ABSTRACT
Background: Cranioplasty in pediatrics is quite challenging and intricated. The ideal material for it is still debatable until now due to the limited study comparing autologous and implant grafts. This meta-analytic study was conducted to evaluate the risk of infection and revision in pediatric patients after autograft and implant cranioplasty. Methods: A systematic review and meta-analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A thorough literature search was conducted on PubMed, Cochrane, Scopus, and ScienceDirect database. Articles published from 2000 to 2021 were selected systematically using PRISMA based on the predetermined eligibility criteria. The relevant data were, then, analyzed and discussed. Results: A total of four publications investigating the outcome of autograft and implant cranioplasty were included and reviewed. Postoperative infection and revision rate after 126 cranioplasty procedures (both autograft or implant) from 119 patients below 21 years during time frame of study were analyzed. This meta-analysis study showed that the rate of infection and revision after cranioplasty were not different between the autograft and implant groups. Conclusion: Autograft and implant cranioplasty have no significant difference in postoperatively infection and revision rate. This study showed that cranioplasty using implant is a plausible option in pediatric patients with cranial defects, depending on the patients' condition due to similar outcome with autograft cranioplasty. Further studies with larger population and more specific details are necessary to determine the comparison of autograft and implant material in cranioplasty procedure.
ABSTRACT
Human breast milk contains numerous biomolecules. Human milk oligosaccharides (HMOs) are the third most abundant component of breast milk, after lactose and lipids. Amongst the synthetized HMOs, 2'-fucosyllactose (2'-FL) and lacto-N-neotetraose (LNnT) are widely studied and are considered safe for infant nutrition. Several studies have reported the health benefits of HMOs, which include modulation of the intestinal microbiota, anti-adhesive effect against pathogens, modulation of the intestinal epithelial cell response, and development of the immune system. The amount and diversity of HMOs are determined by the genetic background of the mothers (HMO secretors or non-secretors). The non-secretor mothers secrete lower HMOs than secretor mothers. The breastfed infants of secretor mothers gain more health benefit than those of non-secretor mothers. In conclusion, supplementation of infant formula with 2'-FL and LNnT is a promising innovation for infant nutrition.
ABSTRACT
The World Health Organization recommends that infants should be exclusively breastfed for the first 6 months of life to provide optimal nutrition in this critical period of life. After this, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years of age or beyond. For nonbreastfed infants, infant formula is an available option to provide the nutrition needed. Infant formula is usually prepared from industrially modified cow's milk and processed to adjust for the nutritional needs of infants. However, cow's milk is one of the most common causes of food allergy, affecting 2%-5% of all formula-fed infants during their first year of life. One strategy to prevent cow's milk allergy in nonbreastfed infants is the use of partially hydrolyzed formula (pHF) in high-risk infants, which are infants born in families with atopic disease. However, based on an epidemiological study, approximately half of the infants who develop allergy are not part of the at-risk group. This is because the non-at-risk group is significantly larger than the at-risk group and the non-at-risk infants have approximately 15% risk of developing allergies. This study aimed to evaluate the effects of partially hydrolyzed whey formula (pHF-W) in nonbreastfed infants and determine whether pHF-W can prevent atopic disease in high-risk infants and can be used as routine starter formula regardless of the allergy risk status.
