Antenatal Antibiotic Exposure Affects Enteral Feeding, Body Growth, and Neonatal Infection in Preterm Infants: A Retrospective Study

Background: Antibiotics are widely prescribed by obstetricians, which exposes a large number of infants to antenatal antibiotics (AAB). The effect of AAB on various aspects of neonatal development of preterm infants remains unclear.Methods: In this retrospective study, infants born with gestational age (GA) between 22 +0 and 36 +6 weeks at our unit from 2017 to 2019 were included. Multivariable analysis was adopted to examine the associations between AAB exposure and various outcomes related to enteral feeding process, body growth, and neonatal infection after adjusting for potential confounders. Further subanalysis on the exposure level of AAB and stratified analysis by GA (<34 vs. ≥34 weeks) were also conducted.Results: In this cohort comprising 2,543 preterm infants, AAB was associated with decreased risks of feeding intolerance (odds ratio [OR]: 0.63, 95% confidence interval [CI]: 0.48–0.82) and neonatal infection (OR: 0.63, 95% CI: 0.41–0.94). Higher AAB exposure level was associated with higher Z scores of birth weight (β = 0.37, 95% CI: 0.27–0.47), but lower Δbodyweight Z-scores (β = −0.20, 95% CI: −0.27 to −0.13). AAB was positively associated with the parameters related to body growth in infants with GA <34 weeks but negatively associated in those with GA ≥34 weeks.Conclusions: AAB exposure affects the enteral feeding process and neonatal infection. The effects on body growth vary by the exposure level of AAB and GA of infants. A well-designed prospective and preferably multi-centre study with predefined parameters is required to confirm our findings.

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G291(P) Outcome of preterm infants discharged on home oxygen- retrospective study

10.1136/archdischild-2020-rcpch.252 ◽

2020 ◽

Author(s):

P Loganathan ◽

S Hummaida ◽

V Nair

Keyword(s):

Retrospective Study ◽

Preterm Infants

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Human milk feeding and cognitive outcome in preterm infants: the role of infection and NEC reduction

Pediatric Research ◽

10.1038/s41390-021-01367-z ◽

2021 ◽

Author(s):

Winok Lapidaire ◽

Alan Lucas ◽

Jonathan D. Clayden ◽

Chris Clark ◽

Mary S. Fewtrell

Keyword(s):

Breast Milk ◽

Human Milk ◽

Preterm Infants ◽

Neonatal Infection ◽

Necrotising Enterocolitis ◽

Cognitive Outcome ◽

Standard Diet ◽

Risk Of Infection ◽

Verbal Iq

Abstract Background Breast milk has been associated with lower risk of infection and necrotising enterocolitis (NEC) and improved long-term cognitive outcomes in preterm infants but, if unsupplemented, does not meet the nutritional requirements of preterm infants. Methods Preterm infants were randomised to receive a high nutrient intervention diet: preterm formula (PTF) or the standard diet: term formula (TF) or banked donor breast milk (BBM), either as their sole diet or as supplement to maternal breast milk (MBM). IQ tests were performed at ages 7, 15, 20, and 30 years. Results An increase in MBM and BBM intake was associated with a lower chance of neonatal infection/NEC. Neonatal infection/NEC was associated with lower Full Scale IQ (FSIQ) and Performance IQ (PIQ) score at ages 7 and 30 years. The relationship between higher intake of MBM and PIQ at age 7 years was partly mediated by neonatal infection/NEC. The intervention diet was associated with higher Verbal IQ (VIQ) scores compared to the standard diet. There was no evidence that these effects changed from childhood through to adulthood. Conclusions Neonatal diet is an important modifiable factor that can affect long-term cognitive outcome through a ‘human milk’ factor, protecting against infection/NEC, and a ‘nutrient content’ factor. Impact This is the first study to demonstrate the effects of neonatal infection/necrotising enterocolitis (NEC) on IQ in the same cohort in childhood and adulthood. Diet can be a key factor in long-term cognitive outcome in people born preterm by preventing neonatal infection/NEC and providing adequate nutrients. Human milk, whether MBM or BBM, is associated with a reduced risk of infection/NEC. A higher nutrient diet is associated with better cognitive outcome in childhood. Performance IQ is particularly vulnerable to the effects of infection/NEC and verbal IQ to the quantity of (macro)nutrients in the diet.

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Metoclopramide Promotes Enteral Feeding in Preterm Infants with Feeding Intolerance

Developmental Pharmacology and Therapeutics ◽

10.1159/000457579 ◽

1989 ◽

Vol 13 (1) ◽

pp. 38-46 ◽

Cited By ~ 12

Author(s):

William L. Meadow ◽

Kim-Chi Bui ◽

Elene Strates ◽

Roger Dean

Keyword(s):

Preterm Infants ◽

Enteral Feeding ◽

Feeding Intolerance

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Abstract 348: Impact of Low and High Partial Pressure of Carbon Dioxide on Neuron Specific Enolase Derived from Serum and Cerebrospinal Fluid in Patients Who Underwent Targeted Temperature Management After Out-of-hospital Cardiac Arrest: A Retrospective Study

Circulation ◽

10.1161/circ.142.suppl_4.348 ◽

2020 ◽

Vol 142 (Suppl_4) ◽

Author(s):

Changshin Kang

Keyword(s):

Carbon Dioxide ◽

Cerebrospinal Fluid ◽

Cardiac Arrest ◽

Retrospective Study ◽

Neuron Specific Enolase ◽

Weighted Average ◽

Carbon Dioxide Tension ◽

Spontaneous Circulation ◽

Temperature Management ◽

Multi Centre Study

Aim: In a previous study, low and high-normal arterial carbon dioxide tension (PaCO 2 ) were not associated with serum neuron specific enolase (NSE) in cardiac arrest survivors. We assessed the effect of PaCO 2 on NSE in cerebrospinal fluid (CSF) and serum. Methods: This was a retrospective study. PaCO 2 for the first 24 h was analysed in four means, qualitative exposure state (qES), time-weighted average (TWA), median, and minimum-maximum (Min-Max). These subgroups were divided into low (LCO 2 ) and high PaCO 2 (HCO 2 ) groups defined as PaCO 2 ≤35.3 and PaCO 2 >43.5 mmHg, respectively. NSE was measured at 24, 48, and 72 h (sNSE 24,48,72 and cNSE 24,48,72 ) from return of spontaneous circulation (ROSC). The primary outcome was the association between PaCO 2 and the NSE measured at 24 h after ROSC. Results: Forty-two subjects (male, 33; 78.6%) were included in total cohort. PaCO 2 in TWA subgroup was associated with cNSE 24,48,72 , while PaCO 2 in the other subgroup were only associated with cNSE 24 . PaCO 2 and cNSE in qES subgroup showed good correlation (r= -0.61; p< 0.01), and in TWA, Median, and Min-Max subgroup showed moderate correlations (r= -0.57, r= -0.48, and r= -0.60; p< 0.01). Contrastively, sNSE was not associated and correlated with PaCO 2 in all analysis. Poor neurological outcome in LCO 2 was significantly higher than HCO 2 in qES, TWA, and Median subgroups ( p< 0.01, p< 0.01, and p= 0.02). Conclusion: Association was found between NSE and PaCO 2 using CSF, despite including normocapnic ranges; TWA of PaCO 2 may be most strongly associated with CSF NSE levels. A prospective, multi-centre study is required to confirm our results.

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Automated movement analysis to predict motor impairment in preterm infants: a retrospective study

Journal of Perinatology ◽

10.1038/s41372-019-0464-0 ◽

2019 ◽

Vol 39 (10) ◽

pp. 1362-1369 ◽

Cited By ~ 1

Author(s):

Kamini Raghuram ◽

Silvia Orlandi ◽

Vibhuti Shah ◽

Tom Chau ◽

Maureen Luther ◽

...

Keyword(s):

Retrospective Study ◽

Preterm Infants ◽

Motor Impairment ◽

Movement Analysis

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Cyclo-oxygenase-2 expression is associated with mean standardised uptake value on 18F-Fluorodeoxyglucose positron emission tomography in oesophageal adenocarcinoma

British Journal of Radiology ◽

10.1259/bjr.20180668 ◽

2019 ◽

Vol 92 (1099) ◽

pp. 20180668

Author(s):

Kieran G Foley ◽

Adam Christian ◽

James Peaker ◽

Christopher Marshall ◽

Emiliano Spezi ◽

...

Keyword(s):

Cox Regression ◽

Prognostic Significance ◽

Multivariable Analysis ◽

Image Features ◽

Oesophageal Adenocarcinoma ◽

Metabolic Tumour Volume ◽

Multi Centre Study ◽

Cox Regression Analysis ◽

Standardised Uptake Value ◽

Cox 2

Objectives: This pilot study investigated the association of four PET image features and cyclo-oxygenase-2 (COX-2) expression in patients with oesophageal adenocarcinoma. The prognostic significance of these biomarkers was also assessed. Methods: 50 consecutive patients [median age = 68 (range 47 – 84), males = 45) with oesophageal adenocarcinoma had PET/CT staging between January 2011 and July 2015. The maximum and mean standardised uptake values (SUVmax and SUVmean), metabolic tumour volume (MTV) and tumour lesion glycolysis (TLG) were calculated from the primary tumour. Their association with COX-2 status was assessed using Mann-Whitney U tests. Kaplan-Meier and Cox regression analysis tested their prognostic significance. A p-value < 0.05 was considered statistically significant. Results: 32 tumours (64.0%) were COX-2 positive. There was a significant association between SUVmean and COX-2 status (p = 0.019). TLG (hazard ratio (HR) 1.001, 95 % confidence intervals (CI) 1.000 – 1.002, p = 0.018) was significantly associated with overall survival on multivariable analysis. Conclusions: This study investigated the association between PET image features and COX-2 expression in oesophageal adenocarcinoma. The preliminary results signal that a combination of TLG (calculated as product of MTV and SUVmean) and COX-2 status may be a strong and clinically important prognostic biomarker. Our research group are planning a prospective, multi-centre study to validate these findings. Advances in knowledge: Mean standardised uptake value (SUVmean) on PET imaging is associated with COX-2 expression in oesophageal adenocarcinoma.

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Modifications of Own Mothers’ Milk Fortification Protocol Affect Early Plasma IGF-I and Ghrelin Levels in Preterm Infants. A Randomized Clinical Trial

Nutrients ◽

10.3390/nu11123056 ◽

2019 ◽

Vol 11 (12) ◽

pp. 3056

Author(s):

Eleni Agakidou ◽

Thomais Karagiozoglou-Lampoudi ◽

Elisavet Parlapani ◽

Dimitrios J. Fletouris ◽

Kosmas Sarafidis ◽

...

Keyword(s):

Clinical Trial ◽

Preterm Infants ◽

Plasma Levels ◽

Protein Intake ◽

Protein Targeting ◽

Growth Parameter ◽

Transient Effect ◽

Protein Energy ◽

Igf I ◽

Z Scores

The aim was to investigate the effect of two own mother’s milk (OMM) fortification protocols on (a) IGF-I and ghrelin plasma levels at 35 post-conceptional weeks (PCW, T2) and whether this effect is maintained after elimination of the differences in OMM fortification, and (b) growth until 12 months corrected age. Forty-eight OMM-fed preterm infants (GA 24–32 weeks) were randomly allocated to the fixed-fortification (FF) group (n = 23) and the protein-targeting fortification (PTF) group (n = 25) targeting the recommended daily protein intake (PI). Plasma IGF-I and ghrelin were assessed at 35 (T2) and 40 (T3) PCW while growth was longitudinally assessed until 12 months corrected age. PTF group had lower IGF-I and higher ghrelin than FF group at T2, while receiving lower daily protein and energy amounts. PI correlated positively to T2-IGF-I and inversely to T3-ghrelin while energy intake (EI) correlated inversely to T2- and T3-ghrelin. Group and PI were independent predictors of adjusted T2-IGF-I, while group and EI were predictors of adjusted and T2-ghrelin. Growth parameter z-scores were comparable between groups up to 12 months corrected age. Modifications of OMM fortification have a transient effect on early plasma IGF-I and ghrelin levels in preterm infants in a way consistent with the previously recognized protein-energy/endocrine balance, indicating a potential programming effect.

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Allogeneic transplantation improves the overall and progression-free survival of Hodgkin lymphoma patients relapsing after autologous transplantation: a retrospective study based on the time of HLA typing and donor availability

Blood ◽

10.1182/blood-2009-12-253856 ◽

2010 ◽

Vol 115 (18) ◽

pp. 3671-3677 ◽

Cited By ~ 117

Author(s):

Barbara Sarina ◽

Luca Castagna ◽

Lucia Farina ◽

Francesca Patriarca ◽

Fabio Benedetti ◽

...

Keyword(s):

Retrospective Study ◽

Hodgkin Lymphoma ◽

Autologous Transplantation ◽

Multivariable Analysis ◽

Human Leukocyte ◽

Progression Free Survival ◽

Allogeneic Transplantation ◽

Hla Typing ◽

Human Leukocyte Antigen Typing ◽

Leukocyte Antigen

Abstract Hodgkin lymphoma relapsing after autologous transplantation (autoSCT) has a dismal outcome. Allogeneic transplantation (alloSCT) using reduced intensity conditioning (RIC) is a salvage option, but its effectiveness is still unclear. To evaluate the role of RIC alloSCT, we designed a retrospective study based on the commitment of attending physicians to perform a salvage alloSCT; thus, only Hodgkin lymphoma patients having human leukocyte antigen-typing immediately after the failed autoSCT were included. Of 185 patients, 122 found an identical sibling (55%), a matched unrelated (32%) or a haploidentical sibling (13%) donor; 63 patients did not find any donor. Clinical features of both groups did not differ. Two-year progression-free (PFS) and overall survival (OS) were better in the donor group (39.3% vs 14.2%, and 66% vs 42%, respectively, P < .001) with a median follow-up of 48 months. In multivariable analysis, having a donor was significant for better PFS and OS (P < .001). Patients allografted in complete remission showed a better PFS and OS. This is the largest study comparing RIC alloSCT versus conventional treatment after a failed autoSCT, indicating a survival benefit for patients having a donor.

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