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Journal articles on the topic 'Necrotizing enterocoliti'

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Author: Grafiati

Published: 11 March 2023

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1

Buick, R. G. "Colonic stricture and enterocolic fistulae following necrotizing enterocolitis." Journal of Pediatric Surgery 20, no. 4 (August 1985): 466. http://dx.doi.org/10.1016/s0022-3468(85)80257-8.

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2

Araújo, Priscilla Martins, Marilia Cruz Gouveia Câmara, and Maria Gorete Lucena De Vasconcelos. "Enterocolite necrosante em recém-nascidos de um hospital de referência em Recife: estudo epidemiológico." Revista de Enfermagem UFPE on line 2, no. 3 (June 29, 2008): 255. http://dx.doi.org/10.5205/reuol.346-11415-1-le.0203200807.

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ABSTRACTThe mainly objective of this study was to develop an epidemiologic study about necrotizing enterocolitis among newborn from a maternale-infantile reference hospital at Recife city, Pernambuco, Brazil. This is about a descriptive study, transversal, retrospective, from quantitative approach. The random sample was from newborn carries of necrotizing enterocolitis, been born to July from December 2004. The data collection was carried out from secondary data of handbooks, using an instrument and analyzing through Software Epi-info 3.3.2. The findings showed the incidence from 2,04% of necrotizing enterocolitis and 61,9% of mortality. The main motherly unleashed was the cesarean childbirth with 42,9% of the cases, and besides the unleash factors associates to new-born had predominated the prematurely 85,7%, the low weight to born 90,5% and alimentary formula use 95,2%. There was a predominance of abdominal distension and painful abdomen among the presented clinical manifestations. Regards to nursing care, the gauging of the abdominal perimeter and auscultators of the hydrocarbons noises had not been evaluated routinely during the specific physical examination. As conclusions, front to high associated mortality the pathology, among the suggested recommendations, is distinguished the professional necessity make conscience about the semiotics importance, examining clinically the newborn and in repeatedly due to variation of clinical manifestations. Descriptors: neonatal nursing; necrotizing enterocolitis; unleash factors.RESUMOObjetivou-se com esse estudo desenvolver um estudo epidemiológico sobre enterocolite necrosante entre recém-nascidos de um hospital de referência em materno-infantil de Recife, Pernambuco, Brasil. Estudo descritivo, transversal, retrospectivo, de abordagem quantitativa. A amostra aleatória foi de recém-nascidos portadores de enterocolite necrosante, nascidos de julho a dezembro de 2004. A coleta de dados foi em prontuários. Os dados foram analisados através do Software Epi-info, versão 3.3.2. Foi encontrada incidência de 2,04% de enterocolite necrosante e mortalidade de 61,9%. O principal fator desencadeante materno foi o parto cesário, e dentre os fatores desencadeantes associados ao recém-nascido predominou a prematuridade com baixo peso ao nascer com e o uso de fórmulas alimentares. Houve predomínio de distensão abdominal e abdome doloroso entre as manifestações clínicas apresentadas. Em relação aos cuidados de Enfermagem, a aferição do perímetro abdominal e a ausculta dos ruídos hidroaéreos, não foram avaliadas rotineiramente durante o exame físico específico. Diante da alta mortalidade associada à doença, entre as recomendações sugeridas, destacam-se a conscientização do profissional sobre a importância da semiótica, de examinar clinicamente o recém-nascido e de modo repetido pela variação rápida de quadro clinico. Descritores: enfermagem neonatal; enterocolite necrosante; fatores de risco.RESUMENFue objetivo principal dese estudio desarrollar um estúdio epidemiológico sobre enterocolitis necrosante entre recién nascidos de um hospital de referência maternal-infantil en Recife, Pernambuco, Brazil. Estudio transversal, retrospectivo, de abordage cuantitativa. La muestra aleatoria se compone de los recién nascidos portadores de enterocolitis necrotizante, nacido entre julio y diciembre de 2004. La recogida de datos fue a partir de historias clínicas. Los dados fueran analisados a través del Software Epi-info, version 3.3.2. Fue encontrado una incidencia de 2,04% de enterocolitis necrosante y mortalidade de 61,9%. El principal factor desencadenante materno fue el parto cesarea, con 42,9% de los casos, y entre los factores desencadenantes asociados al reciennacido predominó la prematuralidad 85,7%, el bajo peso al nacer 90,5% y el uso de fórmulas alimenticias 95,2%. Hubo predominio de distención abdominal y abdomen doloroso entre las manifestaciones clínicas presentadas. Con relación a los cuidados de enfermería, la aferición del perímetro abdominal y la ausculta de los ruidos hidroaéreos, no fueron evaluados rotineramente durante el examen físico específico. Las conclusiones, frente la alta mortalidad asociada la patología, entre las recomendaciones sugeridas, se destacam la sensibilización de los profesionales sobre la importancia de la semiótica, para examinar clínicamente el recién nascidos y en varias ocasiones por el rápido cambio del marco clínico. Descriptores: enfermaje neonatal, enterocolitis necrotizante, factores de riezgo.

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3

Walsh, Michele C., Robert M. Kliegman, and Maureen Hack. "Severity of Necrotizing Enterocolitis: Influence on Outcome at 2 Years of Age." Pediatrics 84, no. 5 (November 1, 1989): 808–14. http://dx.doi.org/10.1542/peds.84.5.808.

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The long-term outcome of very low birth weight (VLBW) infants with necrotizing enterocolitis has been reported to be similar to that of other VLBW infants. To examine the influence of disease severity on outcome, the growth and neurodevelopment of survivors of necrotizing enterocolitis were evaluated when the babies were 20 months' corrected age. Between 1975 and 1983, 1506 VLBW infants were admitted to the hospital, and necrotizing enterocolitis developed in 84 (5.6%). Forty infants (48%) survived to be 20 months' corrected age, and complete follow-up data were available for 36. Survivors were classified by modified Bell's criteria into four groups by increasing severity of disease; 13 had mild necrotizing enterocolitis (stage IIA, IIB), and 23 had severe necrotizing enterocolitis (stage IIIA, IIIB). The 36 survivors were compared with 766 surviving VLBW infants without necrotizing enterocolitis. There were no perinatal or socioeconomic differences between groups. Compared with infants with stage II necrotizing enterocolitis at 20 months, infants with stage III necrotizing enterocolitis had a higher rate of subnormal body weight (39% vs 15%) and subnormal head circumference (30% vs 0%). Thirty-three percent of necrotizing enterocolitis survivors had significant neurodevelopmental impairment; the majority of impaired infants (10 of 12) were survivors of stage III necrotizing enterocolitis. These findings highlight the importance of continued evaluations for medical and neurodevelopmental sequelae.

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4

Walsh, Michele C., Robert M. Kliegman, and Avroy A. Fanaroff. "Necrotizing Enterocolitis: A Practitioner's Perspective." Pediatrics In Review 9, no. 7 (January 1, 1988): 219–26. http://dx.doi.org/10.1542/pir.9.7.219.

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Neonatal necrotizing enterocolitis is a multifactorial disorder. Factors previously thought to place patients at risk for necrotizing enterocolitis have been found to be identical among neonates with the disease and other neonates who do have it and, thus, are not true risk factors. The mainstays of therapy for necrotizing enterocolitis include bowel decompression, bowel rest, and broadspectrum intravenous antibiotics. The only absolute indication for surgical intervention is perforation of the bowel. Survivors of necrotizing enterocolitis are susceptible to stricture formation which usually occurs 2 to 8 weeks after the acute onset of necrotizing enterocolitis. Common signs include obstipation, vomiting, abdominal distention, and hematochezia.

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5

Hussain, Nusrat, Suleman ., Amna Wajdan, Rabia Bashir, Rabia Saleem, and Sajid Akhtar. "To Determine the Frequency of Necrotizing Enterocolitis in Preterm Infants." Pakistan Journal of Medical and Health Sciences 15, no. 12 (December 10, 2021): 3200–3201. http://dx.doi.org/10.53350/pjmhs2115123200.

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Aim: To determine the frequency of necrotizing enterocolitis in preterm infants Place and duration of study: It is a descriptive cross-sectional study in Pediatric Medicine Department, Nishtar Hospital Multan from March, 2021 to August, 2021 Methodology: The preterm neonates were called for follow up every week for 4 weeks to diagnose Necrotizing enterocolitis. Results; Out of 174 cases, 101 (58%) were males while 73 (42%) were females. Necrotizing enterocolitis (NEC) was noted in 61 (35.1%) while NEC in breastfeeding infants was 14/74 (18.9%) and in formula feeding infants NEC was 47/100 (47%). Conclusion; High frequency of necrotizing enterocolitis was observed in this study among formula fed preterm infants as compared to breastfed preterm infants. Keywords; Breastfeeding, formula feeding, Necrotizing enterocolitis

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6

Duchon, Jennifer, Maria E. Barbian, and Patricia W. Denning. "Necrotizing Enterocolitis." Clinics in Perinatology 48, no. 2 (June 2021): 229–50. http://dx.doi.org/10.1016/j.clp.2021.03.002.

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7

Panigrahi, Pinaki. "Necrotizing Enterocolitis." Pediatric Drugs 8, no. 3 (2006): 151–65. http://dx.doi.org/10.2165/00148581-200608030-00002.

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8

Chu, Alison, Joseph R. Hageman, and Michael S. Caplan. "Necrotizing Enterocolitis." NeoReviews 14, no. 3 (March 2013): e113-e120. http://dx.doi.org/10.1542/neo.14-3-e113.

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9

Rich, Barrie S., and Stephen E. Dolgin. "Necrotizing Enterocolitis." Pediatrics in Review 38, no. 12 (December 2017): 552–59. http://dx.doi.org/10.1542/pir.2017-0002.

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10

Neu, Josef, and W. Allan Walker. "Necrotizing Enterocolitis." New England Journal of Medicine 364, no. 3 (January 20, 2011): 255–64. http://dx.doi.org/10.1056/nejmra1005408.

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11

Coit, Alison Kirse. "Necrotizing Enterocolitis." Journal of Perinatal & Neonatal Nursing 12, no. 4 (March 1999): 53–66. http://dx.doi.org/10.1097/00005237-199903000-00006.

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12

Henry, Marion C. W., and R. Lawrence Moss. "Necrotizing Enterocolitis." Annual Review of Medicine 60, no. 1 (February 2009): 111–24. http://dx.doi.org/10.1146/annurev.med.60.050207.092824.

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13

Bellodas Sanchez, Jenny, and Mark Kadrofske. "Necrotizing enterocolitis." Neurogastroenterology & Motility 31, no. 3 (February 22, 2019): e13569. http://dx.doi.org/10.1111/nmo.13569.

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14

Engum, Scott A., and Jay L. Grosfeld. "Necrotizing enterocolitis." Current Opinion in Pediatrics 10, no. 2 (April 1998): 123–30. http://dx.doi.org/10.1097/00008480-199804000-00002.

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15

Stauffer, UG. "Necrotizing enterocolitis." Acta Paediatrica 83, no. 6 (January 21, 2008): 666–68. http://dx.doi.org/10.1111/j.1651-2227.1994.tb13108.x.

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16

Niemarkt, Hendrik J., Tim G. J. de Meij, Mirjam E. van de Velde, Marc P. van der Schee, Johannes B. van Goudoever, Boris W. Kramer, Peter Andriessen, and Nanne K. H. de Boer. "Necrotizing Enterocolitis." Inflammatory Bowel Diseases 21, no. 2 (February 2015): 436–44. http://dx.doi.org/10.1097/mib.0000000000000184.

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17

Lander, Anthony. "Necrotizing enterocolitis." Surgery (Oxford) 25, no. 7 (July 2007): 305–8. http://dx.doi.org/10.1016/j.mpsur.2007.05.017.

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18

Duthie, Gillian, and Anthony Lander. "Necrotizing enterocolitis." Surgery (Oxford) 31, no. 3 (March 2013): 119–22. http://dx.doi.org/10.1016/j.mpsur.2013.01.007.

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19

Thakkar, Hemanshoo S., and Kokila Lakhoo. "Necrotizing enterocolitis." Surgery (Oxford) 34, no. 12 (December 2016): 617–20. http://dx.doi.org/10.1016/j.mpsur.2016.09.004.

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20

Thakkar, Hemanshoo S., and Kokila Lakhoo. "Necrotizing enterocolitis." Surgery (Oxford) 37, no. 11 (November 2019): 628–31. http://dx.doi.org/10.1016/j.mpsur.2019.09.007.

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21

Kliegman, Robert M., W. Alan Walker, and Robert H. Yolken. "Necrotizing Enterocolitis." Clinics in Perinatology 21, no. 2 (June 1994): 437–55. http://dx.doi.org/10.1016/s0095-5108(18)30355-5.

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22

Caplan, Michael S. "Necrotizing Enterocolitis." Clinics in Perinatology 46, no. 1 (March 2019): i. http://dx.doi.org/10.1016/s0095-5108(18)31460-x.

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23

Neu, Josef. "NECROTIZING ENTEROCOLITIS." Pediatric Clinics of North America 43, no. 2 (April 1996): 409–32. http://dx.doi.org/10.1016/s0031-3955(05)70413-2.

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24

Neu, J. "Necrotizing Enterocolitis." Yearbook of Neonatal and Perinatal Medicine 2011 (January 2011): 119–22. http://dx.doi.org/10.1016/j.ynpm.2011.07.107.

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25

Kim, Wontae, and Jeong-Meen Seo. "Necrotizing Enterocolitis." New England Journal of Medicine 383, no. 25 (December 17, 2020): 2461. http://dx.doi.org/10.1056/nejmicm2020782.

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26

Parker, Leslie A. "Necrotizing Enterocolitis." Advances in Neonatal Care 13, no. 5 (October 2013): 317–24. http://dx.doi.org/10.1097/anc.0b013e31829a872c.

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27

&NA;. "Necrotizing Enterocolitis." Advances in Neonatal Care 13, no. 5 (October 2013): 325–26. http://dx.doi.org/10.1097/anc.0b013e3182a93745.

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28

BLACK, TIMOTHY L., MICHAEL G. CARR, and SHELDON B. KORONES. "Necrotizing Enterocolitis." Southern Medical Journal 82, no. 9 (September 1989): 1103–7. http://dx.doi.org/10.1097/00007611-198909000-00011.

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29

Holton, A. F., and I. Z. Kovar. "Necrotizing enterocolitis." Current Opinion in Infectious Diseases 2, no. 3 (June 1989): 427–31. http://dx.doi.org/10.1097/00001432-198906000-00017.

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30

Foglia, Robert P. "Necrotizing enterocolitis." Current Problems in Surgery 32, no. 9 (September 1995): 757–823. http://dx.doi.org/10.1016/s0011-3840(05)80014-0.

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31

Papillon, Stephanie, Shannon L. Castle, Christopher P. Gayer, and Henri R. Ford. "Necrotizing Enterocolitis." Advances in Pediatrics 60, no. 1 (January 2013): 263–79. http://dx.doi.org/10.1016/j.yapd.2013.04.011.

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32

Wiener, Eugene S. "Necrotizing enterocolitis." Journal of Pediatric Surgery 20, no. 2 (April 1985): 194. http://dx.doi.org/10.1016/s0022-3468(85)80330-4.

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33

Neu, Josef. "Necrotizing enterocolitis." Seminars in Fetal and Neonatal Medicine 23, no. 6 (December 2018): 369. http://dx.doi.org/10.1016/j.siny.2018.08.009.

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34

Kulkarni, Anjali, and R. Vigneswaran. "Necrotizing enterocolitis." Indian Journal of Pediatrics 68, no. 9 (September 2001): 847–53. http://dx.doi.org/10.1007/bf02762112.

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35

Schmidt, H., and J. Kirchner. "Necrotizing enterocolitis." Der Radiologe 37, no. 6 (July 3, 1997): 426–31. http://dx.doi.org/10.1007/s001170050234.

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36

Thakkar, Hemanshoo S., and Kokila Lakhoo. "Necrotizing enterocolitis." Paediatrics and Child Health 28, no. 5 (May 2018): 227–30. http://dx.doi.org/10.1016/j.paed.2018.03.004.

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37

Sodhi, Puja, and Pierre Fiset. "Necrotizing enterocolitis." Continuing Education in Anaesthesia Critical Care & Pain 12, no. 1 (February 2012): 1–4. http://dx.doi.org/10.1093/bjaceaccp/mkr043.

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38

Agnoni, Alysia, and Christine Lazaros Amendola. "Necrotizing enterocolitis." Journal of the American Academy of Physician Assistants 30, no. 8 (August 2017): 16–21. http://dx.doi.org/10.1097/01.jaa.0000521131.85173.f9.

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39

Gephart, Sheila, and Lisa C. Lanning Lowther. "Necrotizing enterocolitis." Journal of the American Academy of Physician Assistants 30, no. 8 (August 2017): 8–9. http://dx.doi.org/10.1097/01.jaa.0000521145.55572.ae.

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40

Hall, Nigel, and Agostino Pierro. "Necrotizing enterocolitis." Hospital Medicine 65, no. 4 (April 2004): 220–25. http://dx.doi.org/10.12968/hosp.2004.65.4.12735.

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41

Bradshaw, Wanda Todd. "Necrotizing Enterocolitis." Journal of Perinatal & Neonatal Nursing 23, no. 1 (January 2009): 87–94. http://dx.doi.org/10.1097/jpn.0b013e318196fefb.

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42

Srinivasan, Pinchi S., Michael D. Brandler, and Antoni D'Souza. "Necrotizing Enterocolitis." Clinics in Perinatology 35, no. 1 (March 2008): 251–72. http://dx.doi.org/10.1016/j.clp.2007.11.009.

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43

Dominguez, Kathleen M., and R. Lawrence Moss. "Necrotizing Enterocolitis." Clinics in Perinatology 39, no. 2 (June 2012): 387–401. http://dx.doi.org/10.1016/j.clp.2012.04.011.

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44

Barnard, John A. "Necrotizing Enterocolitis." American Journal of Diseases of Children 139, no. 4 (April 1, 1985): 375. http://dx.doi.org/10.1001/archpedi.1985.02140060057028.

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45

Davis, Jessica A., Kelley Baumgartel, Michael J. Morowitz, Vivianna Giangrasso, and Jill R. Demirci. "The Role of Human Milk in Decreasing Necrotizing Enterocolitis Through Modulation of the Infant Gut Microbiome: A Scoping Review." Journal of Human Lactation 36, no. 4 (August 26, 2020): 647–56. http://dx.doi.org/10.1177/0890334420950260.

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Background Necrotizing enterocolitis is associated with a high incidence of morbidity and mortality in premature infants. Human milk minimizes necrotizing enterocolitis risk, although the mechanism of protection is not thoroughly understood. Increasingly, dysbiosis of the infant gut microbiome, which is affected by infant diet, is hypothesized to play a role in necrotizing enterocolitis pathophysiology. Research aim The aim of this scoping review was to summarize the state of the science regarding the hypothesis that the gut microbiome composition is a mediator of the relationship between human milk and decreased incidence of necrotizing enterocolitis within a sample of human infants. Methods Electronic databases and reference lists were searched for peer-reviewed primary research articles addressing the link between human milk, gut microbiome composition, and subsequent incidence of necrotizing enterocolitis among human infants. Results A total of four studies met criteria for inclusion in this review. Of these, evidence supporting the link between human milk, gut microbiome composition, and necrotizing enterocolitis was found in two (50%) studies. Conclusion Some evidence linking all three variables is provided in this review. Given the small number of available studies, and the limitations of those studies, more research is urgently needed to thoroughly understand the protection against necrotizing enterocolitis gained through the provision of human milk.

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46

Roy, Amrita, Shivani Dogra, Pallab Chatterjee, and Anindya Chattopadhyay. "Rota-Viral Diarrhoea Progressing to Necrotizing Enterocolitis in Twin Neonates." Journal of Nepal Paediatric Society 37, no. 2 (February 24, 2018): 204–6. http://dx.doi.org/10.3126/jnps.v37i2.17452.

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We report late preterm twins who developed rota-viral diarrheal disease followed by necrotizing enterocolitis. Necrotizing enterocolitis had a fulminant course in both these neonates. Rota-viral infections in new-borns are reported to be mild or asymptomatic but in the above mentioned case, both the twins were severely affected leading to necrotizing enterocolitis. In the absence of risk factors, late preterm and term babies rarely develop Necrotizing Enterocolitis. We aim to highlight the importance of breast feeding through this case and also put forward the consideration for giving a birth dose of Rotaviral vaccination.

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47

Black, Virginia D., Carol M. Rumack, Lula O. Lubchenco, and Beverly L. Koops. "Gastrointestinal Injury in Polycythemic Term Infants." Pediatrics 76, no. 2 (August 1, 1985): 225–31. http://dx.doi.org/10.1542/peds.76.2.225.

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Necrotizing enterocolitis is uncommon among term infants. In this group, necrotizing enterocolitis has been associated with two risk factors: polycythemia and umbilical catheterization. During a randomized trial of partial plasma exchange transfusion for treatment of polycythemia, an increased risk of gastrointestinal problems was noted. Eight hyperviscous patients treated with partial plasma exchange transfusion, no symptomatically treated patients, and no control infants developed typical necrotizing enterocolitis (blood in the stools, pneumatosis, and systemic signs). The incidence of necrotizing enterocolitis was significantly greater among patients treated with exchange transfusion compared with patients treated symptomatically or control subjects (P < .001).

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48

Precioso, Alexander Roberto, and Renata Suman Mascaretti Proença. "Necrotizing enterocolitis, pathogenesis and the protector effect of prenatal corticosteroids." Revista do Hospital das Clínicas 57, no. 5 (September 2002): 243–48. http://dx.doi.org/10.1590/s0041-87812002000500009.

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Necrotizing enterocolitis is the most frequently occurring gastrointestinal disorder in premature neonates. Animal models of necrotizing enterocolitis and prenatal administration of cortisone have demonstrated that cortisone may accelerate maturation of the mucosal barrier, therefore reducing the incidence of this gastrointestinal disorder. The authors present a review of the literature of the most important risk factors associated with necrotizing enterocolitis, such as inflammatory gastrointestinal mediators, enteral feeding and bacterial colonization, and immaturity of the gastrointestinal barrier, and we emphasize the necessity for additional studies to explore the prenatal administration of cortisone as a preventive strategy for necrotizing enterocolitis.

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49

Mekhtieva, S. A., S. R. Nasirova, N. Dzh Rakhimova, and I. A. Gafarov. "Study of biochemical markers in newborns with necrotizing enterocolitis." Kazan medical journal 100, no. 2 (December 15, 2019): 232–38. http://dx.doi.org/10.17816/kmj2019-232.

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Aim. To study the level of biochemical markers to optimize the diagnosis and prognosis of necrotizing enterocolitis in newborns. Methods. 110 newborns with necrotizing enterocolitis were observed in the intensive care unit at the age of 1 to 28 days. According to the stages of necrotizing enterocolitis, all examined newborns were divided into three groups. Group 1 consisted of 49 newborns (40.5%) with necrotizing enterocolitis stage I, group 2 included 48 newborns (39.7%) with necrotizing enterocolitis stage II and group 3 included 13 newborns (10.7%) with necrotizing enterocolitis stage III. In 40 newborns with necrotizing enterocolitis, matrix metalloproteinase-2, -9, -17, cathelicidin, transferrin in the blood and fecal calprotectin in the feces were measured by ELISA. Results. Comparative analysis demonstrated that matrix metalloproteinase-2 was increased in newborns from group 1 by 6.9 times, in group 2 - by 8.3 times and in group 3 - by 10.7 times. Similarly, the level of metalloproteinase-9 was increased in group 1 by 3 times, in group 2 by 3.4 times, and in group 3 by 4.5 times compared to the newborns from the control group. The concentration of metalloproteinase-17 in newborns from groups 1 and 2 was almost the same and increased on average by 2.5 times, and by 3.6 times in group 3 compared to the control. In examined newborns, the highest level of cathelicidin and lowest level of transferrin were observed in necrotizing enterocolitis stage III, which indicates the more severe course of the disease and may be a predictor of changes in treatment tactics. So, taking into account the diagnostic value of fecal calprotectin (75%), it can be used as a noninvasive marker of inflammation in the intestine. Conclusion. The established changes in the level of biochemical markers (metalloproteinases, cathelicidin and transferrin in the blood and fecal calprotectin in feces) have diagnostic and prognostic value in the diagnosis, prediction of outcomes and optimization of treatment tactics of necrotizing enterocolitis in neonatal practice.

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50

Zani, Augusto, and Agostino Pierro. "Necrotizing enterocolitis: controversies and challenges." F1000Research 4 (November 30, 2015): 1373. http://dx.doi.org/10.12688/f1000research.6888.1.

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Necrotizing enterocolitis is a devastating intestinal disease that affects ~5% of preterm neonates. Despite advancements in neonatal care, mortality remains high (30–50%) and controversy still persists with regards to the most appropriate management of neonates with necrotizing enterocolitis. Herein, we review some controversial aspects regarding the epidemiology, imaging, medical and surgical management of necrotizing enterocolitis and we describe new emerging strategies for prevention and treatment.

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