ABSTRACT
Parenteral nutrition (PN) prevents starvation and supports metabolic requirements intravenously when patients are unable to be fed enterally. Clinically, infants are frequently provided PN in intensive care settings along with exposure to antibiotics (ABX) to minimize infection during care. Unfortunately, neonates experience extremely high rates of hepatic complications. Adult rodent and piglet models of PN are well-established but neonatal models capable of leveraging the considerable transgenic potential of the mouse remain underdeveloped. Utilizing our newly established neonatal murine PN mouse model, we administered ABX or controlled drinking water to timed pregnant dams to disrupt the maternal microbiome. We randomized mouse pups to PN or sham surgery controls +/- ABX exposure. ABX or short-term PN decreased liver and brain organ weights, intestinal length, and mucosal architecture (vs. controls). PN significantly elevated evidence of hepatic proinflammatory markers, neutrophils and macrophage counts, bacterial colony-forming units, and evidence of cholestasis risk, which was blocked by ABX. However, ABX uniquely elevated metabolic regulatory genes resulting in accumulation of hepatocyte lipids, triglycerides, and elevated tauro-chenoxycholic acid (TCDCA) in serum. Within the gut, PN elevated the relative abundance of Akkermansia, Enterococcus, and Suterella with decreased Anaerostipes and Lactobacillus compared with controls, whereas ABX enriched Proteobacteria. We conclude that short-term PN elevates hepatic inflammatory stress and risk of cholestasis in early life. Although concurrent ABX exposure protects against hepatic immune activation during PN, the dual exposure modulates metabolism and may contribute toward early steatosis phenotype, sometimes observed in infants unable to wean from PN.NEW & NOTEWORTHY This study successfully established a translationally relevant, murine neonatal parenteral nutrition (PN) model. Short-term PN is sufficient to induce hepatitis-associated cholestasis in a neonatal murine model that can be used to understand disease in early life. The administration of antibiotics during PN protects animals from bacterial translocation and proinflammatory responses but induces unique metabolic shifts that may predispose the liver toward early steatosis.
Subject(s)
Cholestasis , Fatty Liver , Swine , Adult , Infant , Female , Pregnancy , Animals , Humans , Mice , Anti-Bacterial Agents/pharmacology , Disease Models, Animal , Parenteral Nutrition, Total , Homeostasis , Animals, Genetically ModifiedABSTRACT
This article contrasts two very different experiences of one mother breastfeeding her two sons to demonstrate the potential impact of ankyloglossia on breastfeeding. When too restrictive, ankyloglossia, also known as tongue-tie, can cause the newborn to ineffectively suckle at the breast. Breastfeeding difficulties can occur, such as long feedings or damaged nipples. When nurses, lactation consultants and other providers recognize this situation, they can refer women for further care and treatment, which can ultimately lead to breastfeeding success.
Subject(s)
Breast Feeding/adverse effects , Lingual Frenum/surgery , Mouth Abnormalities/complications , Nipples/injuries , Sucking Behavior/physiology , Ankyloglossia , Breast Feeding/methods , Female , Humans , Infant Behavior , Infant Nutritional Physiological Phenomena , Infant, Newborn , Male , Mothers/education , Mouth Abnormalities/diagnosis , Mouth Abnormalities/epidemiology , Mouth Abnormalities/surgery , Nursing Assessment , Sex Factors , Social SupportABSTRACT
The field of nursing offers a wide variety of roles and opportunities. Nurses seek to change jobs for several reasons, including burnout, work/life balance and personal growth. This article offers suggestions for making a smooth transition to a new job, including how to research the market, network and write an effective resume.
