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According to the literature, probiotics are an attractive alternative to prevent necrotizing enterocolitis (NEC). However, due to differences in probiotic composition, randomized controlled trials are necessary to compare different probiotic mixtures. The objective of this study was to compare single strain (Lactobacillus acidophilus boucardii) versus multispecies probiotics on NEC incidence and faecal secretory Immunoglobulin A (sIgA) levels in very low preterm newborns. We performed a double-blind randomized trial in 90 newborns. L. acidophilus boucardii strain or multispecies probiotics were randomly assigned to preterm newborns. As the primary outcome, we evaluated NEC incidence on the total length of neonatal intensive care unit (NICU) stay. As the secondary outcome, we measured the change in faecal sIgA levels from baseline to 3 weeks following the use of probiotics. NEC incidence was similar between groups (0% vs. 2.2% for the single strain and multispecies probiotic, respectively). Faecal sIgA levels increased significantly (p < 0.001) within groups (31% for single strain and 47% for multispecies probiotic), but this increase was not different between groups. Neonates with a faecal sIgA level increment >0.45 mg/dl showed higher gestational age, birth weight, and weight at the second and third weeks of follow up than neonates with a faecal sIgA level increment ≤0.45 mg/dl. No adverse effects were found after probiotics use. No difference between strains of probiotics used was found on NEC incidence or in the increase of faecal sIgA levels. Faecal sIgA levels were positively related to gestational age and body weight in very low preterm infants. ClinicalTrials.gov/NCT02245815. [ABSTRACT FROM AUTHOR]

Objective: To know the association of abdominal ultrasound findings in preterm newborns with necrotizing enterocolitis. Method: Transverse, analytical study, patients with necrotizing enterocolitis abdominal ultrasound was performed: free fluid, large wall more than 2.5 mm, small bowel wall less than 1.1 mm, gas in portal vein, intestinal pneumatosis, decreased and/or absence of peristalsis, increase and/or absence of intestinal blood infusion. Chi square and Mann-Whitney U tests were used to establish association ultrasound findings and necrotizing enterocolitis, alpha level < 0.05, SPSS v.23.0 program. Results: 37 patients. IA stage: small intestine wall less than 1.1 mm with a total of 15 (40%), 13 (35%) decreased peristalsis 11 (29%), absence of peristalsis 8 (21.62%). IB stage: free liquid, increased blood infusion 2 (5%). IIA stage: peristalsis decreased 7 (18%), small intestine wall less than 1.1 mm 4 (10%), free liquid 3 (8%), pneumatosis 2 (5%), absent blood infusion 1 (2%). IIIA stage: 1 (2%) free liquid, thinning of small intestine wall less than 1.1 mm, absence of peristalsis and blood infusion. Conclusion: There is an association of ultrasonographic findings in patients with necrotizing enterocolitis. Most frequent finding: small bowel wall less than 1.1 mm, free fluid, decreased peristalsis. It would be important to implement it as a diagnostic method in all cases for medical and surgical decision-making. [ABSTRACT FROM AUTHOR]

Background: Pulse oximetry has been suggested as a screening test for congenital heart disease (CHD) in asymptomatic newborns. However, most newborns in Mexico are discharged from the hospital without this evaluation., Objective: To evaluate pulse oximetry as a screening test for critical congenital heart disease (CCHD) in term newborns., Methods: We conducted a cross-sectional study in term newborns between July 2010 and April 2011. Pulse oximetry was determined before hospital discharge; in case of post-ductal oxygen saturation < 95%, a Doppler echocardiogram was performed., Results: From 1,037 newborns screened, two had CCHD, one had pulmonary atresia and ventricular septal defect, and one Ebstein´s anomaly. Minor CHD was present in 10 babies. The overall prevalence of CHD was 11.5 per 1000 live births, and the prevalence of CCHD was 3.9 per 1000 live births. For those with critical disease, pulse oximetry had a sensitivity of 100%, specificity 98.8%, positive predictive value 14.2%, negative predictive value 100%, and positive likelihood ratio of 86.2. In regression analysis, oxygen saturation, respiratory frequency, and postnatal age were related with CCHD., Conclusions: Pulse oximetry had a good sensitivity and specificity for the identification of critical congenital heart disease in term newborns. Low oxygen saturation, higher respiratory frequency, and early postnatal age were related with congenital heart disease.