ABSTRACT
Admission rate to neonatal intensive care units [NICU] was considerably increased over the past few decades. Short-term outcomes had been enhanced, and mortality rates had decreased. However, the impact of advanced neonatal care interventions on long-term outcome of infants was not thoroughly reviewed
Objectives: the aim of this review is to investigate the effect of NICU admission on long-term developmental and nutritional outcomes in early childhood years
Methods: Medical database, particularly Medline and Cochrane Library were searched for studies, researches, and review articles about the long-term outcome of neonates who were admitted at neonatal intensive care unit, particularly from the nutritional and developmental perspectives
Results: overall impact of NICU admission on long-term outcome is generally related to the etiological indication of admission; Hypoglycemia, tetanus, low birth weight, and prematurity had a negative impact on childhood development. Adequate nutrition and rapid growth velocity in NICU improved nutritional and physical development
Discussion: long-term outcome of neonatal intensive care unit admission depends to a large degree on the etiology of admission. Adequate nutritional support at neonatal intensive care units had improved developmental and nutritional outcome of preterm and very preterm infants. Term and late term infants admitted at NICUs were not significantly different from their counterparts who were not admitted at NICUs on long-term outcomes
Conclusions: admission at NICU is not an independent risk factor for poor nutritional or developmental outcome at early childhood years, but the etiological indication of NICU admission was more predicting. Early nutrition for low birth weight babies improved nutritional development
ABSTRACT
Purpose: to assess whether Helicobacter pylori [H. pylori] eradication therapy benefits patients with functional dyspepsia [FD]
Methods: randomized controlled trials [RCTs] examining the efficacy and safety of H. pylori eradication therapy for patients with functional dyspepsia published in English [till November 2016] were recognized by searching PubMed, EMBASE, and The Cochrane Library. Pooled estimates were measured using the fixed or random effect model. Overall effect was expressed as a pooled risk ratio [RR] or a standard mean difference [SMD]. All data were analyzed with Review Manager 5.3 and Stata 12.0
Results: this analysis involved 15 RCTs with a total of 3567 patients with FD. These studies were used to assess the benefits of H. pylori eradication therapy for symptom improvement; the pooled RR was 1.26 [95%CI: 1.10-1.40, P < 0.0001]. H. pylori eradication therapy demonstrated symptom improvement during long-term follow-up at >/= 1 year [RR = 1.27; 95%CI: 1.13-1.41, P < 0.0001] but not during short-term follow-up at < 1 year [RR = 1.26; 95%CI: 0.83-1.92, P = 0.27]. Four studies showed no benefit of H. pylori eradication therapy on quality of life with an SMD of -0.01 [95%CI: -0.09 to 0.07, P = 0.74]. Four studies demonstrated that H. pylori eradication therapy reduced the development of peptic ulcer disease compared to no eradication therapy [RR = 0.34; 95%CI: 0.17-0.67, P = 0.002]. Three studies showed that H. pylori eradication therapy increased the likelihood of treatment-related side effects compared to no eradication therapy [RR = 1.87; 95%CI: 1.08-3.47, P = 0.02]. Ten studies demonstrated that patients who received H. pylori eradication therapy were more likely to obtain histologic resolution of chronic gastritis compared to those who did not receive eradication therapy [RR = 7.05; 95%CI: 3.59-13.74, P < 0.00001]
Conclusion: the decision to eradicate H. pylori in patients with functional dyspepsia requires individual assessment