Background: Over the last few years, probiotics have been one of the most studied interventions in neonatal medicine. Objectives: </

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The “Golden Age” of Probiotics: A Systematic Review and Meta-Analysis of Randomized and Observational Studies in Preterm Infants

Cardiovascular Risk Factors and Excess Adiposity Among Overweight Children and Adolescents: The Bogalusa Heart Study

Pediatr Blood Cancer

The Armed Forces Institute of Pathology.

The human gut microbiota is engaged in multiple interactions affecting host health during the host's entire life span. Microbes colonize the neonatal gut immediately following birth. The establishment and interactive development of this early gut microbiota are believed to be (at least partially) driven and modulated by specific compounds present in human milk. It has been shown that certain genomes of infant gut commensals, in particular those of bifidobacterial species, are genetically adapted to utilize specific glycans of this human secretory fluid, thus representing a very intriguing example of host-microbe coevolution, where both partners are believed to benefit. In recent years, various metagenomic studies have tried to dissect the composition and functionality of the infant gut microbiome and to explore the distribution across the different ecological niches of the infant gut biogeography of the corresponding microbial consortia, including those corresponding to bacteria and viruses, in healthy and ill subjects. Such analyses have linked certain features of the microbiota/microbiome, such as reduced diversity or aberrant composition, to intestinal illnesses in infants or disease states that are manifested at later stages of life, including asthma, inflammatory bowel disease, and metabolic disorders. Thus, a growing number of studies have reported on how the early human gut microbiota composition/development may affect risk factors related to adult health conditions. This concept has fueled the development of strategies to shape the infant microbiota composition based on various functional food products. In this review, we describe the infant microbiota, the mechanisms that drive its establishment and composition, and how microbial consortia may be molded by natural or artificial interventions. Finally, we discuss the relevance of key microbial players of the infant gut microbiota, in particular bifidobacteria, with respect to their role in health and disease.

The First Microbial Colonizers of the Human Gut: Composition, Activities, and Health Implications of the Infant Gut Microbiota

Objective. We evaluated the efficacy of probiotics in reducing the incidence and severity of necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants. Patients and Methods. A prospective, masked, randomized control trial was conducted to evaluate the beneficial effects of probiotics in reducing the incidence and severity of NEC among VLBW ( Results. Three hundred sixty-seven infants were enrolled: 180 in the study group and 187 in the control group. The demographic and clinical variables were similar in both groups. The incidence of death or NEC (≥ stage 2) was significantly lower in the study group (9 of 180 vs 24 of 187). The incidence of NEC (≥ stage 2) was also significantly lower in the study when compared with the control group (2 of 180 vs 10 of 187). There were 6 cases of severe NEC (Bell stage 3) in the control group and none in the study group. None of the positive blood culture grew Lactobacillus or Bifidobacterium species. Conclusion. Infloran as probiotics fed enterally with breast milk reduces the incidence and severity of NEC in VLBW infants.

Oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants.

Esophageal strictures in children may be caused by congenital anomaly, caustic agent or foreign body ingestion, complication of reflux esophagitis, and after esophageal surgery. Accidental ingestion of alkaline fluid is the most common cause of corrosive esophagitis in children in Taiwan. In this article, we studied 10 pediatric patients who had esophageal strictures and required endoscopic balloon dilatation (EBD) therapy under general anesthesia from January 2003 to June 2009. The median age of the studied children who received their first EBD treatment was 36.2 months (13.4–60.9 months), with a dilator size of 8.0 mm (5–12 mm). The interval between injury and initial EBD was 3.0 months (1.3–60.8 months). The treatment duration averaged 16.7 months (3.0–69.3 months), with 13.5 (4–31) instances of EBD therapy per patient. The greater the length of stricture, the more number of times EBD was needed. In these cases, no severe complication was found after the procedure. The result indicated that EBD under general anesthesia was a safe and effective method to resolve the symptom of dysphagia and diet condition. Because of the limited number of study cases, long-term studies are required to further confirm the clinical effect of EBD under general anesthesia.

Endoscopic balloon dilatation for esophageal strictures in children younger than 6 years: experience in a medical center.

Little is known about octreotide therapy in asparaginase-associated pancreatitis (AAP) in children. Of the 59 children with acute lymphoblastic leukemia (ALL) receiving E. coliL-asparaginase, 5 patients (8.5%) developed AAP. Octreotide was administered to four patients. Clinical and laboratory improvement were evident after octreotide therapy. There were no deaths and no severe adverse side effects were noted. No pseudocysts were detected; however, two of the four patients developed diabetes. One child without octreotide treatment developed chronic pancreatitis and pseudocyst. We conclude that octreotide therapy appears to be safe and potentially beneficial in the management of AAP in children. Pediatr Blood Cancer 2008;51:824–825. © 2008 Wiley-Liss, Inc.

Octreotide therapy in asparaginase-associated pancreatitis in childhood acute lymphoblastic leukemia.

Postoperative intussusception (POI) is an uncommon but important cause of postoperative intestinal obstruction. We describe three cases of intussusception, which developed after major abdominal surgery. Two of the patients were premature newborns whose conditions were complicated by necrotizing enterocolitis and accepted ostomy. The other case involved a patient with Hirschsprung's disease who had had a previous colostomy and accepted Duhamel pull through procedure. Postoperative intussusception is a rare complication of pediatric abdominal surgery and may occur in premature infants. The ostomy may be the predisposing factor of these patients.

Postoperative Intussusception in Children with Enterostomy

Aim The present study evaluated the contribution of genotype of X-ray repair cross-complementing group 3 (XRCC3), age, gender, and smoking to lung cancer risk in Taiwan. Materials and methods A total of 358 patients with lung cancer and 716 controls were investigated for their XRCC3 rs1799794, rs45603942, rs861530, rs3212057, rs1799796, rs861539, rs28903081 genotype, epidemiological and clinical data for association and gene-Iifestyle interactions. Results The results showed that CT and TT genotypes of XRCC3 rs861539 were associated with increased lung cancer risk (odds ratio=1.81, 95% confidence interval=1.18-2.78; odds ratio=3.43, 95% confidence interval=1.12-10.60, respectively). This polymorphism also influenced lung cancer susceptibility in males and smokers (p=0.0017 and 0.0045, respectively). Conclusion The T allele of XRCC3 rs861539 contributes to increased risk of lung cancer in Taiwanese, particularly those who are male and smokers.

An Chyi Chen

Papers

Oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants.

Endoscopic balloon dilatation for esophageal strictures in children younger than 6 years: experience in a medical center.

Octreotide therapy in asparaginase-associated pancreatitis in childhood acute lymphoblastic leukemia.

Postoperative Intussusception in Children with Enterostomy

Contribution of Genotype of DNA Double-strand Break Repair Gene XRCC3, Gender, and Smoking Behavior to Lung Cancer Risk in Taiwan