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Microcirculation 2022 May 20:e12768. Epub 2022 May 20.

Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Objective: Necrotizing enterocolitis (NEC) is the most prevalent gastrointestinal emergency in premature infants and is characterized by a dysfunctional gut microcirculation. Therefore, there is a dire need for in vivo methods to characterize NEC-induced changes in the structure and function of the gut microcirculation, that is, its vascular phenotype. Since in vivo gut imaging methods are often slow and employ a single-contrast mechanism, we developed a rapid multicontrast imaging technique and a novel analyses pipeline for phenotyping the gut microcirculation. Read More

Heart Surg Forum 2022 Mar 24;25(2):E229-E231. Epub 2022 Mar 24.

Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Guoxuexiang 37th, 610041 Chengdu, Sichuan, P.R. China.

Background: A one-month-old neonate presented to the hospital with dyspnea and bloody stool, which happened suddenly and progressed over two days.

Case Presentation: Computed tomography and three-dimensional reconstruction of the trachea and heart was done, demonstrating significant trachea stenosis, aberrant right subclavian artery arising from Kommerell's diverticulum, and patent ductus arteriosus. Reconstruction of the aberrant subclavian artery, resection of the diverticulum, and ligation of ductus arteriosus was performed. Read More

Pediatr Neonatol 2022 Mar 28. Epub 2022 Mar 28.

Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea; Department of Pediatrics, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, South Korea.

Background: The study aimed to identify factors associated with compliance to follow-up (FU) appointments among infants following their discharge from the neonatal intensive care unit (NICU).

Methods: This retrospective cohort study reviewed 657 infants (birth weight <1500 g or gestational age [GA] <32 weeks), born between 2011 and 2015. A total of 525 eligible infants were classified into two groups: the compliant group (n = 360), who attended clinics from 18 to 24 months, and the non-compliant group (n = 165), who were lost to FU before 18 months. Read More

BMJ Case Rep 2022 03 30;15(3). Epub 2022 Mar 30.

404 Military Hospital of Larissa, Larissa, Greece.

N Engl J Med 2022 Mar 12;386(11):1070. Epub 2022 Mar 12.

Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

Br J Radiol 2022 Apr 27;95(1132):20211101. Epub 2022 Jan 27.

Department of Radiology, University of Florida College of Medicine, Gainesville, Florida, United States.

Objectives: Pneumatosis intestinalis is a radiographic finding that refers to the presence of gas within the walls of the small or large bowel. This sign is diagnostic in the setting of premature infants with suspected necrotizing enterocolitis. Earlier detection of NEC on X-ray is vital to improve the overall management in these infants. Read More

J Ultrasound Med 2022 Jan 18. Epub 2022 Jan 18.

Department of Radiology, Haeundae Paik Hospital, Inje University, Busan, Korea.

Objectives: To identify sonographic findings that predict clinical outcomes in neonates with portal vein gas.

Methods: This retrospective study included neonates with portal vein gas detected using ultrasound (US). The US images were reviewed by a pediatric radiologist. Read More

Ital J Pediatr 2022 Jan 10;48(1). Epub 2022 Jan 10.

Department of Pediatrics, Hanyang University College of Medicine, 222-1 Wangsimni-ro Seongdong-gu, Seoul, 04763, South Korea.

Background: Necrotizing enterocolitis (NEC) is a devastating disease in preterm infants with significant morbidities, including neurodevelopmental impairment (NDI). This study aimed to investigate whether NEC is associated with (1) brain volume expansion and white matter maturation using diffusion tensor imaging analysis and (2) NDI compared with preterm infants without NEC.

Methods: We included 86 preterm infants (20 with NEC and 66 without NEC) with no evidence of brain abnormalities on trans-fontanelle ultrasonography and magnetic resonance imaging at term-equivalent age (TEA). Read More

Ultrasound Obstet Gynecol 2022 05;59(5):596-605

Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.

Objective: To assess the performance of placental, fetal and maternal cardiovascular markers in the prediction of adverse perinatal and maternal outcomes in women with suspected or confirmed pre-eclampsia.

Methods: This was a prospective prognostic accuracy study of women with suspected or confirmed pre-eclampsia who underwent a series of investigations to measure maternal hemodynamic indices, mean arterial pressure, augmentation index, ophthalmic artery peak systolic velocity (PSV) ratio, uterine artery pulsatility index (UtA-PI), fetal biometric and Doppler parameters, soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF). The performance of these markers, individually or in combination, in predicting adverse perinatal and maternal outcomes was then assessed using receiver-operating-characteristics (ROC)-curve analysis. Read More

Paediatr Anaesth 2022 Mar 10;32(3):421-428. Epub 2022 Jan 10.

Université de Paris, Paris, France.

Background: The goal of the present study was to investigate intraoperative factors associated with major neurological complications at 1 year following surgery for necrotizing enterocolitis.

Material And Methods: The study consisted of a retrospective review of medical charts of patients operated for over one calendar year in one institution. Data collected included demographic data, cardiac resuscitation at birth, Bell classification, antibiotics usage, time of day of surgery, surgical technique, surgical duration, type of ventilation, intraoperative vasoactive agents, and albumin use, nadir cerebral saturation, the decrease in cerebral saturation from baseline, the time period when cerebral saturation was at least 20% below baseline, and the mean arterial pressure at nadir cerebral saturation. Read More

Korean J Radiol 2022 01;23(1):124-138

Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Gastrointestinal (GI) emergencies in neonates and infants encompass from the beginning to the end of the GI tract. Both congenital and acquired conditions can cause various GI emergencies in neonates and infants. Given the overlapping or nonspecific clinical findings of many different neonatal and infantile GI emergencies and the unique characteristics of this age group, appropriate imaging is key to accurate and timely diagnosis while avoiding unnecessary radiation hazard and medical costs. Read More

Eur J Pediatr 2022 Apr 4;181(4):1739-1749. Epub 2022 Jan 4.

Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

Clinical management of gut injury has been a challenge to the clinician since the first description of necrotizing enterocolitis (NEC) about 50 years ago, and it is still poorly defined. Most of the diagnostic markers are non-specific, and there is no consensus yet on a reliable gold standard for diagnosis. This report describes our approach to integrating point of care intestinal ultrasound (IUS) as the primary radiological assessment modality with other clinical and biochemical markers. Read More

BMC Pediatr 2021 12 24;21(1):587. Epub 2021 Dec 24.

Pediatric Surgery Department, Alexandria Faculty of Medicine, Alexandria, 21615, Egypt.

Background: While necrotizing enterocolitis (NEC) is a prevalent condition in preterm neonates admitted to neonatal intensive care unit (NICU), intussusception is exceedingly uncommon and often overlooked. This is due to the fact that they share many clinical characteristics. The initial misdiagnosis of intussusception in preterm neonates (IPN) especially has led to a delay in their management, which increases the risk of developing compromised bowel. Read More

Ultrasound Obstet Gynecol 2022 02;59(2):263-266

Fetal Medicine Research Institute, King's College Hospital, London, UK.

BMC Pediatr 2021 12 20;21(1):582. Epub 2021 Dec 20.

Department of Neonatology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 West Xueyuan Road, Wenzhou, 325027, Zhejiang, China.

Background: Studies have shown that neurological damage is common in necrotizing enterocolitis (NEC) survivors. The purpose of the study was to investigate the predictive value of amplitude-integrated electroencephalogram (aEEG) for neurodevelopmental outcomes in preterm infants with NEC.

Methods: Infants with NEC were selected, and the control group was selected based on 1:1-2 pairing by gestational age. Read More

J Pediatr Surg 2022 Apr 29;57(4):747-752. Epub 2021 Oct 29.

Department of Pediatric Surgery, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark; Department of Surgical Gastroenterology, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark.

Background: Reduced intestinal perfusion is thought to be a part of the pathogenesis in necrotizing enterocolitis (NEC). This study aims to evaluate the intestinal perfusion assessment in NEC-lesions by quantitative fluorescence angiography with indocyanine green (q-ICG) during laparoscopy and open surgery.

Methods: Thirty-four premature piglets were delivered by cesarean section and fed with parenteral nutrition and increasing infant formula volumes to induce NEC. Read More

Chest 2021 12;160(6):e661-e664

Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.

Pediatr Surg Int 2022 Mar 27;38(3):399-407. Epub 2021 Nov 27.

Division of Pediatric General, Thoracic and Fetal Surgery, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA.

Purpose: The significance and management of pediatric pneumatosis intestinalis (PI) remains poorly defined. We sought to add clarity in children beyond the neonatal period.

Methods: Pediatric patients 3 months-18 years admitted to a quaternary children's hospital with a diagnosis of PI were included in this retrospective study. Read More

Acta Paediatr 2022 Mar 6;111(3):546-553. Epub 2021 Dec 6.

Department of Clinical Medicine, University of Bergen, Bergen, Norway.

Aim: We evaluated the role of placental pathology in predicting adverse outcomes for neonates born extremely preterm (EPT) before 28 weeks of gestation.

Methods: This was a prospective observational study of 123 extremely preterm singletons born in a hospital in western Norway, and the placentas were classified according to the Amsterdam criteria. The associations between histologic chorioamnionitis (HCA), by the presence or the absence of a foetal inflammatory response (FIR+ or FIR-), maternal vascular malperfusion (MVM) as a whole and adverse neonatal outcomes were evaluated by logistic regression analyses. Read More

Eur J Pediatr 2022 Mar 8;181(3):1117-1124. Epub 2021 Nov 8.

Department of Women's and Children's Health, University of Liverpool, Liverpool Health Partners, Liverpool, UK.

Monitoring patent ductus arteriosus (PDA) in premature infants is currently performed intermittently using echocardiography which requires considerable expertise. The aim of this pilot study was to investigate whether PDA status could be assessed from standard neonatal intensive care monitoring. Electrocardiography (ECG) and blood pressure (BP) waveforms were acquired from extremely preterm infants using standard neonatal monitors. Read More

Nucleic Acids Res 2022 01;50(D1):D808-D816

Key Laboratory of Molecular Biophysics of the Ministry of Education, Hubei Key Laboratory of Bioinformatics and Molecular-imaging, Center for Artificial Intelligence Biology, Department of Bioinformatics and Systems Biology, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan 430074, China.

mBodyMap is a curated database for microbes across the human body and their associations with health and diseases. Its primary aim is to promote the reusability of human-associated metagenomic data and assist with the identification of disease-associated microbes by consistently annotating the microbial contents of collected samples using state-of-the-art toolsets and manually curating the meta-data of corresponding human hosts. mBodyMap organizes collected samples based on their association with human diseases and body sites to enable cross-dataset integration and comparison. Read More

BMJ Case Rep 2021 Oct 19;14(10). Epub 2021 Oct 19.

Neonatal Intensive Care Unit (NICU), Women's Wellness and Research Center (WWRC), Hamad Medical Corporation, Doha, Qatar.

Pediatr Radiol 2022 Apr 16;52(4):702-715. Epub 2021 Oct 16.

Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.

Ultrasound has proved to be a useful modality for enhancing the diagnostic accuracy of necrotizing enterocolitis and associated complications. The standard imaging algorithm for evaluating necrotizing enterocolitis includes radiographs and clinical symptoms, the combination of which constitutes the Bell criteria. Major limitations of using the Bell criteria for diagnosing and clinically managing necrotizing enterocolitis include low diagnostic accuracy of radiographs and nonspecific symptomatology of preterm infants. Read More

EBioMedicine 2021 Oct 7;72:103607. Epub 2021 Oct 7.

Key Laboratory of Clinical Laboratory Diagnostics of Ministry of Education, Faculty of Laboratory Medicine, Chongqing Medical University, China. Electronic address:

Background: The initial clinical manifestations and abdominal imaging findings of neonates with necrotising enterocolitis (NEC) and food protein-induced enterocolitis syndrome (FPIES) are sometimes similar; however, their prognosis and therapies are different. We aimed to evaluate the utility of interleukin (IL)-27 as a differentiation marker between NEC and highly suspected early onset (HSEO)-FPIES.

Methods: All samples used in this study were obtained from the neonatal diagnosis centre of Children's Hospital of Chongqing Medical University. Read More

Pediatr Neonatol 2022 01 23;63(1):93-94. Epub 2021 Sep 23.

Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan. Electronic address:

Arch Dis Child Fetal Neonatal Ed 2022 Jul 4;107(4):371-379. Epub 2021 Oct 4.

Division of Fetal Therapy and Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA

Objective: We sought to perform a meta-analysis of the predictive value of antenatal ultrasonographic markers of bowel dilation, gastric dilation, polyhydramnios and abdominal circumference that predict complex gastroschisis and adverse perinatal outcomes DATA SOURCES: PubMed, Web of Science, Scopus and Embase were searched for relevant articles up to December 2020. Studies reporting prenatal ultrasonographic markers including intra-abdominal bowel dilation (IABD), extra-abdominal bowel dilation (EABD), bowel wall thickness, polyhydramnios, abdominal circumference <5th percentile, gastric dilation (GD) and bowel dilation not otherwise specified (BD-NOS) were included. The primary outcome was prediction of complex gastroschisis; secondary outcomes were length of hospital stay for newborn, time to full enteral feeding, postnatal mortality rate, incidence of necrotising enterocolitis and short bowel syndrome. Read More

Pediatr Surg Int 2022 Feb 28;38(2):225-233. Epub 2021 Sep 28.

Department of Surgery, Boston Children's Hospital/Harvard Medical School, 300 Longwood Avenue - Fegan 3, Boston, MA, 02115, USA.

Purpose: We evaluated the diagnostic utility of abdominal ultrasound (AUS), an adjunct to abdominal X-ray (AXR), for necrotizing enterocolitis (NEC) in congenital heart disease (CHD) patients.

Methods: 86 patients with suspected NEC from 2009 to 2018 were classified as with CHD (n = 18) if they required cardiac intervention versus without CHD (n = 68). Clinical and radiological data were collected, including AXR and AUS concordance. Read More

Trials 2021 Sep 15;22(1):627. Epub 2021 Sep 15.

Radboud Institute for Health Sciences, Amalia Children's Hospital, Department of Paediatrics, Division of Neonatology, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525, GA, Nijmegen, The Netherlands.

Background: Controversy exists about the optimal management of a patent ductus arteriosus (PDA) in preterm infants. A persistent PDA is associated with neonatal mortality and morbidity, but causality remains unproven. Although both pharmacological and/or surgical treatment are effective in PDA closure, this has not resulted in an improved neonatal outcome. Read More

Adv Neonatal Care 2021 Oct;21(5):365-370

Neonatology Division, University of Utah, Salt Lake City (Drs Chan and Yang); Diagnostic Imaging, Intermountain Healthcare, Salt Lake City, Utah (Ms Gordon and Dr Dance); and University of Utah School of Medicine, Salt Lake City (Ms Weekes).

Background: Abdominal x-ray (KUB) routinely aids in detecting necrotizing enterocolitis (NEC), one of the most serious neonatal intestinal diseases. However, a KUB may miss up to 50% of the early signs of NEC. Recent advances in abdominal ultrasound (AUS) can expedite this diagnosis and improve clinical management. Read More

Br J Ophthalmol 2021 Aug 13. Epub 2021 Aug 13.

Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina, USA

Background/aims: Neonatal insults from systemic diseases have been implicated in the pathway of impaired neurodevelopment in preterm infants. We aimed to investigate the associations between systemic health factors and retinal nerve fibre layer (RNFL) thickness in preterm infants.

Methods: We prospectively enrolled infants and imaged both eyes at 36±1 weeks postmenstrual age (PMA) using a hand-held optical coherence tomography system at the bedside in the Duke intensive care nurseries. Read More