array:26 [
  "pii" => "S0021755718306247"
  "issn" => "00217557"
  "doi" => "10.1016/j.jped.2018.07.001"
  "estado" => "S300"
  "fechaPublicacion" => "2018-09-01"
  "aid" => "702"
  "copyright" => "Sociedade Brasileira de Pediatria"
  "copyrightAnyo" => "2018"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "cor"
  "cita" => "J Pediatr (Rio J). 2018;94:566"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 400
    "formatos" => array:3 [
      "EPUB" => 68
      "HTML" => 183
      "PDF" => 149
    ]
  ]
  "Traduccion" => array:1 [
    "pt" => array:20 [
      "pii" => "S2255553618301204"
      "issn" => "22555536"
      "doi" => "10.1016/j.jpedp.2018.07.003"
      "estado" => "S300"
      "fechaPublicacion" => "2018-09-01"
      "aid" => "702"
      "copyright" => "Sociedade Brasileira de Pediatria"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "cor"
      "cita" => "J Pediatr (Rio J). 2018;94:566"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 620
        "formatos" => array:3 [
          "EPUB" => 90
          "HTML" => 329
          "PDF" => 201
        ]
      ]
      "pt" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta ao Editor</span>"
        "titulo" => "Necrotizing enterocolitis and appendicitis in preterm infants"
        "tienePdf" => "pt"
        "tieneTextoCompleto" => "pt"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "566"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Enterocolite necrosante e apendicite no prematuro"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "pt" => true
        ]
        "contienePdf" => array:1 [
          "pt" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Adauto D&#46;M&#46; Barbosa"
            "autores" => array:1 [
              0 => array:2 [
                "nombre" => "Adauto D&#46;M&#46;"
                "apellidos" => "Barbosa"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "pt"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S0021755718306247"
          "doi" => "10.1016/j.jped.2018.07.001"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755718306247?idApp=UINPBA000049"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553618301204?idApp=UINPBA000049"
      "url" => "/22555536/0000009400000005/v2_201810250609/S2255553618301204/v2_201810250609/pt/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S0021755718307927"
    "issn" => "00217557"
    "doi" => "10.1016/j.jped.2018.07.002"
    "estado" => "S300"
    "fechaPublicacion" => "2018-09-01"
    "aid" => "703"
    "copyright" => "Sociedade Brasileira de Pediatria"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "cor"
    "cita" => "J Pediatr &#40;Rio J&#41;. 2018;94:567-8"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 424
      "formatos" => array:3 [
        "EPUB" => 68
        "HTML" => 203
        "PDF" => 153
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Perforation of the cecal appendix in the neonatal period"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "567"
          "paginaFinal" => "568"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Perfura&#231;&#227;o do apendice cecal no per&#237;odo neonatal"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Let&#237;cia Feldens, Jo&#227;o C&#46;K&#46; de Souza, Jos&#233; C&#46; Fraga"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Let&#237;cia"
              "apellidos" => "Feldens"
            ]
            1 => array:2 [
              "nombre" => "Jo&#227;o C&#46;K&#46; de"
              "apellidos" => "Souza"
            ]
            2 => array:2 [
              "nombre" => "Jos&#233; C&#46;"
              "apellidos" => "Fraga"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "pt" => array:9 [
        "pii" => "S2255553618301216"
        "doi" => "10.1016/j.jpedp.2018.07.004"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "pt"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553618301216?idApp=UINPBA000049"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755718307927?idApp=UINPBA000049"
    "url" => "/00217557/0000009400000005/v1_201810100616/S0021755718307927/v1_201810100616/en/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S0021755717303583"
    "issn" => "00217557"
    "doi" => "10.1016/j.jped.2017.07.020"
    "estado" => "S300"
    "fechaPublicacion" => "2018-09-01"
    "aid" => "602"
    "copyright" => "Sociedade Brasileira de Pediatria"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "J Pediatr &#40;Rio J&#41;. 2018;94:559-65"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1126
      "formatos" => array:3 [
        "EPUB" => 68
        "HTML" => 786
        "PDF" => 272
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Role of serum &#40;1&#44;3&#41;-&#946;-<span class="elsevierStyleSmallCaps">d</span>-glucan assay in early diagnosis of invasive fungal infections in a neonatal intensive care unit"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "559"
          "paginaFinal" => "565"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "O papel do &#40;1&#46;3&#41;-&#946;-D-glucano no soro no diagn&#243;stico precoce de infec&#231;&#245;es f&#250;ngicas invasivas em uma unidade de terapia intensiva neonatal"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0015"
          "etiqueta" => "Figure 3"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr3.jpeg"
              "Alto" => 1414
              "Ancho" => 1460
              "Tamanyo" => 56761
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">ROC curve of 1&#44;3-&#946;-<span class="elsevierStyleSmallCaps">d</span>-glucan for discrimination between no fungemia and definite fungemia groups&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Abd Elazeez Shabaan, Lobna Mahmoud Elbaz, Wafaa M&#46; El-Emshaty, Basma Shouman"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Abd Elazeez"
              "apellidos" => "Shabaan"
            ]
            1 => array:2 [
              "nombre" => "Lobna Mahmoud"
              "apellidos" => "Elbaz"
            ]
            2 => array:2 [
              "nombre" => "Wafaa M&#46;"
              "apellidos" => "El-Emshaty"
            ]
            3 => array:2 [
              "nombre" => "Basma"
              "apellidos" => "Shouman"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "pt" => array:9 [
        "pii" => "S225555361730201X"
        "doi" => "10.1016/j.jpedp.2017.07.007"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "pt"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S225555361730201X?idApp=UINPBA000049"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755717303583?idApp=UINPBA000049"
    "url" => "/00217557/0000009400000005/v1_201810100616/S0021755717303583/v1_201810100616/en/main.assets"
  ]
  "asociados" => array:2 [
    0 => array:20 [
      "pii" => "S0021755717301419"
      "issn" => "00217557"
      "doi" => "10.1016/j.jped.2017.06.010"
      "estado" => "S300"
      "fechaPublicacion" => "2018-05-01"
      "aid" => "551"
      "copyright" => "Sociedade Brasileira de Pediatria"
      "documento" => "article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "fla"
      "cita" => "J Pediatr &#40;Rio J&#41;. 2018;94:320-4"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 991
        "formatos" => array:3 [
          "EPUB" => 104
          "HTML" => 618
          "PDF" => 269
        ]
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
        "titulo" => "There is an association between disease location and gestational age at birth in newborns submitted to surgery due to necrotizing enterocolitis"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "pt"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "320"
            "paginaFinal" => "324"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Existe associa&#231;&#227;o entre a localiza&#231;&#227;o da doen&#231;a e a idade gestacional ao nascimento de rec&#233;m-nascidos operados por enterocolite necrosante"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "pt" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figure 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1088
                "Ancho" => 1653
                "Tamanyo" => 82468
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Association between the site of involvement of necrotizing enterocolitis and gestational age&#44; by group&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Let&#237;cia Feldens, Jo&#227;o C&#46;K&#46; de Souza, Jos&#233; C&#46; Fraga"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "Let&#237;cia"
                "apellidos" => "Feldens"
              ]
              1 => array:2 [
                "nombre" => "Jo&#227;o C&#46;K&#46; de"
                "apellidos" => "Souza"
              ]
              2 => array:2 [
                "nombre" => "Jos&#233; C&#46;"
                "apellidos" => "Fraga"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "pt" => array:9 [
          "pii" => "S2255553617301271"
          "doi" => "10.1016/j.jpedp.2017.09.013"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "pt"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553617301271?idApp=UINPBA000049"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755717301419?idApp=UINPBA000049"
      "url" => "/00217557/0000009400000003/v2_201805190418/S0021755717301419/v2_201805190418/en/main.assets"
    ]
    1 => array:20 [
      "pii" => "S0021755718307927"
      "issn" => "00217557"
      "doi" => "10.1016/j.jped.2018.07.002"
      "estado" => "S300"
      "fechaPublicacion" => "2018-09-01"
      "aid" => "703"
      "copyright" => "Sociedade Brasileira de Pediatria"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "cor"
      "cita" => "J Pediatr &#40;Rio J&#41;. 2018;94:567-8"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 424
        "formatos" => array:3 [
          "EPUB" => 68
          "HTML" => 203
          "PDF" => 153
        ]
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
        "titulo" => "Perforation of the cecal appendix in the neonatal period"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "567"
            "paginaFinal" => "568"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Perfura&#231;&#227;o do apendice cecal no per&#237;odo neonatal"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Let&#237;cia Feldens, Jo&#227;o C&#46;K&#46; de Souza, Jos&#233; C&#46; Fraga"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "Let&#237;cia"
                "apellidos" => "Feldens"
              ]
              1 => array:2 [
                "nombre" => "Jo&#227;o C&#46;K&#46; de"
                "apellidos" => "Souza"
              ]
              2 => array:2 [
                "nombre" => "Jos&#233; C&#46;"
                "apellidos" => "Fraga"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "pt" => array:9 [
          "pii" => "S2255553618301216"
          "doi" => "10.1016/j.jpedp.2018.07.004"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "pt"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2255553618301216?idApp=UINPBA000049"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755718307927?idApp=UINPBA000049"
      "url" => "/00217557/0000009400000005/v1_201810100616/S0021755718307927/v1_201810100616/en/main.assets"
    ]
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "Necrotizing enterocolitis and appendicitis in preterm infants"
    "tieneTextoCompleto" => true
    "saludo" => "<span class="elsevierStyleItalic">Dear Editor</span>&#44;"
    "paginas" => array:1 [
      0 => array:1 [
        "paginaInicial" => "566"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Adauto D&#46;M&#46; Barbosa"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "Adauto D&#46;M&#46;"
            "apellidos" => "Barbosa"
            "email" => array:1 [
              0 => "adutra&#64;vm&#46;uff&#46;br"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Universidade Federal Fluminense &#40;UFF&#41;&#44; Faculdade de Medicina&#44; Niter&#243;i&#44; RJ&#44; Brazil"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Enterocolite necrosante e apendicite no prematuro"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">I read with great interest the article entitled &#8220;There is an association between disease location and gestational age at birth in newborns submitted to surgery due to necrotizing enterocolitis&#8221;&#44; by Feldens et al&#46;&#44; published in the Journal of Pediatrics&#44;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> and we have observed surgical descriptions that corroborate those found in that study regarding the different locations of necrotizing enterocolitis &#40;NEC&#41;&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Our letter to the editor does not intend to contradict the findings of the excellent study by the authors&#44; but rather to raise an issue that remains unexplored and without a plausible explanation&#44; and which we have not seen being formally addressed in studies that involve the subject&#46; When reviewing the intestinal tract of preterm newborns with NEC during exploratory laparotomy&#44; the classic surgical description of the findings is restricted to perforations that affect the jejunum&#44; terminal ileum&#44; and proximal portion of the colon to a greater or lesser extent&#46; However&#44; we have not found reports on the status of the ileocecal valve and particularly of the cecal appendix in cases of NEC&#44; which would provide opportune clarification about the participation of this organ&#8212;once considered vestigial&#8212;in the disease&#44; which could present as &#8220;acute appendicitis&#8221; at its onset&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In the Journal of Pediatrics<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> we described a case entitled &#8220;Appendicitis in a premature newborn&#8221;&#44; which occurred in a newborn with a gestational age of 34 weeks&#44; mildly asphyxiated&#44; and who at 9 days of life developed a classic clinical picture of NEC with abdominal distension&#44; hyperemia of the flanks and&#44; lastly&#44; pneumoperitoneum&#44; leading to surgical intervention&#44; which disclosed not a jejunal&#44; ileal&#44; or colonic perforation&#44; but a cecal appendix perforation whose specimen&#44; when assessed in the pathological anatomy division&#44; confirmed it to be a ruptured cecal appendix with an intense inflammatory process&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In this sense&#44; there have been few descriptions associating appendicitis in preterm infants with NEC&#44;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">3&#8211;5</span></a> which allows us to enquire&#58; wouldn&#8217;t it be prudent to describe the status of the cecal appendix together with the jejunal&#44; ileal&#44; and colonic examination in studies involving cases of NEC&#63; Or is NEC limited to those intestinal segments&#44; and acute appendicitis in preterm infants is a mere finding&#63;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The author declares no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflicts of interest"
        ]
        1 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Barbosa AD&#46; Necrotizing enterocolitis and appendicitis in preterm infants&#46; J Pediatr &#40;Rio J&#41;&#46; 2018&#59;94&#58;566&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "There is an association between disease location and gestational age at birth in newborns submitted to surgery due to necrotizing enterocolitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Feldens"
                            1 => "J&#46;C&#46; Souza"
                            2 => "J&#46;C&#46; Fraga"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Pediatr &#40;Rio J&#41;"
                        "fecha" => "2018"
                        "volumen" => "94"
                        "paginaInicial" => "320"
                        "paginaFinal" => "336"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Appendicitis in the premature newborn"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;D&#46; Barbosa"
                            1 => "I&#46;F&#46; J&#250;nior"
                            2 => "R&#46;R&#46; Caetano"
                            3 => "V&#46;G&#46; Lopes"
                            4 => "A&#46;M&#46; Santos"
                            5 => "E&#42;D&#46; Franco"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Pediatr &#40;Rio J&#41;"
                        "fecha" => "2000"
                        "volumen" => "76"
                        "paginaInicial" => "466"
                        "paginaFinal" => "468"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Appendicitis in neonatal &#40;AN&#41; patients with secondary necrotizing enterocolitis &#40;ECN&#41; due to sepsis in the uterus&#58; a case report"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;C&#46; L&#243;pez-Vald&#233;s"
                            1 => "R&#46; Escarcega-Serv&#237;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Gac Med Mex"
                        "fecha" => "2016"
                        "volumen" => "152"
                        "paginaInicial" => "419"
                        "paginaFinal" => "423"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27335199"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute neonatal appendicitis&#58; a diagnosis to consider in abdominal sepsis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;P&#46; Arias-Llorente"
                            1 => "P&#46; Fl&#243;rez-D&#237;ez"
                            2 => "M&#46; Oviedo-Guti&#233;rrez"
                            3 => "M&#46; Su&#225;rez-Rodr&#237;guez"
                            4 => "M&#46; Costa-Romero"
                            5 => "G&#46; Sol&#237;s-S&#225;nchez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3233/NPM-14814003"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neonatal Perinatal Med"
                        "fecha" => "2014"
                        "volumen" => "7"
                        "paginaInicial" => "241"
                        "paginaFinal" => "246"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25318628"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neonatal appendicitis&#58; a new look at an old zebra"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46; Jancelewicza"
                            1 => "G&#46; Kimb"
                            2 => "D&#46; Miniatia"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jpedsurg.2008.08.009"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Surg"
                        "fecha" => "2008"
                        "volumen" => "43"
                        "paginaInicial" => "E1"
                        "paginaFinal" => "E5"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19040912"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/00217557/0000009400000005/v1_201810100616/S0021755718306247/v1_201810100616/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "18984"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Letters to the editor"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/00217557/0000009400000005/v1_201810100616/S0021755718306247/v1_201810100616/en/main.pdf?idApp=UINPBA000049&text.app=https://jped.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0021755718306247?idApp=UINPBA000049"
]
Share
Journal Information
Vol. 94. Issue 5.
Pages 566 (September - October 2018)
Vol. 94. Issue 5.
Pages 566 (September - October 2018)
Letter to the Editor
Open Access
Necrotizing enterocolitis and appendicitis in preterm infants
Enterocolite necrosante e apendicite no prematuro
Visits
2186
Adauto D.M. Barbosa
Universidade Federal Fluminense (UFF), Faculdade de Medicina, Niterói, RJ, Brazil
Related content
Letícia Feldens, João C.K. de Souza, José C. Fraga
J Pediatr (Rio J). 2018;94:567-810.1016/j.jped.2018.07.002
Letícia Feldens, João C.K. de Souza, José C. Fraga
This item has received

Under a Creative Commons license
Article information
Full Text
Bibliography
Download PDF
Statistics
Full Text
Dear Editor,

I read with great interest the article entitled “There is an association between disease location and gestational age at birth in newborns submitted to surgery due to necrotizing enterocolitis”, by Feldens et al., published in the Journal of Pediatrics,1 and we have observed surgical descriptions that corroborate those found in that study regarding the different locations of necrotizing enterocolitis (NEC).

Our letter to the editor does not intend to contradict the findings of the excellent study by the authors, but rather to raise an issue that remains unexplored and without a plausible explanation, and which we have not seen being formally addressed in studies that involve the subject. When reviewing the intestinal tract of preterm newborns with NEC during exploratory laparotomy, the classic surgical description of the findings is restricted to perforations that affect the jejunum, terminal ileum, and proximal portion of the colon to a greater or lesser extent. However, we have not found reports on the status of the ileocecal valve and particularly of the cecal appendix in cases of NEC, which would provide opportune clarification about the participation of this organ—once considered vestigial—in the disease, which could present as “acute appendicitis” at its onset.

In the Journal of Pediatrics2 we described a case entitled “Appendicitis in a premature newborn”, which occurred in a newborn with a gestational age of 34 weeks, mildly asphyxiated, and who at 9 days of life developed a classic clinical picture of NEC with abdominal distension, hyperemia of the flanks and, lastly, pneumoperitoneum, leading to surgical intervention, which disclosed not a jejunal, ileal, or colonic perforation, but a cecal appendix perforation whose specimen, when assessed in the pathological anatomy division, confirmed it to be a ruptured cecal appendix with an intense inflammatory process.

In this sense, there have been few descriptions associating appendicitis in preterm infants with NEC,3–5 which allows us to enquire: wouldn’t it be prudent to describe the status of the cecal appendix together with the jejunal, ileal, and colonic examination in studies involving cases of NEC? Or is NEC limited to those intestinal segments, and acute appendicitis in preterm infants is a mere finding?

Conflicts of interest

The author declares no conflicts of interest.

References
[1]
L. Feldens, J.C. Souza, J.C. Fraga.
There is an association between disease location and gestational age at birth in newborns submitted to surgery due to necrotizing enterocolitis.
J Pediatr (Rio J), 94 (2018), pp. 320-336
[2]
A.D. Barbosa, I.F. Júnior, R.R. Caetano, V.G. Lopes, A.M. Santos, E*D. Franco.
Appendicitis in the premature newborn.
J Pediatr (Rio J), 76 (2000), pp. 466-468
[3]
J.C. López-Valdés, R. Escarcega-Servín.
Appendicitis in neonatal (AN) patients with secondary necrotizing enterocolitis (ECN) due to sepsis in the uterus: a case report.
Gac Med Mex, 152 (2016), pp. 419-423
[4]
R.P. Arias-Llorente, P. Flórez-Díez, M. Oviedo-Gutiérrez, M. Suárez-Rodríguez, M. Costa-Romero, G. Solís-Sánchez, et al.
Acute neonatal appendicitis: a diagnosis to consider in abdominal sepsis.
J Neonatal Perinatal Med, 7 (2014), pp. 241-246
[5]
T. Jancelewicza, G. Kimb, D. Miniatia.
Neonatal appendicitis: a new look at an old zebra.
J Pediatr Surg, 43 (2008), pp. E1-E5

Please cite this article as: Barbosa AD. Necrotizing enterocolitis and appendicitis in preterm infants. J Pediatr (Rio J). 2018;94:566.

Copyright © 2018. Sociedade Brasileira de Pediatria
Download PDF
Idiomas
Jornal de Pediatria (English Edition)
Article options
Tools
en pt
Taxa de publicaçao Publication fee
Os artigos submetidos a partir de 1º de setembro de 2018, que forem aceitos para publicação no Jornal de Pediatria, estarão sujeitos a uma taxa para que tenham sua publicação garantida. O artigo aceito somente será publicado após a comprovação do pagamento da taxa de publicação. Ao submeterem o manuscrito a este jornal, os autores concordam com esses termos. A submissão dos manuscritos continua gratuita. Para mais informações, contate assessoria@jped.com.br. Articles submitted as of September 1, 2018, which are accepted for publication in the Jornal de Pediatria, will be subject to a fee to have their publication guaranteed. The accepted article will only be published after proof of the publication fee payment. By submitting the manuscript to this journal, the authors agree to these terms. Manuscript submission remains free of charge. For more information, contact assessoria@jped.com.br.
Cookies policy Política de cookies
To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.