Human milk and necrotizing enterocolitis
This article will review the protective factors in human milk, clinical studies of human milk and NEC, and practices to enhance human milk use in neonatal intensive care units. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - November 6, 2017 Category: Pediatrics Authors: Aloka L. Patel, Jae H. Kim Source Type: research
Probiotics and Necrotizing Enterocolitis
In this review, we summarize existing knowledge regarding the effects of probiotics on necrotizing enterocolitis (NEC). We review the role of the microbiome in NEC and pre-clinical data on mechanisms of probiotic action. Next, we summarize existing randomized clinical trials and observational studies of probiotics to prevent NEC. We also summarize findings from several recent meta-analyses and report a new cumulative meta-analysis of probiotic trials. Finally, we review data from cohorts routinely using commercially available probiotics. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - November 6, 2017 Category: Pediatrics Authors: Ravi Mangal Patel, Mark A. Underwood Source Type: research
Anemia, red blood cell transfusions, and necrotizing enterocolitis
In the past 15 years, multiple clinical studies have identified a temporal association between red blood cell (RBC) transfusions and necrotizing enterocolitis (NEC). With some variability, most of these studies indicate that up to one-third of all cases of NEC involving very-low-birth weight infants may occur within 24 –48 hours after receiving a RBC transfusion. There is also evidence that the risk of such transfusion-associated NEC may be higher in infants transfused with the greatest severity of anemia. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - November 6, 2017 Category: Pediatrics Authors: Akhil Maheshwari, Ravi M. Patel, Robert D. Christensen Source Type: research
Treatment of perianal Crohn ’s disease
Perianal Crohn ’s is a common manifestation of Crohn’s disease. Primary manifestations of perianal disease mirror common anorectal conditions, however treatment is less successful than in those patients without Crohn’s related perianal disease. A multimodal approach to therapy including medical and surgical modalities is often necessary. The goal of treatment is to manage symptoms while maintaining continence. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - October 10, 2017 Category: Pediatrics Authors: Jill M. Zalieckas Source Type: research
Very Early Onset Inflammatory Bowel Disease
Very early onset inflammatory bowel disease (VEO-IBD) represents a unique and growing subset of patients with inflammatory bowel disease (IBD). Some VEO-IBD patients present with immunodeficiency and possess loss of function genetic mutations involving immune pathways that cause their IBD. A search for Mendelian causes of IBD is likely most beneficial when the presentation involves extra-intestinal autoimmunity or involves intestinal histopathology that is atypical for IBD. While a subset of these young patients will have highly aggressive courses (and likely present with immunodeficiency), the majority of patients with VE...
Source: Seminars in Pediatric Surgery - October 10, 2017 Category: Pediatrics Authors: Christopher J. Moran Source Type: research
Treatment of Perianal Crohn ′s Disease
Perianal Crohn ′s is a common manifestation of Crohn′s disease. Primary manifestations of perianal disease mirror common anorectal conditions, however treatment is less successful than in those patients without Crohn′s related perianal disease. A multimodal approach to therapy including medical and surgical modalities is often necessary. The goal of treatment is to manage symptoms while maintaining continence. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - October 10, 2017 Category: Pediatrics Authors: Jill Zalieckas Source Type: research
Preface
Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract that is associated with significant morbidity. IBD is caused by a complex interaction between an abnormal immune response and intestinal dysbiosis in a genetically susceptible host. While the precise mechanisms underlying IBD pathogenesis remain unknown, recent studies have identified key factors in each of these components influencing disease onset and progression. Large-scale genomic studies, for example, have identified numerous susceptibility loci, especially among genes involved in immune pathways, that are associated wit...
Source: Seminars in Pediatric Surgery - October 6, 2017 Category: Pediatrics Authors: Allan M. Goldstein Source Type: research
Pediatric Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract that is associated with significant morbidity. IBD is caused by a complex interaction between an abnormal immune response and intestinal dysbiosis in a genetically susceptible host. While the precise mechanisms underlying IBD pathogenesis remain unknown, recent studies have identified key factors in each of these components influencing disease onset and progression. Large-scale genomic studies, for example, have identified numerous susceptibility loci, especially among genes involved in immune pathways, that are associated wit...
Source: Seminars in Pediatric Surgery - October 6, 2017 Category: Pediatrics Authors: Allan M. Goldstein Source Type: research
Clinical presentation of Crohn ’s, ulcerative colitis, and indeterminate colitis: Symptoms, extraintestinal manifestations, and disease phenotypes
The incidence of inflammatory bowel disease (IBD) is rising with 25% of IBD diagnosed in children under 18 years of age. The clinical presentation of IBD in children is often vague leading to initial misdiagnosis as infectious colitis or irritable bowel syndrome. When IBD is identified, overlap in histologic and endoscopic features may lead to difficulty distinguishing Crohn ’s disease from ulcerative colitis, resulting in a higher frequency of the diagnosis indeterminate colitis or IBD unspecified. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - October 5, 2017 Category: Pediatrics Authors: Yangyang R. Yu, J. Ruben Rodriguez Source Type: research
Surgical care of the pediatric Crohn ’s disease patient
Despite the significant advances in the medical management of inflammatory bowel disease over the last decade, surgery continues to play a major role in the management of pediatric Crohn ’s disease (CD). While adult and pediatric Crohn’s disease may share many clinical characteristics, pediatric Crohn’s patients often have a more aggressive phenotype, and the operative care given by the pediatric surgeon to the newly diagnosed Crohn’s patient is very different in nature to t he surgical needs of adult patients after decades of disease progression. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - October 5, 2017 Category: Pediatrics Authors: Dylan Stewart Source Type: research
Surgical Options in the Treatment of Ulcerative Colitis
Children and young adults with ulcerative colitis tend to present with more extensive colonic disease than an adult population. The need for surgical intervention in the pediatric population with ulcerative colitis occurs earlier after diagnosis and has a greater incidence than a comparably matched adult population with an estimated need for colectomy at 5 years following diagnosis of 14 –20%. Perhaps, even more than the adult population, there is a desire to restore intestinal continuity for the pediatric patient to achieve as healthy and normal quality of life as possible. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - October 5, 2017 Category: Pediatrics Authors: Daniel P. Ryan, Daniel P. Doody Source Type: research
Overview of paediatric IBD
Inflammatory bowel disease (IBD) is a chronic complex disease of children and adults requiring a range of medications and surgical techniques to induce and maintain remission. In common with other immune-mediated inflammatory disorders, it has shown an ever-increasing rise in incidence worldwide over the last 50 years. The cause of IBD arises from interactions between the microbiome in the gut and the gastrointestinal and systemic immune system in genetically susceptible persons, and with environmental triggers to both develop IBD and have relapses of IBD. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - October 5, 2017 Category: Pediatrics Authors: David C. Wilson, Richard K. Russell Source Type: research
Clinical presentation of Crohn ′s, Ulcerative colitis, and Indeterminate colitis: Symptoms, extraintestinal manifestations, and disease phenotypes
The incidence of inflammatory bowel disease (IBD) is rising with 25% of IBD diagnosed in children under 18 years of age. The clinical presentation of IBD in children is often vague leading to initial misdiagnosis as infectious colitis or irritable bowel syndrome. When IBD is identified, overlap in histologic and endoscopic features may lead to difficulty distinguishing Crohn ′s disease from ulcerative colitis, resulting in a higher frequency of the diagnosis indeterminate colitis or IBD unspecified. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - October 5, 2017 Category: Pediatrics Authors: Yangyang R. Yu, J. Ruben Rodriguez Source Type: research
Medical management of pediatric inflammatory bowel disease
Inflammatory bowel diseases (IBD) are chronic autoimmune conditions of the gut affecting both pediatric and adult patients. Medical therapy is often successful at inducing and maintaining remission and preventing disease complications. The mainstays of treatment are medications and other therapies that reduce inflammation and suppress the overactive immune system. Here we review current medical therapies for pediatric IBD, discuss future therapeutics, and present current treatment goals and approaches. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - October 5, 2017 Category: Pediatrics Authors: Katherine R. Baldwin, Jess L. Kaplan Source Type: research
Management of acute severe ulcerative colitis in children
The incidence of pediatric-onset ulcerative colitis (UC) is rising. Children often present with a more severe disease phenotype as compared to adults with over a third requiring hospitalization for the management of acute severe ulcerative colitis (ASUC). Further, in pediatric patients presenting with inflammatory Bowel Disease (IBD) limited to the colon, a definitive diagnosis of UC vs. Crohn ′s Disease is often unclear. Here, we review the unique aspects of pediatric ASUC including the epidemiology, diagnosis, medical and surgical management of this disease. (Source: Seminars in Pediatric Surgery)
Source: Seminars in Pediatric Surgery - October 5, 2017 Category: Pediatrics Authors: Vei Shaun Siow, Riha Bhatt, Kevin P. Mollen Source Type: research
