Duggan Covington (mileidea72)
rently available. What is New • The exposure of preterm infants to PFASs through HM feeding might exceed reference values reported for older and healthier infants. • Given the immunological and developmental vulnerability of preterm infants, the risks related to their exposure to PFASs deserve further investigation. As HM represents the optimal feeding for preterm infants, it will be fundamental to focus on how maternal exposure and subsequent transfer through HM feeding can be reduced.In orally fed preterm infants, poor weight gain may be linked to low fecal pancreatic elastase-1 (FPE-1) activity, indicative of exocrine pancreatic insufficiency. The objective of this study was the retrospective assessment of the effect of exogenous digestive enzyme replacement by gavage in preterm infants with growth failure and low FPE-1 ( less then 200 μg/g). We analyzed weight gain relative to baseline and caloric intake during 14-day periods before and after institution of digestive enzyme replacement containing 6000 U lipase and 240 U protease kg-1 d-1. Among 46 of 132 preterm infants less then 1250g birth weight surviving to at least 14 days in whom FPE-1 was determined, 38 infants had low FPE-1 ( less then 200 μg/g), and 33 infants received exogenous digestive enzyme replacement. Average daily weight gain significantly increased from 14.4 [range 2.6-22.4] g kg-1 d-1 to 17.4 [8.4-29.0] g kg-1 d-1 (P = 0.001), as did weight gain per kcal, from 0.08 [0.02-0.13] g kcal-1 d-1 to 0.11 [0.05-0.18] g kcal-1 d-1.Conclusion In preterm infants with signs and symptoms of exocrine pancreatic insufficiency, exogenous digestive enzyme replacement is associated with improved growth. What is Known • Very preterm infants on full enteral nutrition may display growth failure linked to transient poor exocrine pancreatic function. • Porcine pancreatic enzymes covered with an acid-resistant coating are too large to pass the internal diameter of most gavage tubes used in very preterm infants. What is New • Administration of a liquid formulation of acid-resistant microbial digestive enzymes in preterm infants with growth failure and low fecal pancreatic elastase-1 values was associated with improved weight gain. • Response to exogenous digestive enzyme replacement was associated with the prior extent of growth failure. One of the key factors to the successful revision of total knee arthroplasty (rTKA) is the reconstruction of the joint line, which can be determined using the epicondylar ratio (ER). The measurement is established in X-ray and MRI. However, it is not known whether computed tomography (CT) allows a more reliable determination. The objective was to assess the reliability of the ER in CT and to determine the correlation between the ER in CT and a.p. X-ray of the knee. The ER was determined on X-ray and CT images of a consecutive series of 107 patients, who underwent rTKA. Measurements were made by two blinded observes, one measured twice. The inter- and intraobserver agreement, as well as the correlation between the two methods, were quantified with the Intraclass Correlation Coefficient. The average lateral ER was 0.32 (± 0.04) in X-ray and 0.32 (± 0.04) in CT. On the medial side, the average ER was 0.34 (± 0.04) in X-ray and 0.35 (± 0.04) in CT. The interobserver agreement for the same imaging modality was lateral 0.81 and medial 0.81 in X-ray as well as lateral 0.74 and medial 0.85 in CT. selleck products The correlation between the two methods was lateral 0.81 and medial 0.79. The ER can be reliably determined in X-ray and CT. Measurements of the two image modalities correlate. Prior to rTKA, the sole use of the X-ray is possible. The ER can be reliably determined in X-ray and CT. Measurements of the two image modalities correlate. Prior to rTKA, the sole use of the X-ray is possible. Open reduction and internal fixation is considered the gold standard of treatment for displaced acetabula