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Article ; Online: Temporary protection: its impact on healthcare for Syrian refugees in Turkey.

Chong, Clara

2018 Volume 10, Issue 4, Page(s) 217–218

Language	English
Publishing date	2018-05-16
Publishing country	England
Document type	Editorial
ZDB-ID	2526175-7
ISSN	1876-3405 ; 1876-3413
ISSN (online)	1876-3405
ISSN	1876-3413
DOI	10.1093/inthealth/ihy032
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Article ; Online: Letter to the editor: NICU costs are not the whole story.

Davidson, Joseph / Chong, Clara / Yardley, Iain

Journal of pediatric surgery

2020 Volume 55, Issue 10, Page(s) 2246

MeSH term(s)	Costs and Cost Analysis ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Length of Stay
Language	English
Publishing date	2020-06-27
Publishing country	United States
Document type	Letter
ZDB-ID	80165-3
ISSN	1531-5037 ; 0022-3468
ISSN (online)	1531-5037
ISSN	0022-3468
DOI	10.1016/j.jpedsurg.2020.05.050
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Article ; Online: Retroperitoneoscopic single-instrument horseshoe nephrectomy for dilated non-functioning right moiety.

Chong, Clara / Mishra, Pankaj / Paul, Anu / Taghizadeh, Arash / Garriboli, Massimo

Journal of pediatric urology

2021 Volume 17, Issue 4, Page(s) 577–578

Abstract: Retroperitoneoscopic horseshoe nephrectomy is an uncommon procedure, in particular in the paediatric practice. We present a procedure carried out via a posterior approach with a single working port in a 20 months old boy. The video goes through the ... ...

Abstract	Retroperitoneoscopic horseshoe nephrectomy is an uncommon procedure, in particular in the paediatric practice. We present a procedure carried out via a posterior approach with a single working port in a 20 months old boy. The video goes through the technical aspect, from the positioning of the patient and the port insertion, to the end of procedure. Highlighted are the critical steps of directing the initial fascial dissection more caudal and medial compared to a standard approach for nephrectomy, as well as tips to safely ligate and divide the very short right renal vein. The operative time was 90 min. The postoperative course was uneventful. The retroperitoneal access provides a good visualisation of the hylum (including the IVC in case of right side approach), the ureter and the isthmus and has the advantage to preserve the abdominal cavity. The retroperitoneal approach is safe also in horseshoe kidney.
MeSH term(s)	Child ; Fused Kidney/diagnostic imaging ; Fused Kidney/surgery ; Humans ; Infant ; Laparoscopy ; Male ; Nephrectomy ; Retroperitoneal Space/surgery ; Ureter
Language	English
Publishing date	2021-04-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2237683-5
ISSN	1873-4898 ; 1477-5131
ISSN (online)	1873-4898
ISSN	1477-5131
DOI	10.1016/j.jpurol.2021.04.018
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Article ; Online: Exploring Growth Failure in Neonates With Enterostomy.

Davidson, Joseph R / Omran, Kareem / Chong, Clara K L / Eaton, Simon / Edwards, A David / Yardley, Iain E

Journal of pediatric surgery

2023 Volume 59, Issue 2, Page(s) 211–215

Abstract: Aim of the study: Neonatal enterostomy is a known risk for growth failure. We hypothesized that episodes of inflammation may drive a catabolic state, exploring this by assessing serum biochemistry alongside growth trajectory in enterostomy patients.: ... ...

Abstract	Aim of the study: Neonatal enterostomy is a known risk for growth failure. We hypothesized that episodes of inflammation may drive a catabolic state, exploring this by assessing serum biochemistry alongside growth trajectory in enterostomy patients. Methods: A retrospective analysis of infants with histologically confirmed NEC from 01/2012-07/2021 in a tertiary neonatal surgical centre was performed. Change in weight-for-age Z-score (ΔZ) between stoma formation and closure was calculated. Serum CRP (C-reactive protein), urea, and creatinine levels were recorded and duration of elevated levels calculated as Area Under Curve (AUC). We examined for trends of serum levels rising together using intersecting moving averages. Spearman's correlation analysis was performed, while multivariable linear regression examined factors associated with ΔZ. Results: 79 neonates were included. At stoma formation, median Z-score was -1.42 [range -4.73, +1.3]. Sixty-two patients (78 %) had a fall in Z-score during their time with a stoma, 16 (20 %) had a ΔZ less than -2. Urea AUC was significantly univariably correlated with ΔZ and remained statistically significant in a multivariable model (Exp(B) x 100 = -0.57[-1, -0.09]; p = 0.022). The number of biomarker peaks correlated significantly with ΔZ for urea (r = -0.25; p = 0.025) and CRP (r = -0.35; p = 0.0017) but not Creatinine (r = -0.21; p = 0.066). Analysing the number of peaks of any combination of variables coinciding was consistently significantly correlated negatively with ΔZ (r = -0.29 to -0.27; p ≤ 0.016 for all). Conclusion: Our data shows that infants who were more severely affected by growth failure had more frequent and severe uremia while they had a stoma (suggesting a catabolic state). Disturbances in urea were commonly associated with CRP, suggesting that inflammation is a significant factor in growth failure in these infants. These findings promote aggressive management of sepsis in these infants, as well as suggesting an earlier closure of stoma to minimise their "at-risk"' period.
MeSH term(s)	Infant, Newborn ; Infant ; Humans ; Retrospective Studies ; Enterostomy ; Surgical Stomas ; Failure to Thrive/etiology ; Inflammation ; Urea ; Enterocolitis, Necrotizing/surgery
Chemical Substances	Urea (8W8T17847W)
Language	English
Publishing date	2023-10-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	80165-3
ISSN	1531-5037 ; 0022-3468
ISSN (online)	1531-5037
ISSN	0022-3468
DOI	10.1016/j.jpedsurg.2023.10.010
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Article ; Online: Factors Associated With the Microbiome in Moderate-Late Preterm Babies: A Cohort Study From the DIAMOND Randomized Controlled Trial.

Chong, Clara Yieh Lin / Vatanen, Tommi / Alexander, Tanith / Bloomfield, Frank H / O'Sullivan, Justin M

Frontiers in cellular and infection microbiology

2021 Volume 11, Page(s) 595323

Abstract: The gut microbiota of preterm infants is affected by perinatal factors and, in turn, may impact upon infant health. In this study, we collected fecal samples at Day-10 (D10) and 4-months corrected-age (4M) from 227 moderate-late preterm (MLPT) babies ... ...

Abstract	The gut microbiota of preterm infants is affected by perinatal factors and, in turn, may impact upon infant health. In this study, we collected fecal samples at Day-10 (D10) and 4-months corrected-age (4M) from 227 moderate-late preterm (MLPT) babies enrolled in a randomized controlled trial of nutritional management. A total of 320 samples underwent 16S amplicon sequencing, and shotgun metagenomic sequencing was performed on 94 samples from the 4M time point. The microbiome of babies whose families lived in lower socioeconomic status (SES) areas exhibited a significantly higher microbial alpha diversity at D10 (Wilcoxon test
MeSH term(s)	Cohort Studies ; Diamond ; Feces ; Female ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Microbiota ; Pregnancy ; RNA, Ribosomal, 16S
Chemical Substances	RNA, Ribosomal, 16S ; Diamond (7782-40-3)
Language	English
Publishing date	2021-03-01
Publishing country	Switzerland
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2619676-1
ISSN	2235-2988 ; 2235-2988
ISSN (online)	2235-2988
ISSN	2235-2988
DOI	10.3389/fcimb.2021.595323
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Article ; Online: Long-term outcome following cholecystocolostomy in 41 patients with progressive familial intrahepatic cholestasis.

Li, Qianqing / Chong, Clara / Sun, Rui / Yin, Tong / Huang, Ting / Diao, Mei / Li, Long

Pediatric surgery international

2021 Volume 37, Issue 6, Page(s) 723–730

Abstract: Purpose: Progressive familial intrahepatic cholestasis (PFIC) is a cohort of autosomal recessive syndromes which presents with jaundice, severe pruritus and liver derangement. Without treatments, patients progress to liver failure in early childhood. ... ...

Abstract	Purpose: Progressive familial intrahepatic cholestasis (PFIC) is a cohort of autosomal recessive syndromes which presents with jaundice, severe pruritus and liver derangement. Without treatments, patients progress to liver failure in early childhood. Biliary diversion strategies have been deployed to interrupt enterohepatic circulation to alleviate symptoms and delay progression to cirrhosis. Cholecystocolostomy has been the diversion method of choice at our institution and we aim to evaluate its long-term outcome. Methods: All patients with PFIC who underwent cholecystocolostomy between August 2003 to May 2019 were included. PFIC diagnosed by clinical course, serum liver biochemistry and genotyping excluding other causes of cholestasis. All patients received ursodeoxycholic acid prior to biliary diversion. Those without long-term follow-up were excluded. Long-term follow-up conducted with physical examination, abdominal ultrasonography, liver function tests, contrast enema studies and colonoscopies. Outcome analysis was performed with patients divided into three groups according to their postoperative responses. Results: 58 children underwent cholecystocolostomy, 41 were included in the study. Overall survival rate was 73.2% without a liver transplant. Survival improved to 81.1% in those without cirrhosis. 83.3% of those without a transplant was to no longer need any medication after their cholecystocolostomy. Recurrent cholestasis was seen in those with constipation (n = 8), ascending cholangitis (n = 10), intrahepatic reflux from Y-loop (n = 3) and cystic duct stenosis (n = 4). Conclusion: Cholecystocolostomy is a safe and effective technique for treatment of cholestasis in PFIC patients without cirrhosis. Careful monitoring and proactive management of postoperative constipation and ascending cholangitis is required to prevent stenosis of the cystic duct leading to recurrent cholestasis.
MeSH term(s)	Anastomosis, Surgical ; Child ; Child, Preschool ; Cholecystostomy/methods ; Cholestasis, Intrahepatic/diagnosis ; Cholestasis, Intrahepatic/surgery ; Colostomy/methods ; Follow-Up Studies ; Gallbladder/surgery ; Humans ; Infant ; Male ; Time Factors ; Treatment Outcome ; Ultrasonography
Language	English
Publishing date	2021-03-02
Publishing country	Germany
Document type	Journal Article
ZDB-ID	632773-4
ISSN	1437-9813 ; 0179-0358
ISSN (online)	1437-9813
ISSN	0179-0358
DOI	10.1007/s00383-021-04871-9
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The microbial biogeography of the gastrointestinal tract of preterm and term lambs.

Chong, Clara Yieh Lin / Vatanen, Tommi / Oliver, Mark / Bloomfield, Frank H / O'Sullivan, Justin M

Scientific reports

2020 Volume 10, Issue 1, Page(s) 9113

Abstract: Nutritional supplementation is a common clinical intervention to support the growth of preterm infants. There is little information on how nutritional supplementation interacts with the developing microbiome of the small intestine, the major site for ... ...

Abstract	Nutritional supplementation is a common clinical intervention to support the growth of preterm infants. There is little information on how nutritional supplementation interacts with the developing microbiome of the small intestine, the major site for nutrient metabolism and absorption. We investigated the effect of preterm birth and nutritional supplementation on the mucosal and luminal microbiota along the gastrointestinal tract (GIT) of preterm lambs. Preterm lambs (n = 24) were enterally supplemented with branched-chain amino acids (BCAAs), carbohydrate (maltodextrin), or water for two weeks from birth. Term lambs (n = 7) received water. Mucosal scrapings and luminal samples were collected from the duodenum, jejunum, ileum (small intestine) and colon at six weeks post-term age and analysed by 16S rRNA amplicon sequencing. Anatomical site explained 54% (q = 0.0004) of the variance and differences between the term and preterm groups explained 5.7% (q = 0.024) of the variance in microbial beta-diversities. The colon was enriched with Tenericutes and Verrucomicrobia compared to the small intestine, while Actinobacteria, and superphylum Patescibacteria were present in higher abundance in the small intestine compared to the colon. Our findings highlight that early-life short-term nutritional supplementation in preterm lambs does not alter the microbial community residing in the small intestine and colon.
MeSH term(s)	Actinobacteria ; Amino Acids, Branched-Chain/administration & dosage ; Amino Acids, Branched-Chain/metabolism ; Animal Nutritional Physiological Phenomena ; Animals ; Animals, Newborn/metabolism ; Animals, Newborn/microbiology ; Colon/microbiology ; Gastrointestinal Microbiome ; Intestinal Absorption ; Intestine, Small/microbiology ; Nutrients/metabolism ; Polysaccharides/administration & dosage ; Polysaccharides/metabolism ; Premature Birth/metabolism ; Sheep/metabolism ; Sheep/microbiology ; Tenericutes ; Term Birth/metabolism ; Verrucomicrobia ; Water/administration & dosage ; Water/metabolism
Chemical Substances	Amino Acids, Branched-Chain ; Polysaccharides ; Water (059QF0KO0R) ; maltodextrin (7CVR7L4A2D)
Language	English
Publishing date	2020-06-04
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-020-66056-z
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Article ; Online: Factors Affecting Gastrointestinal Microbiome Development in Neonates.

Chong, Clara Yieh Lin / Bloomfield, Frank H / O'Sullivan, Justin M

Nutrients

2018 Volume 10, Issue 3

Abstract: The gut microbiome is established in the newborn period and is recognised to interact with the host to influence metabolism. Different environmental factors that are encountered during this critical period may influence the gut microbial composition, ... ...

Abstract	The gut microbiome is established in the newborn period and is recognised to interact with the host to influence metabolism. Different environmental factors that are encountered during this critical period may influence the gut microbial composition, potentially impacting upon later disease risk, such as asthma, metabolic disorder, and inflammatory bowel disease. The sterility dogma of the foetus in utero is challenged by studies that identified bacteria, bacterial DNA, or bacterial products in meconium, amniotic fluid, and the placenta; indicating the initiation of maternal-to-offspring microbial colonisation in utero. This narrative review aims to provide a better understanding of factors that affect the development of the gastrointestinal (GI) microbiome during prenatal, perinatal to postnatal life, and their reciprocal relationship with GI tract development in neonates.
MeSH term(s)	Age Factors ; Anti-Bacterial Agents/therapeutic use ; Bacteria/classification ; Bacteria/drug effects ; Bacteria/growth & development ; Bottle Feeding ; Breast Feeding ; Child Development ; Environment ; Fetal Development ; Gastrointestinal Microbiome/drug effects ; Gastrointestinal Tract/drug effects ; Gastrointestinal Tract/growth & development ; Gastrointestinal Tract/microbiology ; Gestational Age ; Host-Pathogen Interactions ; Humans ; Infant Formula ; Infant Nutritional Physiological Phenomena ; Infant, Newborn ; Milk, Human/microbiology ; Nutritional Status
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2018-02-28
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu10030274
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Randomised Double-Blind Placebo-Controlled Trial of Inulin with Metronidazole in Non-Alcoholic Fatty Liver Disease (NAFLD)

Chong, Clara Yieh Lin / Orr, David / Plank, Lindsay D / Vatanen, Tommi / O'Sullivan, Justin M / Murphy, Rinki

Nutrients. 2020 Mar. 27, v. 12, no. 4

2020

Abstract: Background: Non-alcoholic fatty liver disease (NAFLD) can be ameliorated by weight loss although difficult to maintain. Emerging evidence indicates that prebiotics and antibiotics improve NAFLD. Aim: To determine whether inulin supplementation after ... ...

Abstract	Background: Non-alcoholic fatty liver disease (NAFLD) can be ameliorated by weight loss although difficult to maintain. Emerging evidence indicates that prebiotics and antibiotics improve NAFLD. Aim: To determine whether inulin supplementation after brief metronidazole therapy is effective in reducing alanine aminotransferase (ALT) and maintaining weight loss achieved through a very-low-calorie diet (VLCD) among people with NAFLD. Methods: Sixty-two people with NAFLD commenced 4-week VLCD using Optifast meal replacements (600 kcal/day). Sixty were then randomised into a 12-week double-blind, placebo-controlled, parallel three-arm trial: (1) 400 mg metronidazole twice daily in Week 1 then inulin 4 g twice daily OR (2) placebo twice daily in week one then inulin OR (3) placebo-placebo. Main outcomes were ALT and body weight at 12 weeks. Fecal microbiota changes were also evaluated. Results: Mean body mass index (BMI) and ALT reduced after VLCD by 2.4 kg/m² and 11 U/L, respectively. ALT further decreased after metronidazole-inulin compared to after placebo-placebo (mean ALT change -19.6 vs. -0.2 U/L, respectively; p = 0.026); however, weight loss maintenance did not differ. VLCD treatment decreased the ratio of Firmicutes/Bacteroidetes (p = 0.002). Conclusion: Brief metronidazole followed by inulin supplementation can reduce ALT beyond that achieved after VLCD in patients with NAFLD.
Keywords	Bacteroidetes ; Firmicutes ; alanine transaminase ; antibiotics ; body mass index ; body weight ; fatty liver ; intestinal microorganisms ; inulin ; metronidazole ; nutrients ; patients ; people ; placebos ; prebiotics ; therapeutics ; very low calorie diet ; weight loss
Language	English
Dates of publication	2020-0327
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
Note	NAL-light
ZDB-ID	2518386-2
ISSN	2072-6643
ISSN	2072-6643
DOI	10.3390/nu12040937
Database	NAL-Catalogue (AGRICOLA)

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Article: Factors Affecting Gastrointestinal Microbiome Development in Neonates

Chong, Clara Yieh Lin / Bloomfield, Frank H / O’Sullivan, Justin M

Nutrients. 2018 Feb. 28, v. 10, no. 3

2018

Abstract	The gut microbiome is established in the newborn period and is recognised to interact with the host to influence metabolism. Different environmental factors that are encountered during this critical period may influence the gut microbial composition, potentially impacting upon later disease risk, such as asthma, metabolic disorder, and inflammatory bowel disease. The sterility dogma of the foetus in utero is challenged by studies that identified bacteria, bacterial DNA, or bacterial products in meconium, amniotic fluid, and the placenta; indicating the initiation of maternal-to-offspring microbial colonisation in utero. This narrative review aims to provide a better understanding of factors that affect the development of the gastrointestinal (GI) microbiome during prenatal, perinatal to postnatal life, and their reciprocal relationship with GI tract development in neonates.
Keywords	DNA ; amniotic fluid ; asthma ; bacteria ; environmental factors ; fetus ; gastrointestinal system ; inflammatory bowel disease ; intestinal microorganisms ; metabolic diseases ; metabolism ; microbial colonization ; microbiome ; neonates ; placenta ; risk
Language	English
Dates of publication	2018-0228
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2518386-2
ISSN	2072-6643
ISSN	2072-6643
DOI	10.3390/nu10030274
Database	NAL-Catalogue (AGRICOLA)

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