JPGN reports最新文献

Objectives: Breast milk is the recommended nutritional source for newborns and has been associated with decreased morbidity in low-birth-weight and preterm infants. In situations where breast milk is not available, donor breast milk is an alternative. Milk banking is becoming increasingly common worldwide to meet this need. Although the benefits of donor breast milk for the recipient infant are well established, the health impact on the breast milk donor and the infant of the breast milk donor is an area of current research. We aim to synthesize and evaluate the available evidence regarding the impact of donating breast milk on the health, lactation, and well-being of the breast milk donor, and the health and growth of the infant of the breast milk donor.

Methods: We will search electronic databases, grey literature, and the websites of relevant international organizations. We will include studies that involve lactating women and their infants, healthy or with health conditions, who donate breast milk, without restrictions on study date, language, or study design. If sufficient homogeneity exists between studies, we will complete meta-analyses. We will evaluate the risk of bias using the Risk of Bias tool or the Cochrane Risk of Bias in Non-Randomized Studies tool. We will evaluate the overall certainty of the evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Conclusion: In this systematic review and meta-analysis, we will summarize the current literature regarding the effects of human milk donation on human milk donors and their infants.

Objectives: Human milk has been shown to reduce severe morbidity in preterm/low-birth-weight infants and is therefore the recommended nutritional source. When infants cannot receive maternal milk, donor human milk (DHM) is recommended. The use of human milk banking facilities is increasing to meet the need for DHM. DHM is unique compared to maternal milk as it must be processed and stored. The processing and storage of animal milk has been more rigorously studied than human milk and can serve as proxy to create DHM banking guidelines.

Methods and analysis: We will search electronic databases, grey literature, and the websites of relevant international organizations. We will include studies that evaluated the impact of storage, handling, and treatment on the nutritional quality and safety of animal milk. We will not restrict study date, language, or design. If sufficient homogeneity exists between studies, we will conduct a meta-analysis. We will evaluate the methodological quality of each study using the SYRCLE's (Systematic Review Centre for Laboratory Animal Experimentation) risk of bias tool. (1) We will evaluate the overall certainty of the evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Conclusion: In this systematic review and meta-analysis, commissioned by the World Health Organization, we will synthesize the available literature regarding the impact of various storage, handling, and treatment practices on the nutritional quality and safety of animal milk.

Our objective was to summarize the available literature on the use of preoperative esophagogastroduodenoscopy (EGD) and its impact on management and/or postoperative outcomes in pediatric patients undergoing metabolic and bariatric surgery. We performed a search using PubMed in February 2023 for articles examining EGD and any clinical correlation in pediatric patients undergoing bariatric surgery. Search results were manually reviewed and included in the study if they examined findings of EGD done prior to bariatric surgery and were excluded if they were not primarily done in pediatric or adolescent patients. Our search yielded 549 distinct articles, with a total of four articles remaining after applying inclusion and exclusion criteria. All four studies were retrospective. A total of 244 patients were studied, with an age range of 9-25 years. Of the patients whose respective findings were reported, 21/150 patients (14%) had esophagitis, 55/150 (37%) had gastritis, 55/244 (23%) had Helicobacter pylori, and 18/150 (12%) had duodenitis. There were a total of 60 findings that changed medical management, and one that changed surgical management. A high proportion of positive EGD findings that changed medical management was evident, and one study suggested that mucosal inflammation may be a prognostic indicator for postoperative weight loss. However, there is a paucity of data examining the utility of routine EGD prior to bariatric surgery, specifically in pediatric patients, and more studies are therefore needed to construct the evidence basis for guidelines.

Infant formulas are meant to be used until 1 year of age, at which point children are transitioned to non-infant formulas or cow's milk, depending on their remaining dietary intake. Noninfant formulas and cow's milk are appropriate for children who have an average weight at that 1-year mark (9-9.5 kg); however, can contribute significant protein and/or electrolytes to children who are underweight for age, particularly if they still rely heavily on formula feeding for their caloric intake. In this short communication, we present several cases of patients who received excessive amounts of nutrients for age following the formula transition at the 1-year mark. We also provide recommendations for clinicians to consider when faced with underweight infants who are meant to be transitioning off infant formulas.

We describe a case of granulomatosis with polyangiitis (GPA) in a 7-year-old-male who initially presented with symptoms concerning for Inflammatory bowel disease. GPA is a rare, multisystemic necrotizing vasculitis involving small arteries and veins. The clinical presentation can be variable given its multisystemic involvement but more commonly involves the upper and lower airways and kidneys. This case highlights rare gastrointestinal symptoms of GPA, further complicated by an additional unique finding of splenic infarction. We hope to raise awareness for this rare illness to assist in diagnosis and treatment, as timely induction of remission can reduce significant morbidity and mortality in the pediatric population.