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.
Our Most Popular Resources
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.
Factors Associated With Lactation Outcomes Among Mothers of Infants With Congenital Heart Disease
Mothers of infants with CHD, especially primiparous or those with diabetes, should receive prenatal lactation education, prenatal access to breast pumps, and postnatal lactation support. Research should explore interventions to improve lactation outcomes among this group.
KEY FINDINGS: Mothers of infants with CHD, especially primiparous or those with diabetes, should receive prenatal lactation education, prenatal access to breast pumps, and postnatal lactation support. Research should explore interventions to improve lactation outcomes among this group.
BACKGROUND: The prevalence of mother's own milk (MOM) feeding among infants with congenital heart defects (CHD) is low. Objective of this study is to examine associations between maternal, infant, and clinical practice factors and lactation outcomes among mothers of infants with CHD during the first 14 days postpartum. Dyads were eligible if the infant was born at the institution and the mother provided MOM for feeding. Bivariate analyses, linear regression, and logistic regression analyses were performed.
DETAILS: Of the 93 mothers enrolled, 90 (96.8%) achieved secretory activation (SA), 45 (50%) achieved coming to volume (CTV), and 31 (34.4%) achieved full lactation. Mean time to SA was 92.17 ± 44.95 hours. Multiparity was associated with reduced time to SA by 32.93 hours (95% CI, -49.16 to 16.69; P < .001). A cubic increase in pumping frequency on days 3 to 5 inversely affected time to SA (P = .002). Multiparity was associated with a 3.35 (95% CI, 1.1201-9.366) higher odds of achieving CTV (P = .021) and diabetes with a 0.126 (95% CI, 0.032-0.492) lower odds (P = .003). Odds of reaching full lactation were lower in women with Medicaid insurance (0.333, 95% CI, 0.125-0.0886; P = 0.28) and those with diabetes (0.182, 95% CI, 0.307-0.905; P = .037) and higher in multiparous women (5.437, 95% CI, 1.538-19.217; P = .009).
Our Most Popular Resources
Copyright © The National Association of Neonatal Nurses. All rights reserved.
Source: Iapicca, L. C., Bendixen, M. M., Spatz, D. L., et al. Factors Associated With Lactation Outcomes Among Mothers of Infants With Congenital Heart Disease. Advances in Neonatal Care. 2025; 25(6): 607-616. Published: December, 2025. DOI: 10.1097/ANC.0000000000001315.
Effects of Continuous Glucose Monitoring on Impaired Awareness of Hypoglycemia in Older Adults With Type 1 Diabetes
In older adults with type 1 diabetes, CGM improves hypoglycemia; however, its role in improving IAH is variable, depending on the scoring method. This study highlights the limitations of the Clarke score.
Summary
A Post Hoc Analysis of the WISDM Study.
[Posted 28/Jan/2026]
AUDIENCE: Endocrinology, Nephrology
KEY FINDINGS: In older adults with type 1 diabetes, CGM improves hypoglycemia; however, its role in improving IAH is variable, depending on the scoring method. This study highlights the limitations of the Clarke score.
BACKGROUND: Although continuous glucose monitoring (CGM) reduces hypoglycemia and may improve impaired awareness of hypoglycemia (IAH), its effectiveness in older adults at high risk remains unknown.
DETAILS: This post hoc analysis of the WISDM study focuses on CGM use over 52 weeks. IAH was assessed using the Clarke original score (Clarke-full) and its subscales, Hypoglycemia Awareness Factor (HAF) and Severe Hypoglycemia Experienced Factors (SHEF), at baseline, 26 weeks, and 52 weeks. After 26 weeks (n = 184) and 52 weeks (n = 94) of CGM use, Clarke-SHEF decreased significantly (P = 0.02 and P < 0.0001, respectively), whereas Clarke-full and Clarke-HAF remained unchanged. After 52 weeks, Clarke-full but not Clarke-HAF improved in the IAH subgroup, highlighting the importance of selecting the appropriate scoring method for IAH.
Our Most Popular Resources
Copyright © American Diabetes Association. All rights reserved.
Source: Bilal, A., Yi, F., Whitaker, K., et al. Effects of Continuous Glucose Monitoring on Impaired Awareness of Hypoglycemia in Older Adults With Type 1 Diabetes: A Post Hoc Analysis of the WISDM Study. Diabetes Care . 2026; 49(1): 86-91. Published: January, 2026. DOI: 10.2337/dc25-0971.
Medical Management and Revascularization for Asymptomatic Carotid Stenosis
Among patients with high-grade stenosis without recent symptoms, the addition of stenting led to a lower risk of a composite of perioperative stroke or death or ipsilateral stroke within 4 years than intensive medical management alone. Carotid endarterectomy did not lead to a significant benefit.
KEY FINDINGS: Among patients with high-grade stenosis without recent symptoms, the addition of stenting led to a lower risk of a composite of perioperative stroke or death or ipsilateral stroke within 4 years than intensive medical management alone. Carotid endarterectomy did not lead to a significant benefit.
BACKGROUND: Improvements in medical therapy, carotid-artery stenting, and carotid endarterectomy call into question the preferred management of asymptomatic carotid stenosis. Whether adding revascularization to intensive medical management would provide greater benefit than intensive medical management alone is unclear.
DETAILS: Authors conducted two parallel, observer-blinded clinical trials that enrolled patients with high-grade (>=70%) asymptomatic carotid stenosis across 155 centers in five countries. The stenting trial compared intensive medical management alone (medical-therapy group) with carotid-artery stenting plus intensive medical management (stenting group); the endarterectomy trial compared intensive medical management alone (medical-therapy group) with carotid endarterectomy plus intensive medical management (endarterectomy group). The primary outcome was a composite of any stroke or death, assessed from randomization to 44 days, or ipsilateral ischemic stroke, assessed during the remaining follow-up period up to 4 years. A total of 1245 patients underwent randomization in the stenting trial and 1240 in the endarterectomy trial. In the stenting trial, the 4-year incidence of primary-outcome events was 6.0% (95% confidence interval [CI], 3.8 to 8.3) in the medical-therapy group and 2.8% (95% CI, 1.5 to 4.3) in the stenting group (P=0.02 for the absolute difference). In the endarterectomy trial, the 4-year incidence of primary-outcome events was 5.3% (95% CI, 3.3 to 7.4) in the medical-therapy group and 3.7% (95% CI, 2.1 to 5.5) in the endarterectomy group (P=0.24 for the absolute difference). From day 0 to 44, in the stenting trial, no strokes or deaths occurred in the medical-therapy group and seven strokes and one death occurred in the stenting group; in the endarterectomy trial, three strokes occurred in the medical-therapy group and nine strokes occurred in the endarterectomy group.
Our Most Popular Resources
Optical Feedback for Safe Automatic Laser Lithotripsy
The developed optical guidance system provides real-time feedback during laser lithotripsy, improving safety and precision by reducing the risk of accidental tissue damage. The proposed technology is expected to enhance outcomes in minimally invasive urological laser procedures.
Summary
Tissue Sensor Implementation in a Clinical System
[Posted 20/Jan/2026]
AUDIENCE: General Surgery, Nephrology, Internal Medicine
KEY FINDINGS: The developed optical guidance system provides real-time feedback during laser lithotripsy, improving safety and precision by reducing the risk of accidental tissue damage. The proposed technology is expected to enhance outcomes in minimally invasive urological laser procedures.
BACKGROUND: Purpose of this study is to develop an optical feedback system compatible with a commercial surgical laser for automatically distinguishing between urinary stones and soft tissues during laser lithotripsy, thereby enhancing procedural safety.
DETAILS: The system, based on diffuse reflectance spectroscopy (DRS), was implemented in an engineered clinical theranostic platform. In vivo experiments were conducted to collect and analyze DRS spectra of tissues during laser lithotripsy. Illumination was performed via the endoscope, and detection was performed via the treatment fiber. Classification of urinary stones and soft tissues was performed using machine learning methods, i.e., Principal Component Analysis (PCA) and Linear Discriminant Analysis (LDA). The system demonstrated high diagnostic performance, with 93% sensitivity for soft tissue identification and 93% specificity for stone detection evaluated by the LDA method. This real-time differentiation effectively minimized unintended laser exposure to non-target tissues.
Our Most Popular Resources
Copyright © Wiley Periodicals LLC. All rights reserved.
Source: Korneva, N., Budylin, G., Tseregorodtseva, P., et al. Optical Feedback for Safe Automatic Laser Lithotripsy: Tissue Sensor Implementation in a Clinical System. Lasers Surg. Med.. 2026; 58(1): 38-48. Published: January, 2026. DOI: 10.1002/lsm.70081.
Re-envisioning the Lifespan Approach to Cardiovascular Disease Prevention and Treatment in Women
The anticipated life course of women supports a broadening focus on CVD toward that of lifelong care and emphasize key transitional stages for women - early risk factor onset, pregnancy, menopausal transition, and so on. This review is a call to action to re-envision a health system approach for lifespan prevention, detection, and treatment pathways to reduce CVD risk in women.
KEY FINDINGS:
- Mortality: CVD deaths in women exceed combined deaths from breast and lung diseases.
- Gap in Care: Insufficient sex-specific evidence continues to hinder lifesaving care.
- Call to Action: Transition from episodic care to a lifelong cardiovascular health system for women.
BACKGROUND: Despite the common misconception that respiratory or oncological diseases pose the greatest threat to women, Cardiovascular Disease (CVD) accounts for more female deaths than breast cancer, lung cancer, and chronic lung disease combined, with a comparable mortality to that of men. Historically, both the public and the medical community have underestimated CVD risks in women, leading to diagnostic delays and a scarcity of sex-specific evidence to guide clinical interventions. While advances have been made in the diagnosis, treatment and outcomes of CVD in women, there often remains insufficient evidence to guide effective, lifesaving care of women.
DETAILS: This review of sex-specific and traditional CVD risk and risk-enhancing factors in women identifies areas of knowledge gaps to consider for investigation. A focus on the coronary vasculature reveals physiological differences of clinical relevance which can be interrogated. Inspection of and addressing disadvantage and gender bias in both the medical and lay communities should continue to be addressed. As CVD results from traditional risk factors and emerging risk-enhancing factors, a focus on the detection of preclinical cardiovascular disease may be of particular importance for women. Unique risk markers originate early in pre-menopausal women, as this is considered a healthy period of life. Awareness and implementation of the existing knowledge of sex-specific risk factors and sex-specific thresholds to educate women and physicians are needed. The anticipated life course of women supports a broadening focus on CVD toward that of lifelong care and emphasize key transitional stages for women-early risk factor onset, pregnancy, menopausal transition, and so on. This review is a call to action to re-envision a health system approach for lifespan prevention, detection, and treatment pathways to reduce CVD risk in women.
Our Most Popular Resources
Specialty: