Fecal Calprotectin Excretion in Preterm Infants during the Neonatal Period

Fecal calprotectin has been proposed as a non-invasive marker of intestinal inflammation in inflammatory bowel disease in adults and children. Fecal calprotectin levels have been reported to be much higher in both healthy full-term and preterm infants than in children and adults.To determine the time course of fecal calprotectin (f-calprotectin) excretion in preterm infants from birth until hospital discharge and to identify factors influencing f-calprotectin levels in the first weeks of life, including bacterial establishment in the gut.F-calprotectin was determined using an ELISA assay in 147 samples obtained prospectively from 47 preterm infants (gestational age, and birth-weight interquartiles 27–29 weeks, and 880–1320 g, respectively) at birth, and at 2-week intervals until hospital discharge. (p = 0.047).During the first weeks of life, the high f-calprotectin values observed in preterm infants could be linked to the gut bacterial establishment

Le syndrome d Abernethy

Le syndrome d Abernethy désigne un shunt porto-systémique congénital secondaire à une hypoplasie ou à une absence de veine porte. Seulement 61 cas ont été recensés, essentiellement chez des enfants. Les absences congénitales de veine porte sont fréquemment associées à des malformations cardiaques et à des tumeurs hépatiques à type d hyperplasie nodulaire focale. Parmi les complications du syndrome d Abernethy, on distingue des cas d encéphalopathie avec hyperammoniémie, des syndromes hépato-pulmonaires. Après avoir rapporté l observation d un enfant porteur du syndrome d Abernethy, nous reprendrons les principales données de la littérature afin d établir les objectifs d une prise en charge adaptée.NANTES-BU Médecine pharmacie (441092101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

<i>Limosilactobacillus fermentum</i> CECT5716: Clinical Potential of a Probiotic Strain Isolated from Human Milk

Breastfeeding provides the ideal nutrition for infants. Human milk contains a plethora of functional ingredients which foster the development of the immune system. The human milk microbiota predominantly contributes to this protective effect. This is mediated by various mechanisms, such as an antimicrobial effect, pathogen exclusion and barrier integrity, beneficial effects on the gastrointestinal microbiota, vitamin synthesis, immunity enhancement, secreted probiotic factors, and postbiotic mechanisms. Therefore, human milk is a good source for isolating probiotics for infants who cannot be exclusively breastfed. One such probiotic which was isolated from human milk is Limosilactobacillus fermentum CECT5716. In this review, we give an overview of available interventional studies using Limosilactobacillus fermentum CECT5716 and summarise preclinical trials in several animal models of different pathologies, which have given first insights into its mechanisms of action. We present several randomised clinical studies, which have been conducted to investigate the clinical efficacy of the Limosilactobacillus fermentum CECT5716 strain in supporting the host’s health

Obésité dans les écoles nantaises en 2005

Ce travail a été réalisé à partir de données anthropométriques relevées par la Médecine Scolaire chez les enfants nantais des classes de grande section et de CM2 en 2005, soit 4975 enfants. Les principaux résultats sont les suivants. En utilisant les références IOTF : Dans le groupe des grandes sections (soit les 5 -6 ans), on retrouve respectivement 6,13 % des filles et 4,69 % des garçons en surpoids et 2,04 % des filles contre 1,69 % de garçons obèses. Dans le groupe des CM2 (soit les 10-11 ans), on comptabilise respectivement 8,43% de filles contre 8,99% de garçons en surpoids et 2,69% de filles contre 0,94% de garçons obèses. En comparant nos données avec les données nantaises de 1988 et 1998, récoltées sur les mêmes classes d âge, on note une progression nette de la prévalence du surpoids et de l obésité dans les deux sexes entre 1988 et 1998, mais une tendance à la stabilisation entre 1998 et 2005. En comparant nos données avec celles des études nationales, la prévalence du surpoids et de l obésité retrouvée chez les enfants nantais est nettement inférieure à celle des enfants des autres régions. En analysant les données par quartiers, on constate que l habitation en quartier défavorisé (écoles classées ZEP) multiplie par 2,3 le risque d obésité par rapport aux quartiers favorisés.NANTES-BU Médecine pharmacie (441092101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Can antibiotic treatment in preweaning rats alter body composition in adulthood?

International audienceIt is suggested that antibiotherapy in infancy might program adult body composition and thus could be a determinant of obesity risk. Although not convincingly substantiated by existing literature, this assumption is plausible since antibiotics affect intestinal microbiota, whose composition in adulthood is potentially programmable during infancy and which is able to interact with both fat development and central control of appetite. In order to substantiate the link between antibiotherapy and programming of adult body composition, the present study investigated the impact of a course of amoxicillin treatment in neonatal period on subsequent growth and body composition in rats. Suckling rat pups were treated by oral gavage with an amoxicillin solution (150 mg·kg(-1)) or vehicle from postnatal day (PND)5 to PND15. All animals were fully weaned at PND21 then fed a standard diet until PND130. Animal growth and food intake were followed up until PND130, when body composition and plasma leptin were measured. Faecal microbiota was typified at regular intervals using real-time quantitative polymerase chain reaction. Preweaning amoxicillin treatment affected the composition of the faecal microbiota of pups at PND21 but this impact did not sustain long beyond the antibiotic supplementation. Immediately after weaning, a transient increase in food intake (+11%) was noticed in amoxicillin-treated animals. However, no significant impact on either growth or body composition at adulthood was observed. In a neonatal animal model there is no evidence of a programming of adult body weight and composition by wide-spectrum antibiotic treatment in early life

A New Partially Hydrolyzed Whey-Based Follow-on Formula with Age-Adapted Protein Content Supports Healthy Growth during the First Year of Life.

International audienceBACKGROUND: Standard infant formulae often have higher protein content than breastmilk in order to compensate for potentially lower digestibility; excess protein intake may promote adverse effects later in life. A new partially hydrolyzed whey-based (pHF-W) follow-on formula (FoF) with age-adapted protein content was evaluated for growth and gastrointestinal (GI) tolerance in healthy infants. METHODS: Formula-fed (FF) infants (n = 108) received standard pHF-W formula (1.9 g protein/100 kcal) from enrollment (age ≤q 30 days) until age 120 days followed by new pHF-W FoF (1.6 g protein/100 kcal) until 360 days. Weight gain velocity (WGV) (mean daily WG from enrollment to age 180 days) was compared to WHO growth standards and a breastfed (BF) reference group (n = 86) (non-inferiority margin -3 g/day). GI tolerance was assessed using a validated questionnaire (scale range 13-65). RESULTS: WGV in FF infants (mean ± SD 24.0 ± 4.4 g/day) was non-inferior to BF (23.7 ± 3.9 g/day) and WHO standards (all p ≤q 0.013). Weight-for-age, length-for-age, weight-for-length, and head circumference-for-age z-scores of FF infants were not significantly different from BF at any timepoint. Symptoms of GI intolerance were low (≤q23) at all timepoints and similar between groups. CONCLUSION: A new pHF-W FoF with age-adapted protein content fed sequentially after standard pHF-W infant formula is safe, well-tolerated, and promotes a healthy growth pattern consistent with BF infants and WHO standards during the first year of life. CLINICAL TRIAL REGISTRATION: [https://clinicaltrials.gov/], identifier [NCT03276663]

Can intestinal microbiota be involved in nutritional programming?

Can intestinal microbiota be involved in nutritional programming?. Colloque fondateur de La Société Francophone Origines Développementales de la Santé (SF-DOHaD

Frequency of abnormal glucose tolerance test suggestive of dumping syndrome following oesophageal atresia repair

International audienceDumping syndrome (DS) is mostly described as a complication of antireflux surgery in oesophageal atresia (OA) but we previously reported 2 cases of DS before any other surgery in infants operated at birth for OA. The objectives of the present study were to assess the prevalence of abnormal oral glucose tolerance test (OGTT) at 3 months of age in infants operated at birth with type C OA, to describe symptoms and clinical features, and to assess risk factors in infants presenting with abnormal OGTT suggestive of DS.A prospective case series study including infants with type C OA without fundoplication, born between 2013 and 2016 in 8 centres was conducted. An OGTT was performed between 2.5 and 3.5 months. Abnormal OGTT was defined as early hyperglycaemia (>1.8 g/L until 30 minutes; >1.7 g/L between 30 minutes and 2 hours; and >1.4 g/L between 2 and 3 hours) and/or late hypoglycaemia (<0.6 g/L after 2 hours).Eleven of the 38 OGTT (29%) showed abnormalities. None of the patients' demographics (birth weight, sex, prematurity, associated malformation, use of enteral nutrition) or conditions of the surgery tested was associated with abnormal OGTT. No clinical sign was specific for it.DS should be considered in every infant operated at birth for OA presenting with digestive symptoms. No risk factor was predictive for abnormal OGTT. An OGTT to screen for potential DS around 3 months of age should be considered in infants born with EA.DUMPING NCT02525705

Priority target conditions for algorithms for monitoring children's growth: Interdisciplinary consensus

<div><p>Background</p><p>Growth monitoring of apparently healthy children aims at early detection of serious conditions through the use of both clinical expertise and algorithms that define abnormal growth. Optimization of growth monitoring requires standardization of the definition of abnormal growth, and the selection of the priority target conditions is a prerequisite of such standardization.</p><p>Objective</p><p>To obtain a consensus about the priority target conditions for algorithms monitoring children's growth.</p><p>Methods</p><p>We applied a formal consensus method with a modified version of the RAND/UCLA method, based on three phases (preparatory, literature review, and rating), with the participation of expert advisory groups from the relevant professional medical societies (ranging from primary care providers to hospital subspecialists) as well as parent associations. We asked experts in the pilot (n = 11), reading (n = 8) and rating (n = 60) groups to complete the list of diagnostic classification of the <i>European Society for Paediatric Endocrinology</i> and then to select the conditions meeting the four predefined criteria of an ideal type of priority target condition.</p><p>Results</p><p>Strong agreement was obtained for the 8 conditions selected by the experts among the 133 possible: celiac disease, Crohn disease, craniopharyngioma, juvenile nephronophthisis, Turner syndrome, growth hormone deficiency with pituitary stalk interruption syndrome, infantile cystinosis, and hypothalamic-optochiasmatic astrocytoma (in decreasing order of agreement).</p><p>Conclusion</p><p>This national consensus can be used to evaluate the algorithms currently suggested for growth monitoring. The method used for this national consensus could be re-used to obtain an international consensus.</p></div