scholarly journals Recent Potential Noninvasive Biomarkers in Necrotizing Enterocolitis

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Kewei Wang ◽  
Guozhong Tao ◽  
Zhen Sun ◽  
Karl G. Sylvester
Keyword(s):  
Necrotizing Enterocolitis ◽  
Very Low Birth Weight ◽  
Gastrointestinal Disease ◽  
Unmet Need ◽  
Preterm Neonates ◽  
Diagnostic Biomarkers ◽  
The Past ◽  
Clinical Associations ◽  
Noninvasive Biomarkers ◽  
Urine And Serum

Necrotizing enterocolitis (NEC) is a rare but devastating gastrointestinal disease that predominately affects preterm neonates. Numerous studies have revealed that NEC is strongly associated with very low birth weight, degree of prematurity, formula feeding, infection, hypoxic/ischemic injury, and enteric dysbiosis. Given these clinical associations, the search for a deeper understanding of disease pathogenesis has led to an intense interest in the discovery and development of noninvasive biomarkers of NEC from stool, urine, and serum. Biomarkers for NEC may serve at least two general purposes of urgent unmet need: to improve diagnostic accuracy and disease prediction and to reveal the mechanism of the disease. This review will provide an overview of recent research focused on clinical NEC and highlight the advances that were made within the past five years towards the development of noninvasive diagnostic biomarkers.

scholarly journals Necrotizing enterocolitis: It’s not all in the gut

2019 ◽  
Vol 245 (2) ◽  
pp. 85-95
Author(s):  
Alissa L Meister ◽  
Kim K Doheny ◽  
R Alberto Travagli
Keyword(s):  
Necrotizing Enterocolitis ◽  
Very Low Birth Weight ◽  
Gastrointestinal Disease ◽  
Clinical Signs ◽  
Preterm Neonates ◽  
Non Invasive ◽  
Insidious Onset ◽  
Bowel Rest ◽  
Skin To Skin

Necrotizing enterocolitis is the leading cause of death due to gastrointestinal disease in preterm neonates, affecting 5–12% of neonates born at a very-low birth weight. Necrotizing enterocolitis can present with a slow and insidious onset, with some neonates displaying early symptoms such as feeding intolerance. Treatment during the early stages includes bowel rest and careful use of antibiotics, but surgery is required if pneumoperitoneum and intestinal perforation occur. Mortality rates among neonates requiring surgery are estimated to be 20–30%, mandating the development of non-invasive and reliable biomarkers to predict necrotizing enterocolitis before the onset of clinical signs. Such biomarkers would allow at-risk neonates to receive maximal preventative therapies such as careful nutritional consideration, probiotics, and increased skin-to-skin care. Impact statement Necrotizing enterocolitis (NEC) is a devastating gastrointestinal disease; its high mortality rate mandates the development of non-invasive biomarkers to predict NEC before its onset. This review summarizes the pathogenesis, prevention, unresolved issues, and long-term outcomes of NEC.

scholarly journals Association Between Platelet-to-Lymphocyte Ratio and Preterm Necrotizing Enterocolitis

2021 ◽  
Vol 9 ◽  
Author(s):  
Juan Zheng ◽  
Hua Wang
Keyword(s):  
Necrotizing Enterocolitis ◽  
Very Low Birth Weight ◽  
University Hospital ◽  
Preterm Neonates ◽  
Control Group ◽  
Platelet To Lymphocyte Ratio ◽  
Retrospective Case ◽  
Low Birth Weight Infants ◽  
Intestinal Necrosis ◽  
Lymphocyte Ratio

Introduction: Necrotizing enterocolitis (NEC) is a fatal condition for very-low-birth-weight infants. Necrotizing enterocolitis is a multi-factor phenomenon that results in intestinal mucosal damage and leads to intestinal necrosis. However, sensitive laboratory indicators for NEC are lacking, making early diagnosis difficult. This study aimed to explore the relationship between the platelet-to-lymphocyte ratio (PLR) and NEC in preterm neonates to enable an earlier diagnosis of the condition.Methods: This was a retrospective case–control study of preterm neonates diagnosed with NEC between January 2018 and December 2019 in the West China Second University Hospital. Controls were selected from preterm neonatal intensive care unit (NICU) graduates, and they were matched for gestation and year of birth to the preterms diagnosed without NEC. In total, 93 and 107 infants were included in the NEC and control groups, respectively. Empowerstats analysis was used to identify the association between PLR and preterm NEC.Results: The NEC group had significantly higher PLR levels than the control group. PLR > 100 within 1 week before NEC diagnosis was a risk factor for NEC. There was a positive connection between PLR and preterm NEC. A PLR of >100 was determined as the optimal cutoff for predicting preterm NEC, with patients with PLR >100 having a higher risk of NEC [odds ratio (OR): 18.82 (95% confidence interval (CI): 2.93–120.98), p = 0.002].Conclusions: A PLR of >100 within 1 week after clinical abnormalities is associated with a high risk of NEC in preterm neonates.

scholarly journals Single strain versus multispecies probiotic on necrotizing enterocolitis and faecal IgA levels in very low birth weight preterm neonates: A randomized clinical trial

2019 ◽  
Vol 60 (5) ◽  
pp. 564-569
Author(s):  
Guadalupe Gómez–Rodríguez ◽  
Norma Amador-Licona ◽  
Leonel Daza-Benítez ◽  
Gloria Barbosa-Sabanero ◽  
Deyanira Carballo-Magdaleno ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Randomized Clinical Trial ◽  
Necrotizing Enterocolitis ◽  
Very Low Birth Weight ◽  
Preterm Neonates ◽  
Single Strain

Reduced Formula Intake with Donor Milk (DM) Impacts Necrotizing Enterocolitis (NEC) in Very Low Birth Weight (VLBW) Infants:

PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 443A-443A
Author(s):  
Jennifer S. Wicks ◽  
Anita L. Esquerra-Zwiers ◽  
Laura M. Rogers ◽  
Celina M. Scala ◽  
Shirley Chen ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Necrotizing Enterocolitis ◽  
Very Low Birth Weight ◽  
Donor Milk ◽  
Vlbw Infants

Frühgeborene unter maschineller Beatmung: Immunmodulatorischer Effekt der präventiven Gabe von Azithromycin

2020 ◽  
pp. 1-3
Author(s):  
Maximilian Jorczyk
Keyword(s):  
Very Low Birth Weight ◽  
Controlled Trial ◽  
Preterm Neonates ◽  
Double Blind ◽  
Mechanically Ventilated ◽  
Before And After ◽  
Anti Inflammatory ◽  
To Receive ◽  
Therapeutic Possibilities ◽  
Inflammatory Effect

<b>Introduction:</b> Macrolides have anti-inflammatory and immunomodulatory properties that give this class of antibiotics a role that differs from its classical use as an antibiotic, which opens new therapeutic possibilities. <b>Objective:</b> The aim of this study was to evaluate the anti-inflammatory effect of azithromycin in preventing mechanical ventilation (MV)-induced lung injury in very-low-birth-weight preterm neonates. <b>Methods:</b> This is a randomized, double-blind, placebo-controlled trial of preterm neonates who received invasive MV within 72 h of birth. Patients were randomized to receive intravenous azithromycin (at a dose of 10/mg/kg/day for 5 days) or placebo (0.9% saline) within 12 h of the start of MV. Two blood samples were collected (before and after intervention) for measurement of interleukins (ILs) and PCR for <i>Ureaplasma</i>. Patients were followed up throughout the hospital stay for the outcomes of death and bronchopulmonary dysplasia defined as need for oxygen for a period of ≥28 days of life (registered at ClinicalTrials.gov, No. NCT03485703). <b>Results:</b> Forty patients were analyzed in the azithromycin group and 40 in the placebo group. Five days after the last dose, serum IL-2 and IL-8 levels dropped significantly in the azithromycin group. There was a significant reduction in the incidence of death and O<sub>2</sub> dependency at 28 days/death in azithromycin-treated patients regardless of the detection of <i>Ureaplasma</i> in blood. <b>Conclusions:</b> Azithromycin has anti-inflammatory effects, with a decrease in cytokines after 5 days of use and a reduction in death and O<sub>2</sub> dependency at 28 days/death in mechanically ventilated preterm neonates.

scholarly journals Translating Molecular Profiling of Soft Tissue Sarcomas into Daily Clinical Practice

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 512
Author(s):  
Celine Jacobs ◽  
Lore Lapeire
Keyword(s):  
Soft Tissue ◽  
Unmet Need ◽  
Soft Tissue Sarcomas ◽  
Molecular Profiling ◽  
Point Of View ◽  
Molecular Techniques ◽  
Mesenchymal Tumors ◽  
The Past ◽  
Cancer Types ◽  
Sarcoma Treatment

Soft tissue sarcomas are a group of rare mesenchymal tumors with more than 70 subtypes described. Treatment of these subtypes in an advanced setting is mainly according to a one-size-fits-all strategy indicating a high unmet need of new and more targeted therapeutic options in order to optimize survival. The introduction of advanced molecular techniques in cancer has led to better diagnostics and identification of new therapeutic targets, leading to more personalized treatment and improved prognosis for several cancer types. In sarcoma, a likewise evolution is seen, albeit at a slower pace. This manuscript describes how in the past years advanced molecular profiling in soft tissue sarcomas was able to identify specific and often pathognomonic aberrations, deferring standard sarcoma treatment in favor of more targeted treatment from an oncologist’s point of view.

scholarly journals Optimizing Nutritional Strategies to Prevent Necrotizing Enterocolitis and Growth Failure after Bowel Resection

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 340
Author(s):  
Laura Moschino ◽  
Miriam Duci ◽  
Francesco Fascetti Leon ◽  
Luca Bonadies ◽  
Elena Priante ◽  
...  
Keyword(s):  
Necrotizing Enterocolitis ◽  
Bowel Resection ◽  
Gastrointestinal Disease ◽  
Nutrient Deficiency ◽  
Growth Failure ◽  
Failure To Thrive ◽  
Rehabilitation Programs ◽  
Neurodevelopmental Impairment ◽  
Intestinal Rehabilitation ◽  
Nutritional Strategies

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.

scholarly journals Challenge in diagnosis of late onset necrotizing enterocolitis in a term infant: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gunadi ◽  
Dian Nirmala Sirait ◽  
Aditya Rifqi Fauzi ◽  
Ninditya Nugroho ◽  
Fadil Fahri ◽  
...  
Keyword(s):  
Ct Scan ◽  
Necrotizing Enterocolitis ◽  
Intestinal Inflammation ◽  
Late Onset ◽  
Gastrointestinal Disease ◽  
Early Recognition ◽  
Ileocecal Valve ◽  
Abdominal Distention ◽  
Clinical Deterioration ◽  
Wall Thickening

Abstract Background Necrotizing enterocolitis (NEC) is a common devastating inflammatory gastrointestinal disease and frequently occurs in premature infants. Here, we reported a case of late-onset NEC in a term neonate with good outcome after surgery for long-term follow-up. Case presentation Ten-week-old male came to emergency unit due to prolonged diarrhea and abdominal distention. He was born at gestational age of 40 weeks with birth weight and Apgar score of 2800 g and 7/8, respectively. He had no history of formula feeding. Two weeks before admitted to the hospital, the patient had frequent diarrhea with fever. He was found lethargic with abdominal distention, absence of bowel sounds and abdominal tenderness. Plain abdominal x-ray and CT scan showed gastric and intestinal dilatation and gasless colon, suggesting a small bowel obstruction, and bowel wall thickening indicating peritonitis, without any free subdiaphragmatic air (pneumoperitoneum). Moreover, the patient did not have a congenital heart disease. While in intensive medical treatment, he showed a continuous clinical deterioration. All findings were suggestive of intestinal inflammation with clinical deterioration, and we decided to perform an emergency exploratory laparotomy and found an ischemia along the jejunoileal with a perforation at 25 cm above the ileocecal valve. Subsequently, we performed a double-barrel ileostomy through a separate incision from the laparotomy. Histopathological findings confirmed the diagnosis of NEC. We closed the stoma at postoperative day 43. The patient was discharged uneventfully a month after stoma closure. Conclusion Abdominal CT scan might be useful to establish an early recognition of late-onset NEC; thus, immediate surgical intervention might be performed to decrease its morbidity and mortality. Moreover, late-onset NEC in term neonates might occur without any risk factors or significant co-morbidities.

scholarly journals Cognitive impairments induced by necrotizing enterocolitis can be prevented by inhibiting microglial activation in mouse brain

2018 ◽  
Vol 10 (471) ◽  
pp. eaan0237 ◽  
Author(s):  
Diego F. Niño ◽  
Qinjie Zhou ◽  
Yukihiro Yamaguchi ◽  
Laura Y. Martin ◽  
Sanxia Wang ◽  
...  
Keyword(s):  
Necrotizing Enterocolitis ◽  
Microglial Activation ◽  
Gastrointestinal Disease ◽  
Cognitive Impairments ◽  
High Mobility ◽  
Neurological Dysfunction ◽  
Mucosal Inflammation ◽  
Signaling Axis ◽  
The Brain

Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease of the premature infant. One of the most important long-term complications observed in children who survive NEC early in life is the development of profound neurological impairments. However, the pathways leading to NEC-associated neurological impairments remain unknown, thus limiting the development of prevention strategies. We have recently shown that NEC development is dependent on the expression of the lipopolysaccharide receptor Toll-like receptor 4 (TLR4) on the intestinal epithelium, whose activation by bacteria in the newborn gut leads to mucosal inflammation. Here, we hypothesized that damage-induced production of TLR4 endogenous ligands in the intestine might lead to activation of microglial cells in the brain and promote cognitive impairments. We identified a gut-brain signaling axis in an NEC mouse model in which activation of intestinal TLR4 signaling led to release of high-mobility group box 1 in the intestine that, in turn, promoted microglial activation in the brain and neurological dysfunction. We further demonstrated that an orally administered dendrimer-based nanotherapeutic approach to targeting activated microglia could prevent NEC-associated neurological dysfunction in neonatal mice. These findings shed light on the molecular pathways leading to the development of NEC-associated brain injury, provide a rationale for early removal of diseased intestine in NEC, and indicate the potential of targeted therapies that protect the developing brain in the treatment of NEC in early childhood.

scholarly journals Trends in survival of patients with Burkitt lymphoma/leukemia in the USA: an analysis of 3691 cases

Blood ◽  
2013 ◽  
Vol 121 (24) ◽  
pp. 4861-4866 ◽  
Author(s):  
Luciano J. Costa ◽  
Ana C. Xavier ◽  
Amy E. Wahlquist ◽  
Elizabeth G. Hill
Keyword(s):  
United States ◽  
Young Adults ◽  
Burkitt Lymphoma ◽  
Unmet Need ◽  
The United States ◽  
The Past ◽  
Black Patients ◽  
Key Points ◽  
The Usa

Key Points Survival of patients with BL improved substantially in the United States during the past decade, mainly among young adults. Survival of patients with BL remains relatively low, particularly for older and black patients, identifying an unmet need.

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