The Association Between Human Milk and Human Milk Fortifiers and Necrotising Enterocolitis In Preterm Infants
The results of this review indicate that low birth weight, very low birth weight and extremely low birth weight infants fed with human milk fortified with human milk fortifiers are at a decreased risk for necrotising enterocolitis than those who are fed with formula milk and non-human milk fortifiers.
KEY FINDINGS: Necrotising enterocolitis continues to be one of the most devastating and unpredictable condition affecting preterm infants, leading to a high degree of morbidity and mortality. Standardised guidelines should be developed and applied in neonatal units, promoting the use of human milk with human milk fortifiers with the aim of reducing the risk of necrotising enterocolitis in preterm infants.
BACKGROUND: The purpose of this review was to determine whether breast milk fortified with human-based fortifiers decreases the incidence of necrotising enterocolitis in preterm infants.
DETAILS: A search was carried out ending July 2021. Academic Search Complete, Cochrane Central Register of Control Trials, Cochrane Database of Systematic Reviews, PubMed, CINAHL plus with full text, Environmental Complete (EBSCO), JAMA Network, MEDLINE, BioMed Central and SAGE Journals and Google Scholar were searched. Keywords included: preterm, infants, breast milk, formula milk and necrotising enterocolitis. Sixteen of the 1316 retrieved papers were included. Human milk, whether mother's own or donor milk, and human milk fortifiers decrease the risk of necrotising enterocolitis, compared to formula milk and non-human fortifiers. The initial number of studies retrieved was 1316. This number was reduced to 650 after removal of duplicates and after applying inclusion and exclusion criteria, this was further reduced to 16 studies. The final number of chosen articles included eight systematic reviews and meta-analysis, two retrospective studies, three multi-centre randomised controlled trials, one comparison cohort, one prospective cohort and one multicentre retrospective cohort. The results of this review appear to provide incontrovertible evidence on the association between human milk and human milk fortifiers and a decreased risk of necrotising enterocolitis in low birth weight, very low birth weight and extremely low birth weight infants when compared to the use of formula milk fortified with non-human fortifiers. The strength of this evidence can be qualified as medium to high.
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Copyright © Neonatal Nurses Association. Published by Elsevier Ltd. All rights reserved.
Source: Magro, S. Cini, A., Sammut, R. (2023). The Association Between Human Milk and Human Milk Fortifiers and Necrotising Enterocolitis In Preterm Infants: A Review. Journal of Neonatal Nursing. 2023; 29(1): 10-19. Published: February, 2023. DOI: 10.1016/j.jnn.2022.02.010.
Association of Nonmodifiable Risk Factors With Alzheimer Disease Blood Biomarkers in Community-Dwelling Adults in the ESTHER Study
This population-based study on dementia biomarkers found that P-tau181 was dependent on age and APOEe4; NfL on age and sex; and GFAP on age, sex, APOEe4, and menopause status. GFAP levels and rate of increase were higher in women, especially in premenopausal participants.
KEY FINDINGS: This population-based study on dementia biomarkers found that P-tau181 was dependent on age and APOEe4; NfL on age and sex; and GFAP on age, sex, APOEe4, and menopause status. GFAP levels and rate of increase were higher in women, especially in premenopausal participants. Future research should confirm these findings and further explore the role of menopause in dementia pathogenesis among women.
BACKGROUND: Dementia-related blood biomarkers are the future of large-scale dementia risk stratification; however, the extent to which phosphorylated tau (P-tau181), neurofilament light (NfL), and glial fibrillary acidic protein (GFAP) are associated with nonmodifiable risk factors has yet to be confirmed in the community, and the role of menopause has yet to be investigated. Therefore, the aim of this study was to examine the association of age, sex, APOEe4 status, and menopause, with dementia-related blood biomarker levels (P-tau181, NfL, and GFAP) and rate of change over 11 years in longitudinal biomarker measurements in community-dwelling adults.
DETAILS: Within this German population-based Epidemiologische Studie zu Chancen der Verhütung, Früherkennung und optimierten Therapie chronischer Erkrankungen in der älteren Bevölkerung cohort study (n = 9,940), a nested case-control study of 1,026 participants (1:1, without dementia during follow-up: incident dementia during follow-up) aged 50-75 years at baseline followed over 17 years was conducted. Blood biomarker measurements (P-tau181, NfL, and GFAP) were completed in blood from baseline, 8-year, and 11-year follow-ups, and cross-sectional and longitudinal regression analyses were used to assess the association with age, sex, APOEe4, and menopause. The mean age of participants was 64 years, and women accounted for slightly over half (54%) of the sample. Age was cross-sectionally and longitudinally significantly associated with all dementia-related biomarkers (p < 0.001). NfL and GFAP levels more strongly correlated (Spearman R = 0.55 and 0.49) with age at baseline than P-tau181 levels (Spearman R = 0.21). Women experienced significantly higher levels and rates of increase in GFAP (p < 0.001) while men experienced higher levels of NfL after adjusting for age and APOEe4 (p < 0.01). APOEe4 status was significantly associated with baseline and longitudinal levels of P-tau181 (baseline β = 0.30, p < 0.05) and GFAP (baseline β = 15.84, p < 0.001). Of interest, premenopausal status was significantly associated with higher GFAP levels after adjusting for age, sex, and APOEe4 (β = 19.09, p < 0.05).
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Copyright © American Academy of Neurology. All Rights Reserved.
Source: Stocker, H., Beyer, L., Trares, K., et al. Association of Nonmodifiable Risk Factors With Alzheimer Disease Blood Biomarkers in Community-Dwelling Adults in the ESTHER Study. American Academy of Neurology. 2025; 104(9): 213500. Published: May 27, 2025. DOI: 10.1212/WNL.000000000021350.
Time to Start Minimal Enteral Nutrition in Low Birth Weight Infants and Its Predictors
As early of initiation of minimal enteral nutrition has a significant role to shorten the time to reach full enteral feeding and reducing malnutrition in the NICU health care staffs treating LBW neonates should consider nutrition as part of the management and special concerns should be given for those who are very preterm and very LBW. Experts in the area and hospitals should prepare feeding initiation protocol to be used across all hospitals and health care staffs to avoid a variation in time to MEN among different neonatal units.
KEY FINDINGS: As early of initiation of minimal enteral nutrition has a significant role to shorten the time to reach full enteral feeding and reducing malnutrition in the NICU health care staffs treating LBW neonates should consider nutrition as part of the management and special concerns should be given for those who are very preterm and very LBW. Experts in the area and hospitals should prepare feeding initiation protocol to be used across all hospitals and health care staffs to avoid a variation in time to MEN among different neonatal units.
BACKGROUND: In Ethiopia the proportion of low birth weight infants is thought to be 17.3%. The purpose of this study was to determine the time to minimal enteral nutrition (MEN) and its predictors in LBW neonates admitted to neonatal intensive care unit in selected hospitals of Addis Ababa, Ethiopia.
DETAILS: An institutional based prospective follow up study was conducted. Both primary and secondary data was used by interviewing mothers and prospective medical chart review of neonates. The Cox regression model was used and variables having a p-value less than 0.05 with 95% CIs in a multivariable analysis were declared as statistically significant association with time to minimal enteral nutrition. 79.4% of them were initiated with MEN. The median time to MEN was 37 h. BW, GA, weight for gestational age, hospital acquired infection, respiratory support and NICU location (hospital) were found to have a statistically significant association with time to initiate minimal enteral nutrition.
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Copyright © Neonatal Nurses Association. Published by Elsevier Ltd. All rights reserved.
Source: Terefe, A., Tachbele, E., Mislu, E., et al. Time to Start Minimal Enteral Nutrition in Low Birth Weight Infants and Its Predictors: A Prospective Follow Up Study. Journal of Neonatal Nursing. 2025; 31(3): 101648. Published: June, 2025. j.jnn.2025.101648.
Medication Prescriptions for Chronic Diseases in Terminal Cancer Patients in Korea
These findings underscore the need to reevaluate prescription practices for terminal cancer patients. Optimizing medication use can decrease polypharmacy, reduce adverse drug reactions, and increase the quality of life (QOL) for these individuals.
KEY FINDINGS: These findings underscore the need to reevaluate prescription practices for terminal cancer patients. Optimizing medication use can decrease polypharmacy, reduce adverse drug reactions, and increase the quality of life (QOL) for these individuals.
BACKGROUND: This study aimed to investigate the prescribing patterns of medications for chronic diseases in patients with terminal cancer in South Korea as their life expectancy declined.
DETAILS: This study analyzed data on cancer patients from the National Health Insurance Service (NHIS) database in South Korea. It included a total of 89,606 patients who died of cancer in 2021. We evaluated prescriptions for dyslipidemia, hypertension, diabetes, and osteoporosis at 52, 12, 4, and 1 week prior to death. A significant proportion of patients nearing death continued to receive prescriptions for chronic disease medications, despite guidelines suggesting that these medications can be discontinued when life expectancy is limited. For instance, 2.6% of patients were prescribed medications for dyslipidemia just 1 week before death, highlighting a discrepancy between clinical practice and recommended guidelines.
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Copyright © Journal of Hospice and Palliative Care. All rights reserved.
Source: Kim, M., Kim, Y., Park, J., et al. Medication Prescriptions for Chronic Diseases in Terminal Cancer Patients in Korea: A Real-World Study. Journal of Hospice & Palliative Nursing. 2025; 28(1): 18-24. Published: April, 2025. DOI: 10.14475/jhpc.2025.28.1.18.
Fear of Disease Progression and Resilience Parallelly Mediated the Effect of Post-Stroke Fatigue on Post-Stroke Depression
An interprofessional effort to minimize patient interruptions at night in an intensive care unit setting led to improved patient sleep quality and sustainable practice changes.
KEY FINDINGS: FOP and resilience parallelly mediated the effect of PSF on PSD, which may provide a novel perspective for healthcare professionals in preventing PSD. Targeted interventions aiming at reducing PSF, lowering FOP levels and enhancing resilience may be possible ways to alleviate PSD.
BACKGROUND: Purpose of the study is to explore the effect of post-stroke fatigue (PSF) on post-stroke depression (PSD) and examine the mediating effects of fear of disease progression (FOP) and resilience between PSF and PSD. This study enriched the literature by exploring the effect of PSF on PSD and further examining the mediating effects of FOP and resilience between PSF and PSD. Findings emphasized the important effects of PSF, FOP and resilience on PSD.
DETAILS: A total of 315 stroke patients participated in the questionnaire survey between November 2022 and June 2023. Data were collected using the General Information Questionnaire, Fatigue Severity Scale, Fear of Disease Progression Questionnaire-Short Form, Connor-Davidson Resilience Scale-10 Item and Hospital Anxiety and Depression Scale-Depression Subscale. Data were analysed by descriptive analysis, Mann-Whitney U-test, Kruskal-Wallis H-test, Pearson or Spearman correlation, hierarchical regression analysis and mediation analysis. PSF had a significant positive total effect on PSD (ß = .354, 95% CI: .251, .454). Additionally, FOP and resilience played a partial parallel-mediating role in the relationship between PSF and PSD (ß = .202, 95% CI: .140, .265), and the total indirect effect accounted for 57.06% of the total effect.
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Copyright © John Wiley & Sons Ltd. All rights reserved.
Source: Ning, L., Fu, Y., Wang, Y., et al. (20245). Fear of Disease Progression and Resilience Parallelly Mediated the Effect of Post-Stroke Fatigue on Post-Stroke Depression: A Cross-Sectional Study. J Clin Nurs. 2025; 34(5): 1753-1764. Published: May, 2025. DOI: 10.1111/jocn.17323.
Distribution of Port-Wine Birthmarks and Glaucoma Outcomes in Sturge-Weber Syndrome
Lower eyelid and choroidal angiomas were associated with glaucoma diagnosis, suggesting a spatial relationship with SWS findings. However, leptomeningeal angiomas were not associated, possibly because these are further from the eye.
KEY FINDINGS: Lower eyelid and choroidal angiomas were associated with glaucoma diagnosis, suggesting a spatial relationship with SWS findings. However, leptomeningeal angiomas were not associated, possibly because these are further from the eye.
BACKGROUND: Objective of the study is to identify which features of Sturge-Weber syndrome (SWS) were most associated with glaucoma onset, severity, and treatment failure at a tertiary care center.
DETAILS: Electronic health records were reviewed for all children with SWS presenting between 2014 and 2020. Examination and imaging findings from dermatology, neurology, and ophthalmology were collected. Logistic regression was used to identify factors associated with glaucoma-related outcomes. Primary outcomes included glaucoma development, progression to surgery, and treatment failure. Failure was defined as having a final intraocular pressure >21 mmHg, devastating complication, or <=20/200 vision. Twenty-three of 44 SWS patients (52.3%) developed glaucoma, and 6 of 23 patients (26.1%) had both eyes affected. Sixteen of 29 eyes (55.2%) required surgery, and 29.6% overall met our failure criteria (mean follow-up: 5.1 ± 4.3 years). Glaucoma diagnosis was associated with bilateral port-wine birthmarks (PWBs; odds ratio [OR] 5.9; 95% confidence interval [CI] 1.3-43.2), PWB with any lower eyelid involvement (OR 9.7, 95% CI 2.6-44.5), and choroidal hemangiomas (OR 3.8, 95% CI 1.1-13.8), but was not associated with upper eyelid or leptomeningeal angiomas, seizures, prior hemispherectomy, or pulsed-dye laser. Eyes that progressed to surgery were more likely to have PWB affecting the lower eyelid (OR 33.7, 95% CI 4.5-728.0). No clinical or demographic factors were associated with treatment failure. In most cases, angle surgery failed (72.7%) but was a temporizing measure before subconjunctival filtering surgery.
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Copyright © The American Academy of Ophthalmology. All rights reserved.
Source: M. Vu, D., Gjerde, H., Elhusseiny, A. M., et al. (20245). Distribution of c and Glaucoma Outcomes in Sturge-Weber Syndrome. Ophthalmology Glaucoma. 2025; 8(2): 181-187. Published: March-April, 2025. DOI: 10.1016/j.ogla.2024.10.007.
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