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Pediatr Res 2021 Jun 8. Epub 2021 Jun 8.

Department of Data Science, University of Mississippi Medical Center, Jackson, MS, USA.

Background: The objective of this study was to determine the risk factors and outcomes of white matter brain injury (WMBI) on magnetic resonance imaging (MRI) at term-equivalent age in infants with surgical necrotizing enterocolitis (NEC).

Methods: This retrospective study compared clinical/pathological information between infants with and those without WMBI.

Results: Out of 69 infants with surgical NEC, 17 (24. Read More

Nurs Child Young People 2021 Jun 1. Epub 2021 Jun 1.

Torbay Hospital, Torquay, England.

Abdominal X-rays (AXRs) are one of the most common imaging modalities used to investigate suspected abdominal conditions in neonates. They are frequently requested for a variety of suspected conditions including necrotising enterocolitis, congenital diaphragmatic hernia, duodenal atresia and Hirschsprung's disease. Nurses play an important role in preparing and supporting neonates who are undergoing an AXR, and in some centres advanced neonatal nurse practitioners may be involved in requesting and interpreting AXRs as part of their enhanced role in patient management. Read More

Pediatr Radiol 2021 May 12. Epub 2021 May 12.

Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.

Contrast-enhanced ultrasound (CEUS) has emerged as a valuable modality for bowel imaging in adults and children. CEUS enables visualization of the perfusion of the bowel wall and of the associated mesentery in healthy and disease states. In addition, CEUS images can be used to make quantitative measurements of contrast kinetics, allowing for objective assessment of bowel wall enhancement. Read More

J Matern Fetal Neonatal Med 2021 Apr 25:1-14. Epub 2021 Apr 25.

Department of Obstetrics and Gynecology, Pediatrics and Physiology, Division of Maternal-Fetal Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.

Objectives: The present systematic review aims to investigate the diagnosis, prognosis, delivery assistance, pregnancy results and postnatal management in gastroschisis.

Study Design: The following data sources were evaluated: The CINAHL, Embase and MEDLINE/PubMed databases were searched, observational and intervention studies published over the past 20 years. The quality of the studies was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). Read More

Bio Protoc 2021 Mar 5;11(5):e3937. Epub 2021 Mar 5.

Division of General and Thoracic Surgery, Physiology and Experimental Medicine Program, The Hospital for Sick Children, Toronto, ON, Canada.

This protocol describes a novel technique to investigate the microcirculation dynamics underlying the pathology in the small intestine of neonatal mice using two-photon laser-scanning microscopy (TPLSM). Recent technological advances in multi-photon microscopy allow intravital analysis of different organs such as the liver, brain and intestine. Despite these advances, live visualization and analysis of the small intestine in neonatal rodents remain technically challenging. Read More

Clinics (Sao Paulo) 2021 26;76:e1816. Epub 2021 Mar 26.

Department of Neonatology, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, 730050, China.

Objective: This study aimed to identify the most useful ultrasound (US) features associated with definite neonatal necrotizing enterocolitis (NEC) and their prognostic values, particularly the calculated markers combined with important features.

Methods: A total of 213 suspected NEC cases were collected from the neonatal department of our hospital from January 2015 to August 2017. Each infant received both X-ray and US examinations. Read More

BMC Pediatr 2021 03 8;21(1):114. Epub 2021 Mar 8.

Department of Pediatrics, Seoul National University Children's Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.

Background: Several studies have suggested that adverse neurodevelopment could be induced by systemic inflammation in preterm infants. We aimed to investigate whether preterm infants with systemic inflammation would have impaired neurodevelopment and which biomarkers and neurophysiologic studies during inflammation are associated with poor neurodevelopment.

Methods: This prospective cohort study enrolled infants born before 30 weeks of gestation or with birth weight < 1250 g. Read More

Pediatr Surg Int 2021 Mar 12;37(3):347-352. Epub 2021 Feb 12.

Division of General and Thoracic Surgery, Translational Medicine, The Hospital for Sick Children, University of Toronto, 1526-555 University Avenue, Toronto, ON, M5G 1X8, Canada.

Purpose: Monitoring disease progression is crucial to improve the outcome of necrotizing enterocolitis (NEC). A previous study indicates that intestinal wall flow velocity was reduced in NEC pups from the initial stages of the disease. This study aims to investigate whether splanchnic perfusion via the superior mesenteric artery (SMA) (i) is altered during NEC development and (ii) can be used as a monitoring tool to assess disease progression. Read More

Neonatology 2021 11;118(1):80-89. Epub 2021 Feb 11.

Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, University of Paris, Paris, France.

Introduction: Retinopathy of prematurity (ROP) is a blinding disease that requires screening by retinal examination. Screening practices are rarely evaluated. We aimed to determine the prevalence of ROP screening in very preterm infants and individual- and center-related factors associated with ROP screening. Read More

Front Pediatr 2020 6;8:593926. Epub 2021 Jan 6.

Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Necrotizing enterocolitis (NEC) is an often-fatal neonatal disease involving intestinal hyperinflammation leading to necrosis. Despite ongoing research, (1) conflicting results and (2) comorbidities of NEC patients make early NEC detection challenging and may complicate therapy development. Most research suggests that NEC pathogenesis is multifactorial, involving a combination of (1) gut prematurity; (2) abnormal bacterial colonization; and (3) ischemia-reperfusion (I/R) injury. Read More

Pediatr Radiol 2021 Apr 4;51(4):658-668. Epub 2021 Jan 4.

Singleton Department of Radiology, Texas Children's Hospital, 6701 Fannin St., Houston, TX, 77030, USA.

Abdominal US is emerging as an alternative to the upper gastrointestinal (GI) series as the preferred diagnostic imaging test for midgut malrotation complicated by volvulus. Unlike the upper GI series, US is free from ionizing radiation, does not require oral contrast agent, and can be performed portably and at times remotely from the interpreting radiologist, expediting diagnosis. Although some institutions do not have a standardized US protocol for midgut volvulus, many routinely use US in the setting of an infant or child with acute abdominal signs or symptoms to evaluate for common conditions such as hypertrophic pyloric stenosis, intussusception, necrotizing enterocolitis and appendicitis. Read More

Medicine (Baltimore) 2020 Dec;99(50):e23613

Department of Neonatal Intensive Care Unit, The Northwest Women's and Children's Hospital, Xi'an, Shanxi, China.

Rationale: Rectal atresia caused by necrotizing enterocolitis (NEC) is a serious and rare complication in children. Magnetic compression anastomosis (MCA) has been effectively applied in children with congenital oesophageal atresia and biliary atresia. Herein, we reported a case of successfully application of MCA in an infant with rectal atresia following NEC. Read More

Radiol Case Rep 2021 Feb 28;16(2):246-249. Epub 2020 Nov 28.

Department of Radiology, State University of New York, Upstate Medical University, Syracuse, NY 13210.

Hepatic portal venous gas (HPVG) is a rare imaging finding in infants and usually indicative of a severe disease process such as necrotizing enterocolitis, bowel ischemia, or bowel wall rupture / infarction. The diagnosis of HPVG may have serious implications such as parenteral nutrition, antibiotics and even surgery. In this case, we present an 8-week-old male with a history of prematurity presenting with HPVG, later concluded to be caused by milk protein allergy. Read More

Biology (Basel) 2020 Nov 26;9(12). Epub 2020 Nov 26.

Department of Microbiology and Immunology, Dalhousie University, Halifax, NS B3H 4R2, Canada.

Because of its unique microvascular anatomy, the intestine is particularly vulnerable to microcirculatory disturbances. During inflammation, pathological changes in blood flow, vessel integrity and capillary density result in impaired tissue oxygenation. In severe cases, these changes can progress to multiorgan failure and possibly death. Read More

Neonatology 2020 25;117(5):555-561. Epub 2020 Nov 25.

Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China.

Objective: The objective of this study is to evaluate the usefulness of fecal microRNA (miR)-223 and miR-451a, as novel noninvasive biomarkers for early diagnosis of necrotizing enterocolitis (NEC) in preterm infants.

Methods: Among the top-listed target miRNAs in our previous differential microarray analysis, miR-223 and miR-451a were quantified in a pilot validation case-controlled study (NEC vs. non-NEC/nonsepsis infants; n = 6 in each group). Read More

BMJ Case Rep 2020 Nov 23;13(11). Epub 2020 Nov 23.

Neonatology, Sunshine Hospital, Saint Albans, Victoria, Australia.

Parechovirus is becoming increasingly recognised as a cause of morbidity in the neonatal population. It is widely known to cause sepsis, encephalitis and myocarditis. We report a case of parechovirus as a possible cause of necrotising enterocolitis in a premature neonate. Read More

Nat Commun 2020 11 13;11(1):5794. Epub 2020 Nov 13.

Biomedicine Discovery Institute and Department of Biochemistry and Molecular Biology, Monash University, Melbourne, VIC, Australia.

Necrotizing enterocolitis (NEC) is a severe, currently untreatable intestinal disease that predominantly affects preterm infants and is driven by poorly characterized inflammatory pathways. Here, human and murine NEC intestines exhibit an unexpected predominance of type 3/T17 polarization. In murine NEC, pro-inflammatory type 3 NKp46RORγtTbet innate lymphoid cells (ILC3) are 5-fold increased, whereas ILC1 and protective NKp46RORγt ILC3 are obliterated. Read More

Pediatr Infect Dis J 2021 02;40(2):e85-e86

Department of Surgery, Division of Pediatric Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas.

We report an infant with COVID-19 who presented with bloody stools, lethargy and imaging findings significant for pneumatosis intestinalis. The infant was treated with conservative therapy, including resuscitation, bowel rest and intravenous antibiotics, successfully avoiding surgical intervention. Read More

Pediatrics 2020 11;146(5)

Pediatric Neurology, Department of Pediatrics and.

Autism spectrum disorder (ASD) is the most common disability-causing neurodevelopmental disorder in childhood. Although inborn errors of metabolism (IEM) are rare causes of ASD, they are significant for several reasons, including implications in genetic counseling and determination of prognosis. In this article, we present a 6-year-old boy who presented to us with ASD and was diagnosed with creatine transporter deficiency. Read More

Early Hum Dev 2020 11 12;150:105191. Epub 2020 Sep 12.

York University, UK.

Cochrane Neonatal was first established in 1993, as one of the original review groups of the Cochrane Collaboration. In fact, the origins of Cochrane Neonatal precede the establishment of the collaboration. In the 1980's, the National Perinatal Epidemiology Unit at Oxford, led by Dr. Read More

Nat Commun 2020 10 2;11(1):4950. Epub 2020 Oct 2.

Translational Medicine Program, The Hospital for Sick Children, Toronto, ON, Canada.

Necrotizing enterocolitis (NEC) is a devastating disease of premature infants with high mortality rate, indicating the need for precision treatment. NEC is characterized by intestinal inflammation and ischemia, as well derangements in intestinal microcirculation. Remote ischemic conditioning (RIC) has emerged as a promising tool in protecting distant organs against ischemia-induced damage. Read More

Radiographics 2020 Oct;40(6):1743-1762

From the Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104 (A.G., M.R.A., M.H., S.A.A.); Department of Radiology, University of Calgary, Calgary, Alberta, Canada (A.M.K.); and Department of Radiology, Lucile Packard Children's Hospital, Stanford University, Stanford, Calif (E.R.).

Contrast material-enhanced US is a technique that is approved by the U.S. Food and Drug Administration for the characterization of liver lesions and intravesicular applications in children; however, contrast-enhanced US has several other pediatric applications in clinical practice. Read More

Pediatrics 2020 09;146(3)

Homerton University Hospital National Health Service Foundation Trust, London, United Kingdom;

Background And Objectives: Preterm infants with necrotizing enterocolitis (NEC) are known to have worse neurodevelopmental outcomes, but there is no substantial evidence to support an underlying pathophysiology. We aimed to examine whether cerebral oxygenation differs in those infants who develop NEC compared to cerebral oxygenation in those who do not.

Methods: We examined 48 infants <30 weeks' gestation admitted to a tertiary level NICU from October 2016 to May 2018. Read More

Int J Cardiovasc Imaging 2021 Jan 1;37(1):269-273. Epub 2020 Aug 1.

The Labatt Family Heart Centre, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.

Feeding intolerance and necrotizing enterocolitis (NEC) cause significant morbidity in neonates with duct-dependent systemic circulations. Whether these complications are associated with low blood flow to the bowel is unproven. The aim of this study was to determine whether low descending aortic (DAO) flow is associated with adverse feeding outcomes in neonates with small left-sided structures, including borderline left ventricle and hypoplastic left heart syndrome (HLHS). Read More

Abdom Radiol (NY) 2020 Jul 31. Epub 2020 Jul 31.

Department of Radiology, Monaldi Hospital, Naples, Italy.

Intestinal pneumatosis (IP) is an infrequent radiological sign defined as pathological gas infiltration into the bowel wall. It may be associated to different underlying clinical conditions-inflammatory bowel diseases, malignancies, chemotherapy, infections, immune deficiency status, trauma, intestinal ischemia, and necrosis-that are often related to emergency state and require a prompt diagnosis. All the imaging techniques, especially abdominal radiography and Computed Tomography, could detect the presence of IP and discern the forms related to emergency conditions. Read More

BMJ Open 2020 07 20;10(7):e033519. Epub 2020 Jul 20.

Neonatal and Intensive Care Department, Medical University of Warsaw, Warsaw, Poland

Introduction: Necrotising enterocolitis (NEC) is one of the most serious conditions in newborn infants, affecting up to 10% of very low birth weight (VLBW) infants. Mortality rates can rise as high as 60%.The suspected diagnosis is confirmed with typical findings on abdominal radiography (AR) such as pneumatosis intestinalis (PI), portal vein gas (PVG) and in extreme cases pneumoperitoneum. Read More

Neurol Sci 2020 Nov 10;41(11):3353-3356. Epub 2020 Jun 10.

Department of Pediatrics, National Taiwan University Hospital, 8, Chung-Shan South Road, Taipei, 100, Taiwan.

We report a patient diagnosed with Aicardi-Goutières syndrome (AGS) with homozygous TREX1 gene mutation. Her magnetic resonance angiography (MRA) showed intracerebral large artery disease, which was rarely reported in the past in TREX1 AGS patients. Her younger sister also had homozygous TREX1 gene mutation and died of necrotizing enterocolitis. Read More

Semin Fetal Neonatal Med 2020 10 2;25(5):101120. Epub 2020 Jun 2.

Division of Neonatology, Department of Pediatrics, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA; Department of Internal Medicine, University of Iowa, 8803 John Pappajohn Pavillion 200 Hawkins Drive, Iowa City, IA, 52242, USA. Electronic address:

Patent ductus arteriosus is associated with multiple comorbidities in premature infants, however a causal link or strategy to decrease these morbidities has not been found. The association between the patent ductus arteriosus and morbidities has biologic plausibility as, like any cardiac mixing lesion, a significant systemic to pulmonic shunt may lead to pulmonary over-circulation and systemic hypoperfusion. Understanding the underlying pathophysiology of associated morbidities in the setting of a patent ductus arteriosus may aid in risk stratifying infants and offer a patient targeted approach to infants with a pathological ductal shunt. Read More

Cell Mol Gastroenterol Hepatol 2020 28;10(3):623-637. Epub 2020 May 28.

Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania; Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address:

Background And Aims: The Extra-Uterine Environment for Neonatal Development (EXTEND) aims to avoid the complications of prematurity, such as NEC. Our goal was to determine if bowel development occurs normally in EXTEND-supported lambs, with specific emphasis on markers of immaturity associated with NEC.

Methods: We compared terminal ileum from 17 pre-term lambs supported on EXTEND for 2- 4 weeks to bowel from age-matched fetal lambs that developed in utero. Read More

Arch Dis Child Fetal Neonatal Ed 2021 Jan 12;106(1):96-103. Epub 2020 May 12.

Neonatal Service, Poole Hospital NHS Foundation Trust, Poole, UK

Necrotising enterocolitis (NEC) is a serious inflammatory bowel disease of prematurity with potentially devastating complications and remains a leading cause of morbidity and mortality among premature infants. In recent years, there has been accumulating data regarding benefits of using bowel ultrasound (BUS) in the diagnosis and management of NEC. Despite this, adoption of robust BUS programmes into clinical practice has been slow. Read More