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Search results for: Necrotising Enterocolitis

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10</div> </div> </div> </div> <h1 class="mt-3 mb-3 text-center" style="font-size:1.6rem;">Search results for: Necrotising Enterocolitis</h1> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">10</span> Milk Curd Obstruction as a Mimic of Necrotising Enterocolitis (NEC)</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Sofia%20Baldelli">Sofia Baldelli</a>, <a href="https://publications.waset.org/abstracts/search?q=Aman%20More"> Aman More</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Milk curd obstruction is commonly reported as being misdiagnosed for NEC, and they predominantly mimic each other in clinical presentation, including abdominal distension, vomiting, constipation, feeding intolerance and frank or occult blood PR. Using the case of a pre-term neonate misdiagnosed with necrotising enterocolitis when in fact, they had milk curd obstruction, we compare the two diagnoses and why they are hard to differentiate, the risk factors for clinicians to consider and the different management options. The main diagnostic tool for these conditions remains the plain radiograph and here we present the original radiograph of the neonate and discuss the classical radiological features of both diagnoses. We conclude that further imaging techniques such as ultrasound might be used to improve diagnosis when X-ray is inconclusive. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=milk%20curd%20obstruction" title="milk curd obstruction">milk curd obstruction</a>, <a href="https://publications.waset.org/abstracts/search?q=Necrotising%20Enterocolitis" title=" Necrotising Enterocolitis"> Necrotising Enterocolitis</a>, <a href="https://publications.waset.org/abstracts/search?q=radiology" title=" radiology"> radiology</a>, <a href="https://publications.waset.org/abstracts/search?q=pediatric%20surgery" title=" pediatric surgery"> pediatric surgery</a> </p> <a href="https://publications.waset.org/abstracts/160518/milk-curd-obstruction-as-a-mimic-of-necrotising-enterocolitis-nec" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/160518.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">108</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">9</span> Jejunostomy and Protective Ileostomy in a Patient with Massive Necrotizing Enterocolitis: A Case Report</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Rafael%20Ricieri">Rafael Ricieri</a>, <a href="https://publications.waset.org/abstracts/search?q=Rogerio%20Barros"> Rogerio Barros</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Objective: This study is to report a case of massive necrotizing enterocolitis in a six-month-old patient, requiring ileostomy and protective jejunostomy as a damage control measure in the first exploratory laparotomy surgery in massive enterocolitis without a previous diagnosis. Methods: This study is a case report of success in making and closing a protective jejunostomy. However, the low number of publications on this staged and risky measure of surgical resolution encouraged the team to study the indication and especially the correct time for closing the patient's protective jejunostomy. The main study instrument will be the six-month-old patient's medical record. Results: Based on the observation of the case described, it was observed that the time for the closure of the described procedure (protective jejunostomy) varies according to the level of compromise of the health status of your patient and of an individual of each person. Early closure, or failure to close, can lead to a favorable problem for the patient since several problems can result from this closure, such as new intestinal perforations, hydroelectrolyte disturbances. Despite the risk of new perforations, we suggest closing the protective jejunostomy around the 14th day of the procedure, thus keeping the patient on broad-spectrum antibiotic therapy and absolute fasting, thus reducing the chances of new intestinal perforations. Associated with the closure of the jejunostomy, a gastric tube for decompression is necessary, and care in an intensive care unit and electrolyte replacement is necessary to maintain the stability of the case. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=jejunostomy" title="jejunostomy">jejunostomy</a>, <a href="https://publications.waset.org/abstracts/search?q=ileostomy" title=" ileostomy"> ileostomy</a>, <a href="https://publications.waset.org/abstracts/search?q=enterocolitis" title=" enterocolitis"> enterocolitis</a>, <a href="https://publications.waset.org/abstracts/search?q=pediatric%20surgery" title=" pediatric surgery"> pediatric surgery</a>, <a href="https://publications.waset.org/abstracts/search?q=gastric%20surgery" title=" gastric surgery"> gastric surgery</a> </p> <a href="https://publications.waset.org/abstracts/156828/jejunostomy-and-protective-ileostomy-in-a-patient-with-massive-necrotizing-enterocolitis-a-case-report" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/156828.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">84</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">8</span> Necrotising Anterior Scleritis and Scleroderma: A Rare Association</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Angeliki%20Vassila">Angeliki Vassila</a>, <a href="https://publications.waset.org/abstracts/search?q=Dimitrios%20Kalogeropoulos"> Dimitrios Kalogeropoulos</a>, <a href="https://publications.waset.org/abstracts/search?q=Rania%20Rawashdeh"> Rania Rawashdeh</a>, <a href="https://publications.waset.org/abstracts/search?q=Nigel%20Hall"> Nigel Hall</a>, <a href="https://publications.waset.org/abstracts/search?q=Najiha%20Rahman"> Najiha Rahman</a>, <a href="https://publications.waset.org/abstracts/search?q=Mark%20Fabian"> Mark Fabian</a>, <a href="https://publications.waset.org/abstracts/search?q=Suresh%20Thulasidharan"> Suresh Thulasidharan</a>, <a href="https://publications.waset.org/abstracts/search?q=Hossain%20Parwez"> Hossain Parwez</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Introduction: Necrotising scleritis is a severe form of scleritis and poses a significant threat to vision. It can manifest in various systemic autoimmune disorders, systemic vasculitis, or as a consequence of microbial infections. The objective of this study is to present a case of necrotizing scleritis associated with scleroderma, which was further complicated by a secondary Staphylococcus epidermidis infection. Methods: This is a retrospective analysis that examines the medical records of a patient who was hospitalised in the Eye Unit at University Hospital Southampton. Results: A 78-year-old woman presented at the eye casualty department of our unit with a two-week history of progressively worsening pain in her left eye. She received a diagnosis of necrotising scleritis and was admitted to the hospital for further treatment. It was decided to commence a three-day course of intravenous methylprednisolone followed by a tapering regimen of oral steroids. Additionally, a conjunctival swab was taken, and two days later, it revealed the presence of S. epidermidis, indicating a potential secondary infection. Given this finding, she was also prescribed topical (Ofloxacin 0.3% - four times daily) and oral (Ciprofloxacin 750mg – twice daily) antibiotics. The inflammation and symptoms gradually improved, leading to the patient being scheduled for a scleral graft and applying an amniotic membrane to cover the area of scleral thinning. Conclusions: Rheumatoid arthritis and granulomatosis with polyangiitis are the most commonly identifiable systemic diseases associated with necrotising scleritis. Although association with scleroderma is extremely rare, early identification and treatment are necessary to prevent scleritis-related complications. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=scleritis" title="scleritis">scleritis</a>, <a href="https://publications.waset.org/abstracts/search?q=necrotizing%20scleritis" title=" necrotizing scleritis"> necrotizing scleritis</a>, <a href="https://publications.waset.org/abstracts/search?q=scleroderma" title=" scleroderma"> scleroderma</a>, <a href="https://publications.waset.org/abstracts/search?q=autoimmune%20disease" title=" autoimmune disease"> autoimmune disease</a> </p> <a href="https://publications.waset.org/abstracts/191903/necrotising-anterior-scleritis-and-scleroderma-a-rare-association" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/191903.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">29</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">7</span> Synthetic Dermal Template Use in the Reconstruction of a Chronic Scalp Wound</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Stephanie%20Cornish">Stephanie Cornish</a> </p> <p class="card-text"><strong>Abstract:</strong></p> The use of synthetic dermal templates, also known as dermal matrices, such as PolyNovo® Biodegradable Temporising Matrix (BTM), has been well established in the reconstruction of acute wounds with a full thickness defect of the skin. Its use has become common place in the treatment of full thickness burns and is not unfamiliar in the realm of necrotising fasciitis, free flap donor site reconstruction, and the management of acute traumatic wounds. However, the use of dermal templates for more chronic wounds is rare. The authors present the successful use of BTM in the reconstruction of a chronic scalp wound following the excision of a malignancy and multiple previous failed attempts at repair, thus demonstrating the potential for an increased scope of use. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=dermal%20template" title="dermal template">dermal template</a>, <a href="https://publications.waset.org/abstracts/search?q=BTM" title=" BTM"> BTM</a>, <a href="https://publications.waset.org/abstracts/search?q=chronic" title=" chronic"> chronic</a>, <a href="https://publications.waset.org/abstracts/search?q=scalp%20wound" title=" scalp wound"> scalp wound</a>, <a href="https://publications.waset.org/abstracts/search?q=reconstruction" title=" reconstruction"> reconstruction</a> </p> <a href="https://publications.waset.org/abstracts/152147/synthetic-dermal-template-use-in-the-reconstruction-of-a-chronic-scalp-wound" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/152147.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">91</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">6</span> Clinical Features, Diagnosis and Treatment Outcomes in Necrotising Autoimmune Myopathy: A Rare Entity in the Spectrum of Inflammatory Myopathies</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Tamphasana%20Wairokpam">Tamphasana Wairokpam</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Inflammatory myopathies (IMs) have long been recognised as a heterogenous family of myopathies with acute, subacute, and sometimes chronic presentation and are potentially treatable. Necrotizing autoimmune myopathies (NAM) are a relatively new subset of myopathies. Patients generally present with subacute onset of proximal myopathy and significantly elevated creatinine kinase (CK) levels. It is being increasingly recognised that there are limitations to the independent diagnostic utility of muscle biopsy. Immunohistochemistry tests may reveal important information in these cases. The traditional classification of IMs failed to recognise NAM as a separate entity and did not adequately emphasize the diversity of IMs. This review and case report on NAM aims to highlight the heterogeneity of this entity and focus on the distinct clinical presentation, biopsy findings, specific auto-antibodies implicated, and available treatment options with prognosis. This article is a meta-analysis of literatures on NAM and a case report illustrating the clinical course, investigation and biopsy findings, antibodies implicated, and management of a patient with NAM. The main databases used for the search were Pubmed, Google Scholar, and Cochrane Library. Altogether, 67 publications have been taken as references. Two biomarkers, anti-signal recognition protein (SRP) and anti- hydroxyl methylglutaryl-coenzyme A reductase (HMGCR) Abs, have been found to have an association with NAM in about 2/3rd of cases. Interestingly, anti-SRP associated NAM appears to be more aggressive in its clinical course when compared to its anti-HMGCR associated counterpart. Biopsy shows muscle fibre necrosis without inflammation. There are reports of statin-induced NAM where progression of myopathy has been seen even after discontinuation of statins, pointing towards an underlying immune mechanism. Diagnosisng NAM is essential as it requires more aggressive immunotherapy than other types of IMs. Most cases are refractory to corticosteroid monotherapy. Immunosuppressive therapy with other immunotherapeutic agents such as IVIg, rituximab, mycophenolate mofetil, azathioprine has been explored and found to have a role in the treatment of NAM. In conclusion,given the heterogeneity of NAM, it appears that NAM is not just a single entity but consists of many different forms, despite the similarities in presentation and its classification remains an evolving field. A thorough understanding of underlying mechanism and the clinical correlation with antibodies associated with NAM is essential for efficacious management and disease prognostication. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=inflammatory%20myopathies" title="inflammatory myopathies">inflammatory myopathies</a>, <a href="https://publications.waset.org/abstracts/search?q=necrotising%20autoimmune%20myopathies" title=" necrotising autoimmune myopathies"> necrotising autoimmune myopathies</a>, <a href="https://publications.waset.org/abstracts/search?q=anti-SRP%20antibody" title=" anti-SRP antibody"> anti-SRP antibody</a>, <a href="https://publications.waset.org/abstracts/search?q=anti-HMGCR%20antibody" title=" anti-HMGCR antibody"> anti-HMGCR antibody</a>, <a href="https://publications.waset.org/abstracts/search?q=statin%20induced%20myopathy" title=" statin induced myopathy"> statin induced myopathy</a> </p> <a href="https://publications.waset.org/abstracts/150434/clinical-features-diagnosis-and-treatment-outcomes-in-necrotising-autoimmune-myopathy-a-rare-entity-in-the-spectrum-of-inflammatory-myopathies" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/150434.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">103</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">5</span> Endoscopic Ultrasound Guided Fine Needle Aspiration/Brush in Cytopathology Diagnosis: A Fifteen-Month Study</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Santosh%20Tummidi">Santosh Tummidi</a>, <a href="https://publications.waset.org/abstracts/search?q=Pragati%20Sathe"> Pragati Sathe</a>, <a href="https://publications.waset.org/abstracts/search?q=Kanchan%20Kothari"> Kanchan Kothari</a>, <a href="https://publications.waset.org/abstracts/search?q=Prachi%20Gholap"> Prachi Gholap</a>, <a href="https://publications.waset.org/abstracts/search?q=Mona%20Agnihotri"> Mona Agnihotri</a>, <a href="https://publications.waset.org/abstracts/search?q=Gwendolyn%20Fernandes"> Gwendolyn Fernandes</a>, <a href="https://publications.waset.org/abstracts/search?q=Leena%20Naik"> Leena Naik</a>, <a href="https://publications.waset.org/abstracts/search?q=Rachana%20Chaturvedi"> Rachana Chaturvedi</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Introduction: EUS-Guided Fine Needle Aspiration/Brush (EUS-FNA/Brush) has become increasingly popular for the diagnosis and staging of gastrointestinal and peri-gastrointestinal lesions. Objective: To evaluate the diagnostic accuracy and spectrum of lesions in gastrointestinal EUS-FNA. Material and Methods: A total of 124 EUS-FNA during the period from Aug 2015-Nov 2016 were studied. Results: Age ranged from 13-80 years with a slight female predominance. CBD was the most common site with 47 cases amongst which were 9 adenocarcinoma, and 7 cases were suspicious for malignancy. Pancreatic EUS-FNA showed 5 adenocarcinoma, 2 SPEN, 1 case each of neuroendocrine tumor, anaplastic carcinoma and NHL. Amongst oesophageal lesions, 3 cases were suspicious for malignancy, and 4 were inflammatory, 4 showed SCC, 1case each adenocarcinoma and leiomyoma. Stomach- 1 case each of adenocarcinoma, granulomatous inflammation, and GIST. Periportal lymph nodes were the commonest nodes, and there were 11 necrotising granulomatous inflammations, 3 metastatic adenocarcinoma, 2 cases of atypical cells and 1 case of NHL. 17 cases were unsatisfactory, 41 cases had histopathology follow up with 85% cases being concordant. Conclusion: EUS-FNA is reliable, sensitive and specific. It can be utilized for better management of intra-abdominal lesions. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=EUS-FNA" title="EUS-FNA">EUS-FNA</a>, <a href="https://publications.waset.org/abstracts/search?q=brush" title=" brush"> brush</a>, <a href="https://publications.waset.org/abstracts/search?q=cytology" title=" cytology"> cytology</a>, <a href="https://publications.waset.org/abstracts/search?q=histopathology" title=" histopathology"> histopathology</a> </p> <a href="https://publications.waset.org/abstracts/69355/endoscopic-ultrasound-guided-fine-needle-aspirationbrush-in-cytopathology-diagnosis-a-fifteen-month-study" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/69355.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">304</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">4</span> Health Outcomes from Multidrug-Resistant Salmonella in High-Income Countries: A Systematic Review and Meta-Analysis</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Andrea%20Parisi">Andrea Parisi</a>, <a href="https://publications.waset.org/abstracts/search?q=Samantha%20Vilkins"> Samantha Vilkins</a>, <a href="https://publications.waset.org/abstracts/search?q=Luis%20Furuya-Kanamori"> Luis Furuya-Kanamori</a>, <a href="https://publications.waset.org/abstracts/search?q=John%20A.%20Crump"> John A. Crump</a>, <a href="https://publications.waset.org/abstracts/search?q=Benjamin%20P.%20Howden"> Benjamin P. Howden</a>, <a href="https://publications.waset.org/abstracts/search?q=Darren%20Gray"> Darren Gray</a>, <a href="https://publications.waset.org/abstracts/search?q=Kathryn%20Glass"> Kathryn Glass</a>, <a href="https://publications.waset.org/abstracts/search?q=Martyn%20Kirk"> Martyn Kirk</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Objectives: Salmonella is a leading cause of foodborne enterocolitis worldwide. Nontyphoidal Salmonella (NTS) infections that are Multi-Drug Resistant (MDR) (non-susceptible to ≥1 agent in ≥3 antimicrobial categories) may result in more severe outcomes, although these effects have not been systematically examined. We conducted a systematic review and meta-analysis to examine impacts of MDR NTS on health in high-income settings. Methods: We systematically reviewed the literature from scientific databases, including PubMed, Scopus and grey literature sources, using PRISMA guidelines. We searched for data from case-control studies, cohorts, outbreaks, reports and theses, imposing no language restriction. We included only publications from January 1990 to September 2016 from high income countries as classified by World Bank. We extracted data from papers on duration of illness, hospitalisation rates, morbidity and mortality for MDR and non-MDR NTS strains. Results: After removing duplicates, the initial search revealed 4258 articles. After further screening, we identified 16 eligible studies for the systematic review, and 9 of these were included in meta-analysis. NTS serotypes differed among the reported studies but serotype Typhimurium, Enteritidis, Newport and Heidelberg were among the most often reported as MDR pathogens. Salmonella infections that were MDR were associated with excess bloodstream infections (OR 1.63; 95%CI 1.18-2.26), excess hospitalisations (OR 2.77; 95%CI 1.47-5.21) and higher mortality (OR 3.54; 95%CI 1.10-11.40). Conclusions: MDR NTS infections are a serious public health concern. With the emergence of MDR Salmonella strains in the high-income countries, it is crucial to restrict the use of antimicrobials both in animals and humans, and intervene to prevent foodborne infections. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=Antimicrobial%20Resistance" title="Antimicrobial Resistance">Antimicrobial Resistance</a>, <a href="https://publications.waset.org/abstracts/search?q=Bloodstream%20Infection" title=" Bloodstream Infection"> Bloodstream Infection</a>, <a href="https://publications.waset.org/abstracts/search?q=Health%20Outcomes" title=" Health Outcomes"> Health Outcomes</a>, <a href="https://publications.waset.org/abstracts/search?q=Hospitalisation" title=" Hospitalisation"> Hospitalisation</a>, <a href="https://publications.waset.org/abstracts/search?q=Invasive%20Disease" title=" Invasive Disease"> Invasive Disease</a>, <a href="https://publications.waset.org/abstracts/search?q=Multi-Drug%20Resistance%20%28MDR%29" title=" Multi-Drug Resistance (MDR)"> Multi-Drug Resistance (MDR)</a>, <a href="https://publications.waset.org/abstracts/search?q=Mortality" title=" Mortality"> Mortality</a>, <a href="https://publications.waset.org/abstracts/search?q=Nontyphoidal%20Salmonella" title=" Nontyphoidal Salmonella"> Nontyphoidal Salmonella</a> </p> <a href="https://publications.waset.org/abstracts/66064/health-outcomes-from-multidrug-resistant-salmonella-in-high-income-countries-a-systematic-review-and-meta-analysis" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/66064.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">379</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">3</span> Muscle and Cerebral Regional Oxygenation in Preterm Infants with Shock Using Near-Infrared Spectroscopy</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Virany%20Diana">Virany Diana</a>, <a href="https://publications.waset.org/abstracts/search?q=Martono%20Tri%20Utomo"> Martono Tri Utomo</a>, <a href="https://publications.waset.org/abstracts/search?q=Risa%20Etika"> Risa Etika</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: Shock is one severe condition that can be a major cause of morbidity and mortality in the Neonatal Intensive Care Unit. Preterm infants are very susceptible to shock caused by many complications such as asphyxia, patent ductus arteriosus, intra ventricle haemorrhage, necrotizing enterocolitis, persistent pulmonal hypertension of the newborn, and septicaemia. Limited hemodynamic monitoring for early detection of shock causes delayed intervention and comprises the outcomes. Clinical parameters still used in neonatal shock detection, such as Capillary Refill Time, heart rate, cold extremity, and urine production. Blood pressure is most frequently used to evaluate preterm's circulation, but hypotension indicates uncompensated shock. Near-infrared spectroscopy (NIRS) is known as a noninvasive tool for monitoring and detecting the state of inadequate tissue perfusion. Muscle oxygen saturation shows decreased cardiac output earlier than systemic parameters of tissue oxygenation when cerebral regional oxygen saturation is still stabilized by autoregulation. However, to our best knowledge, until now, no study has analyzed the decrease of muscle oxygen regional saturation (mRSO₂) and the ratio of muscle and cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Purpose: The purpose of this study is to analyze the decrease of mRSO₂ and ratio of muscle to cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Patients and Methods: This cross-sectional study was conducted on preterm infants with 28-34 weeks gestational age, admitted to the NICU of Dr. Soetomo Hospital from November to January 2022. Patients were classified into two groups: shock and non-shock. The diagnosis of shock is based on clinical criteria (tachycardia, prolonged CRT, cold extremity, decreased urine production, and MAP Blood Pressure less than GA in weeks). Measurement of mRSO₂ and cRSO₂ by NIRS was performed by the doctor in charge when the patient came to NICU. Results: We enrolled 40 preterm infants. The initial conventional hemodynamic parameter as the basic diagnosis of shock showed significant differences in all variables. Preterm with shock had higher mean HR (186.45±1.5), lower MAP (29.8±2.1), and lower SBP (45.1±4.28) than non-shock children, and most had a prolonged CRT. The patients’ outcome was not a significant difference between shock and non-shock patients. The mean mRSO₂ in the shock and non-shock groups were 33,65 ± 11,32 vs. 69,15 ± 3,96 (p=0.001), and the mean ratio mRSO₂/cRSO₂ 0,45 ± 0,12 vs. 0,84 ± 0,43 (p=0,001), were significantly different. The mean cRSO₂ in the shock and non-shock groups were 71,60 ± 4,90 vs. 81,85 ± 7,85 (p 0.082), not significantly different. Conclusion: The decrease of mRSO₂ and ratio of mRSO₂/cRSO₂ can differentiate between shock and non-shock in the preterm infant when cRSO₂ is still normal. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=preterm%20infant" title="preterm infant">preterm infant</a>, <a href="https://publications.waset.org/abstracts/search?q=regional%20muscle%20oxygen%20saturation" title=" regional muscle oxygen saturation"> regional muscle oxygen saturation</a>, <a href="https://publications.waset.org/abstracts/search?q=regional%20cerebral%20oxygen%20saturation" title=" regional cerebral oxygen saturation"> regional cerebral oxygen saturation</a>, <a href="https://publications.waset.org/abstracts/search?q=NIRS" title=" NIRS"> NIRS</a>, <a href="https://publications.waset.org/abstracts/search?q=shock" title=" shock"> shock</a> </p> <a href="https://publications.waset.org/abstracts/162277/muscle-and-cerebral-regional-oxygenation-in-preterm-infants-with-shock-using-near-infrared-spectroscopy" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/162277.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">91</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">2</span> Staphylococcus Aureus Septic Arthritis and Necrotizing Fasciitis in a Patient With Undiagnosed Diabetes Mellitus.</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=Pedro%20Batista">Pedro Batista</a>, <a href="https://publications.waset.org/abstracts/search?q=Andr%C3%A9%20Vinha"> André Vinha</a>, <a href="https://publications.waset.org/abstracts/search?q=Filipe%20Castelo"> Filipe Castelo</a>, <a href="https://publications.waset.org/abstracts/search?q=B%C3%A1rbara%20Costa"> Bárbara Costa</a>, <a href="https://publications.waset.org/abstracts/search?q=Ricardo%20Sousa"> Ricardo Sousa</a>, <a href="https://publications.waset.org/abstracts/search?q=Raquel%20Ricardo"> Raquel Ricardo</a>, <a href="https://publications.waset.org/abstracts/search?q=Andr%C3%A9%20Pinto"> André Pinto</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Background: Septic arthritis is a diagnosis that must be considered in any patient presenting with acute joint swelling and fever. Among the several risk factors for septic arthritis, such as age, rheumatoid arthritis, recent surgery, or skin infection, diabetes mellitus can sometimes be the main risk factor. Staphylococcus aureus is the most common pathogen isolated in septic arthritis; however, it is uncommon in monomicrobial necrotizing fasciitis. Objectives: A case report of concomitant septic arthritis and necrotizing fasciitis in a patient with undiagnosed diabetes based on clinical history. Study Design & Methods: We report a case of a 58-year-old Portuguese previously healthy man who presented to the emergency department with fever and left knee swelling and pain for two days. The blood work revealed ketonemia of 6.7 mmol/L and glycemia of 496 mg/dL. The vital signs were significant for a temperature of 38.5 ºC and 123 bpm of heart rate. The left knee had edema and inflammatory signs. Computed tomography of the left knee showed diffuse edema of the subcutaneous cellular tissue and soft tissue air bubbles. A diagnosis of septic arthritis and necrotising fasciitis was made. He was taken to the operating room for surgical debridement. The samples collected intraoperatively were sent for microbiological analysis, revealing infection by multi-sensitive Staphylococcus aureus. Given this result, the empiric flucloxacillin (500 mg IV) and clindamycin (1000 mg IV) were maintained for 3 weeks. On the seventh day of hospitalization, there was a significant improvement in subcutaneous and musculoskeletal tissues. After two weeks of hospitalization, there was no purulent content and partial closure of the wounds was possible. After 3 weeks, he was switched to oral antibiotics (flucloxacillin 500 mg). A week later, a urinary infection by Pseudomonas aeruginosa was diagnosed and ciprofloxacin 500 mg was administered for 7 days without complications. After 30 days of hospital admission, the patient was discharged home and recovered. Results: The final diagnosis of concomitant septic arthritis and necrotizing fasciitis was made based on the imaging findings, surgical exploration and microbiological tests results. Conclusions: Early antibiotic administration and surgical debridement are key in the management of septic arthritis and necrotizing fasciitis. Furthermore, risk factors control (euglycemic blood glucose levels) must always be taken into account given the crucial role in the patient's recovery. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=septic%20arthritis" title="septic arthritis">septic arthritis</a>, <a href="https://publications.waset.org/abstracts/search?q=Necrotizing%20fasciitis" title=" Necrotizing fasciitis"> Necrotizing fasciitis</a>, <a href="https://publications.waset.org/abstracts/search?q=diabetes" title=" diabetes"> diabetes</a>, <a href="https://publications.waset.org/abstracts/search?q=Staphylococcus%20Aureus" title=" Staphylococcus Aureus"> Staphylococcus Aureus</a> </p> <a href="https://publications.waset.org/abstracts/158831/staphylococcus-aureus-septic-arthritis-and-necrotizing-fasciitis-in-a-patient-with-undiagnosed-diabetes-mellitus" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/158831.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">315</span> </span> </div> </div> <div class="card paper-listing mb-3 mt-3"> <h5 class="card-header" style="font-size:.9rem"><span class="badge badge-info">1</span> In vivo Evaluation of LAB Probiotic Potential with the Zebrafish Animal Model</h5> <div class="card-body"> <p class="card-text"><strong>Authors:</strong> <a href="https://publications.waset.org/abstracts/search?q=I%C3%B1aki%20Iturria">Iñaki Iturria</a>, <a href="https://publications.waset.org/abstracts/search?q=Pasquale%20Russo"> Pasquale Russo</a>, <a href="https://publications.waset.org/abstracts/search?q=Montserrat%20Nacher-V%C3%A1zquez"> Montserrat Nacher-Vázquez</a>, <a href="https://publications.waset.org/abstracts/search?q=Giuseppe%20Spano"> Giuseppe Spano</a>, <a href="https://publications.waset.org/abstracts/search?q=Paloma%20L%C3%B3pez"> Paloma López</a>, <a href="https://publications.waset.org/abstracts/search?q=Miguel%20Angel%20Pardo"> Miguel Angel Pardo</a> </p> <p class="card-text"><strong>Abstract:</strong></p> Introduction: It is known that some Lactic Acid Bacteria (LAB) present an interesting probiotic effect. Probiotic bacteria stimulate host resistance to microbial pathogens and thereby aid in immune response, and modulate the host's immune responses to antigens with a potential to down-regulate hypersensitivity reactions. Therefore, probiotic therapy is valuable against intestinal infections and may be beneficial in the treatment of Inflammatory Bowel Disease (IBD). Several in vitro tests are available to evaluate the probiotic potential of a LAB strain. However, an in vivo model is required to understand the interaction between the host immune system and the bacteria. During the last few years, zebrafish (Danio rerio) has gained interest as a promising vertebrate model in this field. This organism has been extensively used to study the interaction between the host and the microbiota, as well as the host immune response under several microbial infections. In this work, we report on the use of the zebrafish model to investigate in vivo the colonizing ability and the immunomodulatory effect of probiotic LAB. Methods: Lactobacillus strains belonging to different LAB species were fluorescently tagged and used to colonize germ-free zebrafish larvae gastrointestinal tract (GIT). Some of the strains had a well-documented probiotic effect (L. acidophilus LA5); while others presented an exopolysaccharide (EPS) producing phenotype, thus allowing evaluating the influence of EPS in the colonization and immunomodulatory effect. Bacteria colonization was monitored for 72 h by direct observation in real time using fluorescent microscopy. CFU count per larva was also evaluated at different times. The immunomodulatory effect was assessed analysing the differential expression of several innate immune system genes (MyD88, NF-κB, Tlr4, Il1β and Il10) by qRT- PCR. The anti-inflammatory effect was evaluated using a chemical enterocolitis zebrafish model. The protective effect against a pathogen was also studied. To that end, a challenge test was developed using a fluorescently tagged pathogen (Vibrio anguillarum-GFP+). The progression of the infection was monitored up to 3 days using a fluorescent stereomicroscope. Mortality rates and CFU counts were also registered. Results and conclusions: Larvae exposed to EPS-producing bacteria showed a higher fluorescence and CFU count than those colonized with no-EPS phenotype LAB. In the same way, qRT-PCR results revealed an immunomodulatory effect on the host after the administration of the strains with probiotic activity. A downregulation of proinflammatory cytoquines as well as other cellular mediators of inflammation was observed. The anti-inflammatory effect was found to be particularly marked following exposure to LA% strain, as well as EPS producing strains. Furthermore, the challenge test revealed a protective effect of probiotic administration. As a matter of fact, larvae fed with probiotics showed a decrease in the mortality rate ranging from 20 to 35%. Discussion: In this work, we developed a promising model, based on the use of gnotobiotic zebrafish coupled with a bacterial fluorescent tagging in order to evaluate the probiotic potential of different LAB strains. We have successfully used this system to monitor in real time the colonization and persistence of exogenous LAB within the gut of zebrafish larvae, to evaluate their immunomodulatory effect and for in vivo competition assays. This approach could bring further insights into the complex microbial-host interactions at intestinal level. <p class="card-text"><strong>Keywords:</strong> <a href="https://publications.waset.org/abstracts/search?q=gnotobiotic" title="gnotobiotic">gnotobiotic</a>, <a href="https://publications.waset.org/abstracts/search?q=immune%20system" title=" immune system"> immune system</a>, <a href="https://publications.waset.org/abstracts/search?q=lactic%20acid%20bacteria" title=" lactic acid bacteria"> lactic acid bacteria</a>, <a href="https://publications.waset.org/abstracts/search?q=probiotics" title=" probiotics"> probiotics</a>, <a href="https://publications.waset.org/abstracts/search?q=zebrafish" title=" zebrafish"> zebrafish</a> </p> <a href="https://publications.waset.org/abstracts/46742/in-vivo-evaluation-of-lab-probiotic-potential-with-the-zebrafish-animal-model" class="btn btn-primary btn-sm">Procedia</a> <a href="https://publications.waset.org/abstracts/46742.pdf" target="_blank" class="btn btn-primary btn-sm">PDF</a> <span class="bg-info text-light px-1 py-1 float-right rounded"> Downloads <span class="badge badge-light">328</span> </span> </div> </div> </div> </main> <footer> <div id="infolinks" class="pt-3 pb-2"> <div class="container"> <div style="background-color:#f5f5f5;" class="p-3"> <div class="row"> <div class="col-md-2"> <ul class="list-unstyled"> About <li><a href="https://waset.org/page/support">About Us</a></li> <li><a href="https://waset.org/page/support#legal-information">Legal</a></li> <li><a target="_blank" rel="nofollow" href="https://publications.waset.org/static/files/WASET-16th-foundational-anniversary.pdf">WASET celebrates its 16th foundational anniversary</a></li> </ul> </div> <div class="col-md-2"> <ul class="list-unstyled"> Account <li><a href="https://waset.org/profile">My Account</a></li> </ul> </div> <div class="col-md-2"> <ul class="list-unstyled"> Explore <li><a href="https://waset.org/disciplines">Disciplines</a></li> <li><a href="https://waset.org/conferences">Conferences</a></li> <li><a href="https://waset.org/conference-programs">Conference Program</a></li> <li><a href="https://waset.org/committees">Committees</a></li> <li><a href="https://publications.waset.org">Publications</a></li> </ul> </div> <div class="col-md-2"> <ul class="list-unstyled"> Research <li><a href="https://publications.waset.org/abstracts">Abstracts</a></li> <li><a href="https://publications.waset.org">Periodicals</a></li> <li><a href="https://publications.waset.org/archive">Archive</a></li> </ul> </div> <div class="col-md-2"> <ul class="list-unstyled"> Open Science <li><a target="_blank" rel="nofollow" href="https://publications.waset.org/static/files/Open-Science-Philosophy.pdf">Open Science Philosophy</a></li> <li><a target="_blank" rel="nofollow" href="https://publications.waset.org/static/files/Open-Science-Award.pdf">Open Science Award</a></li> <li><a target="_blank" rel="nofollow" href="https://publications.waset.org/static/files/Open-Society-Open-Science-and-Open-Innovation.pdf">Open Innovation</a></li> <li><a target="_blank" rel="nofollow" href="https://publications.waset.org/static/files/Postdoctoral-Fellowship-Award.pdf">Postdoctoral Fellowship Award</a></li> <li><a target="_blank" rel="nofollow" href="https://publications.waset.org/static/files/Scholarly-Research-Review.pdf">Scholarly Research Review</a></li> </ul> </div> <div class="col-md-2"> <ul class="list-unstyled"> Support <li><a href="https://waset.org/page/support">Support</a></li> <li><a href="https://waset.org/profile/messages/create">Contact Us</a></li> <li><a href="https://waset.org/profile/messages/create">Report Abuse</a></li> </ul> </div> </div> </div> </div> </div> <div class="container text-center"> <hr style="margin-top:0;margin-bottom:.3rem;"> <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank" class="text-muted small">Creative Commons Attribution 4.0 International License</a> <div id="copy" class="mt-2">&copy; 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