IntroductionVarious surgical methods are used to treat meconium ileus (MI), including resection with enterostomy (RES), primary anastomosis (RPA), and purse-string enterotomy with intra-operative lavage (PSI). The aim of this study is to discuss the surgical treatment of MI, based on our experience.Patients and methodsOf the 41 MI patients treated at our institution between 1984 and 2007, 18 had simple MI and 23 had complex MI. These groups were analyzed according to treatment modality, concentrating on length of hospital stay, complications [peritonitis, septicemia, adhesive small bowel obstruction (ASBO), and malabsorption/diarrhea], need for additional surgical procedures, mortality.ResultsOf the 18 patients with simple MI, 7 (39%) were successfully treated with diluted Gastrografin® enema. The remaining 11 patients were treated surgically: two underwent RPA, of whom one died; five had RES, of whom one developed ASBO; four underwent PSI, of whom two developed peritonitis. In the complex MI group, 14 patients underwent RPA, with peritonitis occurring in three (one died); nine underwent RES, of whom two developed ASBO.ConclusionIn patients with simple MI, conservative treatment with diluted Gastrografin® enema is an effective initial treatment in our hands. In case of failure, RES is advisable. Patients with complex MI are candidates for RES. RPA and PSI seem to have higher complication rates.

The present study compares the clinical presentation and diagnostic features of meconium ileus (MI) in newborns with and without cystic fibrosis (CF). A retrospective study of 43 patients treated in the Pediatric Surgical Center of Amsterdam was performed. Twenty-three of the patients (53.5%) were diagnosed as having CF. Complex MI was significantly more frequent in patients without CF, and these patients had lower gestational ages and birth weights than patients with CF. All of the patients with complex MI had homozygous DF508 mutations, whereas the patients with simple MI also had other mutations. None of the patients with other mutations had complex MI. Therefore, we conclude that the clinical entity of MI represents a spectrum of underlying pathologies.

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Introduction: The overuse of antibiotics has led to a surge of antibiotic resistant bacteria in recent decades. Animal agriculture has proven to be a significant contributor to this overuse. The investigation of potential alternatives to antibiotics in animal agriculture is thus warranted. Methods: We conducted a literature review exploring four alternatives for antibiotic use in an animal agricultural setting: phytochemicals, antimicrobial peptides, probiotics, and bacteriophages. Results: Four different types of antibiotic alternatives were evaluated. The first one is phytochemicals, a broad group consisting of five subtypes: alkaloids, carotenoids, polyphenols, terpenoids, and organosulfur compounds. Many of these display antibacterial properties such as interacting with the cytoplasmic membrane, immunomodulatory activities, inhibiting specific components of DNA replication, and even inactivating specific enzymes vital for the survival of bacteria. All these subtypes displayed various antibacterial properties in animal studies surrounding poultry and livestock. The second alternative is antimicrobial peptides, which have shown to be effective in treating conditions such as post-weaning stress and necrotic enteritis in various animals. The third alternative is probiotics, which have demonstrated both growth promotion and disease prevention properties. One study also concluded that probiotics provide financial benefits to farmers. The fourth antibiotic alternative is bacteriophages, a class of viruses that infect bacteria. Phages have shown disease prevention and growth promotion properties; they also can prevent the transmission of zoonotic diseases. Discussion: Phytochemicals, antimicrobial peptides, probiotics, and bacteriophages all demonstrate the capability of acting as antibiotic alternatives. Each of these alternatives are unique with their own advantages and disadvantages; hence, the applicability is broad. Conclusion: Four antibiotic alternatives (phytochemicals, antimicrobial peptides, probiotics, and bacteriophages) were researched for disease prevention and growth promotion properties, inherent functions of antibiotics. The applicability of such options in livestock and poultry is vast. Therefore, given more funding for research studies and policy changes, many of these options can be implemented if not already.