Unusual cause of congenital hypothyroidism in a term infant

Both insufficient and excessive maternal iodine consumption can result in congenital hypothyroidism. In East Asian cultures, seaweed is traditionally consumed in high quantities by peripartum women as it is thought to improve lactation. We present a case of transient congenital hypothyroidism due to maternal seaweed consumption at a daily basis during pregnancy and lactation in a Dutch family without Asian background. This case highlights that even in families of non-Asian background, high maternal intake of iodine-rich seaweed occurs and can result in transient or permanent hyperthyrotropinemia in the neonate with risk of impaired neurodevelopmental outcome if untreated

Commentary on "Fish Oil-Containing Lipid Emulsions in Adult Parenteral Nutrition: A Review of the Evidence" (https://doi.org/10.1177/0148607117721907).

This is the peer reviewed version of the following article: Adolph, M. , Calder, P. C., Deutz, N. E., Carmona, T. G., Klek, S. , Lev, S. , Mayer, K. , Michael‐Titus, A. T., Pradelli, L. , Puder, M. , Singer, P. and Vlaardingerbroek, H. (2019), Commentary on “Fish Oil–Containing Lipid Emulsions in Adult Parenteral Nutrition: A Review of the Evidence”. Journal of Parenteral and Enteral Nutrition, 43: 454-455. doi:10.1002/jpen.1047, which has been published in final form at https://doi.org/10.1002/jpen.1047. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived VersionsAbbasoglu et al published a narrative review concerning the use of fish oil–containing lipid emulsions in adult parenteral nutrition (PN).1 We wholeheartedly agree with the authors when they state that “high‐quality and adequately powered RCTs are necessary” and “well‐conducted meta‐analyses can be key to demonstrating positive or negative effects.” However, we disagree with other aspects of their review, particularly assertions of a lack of evidence in favor of using fish oil–containing lipid emulsions rather than more traditional lipid formulations

Der Gebrauch kausativer Konstruktionen mit lassen, bei denen Menschen das Subjekt darstellen : anhand von Beispielen aus Thomas Manns'Doktor Faustus'(1. Teil)

Background: The use of intravenous lipid emulsions in preterm infants has been limited by concerns regarding impaired lipid tolerance. As a result, the time of initiation of parenteral lipid infusion to very-low-birth-weight (VLBW) infants varies widely among different neonatal intensive care units. However, lipids provide energy for protein synthesis and supply essential fatty acids that are necessary for central nervous system development. Objective: The objective was to summarize the effects of initiation of lipids within the first 2 d of life and the effects of different lipid compositions on growth and morbidities in VLBW infants. Design: A systematic review and meta-analysis of publications identified in a search of PubMed, EMBASE, and Cochrane databases was undertaken. Randomized controlled studies were eligible if information on growth was available. Results: The search yielded 14 studies. No differences were observed in growth or morbidity with early lipid initiation. We found a weak favorable association of non-purely soybean-based emulsions with the incidence of sepsis (RR: 0.75; 95% CI: 0.56, 1.00). Conclusions: The initiation of lipids within the first 2 d of life in VLBW infants appears to be safe and well tolerated; however, beneficial effects on growth could not be shown for this treatment nor for the type of lipid emulsion. Emulsions that are not purely soybean oil-based might be associated with a lower incidence of sepsis. Large-scale randomized controlled trials in preterm infants are warranted to determine whether early initiation of lipids and lipid emulsions that are not purely soybean oil-based results in improved long-term outcomes. Am J Clin Nutr 2012;96:255-6

Unusual cause of congenital hypothyroidism in a term infant

Both insufficient and excessive maternal iodine consumption can result in congenital hypothyroidism. In East Asian cultures, seaweed is traditionally consumed in high quantities by peripartum women as it is thought to improve lactation. We present a case of transient congenital hypothyroidism due to maternal seaweed consumption at a daily basis during pregnancy and lactation in a Dutch family without Asian background. This case highlights that even in families of non-Asian background, high maternal intake of iodine-rich seaweed occurs and can result in transient or permanent hyperthyrotropinemia in the neonate with risk of impaired neurodevelopmental outcome if untreated

Content Matters! Quantity and quality of parenteral nutrition for preterm infants

De meeste kinderen die te vroeg geboren worden, en met name de kinderen met een zeer laag geboortegewicht (< 1500 gram) groeien minder goed dan kinderen die op tijd geboren worden. Onderzoek heeft aangetoond dat de lichamelijke en geestelijke ontwikkeling van te vroeg geboren kinderen een grote relatie heeft met voeding en groei in de eerste levensweken. Gedurende de eerste levensdagen verdragen te vroeg geboren kinderen met een zeer laag geboortegewicht nog vrijwel geen melkvoeding en zijn ze afhankelijk van infuusvoeding.Onderzoek naar infuusvoeding is daarom van groot belang om deze kinderen een goede start te geven en te zorgen dat hun groei en ontwikkeling niet onder doet voor die van op tijd geboren kinderen. In dit proefschrift beschrijven we diverse studies naar de hoeveelheid en samenstelling van infuusvoeding. Uit ons onderzoek blijkt dat het direct na de geboorte starten van infuusvoeding met daarin vetten en extra eiwit leidt tot verbeterde groei bij kinderen met een zeer laag geboortegewicht ten opzichte van starten met lagere hoeveelheden eiwit en het later starten met vetten. We hebben ook verschillende vetemulsies met elkaar vergeleken. We vonden dat infuusvoeding met visolie, in plaats van pure sojabonenolie, leidde tot minder infecties en tot een betere groei en dat deze voeding mogelijk ook het onstaan van leverziekte kan voorkomen. Aangezien visolie ook bestanddelen bevat die de hersenontwikkeling kan verbeteren, zal de ontwikkeling van de kinderen die deelgenomen hebben aan deze studies getoetst worden op tweejarige leeftijd. Samenvattend bieden de uitkomsten van dit proefschrift nieuwe mogelijkheden om de groei en ontwikkeling van kinderen met een zeer laag geboortegewicht te verbeteren

The present challenges of parenteral nutrition in preterm infants and children

The goal of pediatricians involved in the nutritional management of preterm infants is to mimic intrauterine growth and to obtain a functional outcome comparable to that for infants born at term. Appropriate administration of nutrients in the first few days to weeks of life will reduce the growth restriction that is frequently observed. Existing guidelines advise providing preterm infants with both amino acids and lipids from birth onward. Despite this knowledge, many hospital units do not comply with these guidelines. Further improvement of the quality of the composition of parenteral solutions for both neonates as well as older children should be the subject of further researc

Intravenous lipids in preterm infants: impact on laboratory and clinical outcomes and long-term consequences

Postnatal growth failure is still one of the most commonly observed morbidities in preterm infants. Intolerance of enteral nutrition is a common problem in these infants and in neonates with surgical conditions. Therefore, adequate parenteral nutrition is crucial to support organ development, including that of the brain. Short-term studies on the early introduction of parenteral lipids have demonstrated that early lipid administration seems safe and well tolerated and prevents essential fatty acid deficiency. Further well-designed and adequately powered studies are necessary to determine the optimal dose of lipid infusion and the long-term effects on morbidity, growth, and neurodevelopment. Administration of a pure soybean oil emulsion might result in excess formation of proinflammatory eicosanoids and peroxidation, and their use reduces the availability of the long-chain polyunsaturated fatty acids necessary for central nervous system development and immune function. Alternatives to the use of pure soybean oils include emulsions with partial replacement of soybean oil with medium-chain triglycerides, olive oil, and/or fish oil. These newer lipid emulsions offer many theoretical advantages. Future large-scale randomized controlled trials in premature infants should demonstrate whether these newer lipid emulsions are truly safe and result in improved short- and long-term outcomes. It seems safe to start lipid emulsions from birth onward at a rate of 2 g lipids/kg/day (based on short-term results only). Mixed lipid emulsions, including those containing fish oil, seem to reduce nosocomial infections in preterm infants and might reduce bile acid accumulation. Liver damage may be reduced by decreasing or removing lipids from parenteral nutrition or may be reduced by using fish oil-containing lipid emulsions containing high levels of vitamin