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Veterinary Journal (London, England :... Apr 2011The aim of this prospective study was to establish a protocol for fast localised abdominal sonography of horses (FLASH) admitted for colic. The FLASH protocol was then...
The aim of this prospective study was to establish a protocol for fast localised abdominal sonography of horses (FLASH) admitted for colic. The FLASH protocol was then presented to clinicians without extensive ultrasound (US) experience to determine whether they could learn to use it in less than 15 min. The clinical subjects comprised 36 horses that had been referred for colic over a 2 month period. Each horse was examined at admission and FLASH findings at seven topographical locations were compared to serial clinical examinations, surgical and non-surgical outcomes, or with post-mortem reports. FLASH was able to show free abdominal fluid and abnormal intestinal loops, with a mean time of 10.7 min required to complete the protocol. The positive and negative predictive values of requirement for surgery of dilated turgid small intestinal loops using FLASH were 88.89% and 81.48%, respectively. The results suggested that FLASH is a technique that can be used in an emergency setting by veterinarians without extensive US experience to detect major intra-abdominal abnormalities in horses with colic.
Topics: Abdomen; Animals; Ascitic Fluid; Colic; Female; Horse Diseases; Horses; Intestine, Small; Male; Predictive Value of Tests; Prospective Studies; Ultrasonography
PubMed: 20347357
DOI: 10.1016/j.tvjl.2010.02.017 -
Gastroenterology Clinics of North... Dec 2018Infant colic is a characteristic group of behaviors seen in young infants. The most prominent feature is prolonged crying. Additional characteristics, including... (Review)
Review
Infant colic is a characteristic group of behaviors seen in young infants. The most prominent feature is prolonged crying. Additional characteristics, including clenching of the fists and flexion of the hips, have led to the suggestion that these behaviors are related to abdominal discomfort. In this article, we show emerging evidence to support the concept that infant colic could represent gut inflammation and microbial dysbiosis that impacts brain function and even brain development.
Topics: Colic; Crying; Humans; Infant; Infant, Newborn
PubMed: 30337035
DOI: 10.1016/j.gtc.2018.07.008 -
Pediatrics Jan 2018DSM17938 has shown promise in managing colic, but conflicting study results have prevented a consensus on whether it is truly effective. (Meta-Analysis)
Meta-Analysis Review
CONTEXT
DSM17938 has shown promise in managing colic, but conflicting study results have prevented a consensus on whether it is truly effective.
OBJECTIVE
Through an individual participant data meta-analysis, we sought to definitively determine if DSM17938 effectively reduces crying and/or fussing time in infants with colic and whether effects vary by feeding type.
DATA SOURCES
We searched online databases (PubMed, Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature, the Database of Abstracts of Reviews of Effects, and Cochrane), e-abstracts, and clinical trial registries.
STUDY SELECTION
These were double-blind randomized controlled trials (published by June 2017) of DSM17398 versus a placebo, delivered orally to infants with colic, with outcomes of infant crying and/or fussing duration and treatment success at 21 days.
DATA EXTRACTION
We collected individual participant raw data from included studies modeled simultaneously in multilevel generalized linear mixed-effects regression models.
RESULTS
Four double-blind trials involving 345 infants with colic (174 probiotic and 171 placebo) were included. The probiotic group averaged less crying and/or fussing time than the placebo group at all time points (day 21 adjusted mean difference in change from baseline [minutes] -25.4 [95% confidence interval (CI): -47.3 to -3.5]). The probiotic group was almost twice as likely as the placebo group to experience treatment success at all time points (day 21 adjusted incidence ratio 1.7 [95% CI: 1.4 to 2.2]). Intervention effects were dramatic in breastfed infants (number needed to treat for day 21 success 2.6 [95% CI: 2.0 to 3.6]) but were insignificant in formula-fed infants.
LIMITATIONS
There were insufficient data to make conclusions for formula-fed infants with colic.
CONCLUSIONS
DSM17938 is effective and can be recommended for breastfed infants with colic. Its role in formula-fed infants with colic needs further research.
Topics: Abdominal Pain; Administration, Oral; Colic; Crying; Double-Blind Method; Female; Humans; Infant; Infant, Newborn; Limosilactobacillus reuteri; Male; Probiotics; Prognosis; Randomized Controlled Trials as Topic; Severity of Illness Index; Treatment Outcome
PubMed: 29279326
DOI: 10.1542/peds.2017-1811 -
Journal of Veterinary Emergency and... Jan 2022Interpreting changes in peritoneal fluid helps clinicians manage colic and other diseases in horses. During abdominal problems in the horse, abdominal fluid...
BACKGROUND
Interpreting changes in peritoneal fluid helps clinicians manage colic and other diseases in horses. During abdominal problems in the horse, abdominal fluid characteristics such as color, turbidity, total nucleated and red blood cell counts, cytology, total protein, and l-lactate change in predictable ways, helping the clinician characterize the disease.
DESCRIPTION
Normal abdominal fluid in horses is odorless, clear to light yellow in color, and transparent. Peritoneal fluid becomes more turbid with increasing levels of protein, number of WBCs or RBCs, or with gross contamination following intestinal rupture. The color of abdominal fluid will also change with the type and quantity of cells or other elements present. The transformation of peritoneal fluid color from golden to orange to red represents increasing levels of RBCs, common with strangulating intestinal lesions. Serosanguinous defines fluid that is both turbid and orange to bloody because of increased total protein, WBCs, and RBCs, and is considered classic for diseases characterized by intestinal ischemia. Peritoneal fluid may also be red or blood-colored because of a hemoperitoneum, or secondary to blood contamination during sample collection. l-Lactate measurement in the abdominal fluid has proven invaluable for the identification of strangulating intestinal injury. Cytology acts as an important supplement to cell counts in peritoneal fluid, and the normal ratio of non-degenerate neutrophils:mononuclear cells of 2:1 changes during various gastrointestinal diseases. Culture of peritoneal fluid samples should be performed when septic peritonitis is suspected.
SUMMARY
Abdominal fluid is a sensitive indicator of intestinal injury and a useful tool to direct treatment. Peritoneal fluid evaluation includes gross visual and olfactory examination, nucleated cell count, total protein, RBC count, lactate levels, cytology, and culture. The changes noted in such variables are related to the type and duration of the abdominal problem.
KEY POINTS
Abdominal fluid interpretation has become central to the triage and management of challenging equine colic patients. The transformation of peritoneal fluid color from golden to orange to red represents increasing levels of RBCs, common with strangulating intestinal lesions. Contamination with RBCs at various concentrations may be secondary to vascular (eg, abdominal wall or mesenteric vessels) or splenic trauma during abdominal fluid collection; however, this must be distinguished from orange to red fluid associated with intestinal strangulating obstruction or hemoabdomen Peritoneal fluid analysis reveals abdominal pathology by recognizing specific changes that occur with disease processes affecting the tissues and organs within this cavity. Abdominal fluid examination should be used as a tool to direct treatment rather than the definitive test for diagnosis of the acute abdomen Septic peritonitis in horses most commonly originates secondary to intestinal compromise or accidents (vascular damage, perforation, or surgical manipulation), leading to bacterial translocation into the abdomen.
Topics: Animals; Ascitic Fluid; Colic; Horse Diseases; Horses; Intestinal Obstruction; Peritonitis
PubMed: 35044063
DOI: 10.1111/vec.13117 -
Journal of Equine Veterinary Science Jul 2020The objective of this study was to evaluate changes in intra-abdominal pressure (IAP) in horses with colic by associating the underlying etiologies with directly...
The objective of this study was to evaluate changes in intra-abdominal pressure (IAP) in horses with colic by associating the underlying etiologies with directly acquired IAP values and survival rate. This is a 2-year cohort study (2014-2016). Horses with clinical signs of colic were admitted to the veterinary teaching hospital during the period 2014-2016. Twenty-eight horses, of different breeds, males (stallions and geldings) and females, aged between 2 and 20 years, and weighing from 300 to 450 kg presenting with clinical signs of colic, were included in the study. IAP was directly acquired at the right flank (standing under sedation) and at the linea alba (supine position under general anesthesia). Twenty IAP measurements were recorded at end expiration for each recording site. IAP values >0.0 mmHg, obtained at the upper right flank in the standing position, were associated with surgical treatment (P < .05). In these cases, signs of colic were associated with strangulated obstructions of the large colon, and a greater likelihood of death as a result of colic (P < .001). Intra-abdominal pressure varied considerably in horses with colic, even for the same underlying etiologies. Horses with colic related to strangulating obstructions of the large intestine had IAP >.0 mmHg, at the upper right flank. These horses were also considerably more likely to require surgical intervention (P < .05) and death/euthanasia was more likely in this group of horses (P < .001).
Topics: Animals; Cohort Studies; Colic; Female; Horse Diseases; Horses; Hospitals, Animal; Hospitals, Teaching; Male
PubMed: 32534775
DOI: 10.1016/j.jevs.2020.102998 -
Journal of Veterinary Emergency and... Nov 2020To determine an abdominal pressure cutoff value for intra-abdominal hypertension (IAH) in the horse and characterize IAH in horses with acute colic.
OBJECTIVE
To determine an abdominal pressure cutoff value for intra-abdominal hypertension (IAH) in the horse and characterize IAH in horses with acute colic.
DESIGN
Prospective clinical cohort.
SETTING
University teaching hospital.
ANIMALS
Nine healthy adult horses and 56 horses with acute colic.
INTERVENTIONS
Ventral intra-abdominal pressure (IAP) was measured in triplicate at end expiration and averaged. Each colic case was classified as medical or surgical and large intestine (LI) or small intestine (SI). Management and final outcome (alive, euthanized, or died) were recorded. IAH was defined as ≥32 mm Hg (mean + 2 SDs of ventral IAP in control horses). Proportions of horses with and without IAH for different lesions were expressed as fractions and percentages. Differences in IAP between groups were determined using ANOVA with post-testing or t-tests. Odds ratio for management strategy (ie, need for medical or surgical) in horses with IAH was performed using Fisher's exact test. P < 0.05 was considered significant.
MEASUREMENTS AND MAIN RESULTS
IAP was higher in horses with colic compared to controls (P = 0.025). Over 18 months, 30.4% of horses with colic had IAH (n = 10 LI lesions, n = 7 SI lesions). Horses with LI medical lesions had the highest IAP of all lesions (mean 36.5 mm Hg). IAH horses with medical lesions were 15 times more likely to survive than IAH horses requiring surgery (P = 0.03).
CONCLUSIONS
Acute colic in horses is associated with an increased ventral IAP compared with healthy controls. IAH does exist in horses with colic, notably LI medical lesions, and is associated with nonsurvival in horses that require surgery.
Topics: Animals; Case-Control Studies; Colic; Female; Horse Diseases; Horses; Humans; Intra-Abdominal Hypertension; Male; Odds Ratio; Prevalence; Prospective Studies
PubMed: 33030800
DOI: 10.1111/vec.13006 -
The Veterinary Clinics of North... Aug 2023Most recurrent episodes of non-specific colic are self-limiting, and the results of clinical examinations are unremarkable. Differentiating these cases from serious... (Review)
Review
Most recurrent episodes of non-specific colic are self-limiting, and the results of clinical examinations are unremarkable. Differentiating these cases from serious diseases can be difficult, but repeated evaluations are warranted. Horses presenting with very frequent bouts of colic are more likely to have serious diseases and a higher mortality rate compared to horses presenting with less frequent bouts of transient colic. Horses with recurrent bouts of prolonged colic are more likely to have motility issues or partial intestinal obstruction. Non-gastrointestinal diseases can also cause recurrent bouts of pain ("false colic"). Adhesions are common causes of colic following abdominal surgery.
Topics: Animals; Horses; Motivation; Horse Diseases; Intestinal Obstruction; Colic
PubMed: 37121784
DOI: 10.1016/j.cveq.2023.03.014 -
Journal of Clinical Nursing Oct 2022To estimate the prevalence and perinatal risk factors associated with parent reported colic, abdominal pain and pain or other discomforts in infants until 3 months of...
Prevalence and perinatal risk factors of parent-reported colic, abdominal pain and other pain or discomforts in infants until 3 months of age - A prospective cohort study in PreventADALL.
AIMS AND OBJECTIVES
To estimate the prevalence and perinatal risk factors associated with parent reported colic, abdominal pain and pain or other discomforts in infants until 3 months of age.
BACKGROUND
Infant colic is a common concern for parents and clinicians. The prevalence varies in different studies and its symptoms overlap with other conditions like abdominal pain and discomfort. Diagnosis criteria are challenging, pathogenesis unclear and risk factors are conflicting.
DESIGN
This was a prospective cohort study.
METHODS
The 1852 mother-child pairs from the PreventADALL prospective birth-cohort answering the 3 months questionnaire were included. Information on perinatal risk factors was collected from the inclusion visit and questionnaires during pregnancy at 18 and 34 weeks, as well as birth charts. STROBE checklist was followed.
RESULTS
The reported prevalence of colic was 3% (59/1852), abdominal pain 22% (415/1852) and pain or other discomfort 6% (119/1852), with a total of 26% (478/1852) infants. Mothers on sick leave in pregnancy and reporting any allergic diseases had a significantly higher odds of reporting infant colic, abdominal pain and pain or other discomforts. Mothers with higher perceived stress in pregnancy exhibited a trend towards higher odds for reporting infant pain. Mothers coming from Sweden were less likely to report infant abdominal pain compared to mothers from Norway.
CONCLUSIONS
The prevalence of abdominal pain and pain or other discomforts was higher than the prevalence of colic. Perinatal risk factors connected to maternal health were associated with all three symptoms.
RELEVANCE TO CLINICAL PRACTICE
Colic and abdominal pain are stressful, symptoms overlap and risk factors for both can be identified in pregnancy. Our study suggests that it is difficult for parents to distinguish among infant colic, abdominal pain and other pain or discomfort and some report two or all three symptoms. Identifying the perinatal risk factors associated with infant pain may help target and support parents.
Topics: Abdominal Pain; Colic; Female; Humans; Infant; Mothers; Parents; Pregnancy; Prevalence; Prospective Studies; Risk Factors
PubMed: 34704296
DOI: 10.1111/jocn.16097 -
Journal of Clinical Nursing Oct 2023The primary aim was to explore whether infants with pain symptoms (colic, abdominal pain and visit to healthcare provider with pain or other discomforts) had increased...
Infant colic and abdominal pain; associations with infant multimorbidity and maternal perceived stress up to 3 months postpartum-A cross-sectional/cohort study in the PreventADALL study.
AIMS AND OBJECTIVES
The primary aim was to explore whether infants with pain symptoms (colic, abdominal pain and visit to healthcare provider with pain or other discomforts) had increased multimorbidity (common infections, eczema and food sensitivity) compared with infants without these conditions. Secondarily, we aimed to determine whether infant pain symptoms were associated with maternal perceived stress in pregnancy and 3 months postpartum.
BACKGROUND
Infant colic and abdominal pain are common concerns in early infancy. Nevertheless, to our knowledge, little research exists on the relationship between infant pain and common infant infections, eczema and food sensitization as comorbidities, and the impact of infant pain on the development of maternal perceived stress from pregnancy to infancy is inconsistent.
DESIGN
This study was cross-sectional and partly prospective.
METHODS
The sample consisted of mother-infant pairs (N = 1852); information regarding infant pain and multimorbidity was collected from the 3-month questionnaire and postpartum visits in the PreventADALL prospective cohort study. Chi-square tests and regression analyses were conducted. The STROBE checklist was followed.
RESULTS
Our results showed a statistically significant higher proportion of respiratory and other infections in infants with pain symptoms. The odds of infant pain were higher for infants with multimorbidity compared to those with no comorbidity. Mothers of infants with colic and of infants visiting healthcare with pain and other discomforts reported statistically significant higher perceived stress by 3 months compared with mothers of infants with no reported pain.
CONCLUSION
Our results indicate an association between infant pain symptoms and the presence of infections. Mothers of infants with colic and visiting healthcare had higher perceived stress compared to the no pain group.
IMPLICATIONS FOR PRACTICE
Our study indicates that infant pain is associated with infant multimorbidity and maternal perceived stress, which may be useful when planning diagnostic, treatment and coping strategies in infant and family care.
PATIENT OR PUBLIC CONTRIBUTION
The PreventADALL is a collaborative study with governmental and patient organisation representation. Selected infants with parents were also contributing during calibrating courses on eczema assessment for the data collectors.
TRIAL REGISTRATION
The study was approved by the Regional Committee in Norway (2014/518) and Sweden (2014/2242-31/4) and registered at clinicaltrial.gov (NCT02449850). Link for clinical trials: https://clinicaltrials.gov/ct2/show/NCT02449850.
Topics: Female; Pregnancy; Infant; Humans; Colic; Prospective Studies; Cohort Studies; Multimorbidity; Cross-Sectional Studies; Postpartum Period; Mothers; Abdominal Pain; Stress, Psychological; Eczema
PubMed: 37462350
DOI: 10.1111/jocn.16825 -
Journal of Pediatric Gastroenterology... Jul 2016Evidence suggests that the gut microbiota in subjects with infantile colic differs from the gut microbiota in an unaffected population. In colicky infants, dysbiosis may... (Review)
Review
PURPOSE OF REVIEW
Evidence suggests that the gut microbiota in subjects with infantile colic differs from the gut microbiota in an unaffected population. In colicky infants, dysbiosis may affect gut motor function and gas production resulting in abdominal pain/colic. If so, it is logical to assume that manipulation of the gut microbiota may play a therapeutic role and also could be a preventive measure in the evolution of these disorders. We aimed to evaluate evidence on the effectiveness of probiotics for treating and preventing infantile colic.
RECENT FINDINGS
The administration of Lactobacillusreuteri DSM 17938 is likely to reduce crying time in breastfed infants with infantile colic, but its role in formula-fed infants is less clear. Data summarized in the current review suggest that L reuteri DSM 17938 may be effective in the reduction of crying/colic both in breastfed and formula-fed infants. Other probiotics (single or in combinations) were studied in single trials only.
SUMMARY
Given the lack of effective therapy for infantile colic and the good safety profile of L reuteri DSM 17938, this therapeutic option could be discussed with caregivers. Data on other probiotics, either positive or negative, are too limited to allow one to draw reliable conclusions.
Topics: Colic; Dysbiosis; Gastrointestinal Diseases; Gastrointestinal Microbiome; Humans; Infant; Infant Nutritional Physiological Phenomena; Infant, Newborn; Probiotics
PubMed: 27380594
DOI: 10.1097/MPG.0000000000001220