Gastrointestinal Injury in Polycythemic Term Infants

PEDIATRICS ◽  
1985 ◽  
Vol 76 (2) ◽  
pp. 225-231
Author(s):  
Virginia D. Black ◽  
Carol M. Rumack ◽  
Lula O. Lubchenco ◽  
Beverly L. Koops
Keyword(s):  
Risk Factors ◽  
Randomized Trial ◽  
Plasma Exchange ◽  
Necrotizing Enterocolitis ◽  
Exchange Transfusion ◽  
Term Infants ◽  
Gastrointestinal Injury ◽  
Control Subjects ◽  
Increased Risk ◽  
Gastrointestinal Problems

Necrotizing enterocolitis is uncommon among term infants. In this group, necrotizing enterocolitis has been associated with two risk factors: polycythemia and umbilical catheterization. During a randomized trial of partial plasma exchange transfusion for treatment of polycythemia, an increased risk of gastrointestinal problems was noted. Eight hyperviscous patients treated with partial plasma exchange transfusion, no symptomatically treated patients, and no control infants developed typical necrotizing enterocolitis (blood in the stools, pneumatosis, and systemic signs). The incidence of necrotizing enterocolitis was significantly greater among patients treated with exchange transfusion compared with patients treated symptomatically or control subjects (P < .001).

scholarly journals Risk Factors for Postural and Functional Balance Impairment in Patients with Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 9 (2) ◽  
pp. 609
Author(s):  
Jaekwan K. Park ◽  
Nicolaas E. P. Deutz ◽  
Clayton L. Cruthirds ◽  
Sarah K. Kirschner ◽  
Hangue Park ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Postural Balance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Balance Impairment ◽  
Functional Balance ◽  
Control Subjects ◽  
Increased Risk

Reduced balance function has been observed during balance challenging conditions in the chronic obstructive pulmonary disease (COPD) population and is associated with an increased risk of falls. This study aimed to examine postural balance during quiet standing with eyes open and functional balance in a heterogeneous group of COPD and non-COPD (control) subjects, and to identify risk factors underlying balance impairment using a large panel of methods. In COPD and control subjects, who were mostly overweight and sedentary, postural and functional balance were assessed using center-of-pressure displacement in anterior-posterior (AP) and medio-lateral (ML) directions, and the Berg Balance Scale (BBS), respectively. COPD showed 23% greater AP sway velocity (p = 0.049). The presence of oxygen therapy, fat mass, reduced neurocognitive function, and the presence of (pre)diabetes explained 71% of the variation in postural balance in COPD. Transcutaneous oxygen saturation, a history of exacerbation, and gait speed explained 83% of the variation in functional balance in COPD. Neurocognitive dysfunction was the main risk factor for postural balance impairment in the control group. This suggests that specific phenotypes of COPD patients can be identified based on their type of balance impairment.

Risk factors, characteristics and outcomes of necrotizing enterocolitis in late preterm and term infants

2013 ◽  
Vol 6 (2) ◽  
pp. 125-130 ◽  
Author(s):  
K. Al Tawil ◽  
H. Sumaily ◽  
I.A. Ahmed ◽  
A. Sallam ◽  
A. Al Zaben ◽  
...  
Keyword(s):  
Risk Factors ◽  
Necrotizing Enterocolitis ◽  
Late Preterm ◽  
Term Infants

Necrotizing Enterocolitis Incidence, Characteristics, and Outcomes in Neonatal Down Syndrome Patients

2017 ◽  
Vol 34 (13) ◽  
pp. 1368-1374
Author(s):  
Urbee Haque ◽  
Yongjie Miao ◽  
Carl Backes ◽  
Clifford Cua
Keyword(s):  
Down Syndrome ◽  
Necrotizing Enterocolitis ◽  
Demographic Data ◽  
Ductus Arteriosus ◽  
Term Infants ◽  
Obstructive Lesion ◽  
Medical Issues ◽  
Increased Risk ◽  
Baseline Characteristics ◽  
Baseline Demographic

Introduction Neonates with Down syndrome (nDS) have multiple medical issues that may place them at an increased risk of necrotizing enterocolitis (NEC). The goal of this study was to determine the incidence, characteristics, and outcomes of nDS patients that developed NEC. Methods Data from the Pediatric Health Information Systems database on all nDS were reviewed. Demographics, medical conditions, development of NEC, and mortality were recorded. Patients were divided into nDS patients who developed NEC (nDS-NEC) versus nDS patients who did not develop NEC (nDS-nNEC). Results Incidence of NEC in nDS patients was 6.6% (381/5,737). Baseline demographic data indicated nDS-NEC patients were more likely to be born earlier, have a diagnosis of congenital diaphragmatic hernia, ventricular septal defect, patent ductus arteriosus, Ebstein's anomaly, or a left-sided obstructive lesion versus nDS-nNEC patients. The odds ratio for death in the nDS-NEC patients was 2.5 (95% confidence interval, 1.8–3.3) versus the nDS-NEC patients. Conclusion The incidence of NEC in nDS patients requiring admission to a children's hospital after birth is much higher than that reported for term infants. Baseline characteristics differ in nDS patients that may place them at a higher risk for NEC. nDS-NEC patients have an increased morbidity and a significantly higher mortality compared with the nDS-nNEC patients.

scholarly journals Aetiologies and risk factors for neonatal sepsis and pneumonia mortality among Alaskan infants

2005 ◽  
Vol 133 (5) ◽  
pp. 877-881 ◽  
Author(s):  
B. D. GESSNER ◽  
L. CASTRODALE ◽  
M. SORIANO-GABARRO
Keyword(s):  
Risk Factors ◽  
Neonatal Sepsis ◽  
Rate Ratio ◽  
Neonatal Period ◽  
Group B Streptococcus ◽  
Sepsis Mortality ◽  
Term Infants ◽  
Gram Positive Bacteria ◽  
Increased Risk ◽  
Group B

We evaluated all fatal neonatal sepsis and pneumonia cases occurring in Alaska during 1992–2000. Risk factors were evaluated using a database of all births occurring during the study period. Of 32 cases, group B streptococcus (GBS) was isolated from 21% (all <7 days of age), Candida spp. from 19% (all >7 days of age), non-GBS Gram-positive bacteria from 50% (53% <7 days of age), and Gram-negative infections from 38% (58% <7 days of age). Infants born at <37 weeks gestation accounted for 72% of cases and had an increased risk of GBS [rate ratio (RR) 9·1, 95% confidence interval (CI) 2·0–41] and non-GBS (RR 40, 95% CI 16–101) disease. Neonatal sepsis mortality has become an outcome concentrated among pre-term infants. Aetiologies include GBS during the early neonatal period, Candida spp. during the late neonatal period, and other bacteria during both periods.

scholarly journals Genitourinary Procedures as Risk Factors for Prosthetic Hip or Knee Infection: A Hospital-Based Prospective Case-Control Study

2015 ◽  
Vol 2 (3) ◽  
Author(s):  
Arjun Gupta ◽  
Douglas R. Osmon ◽  
Arlen D. Hanssen ◽  
Deborah J. Lightner ◽  
Walter R. Wilson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antibiotic Prophylaxis ◽  
Case Control Study ◽  
Joint Infection ◽  
Case Control ◽  
Total Hip ◽  
Control Subjects ◽  
Increased Risk ◽  
The Impact ◽  
Control Study

Abstract Background.  The purpose of this study was to determine the risk of prosthetic joint infection (PJI) as a complication of routine genitourinary (GU) procedures in patients with total hip arthroplasty (THA) or total knee arthroplasty (TKA) and to study the impact of antibiotic prophylaxis administered prior to these procedures. Methods.  We conducted a prospective, single-center, case-control study between December 1, 2001 and May 31, 2006. Case patients were hospitalized with total hip or knee PJI. Control subjects underwent a THA or TKA and were hospitalized during the same period on the same orthopedic floor without a PJI. Data regarding demographic features and potential risk factors were collected. The outcome measure was the odds ratio (OR) of PJI after GU procedures performed within 2 years of admission. Results.  A total of 339 case patients and 339 control subjects were enrolled in the study. Of these, 52 cases (15%) and 55 controls (16%) had undergone a GU procedure in the preceding 2 years. There was no increased risk of PJI for patients undergoing a GU procedure with or without antibiotic prophylaxis (adjusted OR [aOR] = 1.0, 95% confidence interval [CI] = 0.2–4.5, P = .95 and aOR = 1.0, 95% CI = 0.6–1.7, P = .99, respectively). Results were similar in a subset of patients with a joint age less than 6 months, less than 1 year, or greater than 1 year. Conclusions.  Genitourinary procedures were not risk factors for subsequent PJI. The use of antibiotic prophylaxis before GU procedures did not decrease the risk of subsequent PJI in our study.

scholarly journals Factors Associated with Increased Risk of Early Severe Neonatal Morbidity in Late Preterm and Early Term Infants

2021 ◽  
Vol 10 (6) ◽  
pp. 1319
Author(s):  
Tesfaye S. Mengistu ◽  
Veronika Schreiber ◽  
Christopher Flatley ◽  
Jane Fox ◽  
Sailesh Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Significant Risk ◽  
Neonatal Morbidity ◽  
Late Preterm ◽  
Term Infants ◽  
Early Term ◽  
Caesarean Birth ◽  
Emergency Caesarean ◽  
Increased Risk

Although the risk of neonatal mortality is generally low for late preterm and early term infants, they are still significantly predisposed to severe neonatal morbidity (SNM) despite being born at relatively advanced gestations. In this study, we investigated maternal and intrapartum risk factors for early SNM in late preterm and early term infants. This was a retrospective cohort study of non-anomalous, singleton infants (34+0–38+6 gestational weeks) born at the Mater Mother’s Hospital in Brisbane, Australia from January 2015 to May 2020. Early SNM was defined as a composite of any of the following severe neonatal outcome indicators: admission to neonatal intensive care unit (NICU) in conjunction with an Apgar score <4 at 5 min, severe respiratory distress, severe neonatal acidosis (cord pH < 7.0 or base excess <−12 mmol/L). Multivariable binomial logistic regression analyses using generalized estimating equations (GEE) were used to identify risk factors. Of the total infants born at 34+0–38+6 gestational weeks, 5.7% had at least one component of the composite outcome. For late preterm infants, pre-existing diabetes mellitus, instrumental birth and emergency caesarean birth for non-reassuring fetal status were associated with increased odds for early SNM, whilst for early term infants, pre-existing and gestational diabetes mellitus, antepartum hemorrhage, instrumental, emergency caesarean and elective caesarean birth were significant risk factors. In conclusion, we identified several risk factors contributing to early SNM in late preterm and early term cohort. Our results suggest that predicted probability of early SNM decreased as gestation increased.

scholarly journals Case report: necrotizing enterocolitis with a transverse colonic perforation in a 2-day old term neonate and literature review

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jo-Anna Hudson ◽  
Simon Byrns ◽  
Elizabeth Nizalik ◽  
Emanuela Ferretti
Keyword(s):  
Risk Factors ◽  
Necrotizing Enterocolitis ◽  
Term Infant ◽  
Colonic Perforation ◽  
Bloody Stool ◽  
Term Infants ◽  
Case Presentation ◽  
Uncomplicated Pregnancy ◽  
Life Threatening ◽  
Term Baby

Abstract Background Necrotizing enterocolitis (NEC), while classically discussed in preterm and low birth weight neonates, also occurs in the term infant and accounts for 10% of all NEC cases. Despite there being fewer reported cases of NEC in term infants, these presentations demonstrate differences in the onset, severity and risk factors from the classic presentation observed in premature infants. We present a novel case of term NEC that contravenes the reported literature making departures from clinical presentation, risk factors and location of perforation in an otherwise healthy term two-day old infant born after an uncomplicated pregnancy who presented with hematochezia. Case presentation A healthy term baby born after an uneventful pregnancy presented with bloody stool at 2 days of life who was otherwise well. Investigations revealed pneumoperitoneum from a large proximal transverse colonic perforation secondary to NEC. No typical risk factors for NEC were found. Conclusion Given the life-threatening potential of an unrecognized perforation we recommend the inclusion of NEC on the differential for neonatal hematochezia.

scholarly journals Necrotizing Enterocolitis in Children with Congenital Heart Disease: A Literature Review

2021 ◽  
Author(s):  
Sean T. Kelleher ◽  
Colin J. McMahon ◽  
Adam James
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Disease Incidence ◽  
Intestinal Microbiome ◽  
Term Infants ◽  
Increased Risk ◽  
Novel Biomarkers

AbstractInfants with congenital heart disease (CHD) are at an increased risk of developing necrotising enterocolitis (NEC), a serious inflammatory intestinal condition classically associated with prematurity. CHD not only increases the risk of NEC in preterm infants but is one of the most commonly implicated risk factors in term infants. Existing knowledge on the topic is limited largely to retrospective studies. This review acts to consolidate existing knowledge on the topic in terms of disease incidence, pathophysiology, risk factors, outcomes and the complex relationship between NEC and enteral feeds. Potential preventative strategies, novel biomarkers for NEC in this population, and the role of the intestinal microbiome are all explored. Numerous challenges exist in the study of this complex multifactorial disease which arise from the heterogeneity of the affected population and its relative scarcity. Nevertheless, its high related morbidity and mortality warrant renewed interest in identifying those infants most at risk and implementing strategies to reduce the incidence of NEC in infants with CHD.

Neonatal Hyperviscosity II. Effect of Partial Plasma Exchange Transfusion

PEDIATRICS ◽  
1982 ◽  
Vol 69 (4) ◽  
pp. 419-425 ◽  
Author(s):  
K. Goldberg ◽  
F. H. Wirth ◽  
W. E. Hathaway ◽  
M. A. Guggenheim ◽  
J. R. Murphy ◽  
...  
Keyword(s):  
Plasma Exchange ◽  
Blood Viscosity ◽  
Exchange Transfusion ◽  
Blood Count ◽  
Developmental Delays ◽  
Newborn Infants ◽  
Control Child ◽  
Assessment Scale ◽  
Spastic Diplegia ◽  
Control Subjects

To determine the effect of partial plasma exchangetransfusion, 20 newborn infants with neonatal hyperviscosity were randomly assigned to observation or treatment with partial plasma exchange transfusion within the first eight hours after birth. They were studied for organ involvement by roentgenogram, blood count, coagulation studies, and neurologic behavior and were followed up using the Brazelton Neonatal Behavior Assessment scale at 8, 24, and 72 hours and 2 weeks of age; in addition, ten control infants without hyperviscosity of similar birth weights and gestational ages were also studied. Exchange transfusion improved blood viscosity but both hyperviscous groups showed a higher proportion of abnormal results than did the control subjects. Infants receiving exchange transfusions subsequently improved during the period from 8 hours to 2 to 3 weeks of age, until they were indistinguishable from the control subjects. Neurologic improvement in hyperviscous infants who had not received exchange transfusions were significantly slower during this period. At 8 months of age, abnormal neurologic and developmental findings were impressive in both groups; no significant differences in neurologic abnormalities were noted at that time. Developmental delays, tremors, spastic diplegia, and monoparesis were found in four of six untreated infants and five of ten infants who had received exchange transfusions. A fine tremor was present in one control child.

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