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  • 1
    Online Resource
    Online Resource
    The Metabolome and the Gut Microbiota for the Prediction of Necrotizing Enterocolitis and Spontaneous Intestinal Perforation: A Systematic Review
    MDPI AG ; 2022
    In:  Nutrients Vol. 14, No. 18 ( 2022-09-18), p. 3859-
    Details
    In: Nutrients, MDPI AG, Vol. 14, No. 18 ( 2022-09-18), p. 3859-
    Abstract: Necrotizing enterocolitis (NEC) is the most devastating gastrointestinal emergency in preterm neonates. Research on early predictive biomarkers is fundamental. This is a systematic review of studies applying untargeted metabolomics and gut microbiota analysis to evaluate the differences between neonates affected by NEC (Bell’s stage II or III), and/or by spontaneous intestinal perforation (SIP) versus healthy controls. Five studies applying metabolomics (43 cases, 95 preterm controls) and 20 applying gut microbiota analysis (254 cases, 651 preterm controls, 22 term controls) were selected. Metabolomic studies utilized NMR spectroscopy or mass spectrometry. An early urinary alanine/histidine ratio 〉 4 showed good sensitivity and predictive value for NEC in one study. Samples collected in proximity to NEC diagnosis demonstrated variable pathways potentially related to NEC. In studies applying untargeted gut microbiota analysis, the sequencing of the V3–V4 or V3 to V5 regions of the 16S rRNA was the most used technique. At phylum level, NEC specimens were characterized by increased relative abundance of Proteobacteria compared to controls. At genus level, pre-NEC samples were characterized by a lack or decreased abundance of Bifidobacterium. Finally, at the species level Bacteroides dorei, Clostridium perfringens and perfringens-like strains dominated early NEC specimens, whereas Clostridium butyricum, neonatale and Propionibacterium acnei those at disease diagnosis. Six studies found a lower Shannon diversity index in cases than controls. A clear separation of cases from controls emerged based on UniFrac metrics in five out of seven studies. Importantly, no studies compared NEC versus SIP. Untargeted metabolomics and gut microbiota analysis are interrelated strategies to investigate NEC pathophysiology and identify potential biomarkers. Expression of quantitative measurements, data sharing via biorepositories and validation studies are fundamental to guarantee consistent comparison of results.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    URL: Article
    DOI: 10.3390/nu14183859
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2518386-2
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  • 2
    Online Resource
    Online Resource
    Fetal Doppler Evaluation to Predict NEC Development
    MDPI AG ; 2022
    In:  Journal of Personalized Medicine Vol. 12, No. 7 ( 2022-06-25), p. 1042-
    Details
    In: Journal of Personalized Medicine, MDPI AG, Vol. 12, No. 7 ( 2022-06-25), p. 1042-
    Abstract: Antenatal factors play a role in NEC pathogenesis. This study aimed to investigate the predictive value of fetal ductus venosus doppler (DV) for NEC in fetal growth restriction fetuses (FGRF) and to assess the predictive accuracy of IG21 and Fenton curves in NEC development. Data from FGRF, postnatal findings, and Doppler characteristics were collected between 2010 and 2020 at a single center. Patients were then divided into two groups (i.e., with and without NEC). Bivariate and multivariate analyses were performed. We identified 24 cases and 30 controls. Absent or reversed end-diastolic flow (AREDF) and increased resistance in the DV were more impaired in cases (p 〈 0.05). Although the median birthweight was not different, the Fenton z-score was lower in NEC (p 〈 0.05). Fetal cardiopulmonary resuscitation, synchronized intermittent mandatory ventilation, neonatal respiratory distress, persistent patent ductus arteriosus (PDA), and inotropic support were more frequent in the NEC group. Furthermore, NEC patients had lower white blood cells (WBC) (p 〈 0.05). The predictive model for NEC (model 4), including Fenton z-score, WBC, PDA, and DV had an AUC of 84%. Fetal Doppler findings proved effective in predicting NEC in FGR. The Fenton z-score was the most predictive factor considering the fetal growth assessment showing high sensitivity.
    Type of Medium: Online Resource
    ISSN: 2075-4426
    URL: Article
    DOI: 10.3390/jpm12071042
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662248-8
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  • 3
    Online Resource
    Online Resource
    Maternal and placental risk factors associated with the development of necrotizing enterocolitis (NEC) and its severity
    Elsevier BV ; 2019
    In:  Journal of Pediatric Surgery Vol. 54, No. 10 ( 2019-10), p. 2099-2102
    Details
    In: Journal of Pediatric Surgery, Elsevier BV, Vol. 54, No. 10 ( 2019-10), p. 2099-2102
    Type of Medium: Online Resource
    ISSN: 0022-3468
    URL: Article
    DOI: 10.1016/j.jpedsurg.2019.04.018
    RVK:
    XA 10000
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 2039299-0
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  • 4
    Online Resource
    Online Resource
    A survival analysis of cuffed tunneled silicon central venous catheters in children affected by short bowel syndrome: A lesson from the past
    SAGE Publications ; 2022
    In:  The Journal of Vascular Access
    Details
    In: The Journal of Vascular Access, SAGE Publications
    Abstract: Tunneled central venous catheters (CVC) are crucial in the management of children affected by short bowel syndrome (SBS). This work aims to investigate the outcomes of tunneled CVC and to identify factors influencing their survival. Methods: All the children diagnosed with SBS and undergone a procedure of insertion of a tunneled CVC from 2010 to 2019 were included. Demographic data and surgical information about the procedures were collected. Regression models and Kaplan–Meier analysis were performed to estimate the survival. Results: Eighteen patients, eight males (44%), with a median length of residual bowel measuring 72 cm (IQR 50–102 cm), were enrolled. Thirty-nine Broviac CVCs were inserted with a mean number of 2.2 CVCs per patient and 13365 line-days. The overall incidence of complications was 3.2/1000 line-days, and the incidence of central line associated bloodstream infections (CLABSI) was 1.1/1000 line-days. No episode of catheter thrombosis was reported. The median survival was 269 days (IQR 82–1814 days). The survival was negatively influenced by a younger age at insertion ( R 2  = 0.29; p  〈  0.001), 2.7 Fr diameter (median survival 76 days; p  〈  0.001) and the occurrence of complications (median survival 169 days; p = 0.002). The length of residual bowel was a mild risk factor for anticipated removal (OR 1.1; CI95 1.0–1.1; p = 0.05). Conclusion: CVC-related complications negatively influenced the survival of the line. An elder age at insertion together with a larger CVC diameter increased the survival of the line, while a shorter residual bowel was associated with an anticipated removal due to complications.
    Type of Medium: Online Resource
    ISSN: 1129-7298 , 1724-6032
    URL: Article
    DOI: 10.1177/11297298211069458
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2079292-X
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  • 5
    Online Resource
    Online Resource
    Neonatal independent predictors of severe NEC
    Springer Science and Business Media LLC ; 2018
    In:  Pediatric Surgery International Vol. 34, No. 6 ( 2018-6), p. 663-669
    Details
    In: Pediatric Surgery International, Springer Science and Business Media LLC, Vol. 34, No. 6 ( 2018-6), p. 663-669
    Type of Medium: Online Resource
    ISSN: 0179-0358 , 1437-9813
    URL: Article
    DOI: 10.1007/s00383-018-4261-1
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2018
    detail.hit.zdb_id: 1463010-2
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  • 6
    Online Resource
    Online Resource
    Optimizing Nutritional Strategies to Prevent Necrotizing Enterocolitis and Growth Failure after Bowel Resection
    MDPI AG ; 2021
    In:  Nutrients Vol. 13, No. 2 ( 2021-01-24), p. 340-
    Details
    In: Nutrients, MDPI AG, Vol. 13, No. 2 ( 2021-01-24), p. 340-
    Abstract: Necrotizing enterocolitis (NEC), the first cause of short bowel syndrome (SBS) in the neonate, is a serious neonatal gastrointestinal disease with an incidence of up to 11% in preterm newborns less than 1500 g of birth weight. The rate of severe NEC requiring surgery remains high, and it is estimated between 20–50%. Newborns who develop SBS need prolonged parenteral nutrition (PN), experience nutrient deficiency, failure to thrive and are at risk of neurodevelopmental impairment. Prevention of NEC is therefore mandatory to avoid SBS and its associated morbidities. In this regard, nutritional practices seem to play a key role in early life. Individualized medical and surgical therapies, as well as intestinal rehabilitation programs, are fundamental in the achievement of enteral autonomy in infants with acquired SBS. In this descriptive review, we describe the most recent evidence on nutritional practices to prevent NEC, the available tools to early detect it, the surgical management to limit bowel resection and the best nutrition to sustain growth and intestinal function.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    URL: Article
    DOI: 10.3390/nu13020340
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2518386-2
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  • 7
    Online Resource
    Online Resource
    Providing the Best Parenteral Nutrition before and after Surgery for NEC: Macro and Micronutrients Intakes
    MDPI AG ; 2022
    In:  Nutrients Vol. 14, No. 5 ( 2022-02-22), p. 919-
    Details
    In: Nutrients, MDPI AG, Vol. 14, No. 5 ( 2022-02-22), p. 919-
    Abstract: Necrotizing enterocolitis (NEC) is the main gastrointestinal emergency of preterm infants for whom bowel rest and parenteral nutrition (PN) is essential. Despite the improvements in neonatal care, the incidence of NEC remains high (11% in preterm newborns with a birth weight 〈 1500 g) and up to 20–50% of cases still require surgery. In this narrative review, we report how to optimize PN in severe NEC requiring surgery. PN should begin as soon as possible in the acute phase: close fluid monitoring is advocated to maintain volemia, however fluid overload and electrolytes abnormalities should be prevented. Macronutrients intake (protein, glucose, and lipids) should be adequately guaranteed and is essential in each phase of the disease. Composite lipid emulsion should be the first choice to reduce the risk of parenteral nutrition associated liver disease (PNALD). Vitamin and trace elements deficiency or overload are frequent in long-term PN, therefore careful monitoring should be planned starting from the recovery phase to adjust their parenteral intake. Neonatologists must be aware of the role of nutrition especially in patients requiring long-term PN to sustain growth, limiting possible adverse effects and long-term deficiencies.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    URL: Article
    DOI: 10.3390/nu14050919
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2518386-2
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