bluuebunny/crossref_metadata_2025 huggingface dataset:
γ‐Aminobutyric acid concentrations in the cerebrospinal fluid of newborn infants determined by high performance liquid chromatography
Authors: Giroux JD , Moisan‐Cann C , Caroff J , Girin E , Simon B , Broussine L , Barthélémy L , Alix D , Parscau L de
Published: January 2008

γ‐Aminobutyric acid (GABA), a major inhibitory amino acid, has a central role in cardiorespiratory regulation. Its measurement in the cerebrospinal fluid (CSF) complements the study of neurotransmission systems. Forty‐one children were studied (postnatal age <1 year). For each child, date of birth, date of sampling and current treatments were collated and their postnatal (days) and postconception (weeks) ages were calculated. CSF samples were studied using reverse phase high performance liquid chromatography (HPLC) with o‐phthaldialdehyde derivation and spectro‐fluorimetric measurement. A clear increase in levels of GABA was observed around 41 weeks postconception, followed by a progressive decrease, with levels stabilizing after 57 weeks post‐conception. GABA‐regulated neuromodulation therefore appears to be mature at 41 weeks postconception and not at birth. The data could be used in further studies investigating amino acid metabolism in relation to brain function in various neurological disorders.
Secular trend in the sexual maturation of southern Chinese boys
Authors: Wong GWK , Leung SSF , Law WY , Yeung VTF , Lau JTF , Yeung WKY
Published: January 2008

A random sample of 3872 southern Chinese boys ranging from 7 to 21 years of age were selected from primary and secondary schools in Hong Kong for the assessment of sexual maturation. The median ages of onset of puberty and pubic hair development were 11.4 and 12.7 years, respectively. The advancement of sexual maturation coincides with the secular increase in height and weight for Chinese children in Hong Kong.
Phospholipid fatty acids in cord blood: family history and development of allergy
Authors: Yu G , Kjellman N‐IM , Björkstén B
Published: January 2008

The fatty acid composition of umbilical cord serum phospholipids was investigated by gas chromatography in 33 infants with allergic and 35 babies of non‐allergic mothers. The relative levels of the linoleic acid metabolites C20:3, arachidonic acid (AA, C20:4) and C22:4n‐6, and two α‐linolenic acid metabolites, i.e. eicosapentaenoic acid (EPA, 20:5) and docosahexaenoic acid (DHA, C22:6) were significantly higher in infants of allergic mothers than in non‐allergic mothers (all p < 0.05). Furthermore, an altered proportional relationship between the various fatty acids in n‐6 series fatty acids and between n‐3 and n‐6 series fatty acids was present already at birth in infants who developed allergic disease during their first 6 years of life. These observations cannot be employed for the prediction of allergy, however, as the individual variations were considerable.
Duration of action of formoterol and salbutamol dry‐powder inhalation in prevention of exercise‐induced asthma in children
Authors: Daugbjerg P , Nielsen KG , Skov M , Bisgaard H
Published: January 2008

The aim of this study was to evaluate the effect and tolerability of formoterol 12 μg on exercise‐induced asthma in children for 12 h as compared to the effect of salbutamol 400 μg and placebo. The drugs were inhaled as dry powder from a flow‐dependent metered‐dose inhaler (DP‐MDI). Sixteen asthmatic children took part in a double‐blind placebo‐controlled within‐patient single‐centre trial. On each study day the patients were given one of the drugs or placebo in random order, and standardized exercise tests were performed after 3 and 12 h. At a pretrial test the children had demonstrated a median maximum percentage fall of 38% (range 22–79%) in forced expiratory volume in 1 s after exercise challenge. Formoterol showed a median percentage protection of 77% and 70% at 3 and 12 h postexercise, respectively, as compared to 46% and 13% with salbutamol. No side‐effects were observed. Formoterol 12μg administered as dry powder offers significantly better protection against exercise‐induced asthma after 3 and 12 h as compared to salbutamol 400μg and placebo.
Influence of early postnatal dexamethasone therapy on ventilator dependency in surfactant‐substituted preterm infants
Authors: Suske G , Oestreich K , Varnholt V , Lasch P , Kachel W
Published: January 2008

We examined 26 preterm infants with respiratory distress syndrome in a randomized controlled prospective study to determine whether early postnatal dexamethasone therapy (<2h; 0.5 mg/kg per day) over 5 days in addition to substitution of surfactant (100 mg/kg) facilitates extubation and the course of RDS. Control (n= 12) and treated (n= 14) groups were comparable in birthweight (mean ± SD: 1219 ± 292 versus 1446 ± 442g), gestational age (29.3 ± 2.2 versus 30.6 ± 2.7 weeks), prenatal characteristics and initial respiratory and blood gas parameters. In both groups one infant died. Infants in the dexamethasone group responded better to surfactant (12/14 versus 3/12; p < 0.01), were extubated earlier (6.6 versus 14.2 days; p < 0.02) and required less time on supplemental oxygen (4.2 versus 12.5 days; p < 0.02). Pulmonary complications tended to be lower in the dexamethasone group (1/14 versus 4/12), as was the frequency of retinopathy (2/14 versus 6/12; p < 0.05). We conclude that early postnatal dexamethasone therapy improves response to surfactant therapy resulting in better weaning and earlier extubation in premature infants.
Effect of a reduced vitamin K supplementation on prothrombin time in prematures and high‐risk neonates
Authors: Rossi R , Albrecht O , Pollmann H , Jorch G , Harms E
Published: January 2008

Recommendations for vitamin K supplementation were recently changed to 3 x 1 mg orally in healthy term neonates and 0.2 mg parenterally in prematures and high‐risk neonates. Prothrombin times (PT) at reduced vitamin K doses (120 patients, 170 samples) during the first 6 weeks of life were below 40% in 6 patients only; all low PTs were unrelated to vitamin K. In the remaining patients, median PT was 100%; 79% of patients had values above 70%. PT was related to birthweight, gestational age and age. There was no decrease over the observation period. Following reduced oral and parenteral vitamin K regimens PTs were well within published reference values for neonates given larger amounts of vitamin K.
Serum apolipoproteins A‐I and B in male and female full‐term new borns of the Toledo study (Spain)
Authors: Sánchez‐Muniz Bastida FJ , Cuesta C , Perea S , Ureta A
Published: January 2008

Cord serum apolipoproteins (Apo) A‐I and B from 548 healthy, full‐term singletons were studied. Females displayed slightly, but significantly, higher Apo A‐I levels (p < 0.001) than males. Particularly at weeks 38 and 39 (p < 0.05), whereas Apo B was not gender affected but likewise increased (p < 0.05) between weeks 37 and 41. Apo A‐I values increased (p < 0.05) with gestational age in males, but with birthweight in females. Results suggest that small gender and age‐related metabolic differences exist at birth in terms infants
Use of brain lactate levels to predict outcome after perinatal asphyxia
Authors: Leth H , Toft PB , Peitersen B , Lou HC , Henriksen O
Published: January 2008

Perinatal asphyxia is an important cause of neurological disability, but early prediction of outcome can be difficult. We performed proton magnetic resonance spectroscopy (MRS) and global cerebral blood flow measurements by xenon‐133 clearance in 16 infants with evidence of perinatal asphyxia. Cerebral blood flow was determined daily in the first 3 days after birth in seven cases. Proton MRS was performed in 11 infants within the first week (mean 3.7 days), the rest within the first month (mean 22.2 days), and all had a scan around 3 months of age. Four infants died neonatally, three showed neurological deficits and the rest seemed to be progressing normally at neurodevelopmental follow‐up at 1 year of age. A significant correlation was found between initial brain lactate levels and severe outcome (p= 0.0003) just as between cerebral hyperperfusion (mean cerebral blood flow (CBF) 86ml(100g)‐1min‐1), (p = 0.02) and outcome. The diagnostic and prognostic implications of early MRS and CBF are predictive of poor outcome in severely asphyxiated infants.
Altered Na+‐K+ ATPase activity in uraemic adolescents
Authors: Vasarhelyi B , Sallay P , Balog E , Reusz Gy , Tulassay T
Published: January 2008

The Na+‐K+ ATPase enzyme plays an essential role in the regulation of cell composition and volume. Enzyme activity itself is regulated by substrate availability and several hormones. In adult uraemic patients red blood cell Na+‐K+ ATPase activity is decreased. However, it is unknown if children with uraemia exhibit the same phenomenon. Therefore, in the present study we examined whether endogenous digoxin‐like factors (EDLF) and physicochemical membrane properties play a role in the regulation of erythrocyte Na+‐K+ ATPase activity in uraemic children and adolescents. Healthy age‐matched children were used as controls. Enzyme activity was measured in detergent‐pretreated red blood cells and erythrocyte ghosts. Na+‐K+ ATPase activity (2204 ± 538nmol Pi ml erythrocyte−1 h−1 in detergent pretreated erythrocytes; 204 ± 56 nmol Pi mg protein−1 h−1 in ghosts) in adolescents with uraemia was lower compared to controls (3245 ± 362 nmol Pi ml erythrocyte 1 h−1; 266 ± 37 nmol Pi mg protein−1 h−1, p < 0.001, p < 0.05, respectively). Plasma levels of EDLF were elevated in uraemic patients (0.30 ± 0.05 versus 0.21 ±0.04 ng ml−1, p < 0.01). Furthermore, the membrane lipid component was decreased in patients with uraemia, while the cholesterol/phospholipid ratio and membrane fluidity were similar in both groups. No correlation was found between the decrease in Na+‐K+ ATPase and the increase in EDLF concentration and altered membrane lipid components. Our results demonstrate, that similar to the findings of adults, the activity of Na+‐K+ ATPase is diminished in uraemic adolescent patients, and that uraemia‐associated elevation in EDLF and altered membrane components do not play a role in the down‐regulation of Na+‐K+ ATPase. Therefore other factors (presence of other inhibitors and/or reduced number of enzyme molecules) should contribute to the lower activity of the Na+‐K+ pump.
Circulating noradrenaline and β‐adrenergic receptors in children with congestive heart failure
Authors: Wu JR , Chang HR , Chen SS , Huang TY
Published: January 2008

This study was designed to investigate changes in plasma catecholamine concentrations and the number of β‐adrenoceptors (β‐AR) of circulating lymphocyte in 94 noncyanotic congenital heart patients, in 43 patients with congestive heart failure, β‐AR density was significantly lower (p < 0.001) and plasma noradrenergic levels were significantly higher (p < 0.001) compared with corresponding values in 51 patients without heart failure. A significant negative correlation between lymphocyte β‐AR density and plasma noradrenergic levels was observed (r=−0.61, p < 0.001). The degree of left‐to‐right shunt and pulmonary pressure was correlated directly with noradrenaline level and inversely with lymphocyte β‐AR density. Both plasma noradrenaline level and lymphocyte β‐AR density return to normal in children with heart failure after surgical repair. Our results support the idea that changes in noradrenaline level and lymphocyte β‐adrenoceptor density occur concurrently with the presence and severity of heart failure in children.
Asthma and atopy in schoolchildren in a defined population
Authors: Remes ST , Korppi M
Published: January 2008

We investigated the frequency of allergic disorders, the pattern of allergen sensitization and serum total IgE concentration in a population‐based sample of schoolchildren screened on the basis of respiratory symptoms (A= 244). The children were classified on clinical grounds into three groups, asthma (N= 43), other symptoms from lower airways (OSLA; N= 34) and control children (N= 167). The frequency of allergic disorders (allergic rhinitis, conjunctivitis or dermatitis) differed significantly between children with asthma (81%), children with OSLA (62%) and in control children (48%) (p < 0.001). The presence of at least one positive skin prick test result was equally common in children with asthma or OSLA (77%), but lower in control children (40%) (p < 0.001). Serum total IgE concentrations did not differ between the three groups. Two conclusions can be drawn: (i) there is a strong association between clinical allergy, skin reactivity and asthma in school age children, and (ii) a similar association is present between allergy and asthma‐like conditions.
An assessment of behavioural characteristics in infants who died of sudden infant death syndrome using the Early Infancy Temperament Questionnaire
Authors: Kelmanson IA
Published: January 2008

An assessment of the behavioural peculiarities of infants dying of sudden infant death syndrome (SIDS) was carried out using the Early Infancy Temperament Questionnaire (EITQ). Thirty‐six infants (25 boys and 11 girls aged 14 months) in whom the diagnosis of SIDS was confirmed by full necropsy and who died in St Petersburg from 1990 to 1992 entered the study, and the families were approached contemporaneously. A control group consisted of an equal number of age, sex, geographic distribution and date of birth matched live infants from the same city. The infants who died of SIDS had significantly lower estimates of activity in comparison with the babies from the control group. Behavioural defects may be a contributory factor and a sign of increased risk in some babies presenting with SIDS.
Dietary iron intake and iron status in adolescents
Authors: Samuelson G , Bratteby L‐E , Berggren K , Elverby J‐E , Kempe B
Published: January 2008

The aim of this study was to evaluate the dietary iron intake of 15‐year‐old adolescents from two different regions of Sweden, in relation to their iron status. The study comprised 185 boys and 209 girls, randomly selected from the official population register. The iron intake was calculated from a 7‐day record, and varied between 7 and 35 and 6 and 27 mg per day for boys and girls, respectively. The daily median intakes in boys and girls were 18.7 and 14.2 mg, respectively. S‐ferritin, s‐iron, and s‐transferrin saturation, measured in all the subjects, did not differ significantly between the two regions. However, the mean serum ferritin concentration was significantly higher in the boys (36.4μgl‐1) than in the girls (29.4μgl‐1)(p < 0.001). Low s‐ferritin levels, defined as s‐ferritin < 12 μgl‐1 were found in seven boys (3.7%) and in 29 girls (13.9%). None of the adolescents had iron deficiency anaemia, defined as Hb< 110gl‐1 in combination with s‐ferritin < 12μgl‐1. Regression and correlation analyses did not show any significant correlation between dietary iron intake and s‐ferritin, or between s‐ferritin and haemoglobin (Hb), MCH and MCHC. A significant correlation was found, however, between s‐ferritin and transferrin saturation (p < 0.005) in both sexes. When the adolescents who still had s‐ferritin < 12μgl‐1 at a second blood examination were given a 6 weeks trial with oral iron therapy, all of them showed an increase both in s‐ferritin and in blood Hb. The 95% confidence intervals of s‐ferritin for 15‐year‐old Swedish boys and girls were defined as 11‐90 and 7 85 μ.gl‐1, respectively.
Maternal perception of cause, signs and severity of diarrhoea in a suburban West African community
Authors: Sodemann M , Jakobsen MS , Mølbak K , Martins C , Aaby P
Published: January 2008

With the aim of investigating perceived morbidity and care seeking behaviour, a household survey was conducted, where 319 episodes of diarrhoea were followed by interviews every second day. The chance of consultation increased with the number of symptoms reported by the mother. The appearance of the eyes and how the child breastfed were early warnings that mothers recognized best. By contrast, there was an 80% reduction in the likelihood of seeking consultation when the mother perceived the diarrhoea as caused by teeth eruption (n= 96). Children with “teething diarrhoea” were, however, just as likely to develop signs of dehydration as children with non‐teething diarrhoea. We conclude that health education concerning diarrhoea should emphasize early signs of dehydration and the discouragement of “teething” as an explanation of natural diarrhoea.
The correlation of elevated levels of an index of lipid peroxidation (MDA‐TBA) with adverse outcome in the very low birthweight infant
Authors: Inder TE , Darlow BA , Sluis KB , Winterbourn CC , Graham P , Sanderson KJ , Taylor BJ
Published: January 2008

The objective of this study was to examine the relationship between malondialdehyde‐thiobarbituric acid (MDA‐TBA) levels, as a measure of lipid peroxidation, in very low birthweight (VLBW) infants and outcome measures. A prospective observational longitudinal study was carried out in two level III neonatal units in the South Island of New Zealand measuring MDA‐TBA levels in 61 VLBW infants in 1993. MDA‐TBA levels were measured in (i) maternal plasma within 48 h of parturition, (ii) cord plasma, and (iii) infants’plasma at 2, 7, 14 and 28 days of age, and correlated with antenatal and postnatal factors. Elevated levels of plasma MDA‐TBA at 7 days were associated with adverse respiratory and ophthalmological outcome in the VLBW infants. Elevated MDA‐TBA levels were measured at sample times close to the time of death in the infants who died. These results substantiate previously reported preliminary observations and support the hypothesis that oxidative injury, particularly within the first 7 days of life, is associated with the development of the long‐term complications of the pre‐term infant. MDA‐TBA levels appear to be a useful measure to continue to explore the role of free radical mediated disease in the VLBW infant.
Prevalence of coeliac disease in type I diabetes: a multicentre study
Authors: De Vitis I , Ghirlanda G , Gasbarrini G
Published: January 2008

The aim of this study was to point out the prevalence ratio and the clinical presentation of coeliac disease (CD) in a large group of insulin‐dependent diabetes mellitus (IDDM) patients. Patients and methods: 1114 patients affected by IDDM were screened for CD using antigliadin and antiendomysium antibodies. Patients who were positive for at least one test underwent an endoscopic biopsy of the descending duodenum in order to verify the presence of villous atrophy. Subjects with CD started a gluten‐free diet and underwent a clinical follow‐up. Results: Villous atrophy was found in 63 patients (5.6%). Among the Italian population, the rate was 7%. Twenty‐four percent of coeliac patients presented with diarrhoea, while 22% were completely symptom‐free. A significant correlation was found between the presence of villous atrophy and the duration and onset of diabetes. Conclusions: The prevalence of CD in IDDM is higher than previously reported, although the ratio range in different centres from 1.7 to 10%, probably due to both environmental and genetic factors. Twenty‐two percent of coeliac patients were completely symptom‐free. The prevalence seems to be significantly related to the duration and onset of IDDM.
Coeliac disease and malignancies
Authors: Ferguson A , Kingstone K
Published: January 2008

When compared with the general population, patients with coeliac disease (CD) have an increased risk of developing enteropathy‐associated T‐cell lymphoma (EATCL), esophageal and pharyngeal squamous carcinomas and small intestinal adenocarcinomas. The prevalence of histologically confirmed CD in Edinburgh and the Lothians in 1979 was 61 per 100000. The National Health Service Central Records of all 653 subjects registered at that time have been flagged, allowing us to analyse mortality in CD. At a mean of 13.5 years, mortality overall was 1.9‐fold that of the general population (115 deaths observed, 61.8 expected; p < 0.0001). For both sexes the early mortality was much greater than expected, but the excess steadily diminished with time from diagnosis. Much of the increased mortality from malignant disease was accounted for by deaths from lymphoproliferative disease and esophageal cancer. Interim re‐analysis after a further 9 years shows that the pattern of later deaths is consistent with these trends. Clinical and pathological features of lymphomas in CD are described. In serum samples of 41 patients with normal villus architecture while taking a normal diet, but with minor pathological and/or immunological abnormalities, i.e. potential CD, IgA antiendomysium antibodies were positive in 7 with dermatitis herpetiformis but in only 3 others.
Food habits and energy and nutrient intake in Swedish adolescents approaching the year 2000
Authors: Samuelson G , Bratteby L‐E , Enghardt H , Hedgren M
Published: January 2008

In 1993‐94 a nutritional survey of 15‐year‐old adolescents was carried out in Uppsala, a university city in eastern Sweden, and in Trollhättan, an industrial town in the western part of the country. The study was the beginning of a longitudinal nutritional survey of 193 boys and 218 girls randomly selected from the official population register. The dietary methods used were a food frequency questionnaire (FFQ) and a combined estimated and weighed 7‐day dietary record. According to the FFQ both boys and girls consumed cereals, butter or margarine and something from the group meat/fish/eggs every day. Milk, milk products, sweets and snacks were consumed more than once per day. Vegetables and fruit/ roots were consumed less often. There was relatively good correlation between the FFQ and the 7‐day record results.

The mean daily energy intakes of the 15‐year‐old boys and girls were 10.2 and 8.3 M J, respectively, in Uppsala, and 9.8 and 7.4 M J in Trollhättan. The mean daily intakes of sucrose were 74 and 58 g in boys and 64 and 52 g in girls. The average daily dietary fibre intake was 1.8 g/MJ. The daily intake of energy obtained from breakfast was 18% on weekdays and 22% on weekends; 18 and 11% from prepared lunch; 24 and 30% from dinner, 21 and 14% from light meals; and 16 and 28% from snacks, in Uppsala and Trollhättan respectively. The lowest energy intake from a prepared lunch meal was noted during weekends. On both weekdays and weekends, considerable energy was obtained from light meals and snacks. However, nearly 40% of the girls and 28% of the boys had an energy intake from fat of Ylt; 30 energy %.

The mean intakes of vitamin D and selenium and, in the case of girls, iron and zinc, were below the official Swedish Nutrition Recommendations. The daily median intake of iron was 18.7 mg in boys and 14.1 mg in girls. The iron intakes varied between 6 and 35 mg per day. Low serum ferritin concentrations, defined as s‐ferritin <12μg/L, were found in 7 boys (3.7%) and in 29 girls (13.9%).

Significant negative correlations were found between smoking and frequency of consumption of vegetables, roots, fruits and meat. A negative correlation was also found between smoking and the intake of energy and a number of nutrients. Socioeconomic factors seem to be less important for the food habits of teenagers than for those noted during childhood. Only frequent consumption of vegetables was positively correlated to the mothers’educational level.
Does neurological assessment still have a place in the NICU?
Authors: Amiel‐Tison C
Published: January 2008

Comments at discharge from the neonatal intensive care unit tend to concern porencephalic cysts or ventricular dilatation rather than clinical neurological findings. This neglect in collecting clinical information can be understood during the acute stage of neonatal adaptation due to the non‐specificity and lability of many neurological signs. However, it does not seem justified when the infant has recovered, can breathe on his/her own and can tolerate handling. To define optimal Central Nervous System function at 40 weeks (just born or corrected), a simple basic assessment composed of nine variables is proposed, with descriptions and illustrations. Rationale for the timing and selection of variables is discussed. The benefit of this clinical approach is to subdivide children with normal ultrasound imaging into two subgroups according to non‐optimal or optimal responses. Prospective follow‐up of children with non‐optimal responses will reduce the number of late diagnoses of developmental disabilities. Rational optimism for the others will diminish parents’anxiety and neurologic clinics, overload.
The assessment of General Movements is a valuable technique for the detection of brain dysfunction in young infants. A review
Authors: Hadders‐Algra M
Published: January 2008

Recently, a new assessment technique by which to evaluate brain function in the fetus and newborn infant has been developed. The method is based on the assessment of thequalityof General Movements (GMs). GMs are complex movements involving all parts of the body. They are present throughout fetal life and postnatally until about 3–4 months post‐term. The persistent presence of abnormal GMs during the neonatal period and the absence of age‐specific characteristics (“fidgety” movements) around 3 months‐post term are both powerful predictors of the development of handicap.
Very preterm infants at fourteen years: relationship with neonatal ultrasound brain scans and neurodevelopmental status at one year
Authors: Stewart A , Kirkbride V
Published: January 2008

A follow‐up study was carried out on a cohort of 1142 very preterm (< 33 weeks) survivors who had ultrasound (US) brain scanning from birth. Follow‐up was continued into adolescence, and included magnetic resonance imaging (MRI) of the brain at 14–15 y. Neonatal US findings and neurodevelopmental status at 1 y predicted outcome at 8 and 14 y, including cognitive development, poor inter‐hemispheric interaction and school performance. MR brain imaging indicated that neonatal US accurately identified serious, permanent lesions in the brains of these very preterm infants, although US failed to recognise a large proportion of the abnormalities detected in adolescence by MRI. Atrophy of the corpus callosum was one of the commonest findings on MRI brain scans, supporting the hypothesis that damage to this important commissure may account for the poor school performance reported in very low birthweight infants.
Metabolic consequences of intrauterine growth retardation
Authors: Gluckman PD , Cutfield W , Harding JE , Milner D , Jensen E , Woodhall S , Gallaher B , Bauer M , Breier BH
Published: January 2008

This review focuses on intrauterine growth retardation (IUGR) occurring spontaneously and without a defined infective, toxic or genetic cause. Such fetal growth retardation is generally thought to be a consequence of inadequate provision of nutritional substrates across the placenta.
Born small for gestational age: consequences for growth
Authors: Karlberg J , Albertsson‐Wikland K , Baber FM , Low LCK , Yeung CY
Published: January 2008

A large number of studies have documented a strong correlation between size at birth and subsequent height, although the reported incidence of catch‐up growth and consequently the impact on final height has varied with time and between countries. These variations may be real, but could also be related to a number of methodological problems. The aim of this study was to explore two important aspects related to postnatal growth after disturbed fetal growth: first, the definition of small for gestational age (SGA), including the selection of cut‐off points in defining shortness; and, secondly, the importance of the general socio‐economic status of the population with regard to the incidence of growth faltering in early life. Data were analysed from two longitudinal population‐based studies, one from Sweden and one from Hong Kong. Of the Swedish cohort, 3.8% had a birth length below –2 SD scores; in the Hong Kong population the corresponding value was 11.9% (Swedish reference values were used in both studies). The following conclusions were made. Size at birth is important for postnatal growth, and the difference in length at birth of 9–10 cm between the two extreme birth length subgroups remains, on average, until maturity. This seems to be true for the two study populations with different degrees of socio‐economic development. However, the rate of catch‐up growth is highly dependent on the definition of SGA, on the rate of catch‐up growth in early life and on the incidence of growth faltering between 6 and 18 months of age.
Growth hormone secretion and sensitivity in children born small for gestational age
Authors: Chatelain PG , Cauderay MC , Zegher F de , Claris O , Salle B , Tauber M , Chaussain J‐L
Published: January 2008

This short communication discusses aspects of growth hormone (GH) secretion and GH insensitivity in short children born short for gestational age (SGA).
Computer simulation of final height after growth‐promoting therapy
Authors: Karlberg J
Published: January 2008

This short communication discusses the possible influence of final height prediction on the estimation of the growth response to therapy. These influences are illustrated in terms of height at 8 and 18 years of age for 28 prepubertally short boys. On the basis of several treatment simulations and assumptions, we conclude that the mean residual final height: that is, the mean of individual differences between final height and predicted final height, is a robust outcome measure in growth‐promoting studies. However, the treatment residual final height (the difference between final height and predicted final height following growth‐promoting treatment) was only partially correlated (r2= 0.27) with the gain due to treatment, but was highly correlated (r2= 0.75) with the residual final height: thus, growth‐response estimations made on the basis of treatment residual final height may be more dependent on the predicted interval, or confidence interval, of final height than on the effect of growth‐promoting treatment.
Preliminary validation of a prediction model for the short‐term growth response to growth hormone therapy in children with idiopathic short stature
Authors: Spagnoli A , Spadoni GL , Boscherini B
Published: January 2008

A discriminant scoring system, using multivariate analysis, has been developed for pretreatment prediction of responsiveness to a 6‐month trial of growth hormone (GH) treatment in short children with subnormal growth velocity, but without GH deficiency. Inclusion criteria included a birth weight above 2.5 kg, height below the 3rd centile for chronological age, height velocity below the 25th centile for bone age, no signs of puberty, a maximal GH response to pharmacological stimulation of above 10 μg/l and treatment with GH at a dose of 12–16 IU/m2/week. Children with an increase in height velocity greater than 2.5 cm/year after therapy were considered to be responders. Pretreatment clinical data from 67 patients were employed in a discriminant analysis in order to establish the model. The scoring system developed was as follows: score = ‐0.4 + 0.92X1– 0.87X2, where X1 is the height velocity SD score (SDS) for chronological age, and X2 is the bone age SDS for chronological age. This model had a specificity of 96.3% and a sensitivity of 92.5% in predicting the responsiveness to GH. The model has subsequently been applied to a group of 14 patients in order to establish its validity; in this group its sensitivity was 83.3% and its specificity 100%. These preliminary data suggest that the model can be used as a guideline for selecting short, slowly growing, non‐GH‐deficient children who will respond to short‐term GH therapy.
Plasma and serum micronutrient concentrations in preschool children
Authors: Karr M , Mira M , Causer J , Earl J , Alperstein G , Wood F , Fett MJ , Coakley J
Published: January 2008

Abstract The plasma concentrations of vitamin A, vitamin E, β‐carotene and serum concentrations of zinc, retinol‐binding protein and prealbumin were examined for a random cluster sample, stratified by socioeconomic status, of 467 healthy preschool children. Children were aged 9–62 months; 44% were females. The mean plasma values were: vitamin A, 1.29 µmol 1‐1; vitamin E, 18.9 µmol 1‐1; and β‐carotene, 0.30 µmol 1‐1. The mean serum values were: zinc, 13.9 µmol 1‐1; retinol‐binding protein, 25.5mg 1‐1; and prealbumin, 186.2 mg 1‐1. The mean molar ratio of vitamin A to retinol‐binding protein for the study group was 1.10. There were no differences in the mean values of any of the measured micronutrients between the genders. The results of this survey do not indicate that the prevalence of micronutrient deficiency in this preschool population is of public health significance.
High risk of Helicobacter pylori infection associated with cow's milk antibodies in young diabetics
Authors: Pocecco M , Buratti E , Tommasini A , Torre G , Not T
Published: January 2008

Abstract Antibody titres (IgA and IgG) for Helicobacter pylori were assayed in 69 insulin‐dependent diabetes mellitus patients (42 males, age 1–20 years) and 310 healthy controls (171 males, age 1–20 years). A positive antibody titre for Helicobacter pylori was found in 18/69 diabetic subjects compared to 17/310 controls (p < 0.001). There was no difference between Helicobacter pylori positive and negative diabetic subjects as regards age, sex, duration of diabetes, diabetic control, insulin dose and SDS for weight and height. Gastroduodenoscopy revealed presence of Helicobacter pylori and evidence of gastric inflammation in 7/8 symptomatic diabetic children. There was a significant association in the diabetic subjects between positivity for anti‐cow's milk protein and anti‐Helicobacter antibodies, compared to the control group. Seven of the 17 diabetics studied within 3 months of the onset of diabetes had positive antibody titres for Helicobacter. Of these seven patients, five were positive for anti‐cow's milk protein antibodies. In our study the prevalence of Helicobacter pylori infection was significantly higher in diabetic subjects than in controls, but the infection was asymptomatic and there was no correlation with diabetes control. In diabetic subjects Helicobacter pylori infection was associated with a humoral response to cow's milk proteins and was often present from the onset of diabetes.
Young adults with α1antitrypsin deficiency identified neonatally: their health, knowledge about and adaptation to the high‐risk condition
Authors: Sveger T , Thelin T , McNeil TF
Published: January 2008

The psychological and psychosocial consequences of screening for α1‐antitrypsin deficiency (α1 ATD) were investigated when the subjects were 5–7 years old. The present study was conducted when the subjects were 18–20 years old, the foci of interest being their health, psychosomatic problems, knowledge about α1ATD and the potential effect of that knowledge on their lives and future family planning. Samples of 61 PiZ and 61 demographically matched control subjects, 18–20 years old, were asked to participate. Written, structured questionnaires covered the following items: basic familial characteristics, psychosomatic symptoms, opinions on medical check‐ups, information and views on future α1ATD screening, whether the knowledge about α1ATD had affected the life and family planning of α1ATD individuals. Items concerning the “α1ATD matter” were excluded in the questionnaires given to the controls. Questionnaire data were obtained from 50 α1 ATD and 48 control individuals, 41 of each being matched α1ATD‐control pairs. No significant differences were found in demographic or educational backgrounds, psychosomatic complaints such as headache, sleep difficulties, stomach ache, tiredness or anxiety. Lung symptoms occurred more frequently in α1ATD subjects (p= 0.05). Six per cent of the α1ATD individuals planned working careers with a high risk of air pollution. The majority (86%) of the α1ATD subjects perceived the contact with the medical services as positive; 14% as both positive and negative. The information concerning α1ATD was assessed as satisfactory by 73%, as both good and bad by 17% and as unsatisfactory by 10%. All α1ATD subjects advocated general screening for α1ATD, the neonatal period being chosen as optimal by 94%. Half of the α1ATD individuals thought that the knowledge of their high‐risk condition had affected their lives, particularly their awareness of the dangers of smoking and environmental pollution. The majority, 88%, knew that they should avoid smoking to protect their lungs. In conclusion, no negative psychosocial consequences of the neonatal α1AT‐screening were found in early adulthood. The α1ATD individuals were aware of the dangers of smoking and were of the opinion that α1 AT‐screening should be recommended.
Two families of Lowe oculocerebrorenal syndrome with elevated serum HDL cholesterol levels and CETP gene mutation
Authors: Asami T , Inano K , Miida T , Kikuchi T , Uchiyama M
Published: January 2008

The ocuolocerebrorenal syndrome of Lowe (OCRL) is an X‐linked recessive disorder which is characterized by renal tubular dysfunction, congenital cataracts, and cognitive impairment. In a review article by Charnas et al. (N Engl J Med 1991; 324: 1318‐25), hypercholesterolemia, due to elevated highdensity lipoprotein cholesterol (HDLC) levels, was described as being highly prevalent in OCRL patients. This report prompted us to examine three OCRL children in two unrelated families and we confirmed the high prevalence of high serum HDLC levels in the patients (3/3). In addition, we found that their normal family members also had high serum HD‐LC levels (5/7). Analysis of cholesteryl ester transfer protein (CETP) genes, which are now recognized as one of factors increasing serum HDLC levels, revealed the D442G mutation in exon 15 in 5 of 10 family members (1/3 of OCRL patients and 4/7 healthy family members), and no mutation of intron 14 G(+1)‐to‐A. The detected D442G mutation may be one of the causes in our two OCRL families; however, further studies, based on larger numbers of subjects, are needed to confirm these findings.
Alkali therapy versus sodium chloride supplement in low birthweight infants with incipient late metabolic acidosis
Authors: Kalhoff H , Diekmann L , Kunz C , Stock GJ , Manz F
Published: January 2008

Two hundred and eighty‐two patients with birthweights below 2.0 kg were routinely screened for spontaneous development of maximum renal acid stimulation (urine‐pH < 5.4). Sixty episodes in 53 patients of incipient late metabolic acidosis (urine pH < 5.4 on 2 consecutive days) were randomly allocated to oral therapy with 2 mmol/kg/day of either NaHCO3 or NaCl for 7 days. All 27 patients on NaHCO3 therapy, but only 15 from 26 patients on NaCl therapy, showed an increase in urine pH values, combined with a relatively high gain in body weight and a tendency to increased N‐assimilation. Eleven patients on NaCl therapy showed persistent maximal renal acid stimulation on all 7 days with possibly lower weight gain and no clear change in N‐assimilation. Thus, in patients with incipient late metabolic acidosis, NaCl therapy is not as beneficial as NaHCO3 therapy.
Comparison of body surface and airway triggered ventilation in extremely premature infants
Authors: Laubscher B , Greenough A , Kavadia V
Published: January 2008

Failure of patient triggered ventilation in very premature infants may reflect the use of inappropriate triggering systems. We have therefore compared the performance of an airway and a body surface trigger in 12 infants of median gestational age 26 weeks (range 24–27). Airway flow and oesophageal and ventilator pressure changes were recorded during two periods of patient triggered ventilation. From the traces, the degree of asynchrony (inflation extending beyond inspiration), triggering rate, sensitivity (proportion of the infant's breaths detected) and trigger delay (response time) were calculated. Although with both triggering systems there was a high rate of asynchrony, the triggering rate (p < 0.05), sensitivity (p < 0.05) and trigger delay (p < 0.01) were all better with the body surface trigger. These results suggest that the body surface trigger is the more appropriate system for very immature infants.
Survival of very low birthweight and very preterm infants in a geographically defined population
Authors: Cartlidge PHT , Stewart JH
Published: January 2008

Objective: To determine in a geographically defined population 1 year survival of infants with a birthweight of less than 1500g or gestational age less than 32 weeks, and to establish the effect of postnatal age on predicted survival. Design: Cohort analysis of 72427 births to Welsh residents in 1993‐94. Deaths were identified using the All Wales Perinatal Survey, a population‐based surveillance of mortality between 20 weeks of gestation and 1 year of age. Main outcome measures: Birthweight‐ and gestation‐specific infant mortality, and the effect of postnatal age, gender, and multiple pregnancy on predicted survival. Results: In normally formed infants 1 year survival at 24–25 weeks gestation was 35%, compared to 75% at 27–28 weeks, and 95% at 30–31 weeks. In infants with a birthweight of 500‐699g 1 year survival was 18% compared to 70% at 800‐999g, and 97% at 1300‐1499g. The chances of survival improved markedly with increasing postnatal age; at 24–25 weeks gestation it was 35% at birth, 50% at 12 h, 66% at 7 days and 78% at 4 weeks. Infant mortality was higher in males, but multiple pregnancy had no effect. Conclusions: Up‐to‐date birthweight‐ and gestation‐specific survival rates are essential for predicting the outcome of a newborn infant. The rapid change in the chances of survival with increasing postnatal age emphasises especially the importance of revising the prediction as the infant gets older, particularly during the first few days of life,
Oral immunoglobulin treatment in Crohn's disease
Authors: Tjellström B , Stenhammar L , Magnusson K‐E , Sundqvist T
Published: January 2008

Two patients with severe Crohn's disease who failed to respond to traditional medical treatment were given immunoglobulin orally. We used the 6‐h urinary recovery of a mixture of polyethyleneglycols PEG 400 and 1000 (molecular weight range 282–1250 Da) to test the intestinal permeability. Both patients showed a similar permeability pattern with an increased leakage of large‐sized PEGs before treatment and a lower urinary recovery of probes after treatment with immunoglobulin. This might indicate that the inflammatory process in Crohn's disease can be affected from the luminal side of the mucosa.
Prevalence and treatment of chronic idiopathic thrombocytopenic purpura of childhood in Sweden
Authors: Hedman A , Henter J‐I , Hedlund I , Elinder G
Published: January 2008

The frequency and treatment of children with chronic idiopathic thrombocytopenic purpura in Sweden were characterized using a national enquiry based on a questionnaire. Seventy‐five children diagnosed as having chronic idiopathic thrombocytopenic purpura on 1 September 1993 were identified. The prevalence in children between 0.5 and 15.5 years of age was calculated to be 4.6/100 000. The median age at the time of diagnosis was 5 years and the male/female ratio was 1:1.2. Almost half of the patients (43%) were not treated at all during the disease. Steroids (43%) and intravenous immunoglobulin (25%) were most commonly used. Only two children were splenectomized.
Determination of gas‐trapping during high frequency oscillatory ventilation
Authors: Alexander J , Milner AD
Published: January 2008

Objective:To determine the effect of frequency and percent inspiratory time on tidal volume and gastrapping during high‐frequency oscillatory ventilation (HFOV). Subjects: Nine preterm infants with respiratory distress syndrome tested in the first 48 h of life. Methods: Tidal volumes and the presence of gas‐trapping were measured by respiratory jacket plethysmography at frequencies of 10,14, and 17.8 Hz and at inspiratory times of 30%, 50% and 70%, using a commercially available high frequency oscillator. Results: Mean (SD) tidal volumes were 2.40 (1.06) ml/kg at 10 Hz, 2.52 (1.07) ml/kg at 14 Hz and fell significantly to 1.96 (0.92) at 17.8 Hz (p < 0.05). Tidal volumes at 50% inspiratory time were significantly greater than at 30% inspiratory time [2.81 (1.42) ml/kg and 2.32 (1.18) ml/kg, respectively] but fell to baseline levels at 70% inspiratory time. There was no significant gas‐trapping with increases in either frequency or percent inspiratory time. Conclusions: Gas‐trapping is not a significant problem during HFOV in premature infants. Changes in tidal volume with increases in frequency and percent inspiratory time are similar to that seen in animal models.
Infections in neonates delivered at term are associated with increased serum levels of ICAM‐1 and E‐selectin
Authors: Austgulen R , Arntzen KJ , Hæreid PE , Aag S , Døllner H
Published: January 2008

All newborn infants consecutively admitted to the Neonatal Intensive Care Unit (NICU) at the University Hospital of Trondheim during 1993 were eligible to participate in the study. In total, 241 neonates were included, for whom anamnestic, clinical and laboratory characteristics were recorded. Peripheral blood was retrieved at admittance, and serum levels of soluble intercellular adhesion molecule‐1 (ICAM‐1), vascular cell adhesion molecule‐1 (VCAM‐1) and E‐selectin were determined. Newborn infants were classified as infected or non‐infected according to selected criteria, and 24 newborn infants fulfilled the criteria of having an infection, whereas 168 newborn infants were classified as non‐infected. ICAM‐1, VCAM‐1 and E‐selectin were detected in all neonatal samples. Serum concentrations of E‐selectin varied by gestational age (GA), higher levels were found in non‐infected term (GA ≥ 37 weeks) neonates (n= 53) than in those (n= 115) delivered prematurely (GA < 37 weeks) without infection (p < 0.0001), whereas ICAM‐1 and VCAM‐1 concentrations did not differ between groups of non‐infected term and preterm newborn infants. Similarly, newborn infants delivered at term (n= 16) demonstrated higher levels of E‐selectin than premature infants (n= 8) in association with infection (p < 0.001). Both ICAM‐1 and E‐selectin were increased in term newborn infants with infection (n= 16) compared to the non‐infected term group (n= 53)(both p < 0.01), whereas VCAM‐1 concentrations did not differ between the two groups. In the premature groups of infected (n= 8) and non‐infected (n= 115) neonates, no differences in ICAM‐1, VCAM‐1 and E‐selectin concentrations were observed. The use of ICAM‐1 concentration (cut‐off level: 250 μg 1‐1) as a diagnostic test for infection in term neonates yielded a sensitivity of 80% and a specificity of 61%, whereas a sensitivity of 70% and a specificity of 79% were found when E‐selectin concentration (cut‐off level: 150 μ 1‐1was used. Conclusively, increased shedding of soluble ICAM‐1 and E‐selectin is one component of infection‐induced neonatal immune response after full‐time pregnancies. Our data suggest that the ability of increased shedding of soluble ICAM‐1 and E‐selectin molecules is developed during the final weeks of pregnancy. Assessment of ICAM‐1 and E‐selectin concentrations may be used as diagnostic tools with a high sensitivity and a moderate specificity in term neonates suspected of infection.
Bilateral femoral stress fractures in a child due to in‐line (roller) skating
Authors: Toren A , Goshen E , Katz M , Levi R , Rechavi G
Published: January 2008

We report a child who presented with a limp following 6 weeks of strenuous roller skating. Directed X‐rays on admission were normal but a 99mTc‐methylene diphosphanate bone scan demonstrated increased uptake in the mid‐thirds of the femurs compatible with grade IV stress fracture. Immediate abstention from roller skating for 5 weeks resulted in a complete cure. The “new” side effect of this increasingly popular sport is discussed with regard to paediatric stress fractures and to other roller skating‐associated injuries.