasingly reported. To confirm the specific impact of Clostridium butyricum in this pathology, selective culture procedure was used for Clostridia isolation. Whole-genome analysis was employed to investigate genomic relationships between isolates. Stool samples from present study, as well as from previously investigated cases, were implicated including 88 from preterm neonates with necrotizing enterocolitis and 71 from matched controls...
February 14, 2019: Scientific Reports
Toby Debra Yanowitz, Kevin M Sullivan, Anthony J Piazza, Beverly Brozanski, Isabella Zaniletti, Jotishna Sharma, Robert DiGeronimo, Sujir Pritha Nayak, Rajan Wadhawan, Kristina M Reber, Karna Murthy
PURPOSE: Quantify short-term outcomes associated with initial surgery [laparotomy (LAP) vs. peritoneal drain (PD)] for necrotizing enterocolitis (NEC) in extremely-low-birth-weight (ELBW) infants. METHODS: Using the Children's Hospitals Neonatal Database, we identified ELBW infants <32 weeks' gestation with surgical NEC (sNEC). Unadjusted and multivariable regression analyses were used to estimate the associations between LAP (or PD) and death/short bowel syndrome (SBS) and length of stay (LOS)...
January 19, 2019: Journal of Pediatric Surgery
Mashriq Alganabi, Carol Lee, Edoardo Bindi, Bo Li, Agostino Pierro
Necrotizing enterocolitis is a devastating intestinal disease affecting preterm infants. In spite of ongoing research and advancement in neonatal care, mortality remains high, especially in infants with advanced disease. The mechanism of disease development, the progression of intestinal injury, and management remain areas of ongoing research and controversy. In this review, we examine our current understanding of the disease, its epidemiology, the risk factors associated with the development of the disease, and its pathophysiology...
2019: F1000Research
Monika Bajaj, Mirjana Lulic-Botica, Amber Hanson, Girija Natarajan
OBJECTIVE: To evaluate the effect of withholding feeds during transfusion on transfusion associated acute gut injury (TRAGI). STUDY DESIGN: Data were collected on 125 preterm infants before and after the practice of withholding feeds for 12-24 h during transfusion was instituted. Logistic regression was used to examine effects of withholding feeds on TRAGI rates. RESULTS: A total of 19 (15%) infants developed NEC; 6/19 (32%) had TRAGI. Postnatal hydrocortisone use was associated with TRAGI (OR 8...
February 5, 2019: Journal of Perinatology: Official Journal of the California Perinatal Association
Kartik K Venkatesh, Wesley Jackson, Brenna L Hughes, Mathew M Laughon, John M Thorp, David M Stamilio
OBJECTIVE: To investigate the association of chorioamnionitis, and secondarily its duration, on neonatal adverse outcomes for infants born <34 weeks vs. ≥34 weeks. STUDY DESIGN: A secondary analyss from the observational U.S. Consortium on Safe Labor Study. The exposure was chorioamnionitis, and secondarily, its estimated duration. The composite outcome included pneumonia, seizure, necrotizing enterocolitis, sepsis, periventricular/intraventricular/cerebral hemorrhage, mechanical ventilation, and neonatal death...
February 5, 2019: Journal of Perinatology: Official Journal of the California Perinatal Association
Chasen J Greig, Lucy Zhang, Sarah J Armenia, Christine J Park, Anne C Fischer, Michael G Caty, Robert A Cowles
BACKGROUND: Abstracts presented at the American Academy of Pediatrics Section on Surgery (AAP) and American Pediatric Surgical Association (APSA) meetings can be taken as a reasonable representation of academic activity in pediatric surgery. We sought to assess ongoing trends in pediatric surgical research by analyzing the scientific content of each association's yearly meeting. METHODS: Abstracts presented at AAP and APSA between 2009 and 2013 were identified from the final printed programs (n = 910)...
February 2, 2019: Journal of Surgical Research
Sudeepta K Basu, Subechhya Pradhan, Kushal Kapse, Robert McCarter, Jonathan Murnick, Taeun Chang, Catherine Limperopoulos
Advanced neuroimaging techniques have improved our understanding of microstructural changes in the preterm supratentorial brain as well as the cerebellum and its association with impaired neurodevelopmental outcomes. However, the metabolic interrogation of the developing cerebellum during the early postnatal period after preterm birth remains largely unknown. Our study investigates the relationship between cerebellar neurometabolites measured by proton magnetic spectroscopy (1 H-MRS) in preterm infants with advancing post-menstrual age (PMA) and brain injury during ex-utero third trimester prior to term equivalent age (TEA)...
February 4, 2019: Scientific Reports
Huiqing Sun, Shuping Han, Rui Cheng, Mingyan Hei, Foteini Kakulas, Shoo K Lee
Necrotizing enterocolitis (NEC) is the leading cause of death among infants born at <30 weeks' gestation, but donor human milk can reduce the incidence of NEC. Unfortunately, freezing or pasteurizing human milk deactivates beneficial bioactive components. We evaluated the feasibility, safety, and impact of feeding very preterm infants fresh (unprocessed) mother's own milk within 4 hours of expression. In our multicentre prospective cohort analytic study, we fed 109 control and 98 intervention infants previously frozen donor or mother's own milk; only the intervention group was fed fresh mother's own milk once daily from enrollment until 32 weeks' corrected age...
January 30, 2019: Scientific Reports
Bo Li, Alison Hock, Richard Y Wu, Adam Minich, Steven R Botts, Carol Lee, Lina Antounians, Hiromu Miyake, Yuhki Koike, Yong Chen, Augusto Zani, Philip M Sherman, Agostino Pierro
Necrotizing enterocolitis (NEC) is characterized by intestinal injury and impaired mucin synthesis. We recently showed that breast milk exosomes from rodents promote intestinal cell viability, epithelial proliferation, and stem cell activity, but whether they also affect mucus production is unknown. Therefore, the aim of this study was to investigate the effects of bovine milk-derived exosomes on goblet cell expression in experimental NEC and delineate potential underlying mechanisms of action. Exosomes were isolated from bovine milk by ultracentrifugation and confirmed by Nanoparticle Tracking Analysis and through the detection of exosome membrane markers...
2019: PloS One
Balpreet Singh, Prakesh S Shah, Jehier Afifi, C David Simpson, Souvik Mitra, Kimberly Dow, Walid El-Naggar
OBJECTIVE: To evaluate the effect of prophylactic probiotic (PP) administration on rates of necrotizing enterocolitis (NEC), late-onset sepsis (LOS), and mortality in preterm infants. STUDY DESIGN: We conducted a retrospective cohort study of infants < 29 weeks' gestation, admitted to neonatal intensive care units participating in the Canadian Neonatal Network between 1 January 2014 and 31 December 2015. Infants in the exposure group received PP. A multiple logistic regression model with generalized estimation equation was used...
January 28, 2019: Journal of Perinatology: Official Journal of the California Perinatal Association
Michaela Klinke, Deirdre Vincent, Magdalena Trochimiuk, Birgit Appl, Bastian Tiemann, Robert Bergholz, Konrad Reinshagen, Michael Boettcher
BACKGROUND: Necrotizing enterocolitis (NEC) is one of the most devastating diseases in neonates and is characterized by high morbidity and mortality. It has been suggested that neutrophils play a crucial role in NEC pathogenesis and contribute to the hyperinflammatory reaction after bacterial colonization, which ultimately induces NEC. The aim of this study was to investigate whether dissolution of neutrophil extracellular traps (NETs) by systemic DNase1 therapy reduces NEC manifestation and morbidity...
March 2019: Journal of Surgical Research
V L Carvalho, K R Groch, J L Catão-Dias, A C O Meirelles, C P N Silva, A N B Monteiro, J Díaz-Delgado
Strandings of live new-born West Indian manatees (WIMs; Trichechus manatus) are one of the main challenges for the conservation of this species in Brazil, particularly in the northeastern states. Congenital malformations (CMs) are rare in sirenians. We identified CMs in two of 19 stranded WIMs that were rescued, rehabilitated and subjected to complete pathological examinations in Ceará and Rio Grande do Norte States between 1992 and 2017. In case 1, dilation of the cerebral lateral and fourth ventricles with abundant cerebrospinal fluid (internal hydrocephalus), was diagnosed...
January 2019: Journal of Comparative Pathology
Jamie Knell, Sam M Han, Tom Jaksic, Biren P Modi
No abstract text is available yet for this article.
January 2019: Current Problems in Surgery
Paul Peterslund, Lene Rasmussen, Niels Qvist, Tine Plato Hansen, Steffen Husby, Sönke Detlefsen
BACKGROUND: Only few studies have quantitated the frequencies of immune cells in the small bowel mucosa and submucosa during gestation. The aims of this study were to describe the frequencies of T and B cells, eosinophils and mast cells in the normal small bowel mucosa and submucosa (NSB) in relation to gestational age (GA) and in the uninvolved small bowel (USB) of premature newborns with necrotizing enterocolitis (NEC). METHODS: We obtained 36 NSB specimens (GA 12-41 weeks) and 8 NEC-USB specimens (GA 24-32 weeks) from autopsies and surgeries and performed immunostaining for CD3, CD79a, BMK-13 and tryptase as well as the histochemical stains giemsa and toluidine blue...
January 28, 2019: Fetal and Pediatric Pathology
M Bilal Mirza, Muhammad Salman Saleem, Abrar Kamran, Mahvish Hussain, Tariq Khawaja, Kashif Arsalan, Nabila Talat
No abstract text is available yet for this article.
January 2019: Journal of Indian Association of Pediatric Surgeons
Beata Hargitai, Gergely Toldi, Tamas Marton, Velmurugan Ramalingam, Andrew K Ewer, Alison R Bedford Russell
A rare complication of umbilical venous catheter (UVC) insertion is the extravasation of the infusate into the peritoneal cavity. We report 3 cases of abdominal extravasation of parenteral nutrition (PN) fluid via UVCs. Two of these cases presented as "acute abdomen" which were assumed to be necrotizing enterocolitis clinically; however, during postmortem, PN ascites and liver necrosis were found. A further case is described in an infant with congenital diaphragmatic hernia. While we were unable to ascertain direct vessel perforation by the catheter in any of these cases, based on pathological and histological examination, the proposed mechanism of PN fluid extravasation is leakage through microinjuries of liver vessel walls and necrotic parenchyma...
January 25, 2019: Pediatric and Developmental Pathology
Jillian R Baranowski, Erika C Claud
Bacterial colonization patterns in preterm infants differ from those of their term counterparts due to maternal microbial diversity, delivery mode, feeding methods, antibiotic use, and exposure to commensal microbiota and pathogens in the neonatal intensive care unit (NICU). Early gut microbiome dysbiosis predisposes neonates to necrotizing enterocolitis (NEC), a devastating intestinal disease with high morbidity and mortality. Though mechanisms of NEC pathogenesis are not fully understood, the microbiome is a promising therapy target for prevention and treatment...
January 26, 2019: Advances in Experimental Medicine and Biology
Mark A Underwood
PURPOSE OF REVIEW: Probiotic administration to premature infants for the purpose of prevention of necrotizing enterocolitis is common in many parts of the world but uncommon in the United States. The present review will emphasize recent findings in support of routine administration of probiotics to this highly vulnerable population. RECENT FINDINGS: Additional evidence from animal models describing mechanisms of protection of probiotics in the immature gut and updated meta-analyses of randomized placebo-controlled trials and observational cohorts are presented (now including more than 40 000 premature infants from countries across the globe)...
January 16, 2019: Current Opinion in Pediatrics
Le Zhang, Jianfeng Fan, Jingya He, Wenjuan Chen, Weilai Jin, Yuting Zhu, Haibing Sun, Yawen Li, Yingzuo Shi, Yulei Jing, Xiaolei Wang, Shuping Han, Zhengying Li
Necrotizing enterocolitis (NEC) is the most common life-threatening gastrointestinal disease encountered in the premature infant. It has been shown that the intercellular reactive oxygen species (ROS) generation activated by lipopolysaccharide involved in the nuclear factor kappa B (NF-κB) activation and pathogenesis of NEC. Here, we report that an antioxidant peptide from tuna backbone protein (APTBP) reduces the inflammatory cytokines transcription and release. APTBP directly scavenges the free radical through 1,1-diphenyl-2-picrylhydrazyl (DPPH) and 2-phenyl-4,4,5,5-tetramethylimidazoline-1-oxyl 3-oxide (PTIO) assay...
January 17, 2019: Journal of Cellular Physiology
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