Necrotizing enterocolitis in term neonates

Article Abstract:

Neonatal necrotizing enterocolitis (NEC), a widespread and severe inflammation of the intestines, is commonly considered a disease of premature, low-birth-weight infants. However, this condition is also the most common intra-abdominal emergency that requires surgical treatment among all newborn babies. A review of 81 patients with NEC over a five-year period is provided. The babies were treated with intravenous feeding, nasogastric suction, and antibiotics. Seventy-one were born prematurely; 10 full-term neonates were studied more intensively. NEC developed within the first day, or first few days of life, and was associated with abdominal distention, bloody stools, and air in the intestines. Seven of the 10 patients required exploratory laparotomy (opening of the abdominal cavity and surgical inspection). These infants had severe disease of the colon (large bowel); in two infants, the entire colon was removed. Surgery was performed on the others as needed. There was one fatality, an infant with an additional illness. Three patients did not require surgery, but responded to medical treatment. NEC in full-term neonates is associated with several risk factors, according to other research reports, which are discussed. The disorder appears to develop in neonates immediately after feeding begins, while in premature infants, it often does not occur until after the first week of life. In general, NEC in full-term babies has a favorable outcome. However, correct diagnosis is essential. An aggressive surgical approach is also recommended, since physicians accustomed to NEC in premature infants may not take into account the more competent physiological state of the newborn, and may underestimate the extent of disease, based on symptoms that may be less severe. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Diagnosis, Risk factors, Necrotizing enterocolitis, Enterocolitis, Neonatal necrotizing

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Plasma lipid lowering in short-term life-style change

Article Abstract:

An article in the July 1991 issue of the Archives of Internal Medicine demonstrated positive effects on blood lipoprotein (fat) levels in adults who attended the Pritikin Longevity Center in Santa Monica, California. According to the report, data from more than 4,500 subjects showed that the levels of total blood cholesterol, low-density cholesterol (LDL-C), total triglycerides, and high-density cholesterol (HDL-C) all fell during a three-week period when a particular dietary and exercise regimen was followed. The important factors in these changes are: (1) regression to the mean, a statistical phenomenon; (2) the effects of institutionalization, particularly in a low-stress environment; (3) the reduction in saturated fatty acids in the diet; (4) the reduction in dietary cholesterol; and (5) exercise. These are discussed. It should not be assumed from the results that major life-style changes can dramatically lower cholesterol and triglyceride levels in the long run, and there is always the difficulty of following diets that are as limited as the Pritikin plan. Health risks may result from close adherence to a very-low-fat diet, such as low levels of HDL-C (which actually removes cholesterol from cells) or osteoporosis (associated with increased fracture rates) in postmenopausal women (although at present, such risks are unproven). Whether lowering the levels of carbohydrates or unsaturated fatty acids in the diet is more effective in reducing blood cholesterol levels is not known. The superiority of the Pritikin diet to that recommended by the American Heart Association and the National Cholesterol Education Program, which is fat-modified, has not been demonstrated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Physiological aspects, Blood cholesterol, Diet therapy, editorial, Pritikin Longevity Center

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Long-term agreement

Article Abstract:

More than half the patients over the age of 65 who are suffering from depression do not follow dosage recommendations for their antidepressants. Reasons can include forgetfulness, lack of understanding, and physical or visual problems which make reading or opening the packaging difficult. Medication taken twice per day has 72% compliance. However if taken more often the compliance rate falls to 54%. Community nurses can improve this by using psycho-educational packages designed to give the patient greater confidence and understanding. Details of these packages are given.

Drug therapy, Depression in old age, Geriatric depression

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