Journal of Pediatric Gastroenterology & Nutrition最新文献

{"title":"Relationships Between Early Neonatal Nutrition and Neurodevelopment at School Age in Children Born Very Preterm.","authors":"Anna C Tottman, J. Alsweiler, F. Bloomfield, G. Gamble, Yannan Jiang, Myra Leung, Tanya Poppe, B. Thompson, T. Wouldes, J. Harding","doi":"10.1097/MPG.0000000000002471","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002471","url":null,"abstract":"OBJECTIVES To determine whether a new nutrition protocol designed to increase early protein intakes while reducing fluid volume in infants born very preterm was associated with altered neurodevelopment and growth in childhood. METHODS A retrospective, observational cohort study of children born <30 weeks' gestation or <1,500 grams and admitted to the neonatal unit, National Women's Hospital, Auckland, NZ, before and after a change in nutrition protocol. The primary outcome was neurodevelopmental impairment at 7 years (any of Wechsler Intelligence Scale for Children full scale IQ<85, Movement Assessment Battery for Children-2 total score ≤5 centile, cerebral palsy, blind or deaf requiring aids). Outcomes were compared between groups and for the overall cohort using generalised linear regression, adjusted for sex and birth weight z-score. RESULTS Of 201 eligible children, 128 (64%) were assessed (55/89 (62%) exposed to the old nutrition protocol, 73/112 (65%) to the new protocol). Children who experienced the new protocol received more protein, less energy and less carbohydrate in postnatal days 1-7. Neurodevelopmental impairment was similar at 7 years (30/73 (41%) vs 25/55 (45%), adjusted odds ratio (AOR) (95% confidence interval) 0.78 (0.35-1.70), P = 0.55), as was the incidence of cerebral palsy (AOR 7.36 (0.88-61.40), P = 0.07). Growth and body composition were also similar between groups. An extra one g.kg parenteral protein intake in postnatal days 1-7 was associated with a 27% increased odds of cerebral palsy (AOR 1.27 (1.03-1.57), P = 0.006). CONCLUSIONS Higher early protein intakes do not change overall rates of neurodevelopmental impairment or growth at 7 years. Further research is needed to determine the effects of higher early parenteral protein intake on motor development.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78139126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Homozygous NEK8 Mutations in Siblings with Neonatal Cholestasis Progressing to End Stage Liver, Renal and Cardiac Disease.","authors":"S. Hassan, M. T. Wolf, Luis A Umaña, Sadia Malik, N. Uddin, J. Andersen, Amal A. Aqul","doi":"10.1097/MPG.0000000000002517","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002517","url":null,"abstract":"Received March 14, 2019 From the Division of Nutrition, the yDivis Genetics, the §Divisio rics, and the jjDvision University of Texas S Address correspondence of Pediatric Gastroent Pediatrics, University Center, Address 193 (e-mail: amal.aqul@u Supplemental digital co citations appear in th provided in the HTM (www.jpgn.org). The authors report no co Copyright # 2019 by E Hepatology, and Nut Gastroenterology, He DOI: 10.1097/MPG.0000","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"127 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73328765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic Susceptibility and Therapy in Central Line Infections in Pediatric Home Parenteral Nutrition Patients.","authors":"B. Raphael, G. Fournier, Sarah R. McLaughlin, M. Puder, Sarah Jones, Kelly B. Flett","doi":"10.1097/MPG.0000000000002506","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002506","url":null,"abstract":"BACKGROUND Patients receiving home parenteral nutrition (HPN) are at high-risk for central line associated bloodstream infections (CLABSI). However, there are no published management guidelines for the antibiotic treatment of suspected CLABSI in this population. Historical microbiology data may help inform empiric antimicrobial regimens in this population. OBJECTIVE To describe antimicrobial resistance patterns and determine the most appropriate empiric antibiotic therapy in HPN dependent children experiencing a community-acquired CLABSI. METHODS Single-center retrospective cohort study evaluating potential coverage of empiric antibiotic regimens in children on HPN who developed a community-acquired CLABSI. RESULTS From October 1, 2011 to September 30, 2017, there were 309 CLABSI episodes among 90 HPN-dependent children with median age 3.8 years-old.Fifty-nine percent of patients carried the diagnosis of surgical short bowel syndrome. Organisms isolated during these infections included 60% gram-positive bacteria, 34% gram-negative bacteria, and 6% fungi. Among all staphylococcal isolates, 51% were methicillin sensitive. Among enteric gram-negative organisms, sensitivities were piperacillin-tazobactam 71%, cefepime 97% and meropenem 99%. Organisms were sensitive to current institutional standard therapy with vancomycin + piperacillin-tazobactam in 69% of cases compared with vancomycin + cefepime or vancomycin + meropenem in 85% and 96% of cases (both p < 0.01). CONCLUSIONS Empiric antimicrobial therapy for suspected CLABSI in HPN-dependent children should include therapy for methicillin-resistant staphylococci as well as enteric gram-negative organisms. Future studies are needed to evaluate clinical outcomes based upon evidence-based antimicrobial regimens.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86446250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Tolerance and Complication Rates between Early and Delayed Feeding after PEG Placement in Children.","authors":"Jacquelin Peck, Katie Mills, A. Dey, A. T. Nguyen, E. Amankwah, Alexander Wilsey, Emily Swan, Sorany Son, Sara Karjoo, D. McClenathan, M. Wilsey","doi":"10.1097/MPG.0000000000002503","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002503","url":null,"abstract":"BACKGROUND Enteral nutrition is commonly initiated 24-hours after percutaneous endoscopic gastrostomy (PEG) in children. Adult studies report safe refeeding within 1-6 hours of PEG and these findings have been cautiously applied to children. However, comparative studies assessing early vs next-day refeeding in children are currently lacking. This study evaluates feeding tolerance and complications following early vs. next-day refeeding in children. METHODS This is a single-center, pre-post study. In June 2015 our clinical practice changed to begin refeeding within 6-hours of PEG. Children receiving early refeeding from December 2015 to August 2017 were included. A retrospective cohort from February 2013 to April 2015 was used for comparison. RESULTS 46 children received early refeeding after PEG and 37 received next-day refeeding. Gender distribution was similar in the two groups. Early refeeding patients were slightly older (3.5 vs. 2.2 years) and heavier (15.5 kg vs. 11.5 kg) at PEG placement compared to next-day refeeding patients. Early Refeeding patients experienced greater post-procedural nausea and/or vomiting (19% vs 8%, p < 0.001) and leakage, irritation, and infection around the stoma (19% vs 0.0%, p < 0.001). Compared to Early Refeeders, Next-Day Refeeding patients experienced higher occurrence of fever (35% vs 13%, p = 0.021), longer nutritional disruption (24.6 vs 3.7 hours, p < 0.001) and longer length of stay (51 vs. 27 hours; p < 0.001). One Next-Day-Refeeding patient experienced peritonitis. One Early Refeeding patient experienced cellulitis requiring hospitalization and a second experienced gastrostomy tube migration into the peritoneal cavity requiring removal. CONCLUSION Early Refeeders experienced higher rates of post-procedural nausea or vomiting and irritation, leakage or infection around the stoma; but experienced lower rates of post-operative fever. Early refeeding resulted in reduced nutritional interruption and hospital length of stay.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84115647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2018 Reviewer Acknowledgment.","authors":"","doi":"10.1097/MPG.0000000000002165","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002165","url":null,"abstract":"","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80180563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monozygotic Twin Cases of XIAP Deficiency Syndrome.","authors":"S. C. Kim","doi":"10.1097/MPG.0000000000001536","DOIUrl":"https://doi.org/10.1097/MPG.0000000000001536","url":null,"abstract":"","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79124098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NASPGHAN Abstracts","authors":"","doi":"10.1097/mpg.0000000000002164","DOIUrl":"https://doi.org/10.1097/mpg.0000000000002164","url":null,"abstract":"","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80958825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual Presentation of Giant Omental Cystic Lymphangioma Mimicking Hemorrhagic Ascites in a Child.","authors":"Eva Bruloy, E. Haraux, B. Robert, D. Djeddi, P. Buisson","doi":"10.1097/MPG.0000000000001095","DOIUrl":"https://doi.org/10.1097/MPG.0000000000001095","url":null,"abstract":"JP ratory tests were normal. Abdominal ultrasound showed a large amount of ascites. mature lymphocytes. Magnetic resonance imaging revealed clumped bowel loops overlying the spine and the complete absence of ascites between bowel loops and around the liver. Bowel loops were displaced by intraperitoneal, multiloculated, septated T1and T2-hyperintense soft tissue corresponding to venous blood (Fig. 1). Laparotomy revealed a giant cystic lymphangioma of the greater omentum (Fig. 2). The patient is doing well 24 months after surgery with no signs of recurrence.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75880848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Cobblestone\" Appearance of Esophagus: An Unusual Symptom of Pyloric Stenosis.","authors":"Izabella Łazowska-Przeorek, D. Kąkol, K. Karolewska-Bochenek, A. Banaszkiewicz","doi":"10.1097/MPG.0000000000001070","DOIUrl":"https://doi.org/10.1097/MPG.0000000000001070","url":null,"abstract":"e A 3-month-old girl was admitted for suspected upper gastrointestinal (GI) tract bleeding and emesis. She had 3 weeks of regurgitation and 3 days of daily emesis, t weight from the 50th to the 25th percentile. Omeprazole was started on admission. doscopy revealed a ‘‘cobblestone’’ appearance of the esophagus (Fig. 1). Biopsies revealed severe esophagitis (no eosinophils) with ulceration and partial necrosis of the mucosa in the distal esophagus. Upper GI series revealed an enormous stomach with suspicion of infantile hypertrophic pyloric stenosis, confirmed by sonography. She underwent open pyloroplasty with no further emesis and regained her weight quickly. Repeat upper endoscopy at 12 weeks revealed a completely normal esophagus. Biopsies showed mild distal esophagitis. ‘‘Cobblestone esophagitis’’ is a rare endoscopic finding and has been associated with eosinophilic esophagitis, candidiasis, and Barrett esophagus in adults (1–3). It can also be found in severe reflux esophagitis secondary to distal GI obstruction, as in our case. Our patient had an atypical presentation of pyloric stenosis, with no history of projectile vomiting or persistent hunger (4).","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87520617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cystic Echinococcus Infection in a 10-Year-Old Iraqi Refugee.","authors":"Jordan Weitzner, Jacob Bilhartz, J. Magliocca, A. J. Freeman","doi":"10.1097/MPG.0000000000001064","DOIUrl":"https://doi.org/10.1097/MPG.0000000000001064","url":null,"abstract":"FIGURE 1. Axial T2 MRI image of the largest cyst in the right lobe of the liver with 2 additional daughter cysts present within the large cyst. Also partially visible are 2 additional cysts present in the left lobe. MRI1⁄4magnetic resonance imaging. FIGURE 2. Gross anatomical specimen of the large cyst shown on MRI with 1 daughter cyst present. Normal liver parenchyma is seen adjacent to the cyst. MRI1⁄4magnetic resonance imaging.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86622746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}