Intra-amniotic Candida albicans Infection Treated With Liposomal Amphotericin B With a Successful Neonatal Outcome.

Intra-amniotic infection with Candida species is an uncommon but severe condition with high fetal morbimortality and no established clinical guidelines for its management. We report a Candida albicans intra-amniotic infection diagnosed in a 25-week pregnant woman, successfully treated with high-dose liposomal amphotericin B. Pregnancy was prolonged until 30 weeks, and despite persistently positive Candida cultures in amniotic fluid, a healthy newborn was delivered without evidence of systemic infection. Amphotericin concentration was determined at birth, revealing levels over 30 times higher in mother's and cord blood than in the amniotic fluid, probably explaining the clinical protection despite failure in obtaining fungal clearance.

How the training of ultrasonographers influences the certainty of prenatal detection of congenital malformations of interest to the pediatric surgeon.

BACKGROUND: The training needed for doing obstetric ultrasounds is rarely reported. The aim of this study was to determine whether the training of the ultrasonographer influences the prenatal diagnostic certainty of some congenital malformations. METHODS: We conducted a retrospective evaluation of antepartum sonographic findings of newborn infants found ultimately to have a congenital anomaly in a tertiary level pediatric reference center. Data were collected on admission for consecutive patients at a tertiary-level pediatric reference center. The mother´s pregnancy and birth demographic variables and those of the prenatal ultrasound (PUS) were analyzed and correlated with the final diagnosis. RESULTS: Sixty-seven neonates were included. All cases underwent PUS with a mean of 4.6. Prenatal diagnosis was established in 24 cases (35.8%). Thirteen surgical anomalies were detected, particularly anorectal malformation and gastroschisis. The accuracy of PUS was associated with the training of the physician performing the PUS, whereby PUS with the greatest accuracy were performed by gynecologists and maternal-fetal specialists against radiologists and general practitioners (p = 0.005). Patients without an accurate prenatal diagnosis had a greater risk of presenting comorbidities (relative risk [RR]: 1.65, p = < 0.001, 95% confidence interval [CI]: 1.299-2.106). CONCLUSIONS: In our setting, prenatal diagnosis of these malformations is directly determined by the training of the person performing the ultrasound.

INTRODUCCIÓN: Con poca frecuencia se ha reportado el entrenamiento necesario para realizar ultrasonido (US) obstétrico. El objetivo de este estudio fue determinar si el entrenamiento del ultrasonografista influye en la certeza del diagnóstico prenatal de algunas malformaciones congénitas. MÉTODOS: Se llevó a cabo una evaluación retrospectiva de los hallazgos ultrasonográficos prenatales de neonatos que tuvieron malformaciones congénitas en un hospital de referencia pediátrico de tercer nivel. Se realizó al ingreso de neonatos consecutivos en un hospital de referencia de tercer nivel. Se recolectaron y analizaron datos del embarazo y alumbramiento, así como los de los ultrasonidos prenatales (USP) correlacionando con el diagnóstico final. RESULTADOS: Se incluyeron 67 neonatos. Todos tuvieron USP con media de 4.6. Se realizó diagnóstico prenatal en 24 casos (35.8%). Se detectaron 13 malformaciones congénitas, predominando malformación anorectal gastrosquisis. La certeza del USP se asoció con el entrenamiento del individuo que realizó el US y la mayor certeza se encontró cuando lo realizaron ginecólogos y especialistas materno-fetales contra radiólogos y médicos generales (p = 0.005). Los pacientes sin diagnóstico prenatal certero tuvieron mayor riesgo de presentar comorbilidades (riesgo relativo [RR]: 1.65, p = < 0.001, 95% intervalo de confianza [CI]: 1.299-2.106). CONCLUSIONES: En nuestro medio, el diagnóstico prenatal de estas malformaciones está determinado directamente por el entrenamiento de la persona que realiza el ultrasonido.

How the training of ultrasonographers influences the certainty of prenatal detection of congenital malformations of interest to the pediatric surgeon / Cómo el entrenamiento del ultrasonografista influye en la certeza de la detección prenatal de malformaciones congénitas de interés para el cirujano pediatra

Abstract Background: The training needed for doing obstetric ultrasounds is rarely reported. The aim of this study was to determine whether the training of the ultrasonographer influences the prenatal diagnostic certainty of some congenital malformations. Methods: We conducted a retrospective evaluation of antepartum sonographic findings of newborn infants found ultimately to have a congenital anomaly in a tertiary level pediatric reference center. Data were collected on admission for consecutive patients at a tertiary-level pediatric reference center. The mother´s pregnancy and birth demographic variables and those of the prenatal ultrasound (PUS) were analyzed and correlated with the final diagnosis. Results: Sixty-seven neonates were included. All cases underwent PUS with a mean of 4.6. Prenatal diagnosis was established in 24 cases (35.8%). Thirteen surgical anomalies were detected, particularly anorectal malformation and gastroschisis. The accuracy of PUS was associated with the training of the physician performing the PUS, whereby PUS with the greatest accuracy were performed by gynecologists and maternal-fetal specialists against radiologists and general practitioners (p = 0.005). Patients without an accurate prenatal diagnosis had a greater risk of presenting comorbidities (relative risk [RR]: 1.65, p = < 0.001, 95% confidence interval [CI]: 1.299-2.106). Conclusions: In our setting, prenatal diagnosis of these malformations is directly determined by the training of the person performing the ultrasound.

Resumen Introducción: Con poca frecuencia se ha reportado el entrenamiento necesario para realizar ultrasonido (US) obstétrico. El objetivo de este estudio fue determinar si el entrenamiento del ultrasonografista influye en la certeza del diagnóstico prenatal de algunas malformaciones congénitas. Métodos: Se llevó a cabo una evaluación retrospectiva de los hallazgos ultrasonográficos prenatales de neonatos que tuvieron malformaciones congénitas en un hospital de referencia pediátrico de tercer nivel. Se realizó al ingreso de neonatos consecutivos en un hospital de referencia de tercer nivel. Se recolectaron y analizaron datos del embarazo y alumbramiento, así como los de los ultrasonidos prenatales (USP) correlacionando con el diagnóstico final. Resultados: Se incluyeron 67 neonatos. Todos tuvieron USP con media de 4.6. Se realizó diagnóstico prenatal en 24 casos (35.8%). Se detectaron 13 malformaciones congénitas, predominando malformación anorectal gastrosquisis. La certeza del USP se asoció con el entrenamiento del individuo que realizó el US y la mayor certeza se encontró cuando lo realizaron ginecólogos y especialistas materno-fetales contra radiólogos y médicos generales (p = 0.005). Los pacientes sin diagnóstico prenatal certero tuvieron mayor riesgo de presentar comorbilidades (riesgo relativo [RR]: 1.65, p = < 0.001, 95% intervalo de confianza [CI]: 1.299-2.106). Conclusiones: En nuestro medio, el diagnóstico prenatal de estas malformaciones está determinado directamente por el entrenamiento de la persona que realiza el ultrasonido.

Feasibility of Valorization of Post-Consumer Recycled Flexible Polypropylene by Adding Fumed Nanosilica for Its Potential Use in Food Packaging toward Sustainability.

The food industry has a current challenge of increasing the recycling of post-consumer plastics to reduce plastic waste towards a circular economy, especially flexible polypropylene, which is highly demanded in food packaging. However, recycling post-consumer plastics is limited because service life and reprocessing degrade their physical-mechanical properties and modify the migration of components from the recycled material to the food. This research evaluated the feasibility of valorization of post-consumer recycled flexible polypropylene (PCPP) by incorporating fumed nanosilica (NS). For this purpose, the effect of concentration and type (hydrophilic and hydrophobic) of NS on the morphological, mechanical, sealing, barrier and overall migration properties of PCPP films was studied. Incorporating NS improved Young's modulus and, more significantly, tensile strength at 0.5 wt% and 1 wt%, where a better particle dispersion was confirmed by EDS-SEM, but it diminished elongation at breakage of the films. Interestingly, NS tended to increase the seal strength of PCPP nanocomposite films more significantly at higher NS content, showing a seal failure of the adhesive peel type which is preferred for flexible packaging. NS at 1 wt% did not affect the water vapor and oxygen permeabilities of the films. Overall migration of PCPP and nanocomposites exceeded the limit value of 10 mg dm-2 allowed by European legislation at the studied concentrations of 1% and 4 wt%. Nonetheless, NS reduced the overall migration of PCPP from 17.3 to 15 mg dm-2 in all nanocomposites. In conclusion, PCPP with 1 wt% of hydrophobic NS presented an improved overall performance of the studied packaging properties.

Developing Post-Consumer Recycled Flexible Polypropylene and Fumed Silica-Based Nanocomposites with Improved Processability and Thermal Stability.

Collection and mechanical recycling of post-consumer flexible polypropylene packaging is limited, principally due to polypropylene being very light-weight. Moreover, service life and thermal-mechanical reprocessing degrade PP and change its thermal and rheological properties according to the structure and provenance of recycled PP. This work determined the effect of incorporating two fumed nanosilica (NS) types on processability improvement of post-consumer recycled flexible polypropylene (PCPP) through ATR-FTIR, TGA, DSC, MFI and rheological analysis. Presence of trace polyethylene in the collected PCPP increased the thermal stability of the PP and was significantly maximized by NS addition. The onset decomposition temperature raised around 15 °C when 4 and 2 wt% of a non-treated and organically modified NS were used, respectively. NS acted as a nucleating agent and increased the crystallinity of the polymer, but the crystallization and melting temperatures were not affected. The processability of the nanocomposites was improved, observed as an increase in viscosity, storage and loss moduli with respect to the control PCPP, which were deteriorated due to chain scission during recycling. The highest recovery in viscosity and reduction in MFI were found for the hydrophilic NS due to a greater impact of hydrogen bond interactions between the silanol groups of this NS and the oxidized groups of the PCPP.

Iridium-Catalyzed ortho-Selective Borylation of Aromatic Amides Enabled by 5-Trifluoromethylated Bipyridine Ligands.

Iridium-catalyzed borylations of aromatic C-H bonds are highly attractive transformations because of the diversification possibilities offered by the resulting boronates. These transformations are best carried out using bidentate bipyridine or phenanthroline ligands, and tend to be governed by steric factors, therefore resulting in the competitive functionalization of meta and/or para positions. We have now discovered that a subtle change in the bipyridine ligand, namely, the introduction of a CF3 substituent at position 5, enables a complete change of regioselectivity in the borylation of aromatic amides, allowing the synthesis of a wide variety of ortho-borylated derivatives. Importantly, thorough computational studies suggest that the exquisite regio- and chemoselectivity stems from unusual outer-sphere interactions between the amide group of the substrate and the CF3 -substituted aryl ring of the bipyridine ligand.

Is colostomy closure without mechanical bowel preparation safe in pediatric patients? A randomized clinical trial.

BACKGROUND: Mechanical bowel preparation (MBP) is largely used worldwide prior to colostomy closure in children, although its benefits are questioned by scientific evidence, and its use can cause adverse reactions. We hypothesized that colostomy closure procedures in children are not associated with increased complications (surgical site infection [SSI] and anastomotic leakage) when performed without MBP. Thus, we conducted a noninferiority trial to compare the safety and efficacy of colostomy takedown with and without MBP. METHODS: A randomized noninferiority clinical trial was conducted at Hospital Infantil de Mexico in Mexico City from 2015 to 2019, in which the experimental group did not receive MBP prior to colostomy closure. A total of 79 patients were analyzed, and the primary outcomes were safety-related. Data were analyzed using the chi-squared test, Student's t-test, or Mann-Whitney U test as appropriate. RESULTS: The demographics in both groups were comparable. Statistical analysis revealed equivalence in safety outcomes (superficial SSI, 22.5% vs 15.3% p = 0.420; deep SSI, 7.5% vs 0% p = 0.081; reoperation, p = 0.320; intestinal occlusion, p = 0.986); no anastomotic leakage was observed in any group. Secondary outcomes such as fasting time and length of hospital stay after surgery were also similar between the groups. However, patients who received MBP were admitted 2 days before surgery. CONCLUSIONS: Our findings indicate that withholding MBP prior to colostomy takedowns in children is not associated with increased complications. Omitting MBP also leads to less discomfort and shortens hospital length of stay, suggesting that it has safer and more effective procedures. LEVEL OF EVIDENCE: Randomized controlled clinical trial with adequate statistical power.

Hollow Iron Oxide Nanospheres Obtained through a Combination of Atomic Layer Deposition and Electrospraying Technologies.

In the present study, we report on the successful synthesis of hollow iron oxide nanospheres. The hollow Fe3O4 nanospheres were synthesized following a four-step procedure: electrospraying spherical PVP particles, coating these particles with alumina (Al2O3) and hematite (Fe2O3) through atomic layer deposition and, finally, a thermal reduction process to degrade the polymer (PVP) and convert hematite (Fe2O3) into magnetite (Fe3O4). A structural analysis using X-ray diffraction (XRD) confirmed the effectiveness of the thermal reduction process. A morphological analysis confirmed that the four-step procedure allowed for the obtainment of hollow iron oxide nanospheres, even though the reduction process caused a contraction in the diameter of the particles of almost 300 nm, but did not affect the thickness of the walls of the hollow spheres that remained at approximately 15 nm. Magnetic properties of the hollow iron oxide nanospheres enable their use in applications where the agglomeration of magnetic nanostructures in liquid media is commonly not allowed, such as in drug encapsulation and delivery.

Electrospinning and cyclodextrin inclusion complexes: An emerging technological combination for developing novel active food packaging materials.

This review was focused on describing the combination of electrospinning and cyclodextrin inclusion complexes as one of the newest alternatives for the development of food packaging materials with antimicrobial and/or antioxidant properties. The advantages of this technological combination, the routes to design the active materials, the characterization and application of such materials were reviewed. Electrospinning has allowed developing active packaging materials composed by fibrillary structures with a high ratio surface-to-volume. On the other hand, cyclodextrin inclusion complexes have maintained the properties of active compounds when they have been incorporated in packaging materials. Both methods have been recently combined and novel active food packaging materials have been obtained through three different routes. Polymeric solutions containing preformed (route 1) or in-situ formed (route 2) cyclodextrin inclusion complexes have been electrospun to obtain packaging materials. Furthermore, cyclodextrin inclusion complexes solutions have been directly electrospun (route 3) in order to produce those materials. The developed packaging materials have exhibited a high active compound loading with a long lasting release. Therefore, the protection of different foodstuff against microbial growth, oxidation and quality decay as well as the maintenance of their physical and sensory properties have been achieved when those materials were applied as active packaging.

Active PLA Packaging Films: Effect of Processing and the Addition of Natural Antimicrobials and Antioxidants on Physical Properties, Release Kinetics, and Compostability.

The performance characteristics of polylactic acid (PLA) as an active food packaging film can be highly influenced by the incorporation of active agents (AAs) into PLA, and the type of processing technique. In this review, the effect of processing techniques and the addition of natural AAs on the properties related to PLA performance as a packaging material are summarized and described through a systematic analysis, giving new insights about the relation between processing techniques, types of AA, physical-mechanical properties, barriers, optical properties, compostability, controlled release, and functionalities in order to contribute to the progress made in designing antioxidant and antimicrobial PLA packaging films. The addition of AAs into PLA films affected their optical properties and influenced polymer chain reordering, modifying their thermal properties, functionality, and compostability in terms of the chemical nature of AAs. The mechanical and barrier performance of PLA was affected by the AA's dispersion degree and crystallinity changes resulting from specific processing techniques. In addition, hydrophobicity and AA concentration also modified the barrier properties of PLA. The release kinetics of AAs from PLA were tuned, modifying diffusion coefficient of the AAs in terms of the different physical properties of the films that resulted from specific processing techniques. Several developments based on the incorporation of antimicrobial and antioxidant substances into PLA have displayed outstanding activities for food protection against microbial growth and oxidation.

Natural antimicrobials and antioxidants added to polylactic acid packaging films. Part I: Polymer processing techniques.

Currently, reducing packaging plastic waste and food losses are concerning topics in the food packaging industry. As an alternative for these challenges, antimicrobial and antioxidant materials have been developed by incorporating active agents (AAs) into biodegradable polymers to extend the food shelf life. In this context, developing biodegradable active materials based on polylactic acid (PLA) and natural compounds are a great alternative to maintain food safety and non-toxicity of the packaging. AAs, such as essential oils and polyphenols, have been added mainly as antimicrobial and antioxidant natural compounds in PLA packaging. In this review, current techniques used to develop active PLA packaging films were described in order to critically compare their feasibility, advantages, limitations, and relevant processing aspects. The analysis was focused on the processing conditions, such as operation variables and stages, and factors related to the AAs, such as their concentrations, weight losses during processing, and incorporation technique, among others. Recent developments of active PLA-based monolayers and bi- or multilayer films were also considered. In addition, patents on inventions and technologies on active PLA-based films for food packaging were reviewed. This review highlights that the selection of the processing technique and conditions to obtain active PLA depends on the type of the AA regarding its volatility, solubility, and thermosensitivity.

Transition Metal-Promoted Reactions in Aqueous Media and Biological Settings.

During the last decade, there has been a tremendous interest for developing non-natural biocompatible transformations in biologically relevant media. Among the different encountered strategies, the use of transition metal complexes offers unique possibilities due to their high transformative power. However, translating the potential of metal catalysts to biological settings, including living cells or small-animal models such as mice or zebrafish, poses numerous challenges associated to their biocompatibility, and their stability and reactivity in crowded aqueous environments. Herein, we describe the most relevant advances in this direction, with a particular emphasis on the systems' structure, their mode of action and the mechanistic bases of each transformation. Thus, the key challenges from an organometallic perspective might be more easily identified.

Antimicrobial metal-based nanoparticles: a review on their synthesis, types and antimicrobial action.

The investigation of novel nanoparticles with antimicrobial activity has grown in recent years due to the increased incidence of nosocomial infections occurring during hospitalization and food poisoning derived from foodborne pathogens. Antimicrobial agents are necessary in various fields in which biological contamination occurs. For example, in food packaging they are used to control food contamination by microbes, in the medical field the microbial agents are important for reducing the risk of contamination in invasive and routine interventions, and in the textile industry, they can limit the growth of microorganisms due to sweat. The combination of nanotechnology with materials that have an intrinsic antimicrobial activity can result in the development of novel antimicrobial substances. Specifically, metal-based nanoparticles have attracted much interest due to their broad effectiveness against pathogenic microorganisms due to their high surface area and high reactivity. The aim of this review was to explore the state-of-the-art in metal-based nanoparticles, focusing on their synthesis methods, types, and their antimicrobial action. Different techniques used to synthesize metal-based nanoparticles were discussed, including chemical and physical methods and "green synthesis" methods that are free of chemical agents. Although the most studied nanoparticles with antimicrobial properties are metallic or metal-oxide nanoparticles, other types of nanoparticles, such as superparamagnetic iron-oxide nanoparticles and silica-releasing systems also exhibit antimicrobial properties. Finally, since the quantification and understanding of the antimicrobial action of metal-based nanoparticles are key topics, several methods for evaluating in vitro antimicrobial activity and the most common antimicrobial mechanisms (e.g., cell damage and changes in the expression of metabolic genes) were discussed in this review.

Antimicrobial Bilayer Nanocomposites Based on the Incorporation of As-Synthetized Hollow Zinc Oxide Nanotubes.

An antimicrobial polymeric bilayer structure based on the application of an acrylic coating containing hollow zinc oxide nanotubes over a polymeric substrate was developed in this work. Firstly, zinc oxide nanotubes (ZnONT) were obtained by an atomic layer deposition (ALD) process over electrospun polyvinyl alcohol nanofibers followed by polymer removal through calcination with the purpose of obtaining antimicrobial nanostructures with a high specific area. Parameters of electrospinning, ALD, and calcination processes were set in order to obtain successfully hollow zinc oxide nanotubes. Morphological studies through scanning electron microscopy (SEM) and transmission electron microscopy (TEM) microscopies confirmed the morphological structure of ZnONT with an average diameter of 180 nm and thickness of approximately 60 nm. Thermal and X-ray diffraction (XRD) analyses provided evidence that calcination completely removed the polymer, resulting in a crystalline hexagonal wurtzite structure. Subsequently, ZnONT were incorporated into a polymeric coating over a polyethylene extruded film at two concentrations: 0.5 and 1 wt. % with respect to the polymer weight. An antimicrobial analysis of developed antimicrobial materials was performed following JIS Z2801 against Staphylococcus aureus and Escherichia coli. When compared to active materials containing commercial ZnO nanoparticles, materials containing ZnONT presented higher microbial inhibition principally against Gram-negative bacteria, whose reduction was total for films containing 1 wt. % ZnONT. Antiviral studies were also performed, but these materials did not present significant viral reduction.

Intracellular Reactions Promoted by Bis(histidine) Miniproteins Stapled Using Palladium(II) Complexes.

The generation of catalytically active metalloproteins inside living mammalian cells is a major research challenge at the interface between catalysis and cell biology. Herein we demonstrate that basic domains of bZIP transcription factors, mutated to include two histidine residues at i and i+4 positions, react with palladium(II) sources to generate catalytically active, stapled pallado-miniproteins. The resulting constrained peptides are efficiently internalized into living mammalian cells, where they perform palladium-promoted depropargylation reactions without cellular fixation. Control experiments confirm the requirement of the peptide scaffolding and the palladium staple for attaining the intracellular reactivity.

Ruthenium-Catalyzed Redox Isomerizations inside Living Cells.

Tailored ruthenium(IV) complexes can catalyze the isomerization of allylic alcohols into saturated carbonyl derivatives under physiologically relevant conditions, and even inside living mammalian cells. The reaction, which involves ruthenium-hydride intermediates, is bioorthogonal and biocompatible, and can be used for the "in cellulo" generation of fluorescent and bioactive probes. Overall, our research reveals a novel metal-based tool for cellular intervention, and comes to further demonstrate the compatibility of organometallic mechanisms with the complex environment of cells.

A Gastroschisis bundle: effects of a quality improvement protocol on morbidity and mortality.

OBJECTIVE: Gastroschisis incidence is rising. Survival in developed countries is over 95%. However, in underdeveloped countries, mortality is higher than 15% often due to sepsis. The aim of this study was to evaluate the effect on morbidity and mortality of a Quality Improvement Protocol for out-born gastroschisis patients. METHODS: The protocol consisted in facilitating transport, primary or staged reduction at the bedside and sutureless closure, without anesthesia, PICC lines and early feeding. Data was prospectively collected for the Protocol Group (PG) treated between June 2014 through March 2016 and compared to the last consecutive patients Historical Group (HG). Primary outcome was mortality. SECONDARY OUTCOMES: need for and duration of mechanical ventilation (MV), time to first feed (TFF) after closure, parenteral nutrition (TPN), length of stay (LOS) and sepsis. Data were analyzed using χ2 and Mann-Whitney U tests. RESULTS: 92 patients were included (46 HG and 46 PG). Demographic data were homogeneous. Mortality decreased from 22% to 2% (p = 0.007). Mechanical ventilation use decreased from 100% to 57% (p = <0.001), ventilator days from 14 to 3 median days (p = <0.0001), TPN days: 27 to 21 median days (p = 0.026), sepsis decreased from 70% to 37% (p = 0.003) and anesthesia from a 100% to 15% (p = <0.001), respectively. No difference was found in NPO or LOS. CONCLUSION: A major improvement in the morbidity and mortality rates was achieved, with outcomes comparable to those reported in developed countries. It was suitable for all patients with gastroschisis. We believe this protocol can be implemented in other centers to reduce morbidity and mortality. LEVEL OF EVIDENCE: III.

Concurrent and orthogonal gold(I) and ruthenium(II) catalysis inside living cells.

The viability of building artificial metabolic pathways within a cell will depend on our ability to design biocompatible and orthogonal catalysts capable of achieving non-natural transformations. In this context, transition metal complexes offer unique possibilities to develop catalytic reactions that do not occur in nature. However, translating the potential of metal catalysts to living cells poses numerous challenges associated to their biocompatibility, and their stability and reactivity in crowded aqueous environments. Here we report a gold-mediated C-C bond formation that occurs in complex aqueous habitats, and demonstrate that the reaction can be translated to living mammalian cells. Key to the success of the process is the use of designed, water-activatable gold chloride complexes. Moreover, we demonstrate the viability of achieving the gold-promoted process in parallel with a ruthenium-mediated reaction, inside living cells, and in a bioorthogonal and mutually orthogonal manner.

Predictive value of procalcitonin for intestinal ischemia and/or necrosis in pediatric patients with adhesive small bowel obstruction (ASBO).

PURPOSE: Evaluate serum procalcitonin (PCT) level as a predictor of intestinal ischemia or necrosis (IN) in patients with postoperative adhesive small bowel obstruction (ASBO). METHODS: Prospective cohort of consecutive patients with ASBO. Patients previously treated with antibiotics or septic were excluded. PCT was measured at the diagnosis of ASBO and every 24 h afterwards. MAIN OUTCOME: intestinal ischemia or necrosis (IN). RESULTS: Fifty-nine patients were included, 12 of whom were excluded; 47 patients remained in the study; male-to-female ratio = 1.9:1. MANAGEMENT: medical in 15 cases (32%) and surgical in 32 (68%). MAIN OUTCOME: Intestinal necrosis (IN) in 10 patients (21.3%). Mean PCT level was higher in patients with IN (15.11 ng/ml vs. 0.183 ng/ml, p=0.002), the proportion of patients with elevated PCT (>0.5 ng/dl) was higher in patients with IN (70% vs. 8.1%, p=<0.001, RR=26.4 with a 95% CI of 4.39-159.5). Elevated PCT levels at diagnosis had a 70% positive predictive value (PPV) and 91.8% negative predictive value (NPV) for prediction of IN. With a PCT value at diagnosis of >1.0 ng/dl, PPV was 87.5% and NPV, 92.3%. CONCLUSIONS: PCT levels are closely related to the presence of intestinal ischemia and necrosis in children with ASBO. LEVEL OF EVIDENCE: Study of Diagnostic Test, Level II.