bluuebunny/crossref_metadata_2025 huggingface dataset:
Adult Panhypopituitarism Presenting as Idiopathic Growth Hormone Deficiency in Childhood
Authors: CROWNE E. C. , SHALET S. M.
Published: January 2008

ABSTRACT. We report two patients who presented in childhood with isolated growth hormone deficiency and in whom progressive loss of anterior function led to panhypopituitarism in early adult life. The need for continued follow‐up and reassessment of pituitary function in adult life is stressed in the light of the natural history of these patients.
Albumin Binding Properties in Relation to Bilirubin and Albumin Concentrations during the First Week of Life
Authors: ESBJÖRNER E.
Published: January 2008

ABSTRACT.In 19 non‐jaundiced and 22 jaundiced neonates, the serum albumin and bilirubin concentrations were measured during the first week of life. Some of the neonates were followed longitudinally. The albumin binding properties were evaluated by determining the reserve albumin concentration for monoacetyldiaminodiphenyl sulphone (MADDS), a deputy ligand for bilirubin. The reserve albumin concentration for MADDS increased with postnatal age. The reason for this increase is still unexplained. There was an inverse relation between the bilirubin and the reserve albumin concentrations, but when the bilirubin concentration increased by 1 μmol/l, the reserve albumin concentration for MADDS decreased by only 0.2 μmol/l. This shows that the reserve albumin concentration for MADDS does not give a direct measure of the bilirubin binding ability of the serum albumin molecule. In spite of this, it is still possible that a low reserve albumin concentration for MADDS is a risk factor for bilirubin encephalopathy.
Mixed Infection Is Common in Children with Respiratory Adenovirus Infection
Authors: KORPPI M. , LEINONEN M. , MÄKELÄ P. H. , LAUNIALA K.
Published: January 2008

ABSTRACT. The presence of concomitant viral or bacterial infection was evaluated in 20 patients hospitalized for adenovirus infection of the middle or lower airways by using new serological methods for detection of both antigens and antibodies. Adenovirus infection was identified by measurement of antibodies with complement fixation test or by direct detection of viral antigen in nasopharyngeal aspirates. Mixed infection was present in 11 (55%) of the 20 patients. Viral coinfection was demonstrated in five (25%) and bacterial in nine (45%) patients. Bacterial coinfection was common, 67%, in children with an infection focus, pneumonia or acute otitis media, but rare, 13%, in those without it. Seroconversion to nontypable Haemophilus influenzae was indicated in six children; four of them were infants, four had pneumonia and three acute otitis media. Pneumococcal infection was indicated in two patients with pneumonia, both aged over two years. Chlamydia trachomatis was involved in one case. The results indicate that bacterial coinfection is common in respiratory adenovirus infection affecting lower airways, especially if pneumonia is present.
Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy and Deafness (DIDMOAD Syndrome): A Clinical Study in Two Sudanese Families
Authors: SALIH M. A. M. , TUVEMO T.
Published: January 2008

ABSTRACT. Four Sudanese children with DIDMOAD syndrome (diabetes insipidus, diabetes mellitus, optic atrophy and deafness) are reported. They were two boys (aged 15 and 16 years) in one family and a boy and a girl (aged 16 and 6 years, respectively) in another family. Diabetes mellitus was first to appear (at 3–8 years) followed by deafness and visual failure; and the disease ended fatally in one patient (aged 20 years). In the other three, diabetes insipidus was confirmed using water deprivation test for 8 hours. The maximum urine osmolality ranged between 131–523 mOsm/kg, whereas the corresponding plasma osmolality ranged between 315–332 mOsm/kg. Slight further improvement in urine concentration was observed in 2 of the patients following the use of desmopression (DDAVP, 20 μg intranasally). Intravenous pyelography, voiding cystourethrography and ultrasound revealed severe bilateral hydronephrosis, dilated ureters and distended bladder without vesicoureteral reflux in the three patients. With the high rate of consanguinity prevalent in North Africa and the Middle East, we recommend examining children who present with diabetes mellitus in this region for features of DIDMOAD syndrome.
Subcapsular Hemorrhage of the Liver in the Very Low Birthweight Neonate
Authors: SHANKARAN S. , ELIAS E. , ILAGAN N.
Published: January 2008

ABSTRACT. Between 1974 and 1989, 15 neonates were found, at autopsy, to have subcapsular hematoma of the liver in a retrospective clinicopathologic study of 644 neonates. The majority (75 %) of the neonates were < 28 weeks gestation, male gender, and were delivered by the vaginal route following a complicated pregnancy and labor including malpresentation. The clinical course included resuscitation at birth, ventilatory support and hypovolemic shock with death occurring within 24 hours in 11 neonates. Other clinical events included air leak (n=4 infants) and infection (n=4). Intracranial hemorrhage was suspected in all but was found at autopsy in 8 neonates. The subcapsular hematoma was intact in 7 and ruptured in 8 neonates. Hence, subcapsular hemorrhage of the liver should be considered in the differential diagnosis of hypovolemic shock in very low birthweight infants.
Inflammatory Bowel Disease in Children and Adolescents: a Somatic and Psychiatric Investigation
Authors: ENGSTRÖM I. , LINDQUIST B. L.
Published: January 2008

ABSTRACT. Twenty consecutive patients between 9 and 18 years of age with inflammatory bowel disease (IBD) [ulcerative colitis (UC) or Crohn's disease (CD)] were assessed for the presence of psychiatric disorder. The prevalence of psychiatric disorder using the DSM‐111‐R criteria (Diagnostic and Statistical Manual 3rd ed., revised), was 60% in the IBD group compared to 15% in a matched control group (p=0.009). The psychiatric disturbances were mainly depressive or anxiety disorders. The IBD children also scored significantly higher (p=0.0028) on the Child Behaviour Checklist (CBCL) which was completed by the mothers. This indicates more behavioural problems in the IBD group than in the control group. The present study suggests that children and adolescents with IBD comprise a population at high risk for developing a psychiatric disorder that may not be overt but nevertheless plays an important interactive role in the course of the disease.
Lipoprotein Alterations and Plasma Lipoprotein Lipase Reduction in Familial Hemophagocytic Lymphohistiocytosis
Authors: HENTER JAN‐INGE , CARLSON LARS A. , SÖDER OLLE , NILSSON‐EHLE PETER , ELINDER GÖRAN
Published: January 2008

ABSTRACT. Serum lipid abnormalities are common in familial hemophagocytic lymphohistocytosis (FHL), a disorder also characterized by fever, hepatosplenomegaly, pancytopenia and a prominent lymphohistiocytic accumulation in the mononuclear phagocyte system. The lipoprotein pattern in nine children with FHL was studied with a quantitative method measuring cholesterol and triglycerides in each major class of lipoproteins. Triglycerides were markedly elevated during active FHL in serum, very low density lipoproteins, and low density lipoproteins. Cholesterol was increased in very low density lipoproteins whereas both triglycerides and cholesterol were extremely low in high density lipoproteins. These lipoprotein abnormalities, reversible on successful therapy, are compatible with a depressed lipolytic activity. Post‐heparin levels of lipoprotein lipase and hepatic lipase in plasma were studied in four children and found to be markedly low during active FHL. We suggest that inflammatory cytokines, which may strongly suppress lipoprotein lipase activity, can be important mediators in the pathophysiology of FHL and that they may participate in the development of the lipid abnormalities.
Children with Recurrent Respiratory Tract Infections Tend to Belong to Families with Health Problems
Authors: SÖDERSTRÖM M. , HOVELIUS B. , PRELLNER K.
Published: January 2008

ABSTRACT.Children (7‐11 years of age) who had recurrent respiratory tract infections (RTI) treated with antibiotics as preschoolers (n=41), and their families were compared with regard to medical and social factors to families with children of comparable age who had had no such infections as preschoolers, or only isolated episodes (controls;n=29). All the children studied had attended day‐care centres as preschoolers. The two groups of children did not differ with regard to socio‐economic conditions or age at admission to day‐care centres. There was a difference in the two groups with regard to signs noted at physical examination (p<0.05), eardrum changes being observed in 34% of the children with recurrent episodes of RTI as preschoolers and in none of the controls (p< 0.001). Questionnaires answered by parents indicated diseases, particularly cardiovascular diseases, to be significantly more frequent in the families of the children with recurrent RTIs as preschoolers than in those of the controls (p<0.01). Parents of the controls were more often satisfied with their own health (p<0.05) and reported fewer symptoms of minor illness (p<0.05), as compared with parents of the children with recurrent RTIs as preschoolers. Thus, the results of the present study support the idea that children with recurrent bacterial RTIs as preschoolers tend to belong to families with health problems.
Respiratory Illness in Children: Do Deprived Children Have Worse Coughs?
Authors: WYKE S. , HEWISON J. , HEY E. N. , RUSSELL I. T.
Published: January 2008

ABSTRACT. Parents of a stratified random sample of 234 children from 21 general practices in North East England were interviewed at home. All these children had been reported in a postal questionnaire as having had a cough between six and ten weeks before the interview. Interviews covered social characteristics of the family, the severity of the child's cough and the reactions of the parents to hypothetical sets of symptoms. The parents of children in materially deprived circumstances appeared to report worse coughs than other parents. We confirmed this finding by constructing a scale of perceived cough severity. However, we found no evidence that the inequality was due to exaggeration of the severity of the cough by materially deprived parents. Our conclusion that materially deprived children suffer worse respiratory illness is the more important because previous evidence suggets that the after‐effects persist into adulthood.
Recurrent Herpes Simplex Virus Type 2 Encephalitis in a Preterm Neonate: Favourable Outcome after Prolonged Acyclovir Treatment
Authors: BERGSTRÖM T. , TROLLFORS B.
Published: January 2008

ABSTRACT. We describe a case of recurrent herpes simplex virus type 2 (HSV‐2) central nervous system infection in a preterm neonate. On two occasions, encephalitis occurred together with eruption of vesicles on the right arm, and the patient was treated with acyclovir. New recurrences of vesicles followed each attempt to discontinue antiviral treatment, and prompted a continuous long‐term acyclovir prophylaxis. At three years of age, the patient has developed normally. The use of immunoblotting for serologic diagnosis of neonatal HSV‐2 infection is demonstrated.
Nutritional Anemias
Authors: HASCHKE F. , JAVAID NOSHEEN
Published: January 2008

Prevention of nutritional deficiencies should be attained by the consumption of a good diet. Unfortunately, in the case of iron, this is not always possible, and it is advantageous to fortify food with iron. Milk‐based formulas and cereals are the most commonly used iron‐fortified products in infancy and early childhood. Bioavailability of iron from cereals is low and more clinical studies on the field are necessary to demonstrate the effectiveness of iron‐fortified cereals in infants and children of developing countries. Infections and excessive blood loss in infancy related to the use of fresh, pasteurized or powdered cow milk result in much of the anemia we currently see in industrialized countries. Vitamin A deficiency interacts with iron metabolism and recent intervention studies have shown that anemia in Vitamin A deficient children can be successfully treated with oral supplements.
Stunting and Nutrient Deficiences in Children on Alternative Diets
Authors: DAGNELIE P. C. , STAVEREN W. A. VAN , HAUTVAST J. G. J. A.
Published: January 2008

Studies in children fed alternative diets showed that anthropometric parameters and the intake of energy and nutrients by macrobiotic children deviated most from current norms. Therefore weaning practice, growth and haematological status were investigated in 3 age‐cohorts of macrobiotic fed infants between 4 and 18 months of age and a control group. A mixed longitudinal design was used for this study. Main findings were a growth retardation which was strongest in the second cohort (8–14 months of age) and related to a diet low in energy density, fat and protein. Haematological data revealed very low vitamin B12 concentrations with consequently low values of haematocrit and red blood cell count and higher values of mean corpuscular volume and mean corpuscular haemaglobin mass in the macrobiotic group. High folate concentrations also seemed to be a consequence of Vitamin B12 deficiency. Iron deficiency was found in 15% of the macrobiotic group vs. no infants in the control group. Nutritional recommendations acceptable within the macrobiotic philosophy are discussed.
Psychomotor and Mental Development from Birth to Age of Four Years; Sex Differences and Their Relation to Home Environment Children in a New Stockholm Suburb Results from a Longitudinal Prospective Study Starting at the Beginning of Pregnancy
Authors: NORDBERG LILLEMOR , RYDELIUS PER‐ANDERS , ZETTERSTRÖM ROLF
Published: January 2008

Five hundred and thirtytwo pregnant women were interviewed about their psychosocial health at the beginning of pregnancy. According to various factors including alcoholism, mental disease and criminality among the women and their husbands the families were divided in three groups of different degrees according to psychosocial stress. The pregnancies, deliveries and the 497 live‐born children in these families have been investigated with prospective methods. Data concerning the psychological development and psychiatric health of the child were attained by interviewing the mother and evaluating the child during visits to home (age 1 and 4). The physical health and development of the children has been followed by prospective data achieved from the child welfare centers. At one year of age 452 of the children (226 boys, 226 girls) and at four‐five years of age 412 of the children (202 boys, 210 girls) were evaluated by the Griffith's Development Scales. Findings from these evaluations can now be related to a number of factors concerning the psychosocial situation, pediatric riskfactors etc. With the prospective, longitudinal methods used in this project interesting results concerning sex differences related to the mental development have been found. At one year of age girls had higher scores than boys on the Griffiths‐subscale measuring hearing‐and‐speech abilities. At four years of age several significant differences between the sexes were found. Girls had more “even” Griffiths‐profiles and scored higher than boys in several Griffiths‐subscales. The greatest differences at four years of age were found concerning personal‐social function and eye‐hand‐coordination. Boys seem to be specially vulnerable to the psychosocial situation in their homes as the Griffiths‐results at four years of age are lower among boys from homes with psychosocial stress compared to other boys. It should be very interesting to follow and study what these sex differences mean concerning future development, the occurrence of psychopathology and school difficulties.
Growth Hormone Secretion and the Therapeutic Effects of Human Growth Hormone: First Japanese Results of the Kabi Pharmacia International Growth Study/International Cooperative Growth Study
Authors: TANAKA T. , Shizume K. , Hibi I. , Takano K. , Suwa S. , Irie M. , Okada Y. , Ogawa M. , Okuno A. , Kato K. , Kono H. , Sudo M. , Takahara J. , Chihara K. , Nakajima H. , Nishi Y. , Hanyu K. , Tachibana K. , Hirano T. , Fujieda K.
Published: January 2008

Data for a total of 942 new cases of hypopituitarism, out of 3493 patients treated with recombinant human growth hormone (GH) for more than 1 year, have been analysed. The mean peak GH correlated well with clinical variables related to growth and was considered to be a good index of GH secretory capacity. Mean peak GH was correlated inversely with obesity (r= ‐0.253, p < 0.01). The lower the height velocity before treatment, the mean peak GH and the height SDS, the greater was the therapeutic effect achieved. The patients with mean peak GH less than or equal to 5 ng/ml were defined as having complete GH deficiency (GHD), and those with a mean peak GH of 5‐10 ng/ml as having partial GHD. The clinical entity of GH neurosecretory dysfunction could not be identified from either the clinical variables examined or the therapeutic effect. The appearance of GH antibody was considered to be of no clinical significance because its incidence and titre were both low.
Randomized controlled trial of dexamethasone treatment in very‐low‐birth‐weight infants with ventilator‐dependent chronic lung disease
Authors: Ohlsson A , Calvert SA , Hosking M , Shennan AT
Published: January 2008

This randomized controlled trial was designed to answer the question: does administration of dexamethasone to neonates with bronchopulmonary dysplasia decrease the need for assisted ventilation? Twenty‐five infants with a birth weight < 1501 g, requiring mechanical ventilation and FiO2 of ± 0.30 at 21‐35 days of age, were randomized to treatment with iv dexamethasone or to sham injections for 12 days. The primary outcome criterion was extubation within seven days after study entry. Treatment (n= 12) and control (n= 13) groups were well matched at entry. Dexamethasone facilitated weaning from assisted ventilation (p= 0.0154). There was no increased incidence of infection. Dexamethasone treatment resulted in a significant increase in glucosuria (p= 0.0002) and in systolic blood pressure (p= 0.0034). There was a significant decrease in heart rate (p= 0.0001) and a significant weight loss (p= 0.0002) following dexamethasone treatment. Dexamethasone treatment facilitated weaning from assisted ventilation but several systemic effects were noted that deserve further evaluation before dexamethasone becomes routine treatment.
Protease inhibitors in bronchoalveolar lavage fluid from neonates with special reference to secretory leukocyte protease inhibitor
Authors: Ohlsson K , And T Sveger , Svenningsen N
Published: January 2008

An imbalance of proteolytic enzymes and protease inhibitors may contribute to the development of bronchopulmonary dysplasia. We studied secretory leukocyte protease inhibitor (not previously addressed), and α1‐antitrypsin, α1‐antichymotrypsin, α2‐macroglobulin and elastase. Albumin was used as an internal reference. Infants with pneumonia had higher concentrations of secretory leukocyte protease inhibitor (p= 0.02) and elastase (p= 0.04) in bronchoalveolar lavage fluid than those with respiratory distress syndrome; those who also developed bronchopulmonary dysplasia had intermediate values. A decreased concentration of α1‐antitrypsin was found in the second and third postnatal weeks (p= 0.002). Further detailed studies of the balance between proteases and protease inhibitors and of the importance of pulmonary infections in the pathogenesis of bronchopulmonary dysplasia are suggested. Secretory leukocyte protease inhibitor is important both as an elastase inhibitor of bronchial mucus and as a marker of infection in the bronchi.
Total leukocyte and neutrophil count changes associated with antenatal betamethasone administration in premature infants
Authors: Barak M , Cohen A , Herschkowitz S
Published: January 2008

The white blood cell counts of 84 premature infants were included in a retrospective study of 45 infants treated antenatally with betamethasone and 39 non‐treated infants. A significant increase in neutrophil and immature neutrophil forms was found in the treated group when the drug was administered to the mother close to delivery. This effect lasted for three days. Afterwards, although the counts were not significantly high compared to the control group, their physiological decrease was delayed. This study indicates that the known stimulating effect of steroids on total leukocyte and neutrophil counts in adult humans and fetal lambs, also occurs in premature infants. This fact supports recent reports which propose the antenatal maternal administration of betamethasone as a cause of leukemoid reaction or leukocytosis after birth.
Iron status in low‐birth‐weight infants, small and appropriate for gestational age. A follow‐up study
Authors: Olivares M , Llaguno S , Marin V , Hertrampf E , Mena P , Milad M
Published: January 2008

Iron nutrition was measured in 84 low‐birth‐weight infants. At birth, they were assigned to three groups: preterm infants appropriate for gestational age (n= 29); preterm infants small for gestational age (n= 17); and full‐term infants* small for gestational age (n= 38). A sub‐sample of infants was supplemented with iron 3 mg/kg from two to four months of age. At birth, preterm appropriate‐for‐gestational‐age infants had a lower hemoglobin concentration than full‐term small‐for‐gestational‐age infants (p < 0.01) and a higher serum ferritin than preterm small‐for‐gestational‐age infants (p < 0.05). In the non‐supplemented group, full‐term small‐for‐gestational‐age infants had significantly higher hemoglobin concentrations at four months of age. At this age, iron‐supplemented preterm infants appropriate or small for gestational age had significantly higher hemoglobin levels than non‐supplemented subjects, while iron supplementation did not have an effect on final hemoglobin concentration in full‐term small‐for‐gestational‐age infants. We conclude that preterm infants, irrespective of their adequacy for gestational age, show evidence of iron deficiency before four months of age. Full‐term infants do not develop iron deficiency up to this age.
Predictive inability of cord zinc, magnesium and copper levels on the development of benign hyperbilirubinemia in the newborn
Authors: Pintov Shai , Kohelet David , Arbel Eliana , Goldberg Michael
Published: January 2008

Cord serum concentrations of zinc, magnesium and copper were determined in 90 healthy term infants. The infants were divided by peak bilirubin values into an icteric group (peak bilirubin > 136 μmol/1) (n= 21) and a control group (peak bilirubin ≤ 136 μmol/)(n= 69). Mean cord serum zinc, magnesium and copper concentrations in the icteric group did not differ from those of the control group. Furthermore, no significant correlation was found between peak serum bilirubin concentrations and cord serum concentrations of these three elements. We conclude that cord serum concentrations of zinc, magnesium or copper are not useful in predicting which neonates will develop hyperbilirubinemia.
A double‐blind, placebo‐controlled study of the effect of intranasal budesonide in the treatment of children with seasonal rhinitis
Authors: Wolthers Ole D , Jørgensen Bent A , Pedersen Søren
Published: January 2008

The effectiveness of the intranasal glucocorticosteroid budesonide was investigated in children with grass pollen‐induced rhinitis during a pollen season. The trial was of a randomized, double‐blind, placebo‐controlled, parallel‐group design with a one‐week run‐in period and a three‐week treatment period. Twenty‐four children received treatment with budesonide 200 μg bid and 27 children with placebo, administered by a nasal aerosol. Concomitant terfenadine, as required, was allowed in both groups. Recordings of nasal symptom severity, use of terfenadine and adverse effects were made in diaries. Nasal symptoms were significantly less severe in patients treated with budesonide as compared with placebo‐treated patients. An overall assessment of treatment effect made by the children was significantly in favour of budesonide, and the consumption of terfenadine was significantly larger in the placebo than in the budesonide group. These results provide good evidence that intranasal budesonide is effective in seasonal rhinitis in children.
Effects of body movement restraint on cardiac response to auditory stimulation in sleeping infants
Authors: Kahn A , Rebuffat E , Sottiaux M
Published: January 2008

When exposed to an unfamiliar and sudden noise, infant rodents may show an abrupt bradycardia, as part of a “fear‐paralysis response”. The response is enhanced by body movements restraint. To investigate if this reaction is seen in humans, 15 normal infants with a median age of 12 weeks were studied polygraphically. They were exposed to a 100‐dB (A) white noise, while sleeping in REM sleep. Each infant was studied in both “unrestrained” and “restrained’ conditions. Restraint of body movement was obtained by means of sand bags and tightly‐binding bed sheets. During movement restraint, the infants had a significantly greater and earlier decrease in heart rate compared with during the unrestrained condition. No infant had a minimal heart rate less than 95 beats/min. The present observation raises questions about the possible unfavorable effects of tightly wrapped bed sheets around sleeping infants.
Atrial natriuretic peptide in the preterm infant. Lack of correlation with natriuresis and diuresis
Authors: Ekblad H , Kero P , Vuolteenaho O , Arjamaa O , Korvenranta H , Shaffer SG
Published: January 2008

We assessed the relation of atrial natriuretic peptide (ANP) to renal function on postnatal day 2 and day 5 in preterm infants. Plasma ANP concentration was measured by radioimmunoassay in two groups of preterm infants: group 1, gestational age less than 30 weeks, n=10; and group 2, gestational age 30‐34 weeks, n=11. The identity of the immunoreactivity as ANP‐28 was confirmed by HPLC. Plasma ANP was significantly higher in group 1 than in group 2 on day 2 and day 5 (p<0.01) and ANP concentration decreased by day 5 in both groups (group 1, p<0.01; group 2, p<0.02). The results showed no correlation between plasma ANP concentration and urinary sodium excretion or creatinine clearance, which may be due to a blunted renal response to ANP, but other factors may be involved also. We conclude that preterm infants are able to release large amounts of ANP, but a high plasma ANP concentration does not correlate directly with renal regulation of sodium and water balance.
Hemoglobin desaturation during sleep and daytime in patients with cystic fibrosis and severe airway obstruction
Authors: Braggion C , Pradal U , Mastella G
Published: January 2008

Transcutaneous hemoglobin saturation by pulse oximetry was evaluated during sleep and for 2‐3 h during the day in 31 patients with cystic fibrosis (median age 15.2 years; range 7.6‐33.6 years) and severe airway obstruction. Pulse oximetry readings were analyzed as a cumulative percentage of time in which oxygen saturation was <90% during both sleep and daytime. Each patient was also examined using clinical and radiological scores, spirometry and arterial blood‐gas analysis. The agreement between arterial and transcutaneous saturation was evaluated in 29 patients. The difference between transcutaneous and arterial saturation was 2.4 ± 2.0% and it increased as arterial saturation decreased. Clinical and radiological scores and spirometry parameters showed a poor correlation with both overnight and daytime desaturation. An arterial saturation <94% may indicate a risk of consistent desaturation. This occurred for more than 50% of the time in 11 of 20 patients during sleep and in 5 of 20 patients during daytime hours.
Autologous bone marrow transplantation in children with acute lymphoblastic leukemia
Authors: Lönnerholm G , Simonsson B , Arvidson J , Bengtsson M , Carlson K , Hagberg H , Jakobson Å , Kreuger A , Smedmyr B , Tötterman TH , Öberg G
Published: January 2008

We report 25 children with acute lymphoblastic leukemia (ALL) treated with purged autologous bone marrow transplantation (ABMT) at a single center. Two children with high‐risk ALL were transplanted in first remission and 23 with relapsing ALL were transplanted in second (n=21) or third (n=2) remission. There was no procedure‐related mortality. The median time to engraftment (i.e. to reach a polymorphonuclear cell count of 0.5 × 109/1) was 25 days (range 16‐45 days). Seven children relapsed, four within five months after ABMT: 18 of 25 children (72%) are in continuous complete remission after a median follow‐up period of 50 months (range 5‐71 months). The predicted long‐term disease‐free survival is 65% in the whole group and 61% in those transplanted after relapse. Relapse‐free children returned to normal activities within three months after ABMT. The major side effects were development of cataract and gonadal insufficiency. We consider the results promising, but our data do not allow comparison with results reported from treatment with chemotherapy alone, since some of our patients were referred from other centers and represent a selected patient group. Long‐ term follow‐up of well‐defined patient populations is necessary to evaluate the effect of ABMT.
TSH‐secreting pituitary macroadenoma in an 11‐year‐old girl
Authors: Avramides A , Karapiperis A , Triantafyllidou E , Vayas S , Moshidou A , Vyzantiadis A
Published: January 2008

Graves' disease, multinodular toxic goiter or toxic adenoma are the usual causes of hyperthyroidism in children as well as in adults. We report a case of hyperthyroidism due to TSH‐secreting pituitary macroadenoma in an 11‐year‐old girl. The patient was admitted to the Endocrine Department for pituitary function evaluation, five months after transfrontal adenomectomy and pituitary irradiation for a macroadenoma. On admission the patient was clinically hyperthyroid and the work‐up established a diagnosis of hyperthyrodism due to TSH‐secreting adenoma (high levels of TSH in the face of hyperthyroidism, no TSH response to TRH stimulation, diffuse thyroid goiter without eye signs or pretibial myxedema). Of interest in this case was the fact that (a) she is the youngest patient reported with hyperthyroidism due to a TSH‐secreting macroadenoma and (b) hyperthyroidism was diagnosed after adenomectomy.
Blood T and B lymphocyte subpopulations in healthy infants and children
Authors: Heldrup J , Kalm O , Prellner K
Published: January 2008

Monoclonal antibodies and flow cytometry are now used routinely in the diagnosis of many malignant diseases and primary and secondary immunodeficiency states. Technical advances have improved the identification of blood lymphocyte subsets and reliable normal values are now obtainable. Such values have been reported for adults but not for children. We report both absolute and percentage normal values for lymphocytes and their subsets in infants and children of different ages. Our findings show that the absolute and percentage values for most lymphocyte markers differ substantially not only between children and adults, but also between children from different age groups. In infants, erythroid cell contamination of Ficoll gradient‐density isolated mononuclear cells must be removed to obtain reliable flow cytometry values.
Pneumonia and pneumonitis in childhood malignancy
Authors: Shaw NJ , Elton R , Eden OB
Published: January 2008

We conducted a survey over a 21‐year period of the incidence and risk of occurrence of episodes of pneumonia and pneumonitis in children treated for solid tumours and leukaemia. One hundred episodes occurred amongst 219 patients, seven of which were associated with death. Focal opacification on the chest radiograph was more common than diffuse opacification. Patients with leukaemia had a significantly higher rate of occurrence of pneumonia and pneumonitis during the periods of induction and maintenance compared with the off‐treatment period, and during the relapse period compared with the period of maintenance. Patients with solid tumours had a significantly higher rate of occurrence during treatment compared to the off‐treatment period. The rate of occurrence on treatment was the same in patients with solid tumours and acute leukaemia. Children with malignancy have a high incidence of pneumonia and pneumonitis and death is rare if the patient does not have terminal malignant disease.
Epidermal growth factor in human and bovine milk
Authors: Iacopetta BJ , Grieu F , Horisberger M , Sunahara GI
Published: January 2008

The concentration of epidermal growth factor in human and bovine milk was measured by radioreceptor assay. Both human placental plasma membranes and a human epidermoid carcinoma cell were used as the epidermal growth factor receptor source in the assay. The use of placental plasma membrane in the radioreceptor assay gave erroneous results for bovine milk and overestimated the concentration of epidermal growth factor in human milk. Intact cells appear to provide a more accurate measure of the concentration of epidermal growth factor in milk samples. Using A431 cells, we found very low concentrations of epidermal growth factor in bovine milk (< 2 ng/ml) compared to human milk (30‐40 ng/ml). No epidermal growth factor activity was found in several cows' milk‐based infant formulas. These results highlight the caution which must be taken when measuring trace substances such as polypeptide growth factors in complex samples such as milk.
Selenium and human lactation in Australia: milk and blood selenium levels in lactating women, and selenium intakes of their breast‐fed infants
Authors: Cumming Fiona J , Fardy John J , Woodward David R
Published: January 2008

A series of 20 mother‐infant pairs were studied in Brisbane, Australia, at 6–12 weeks postpartum. The mean selenium concentration in maternal blood was 101 (SD±19) ng/g and in maternal serum 81 (± 15) ng/g; serum values appeared low in comparison with those reported for lactating women from Japan and the USA, but similar to those from Finland and from a previous Australian study. Breast milk selenium concentrations (11.9 ± 3.5 ng/g) were also low by international standards, but not as low as in New Zealand or Scandinavia. There was no correlation between selenium concentrations in milk and blood (or serum). The infants' 24‐h breast‐milk intakes were 856 ± 172 g, and their 24‐h selenium intakes 10.7 ± 4.1 μg (compared to the Australian RDI of 10 μg).
Cholesterol screening of seven‐year‐old children. How to identify children at risk
Authors: Larsson B , Vaara I
Published: January 2008

An inquiry was distributed to the parents of 1052 seven‐year‐old school beginners, concerning three issues, i. e. a known family history of myocardial infarction, angina pectoris before the age of 55 years and hyperlipidemia. A total of 147 children with a known family history were included in the study and compared with 148 classmates as control subjects. The proband children were subgrouped according to heredity factors and subjected to multivariate analysis at the 5% significance level for serum cholesterol fractions and trigycerides vs the control group. Statistically significant increased levels of total cholesterol and low density lipoprotein cholesterol, as well as an increased low density lipoprotein cholesterol and high density lipoprotein cholesterol ratio were found for all groups with heredity for hyperlipidemia (p < 0.001). However, no statistically significant difference was observed in the groups with heredity for myocardial infarction or angina pectoris exclusively. Also, there was no difference in any of the risk groups for high density lipoprotein cholesterol and triglycerides. The serum cholesterol levels in the present study were, to our knowledge, higher than those found elsewhere, except for Finland.
Ultrasonographic screening for renal abnormalities in three‐year‐old children
Authors: Mihara Masako , Ito Yuhei , Fukushima Keiko , Yamashita Fumio , Tsunosue Miwako
Published: January 2008

We report the results of ultrasonographic screening to determine the prevalence of renal abnormalities in children. This study was conducted simultaneously with a regular health check using portable realtime ultrasound equipment, from July 1988 to June 1989. Of 2920 three‐year‐old children resident in Kurume City, 2351 (80.5%) were screened. Abnormalities were detected in 11 (0.47%) of these, involving six cases of pelvic dilatation, three cases of unilateral renal agenesis, and two cases of a unilaterally small kidney. However, the simultaneous urinalysis of these 11 children did not disclose these abnormalities. Our results indicate that ultrasonography is an efficient tool for screening for a silent renal abnormality.
Cerebrospinal fluid exchange after intrathecal methotrexate overdose. A report of two cases
Authors: Jakobson ÅM , Kreuger A , Mortimer Ö , Henningsson S , Seidel H , Moe PJ
Published: January 2008

Two patients aged 11 and four years, were accidentally given a 10‐fold overdose of intrathecal methotrexate while being treated for malignant disease. Neither patient developed any signs of neurotoxicity and exchange of lumbar cerebro‐spinal fluid was started 3 and 5 h later, respectively. In one of the patients, who received 120 mg of methotrexate intrathecally, 31% of the given dose was recovered during 2 h of cerebrospinal fluid exchange that was started 3 h after the accidental overdosage. No sequelae were observed in any of the patients. Cerebrospinal fluid exchange is safe and can be recommended in all cases of intrathecal methotrexate overdosage. Ventriculo‐cisternal perfusion is not necessary in cases of a 10‐fold overdose if the patient has no signs of acute neurotoxicity.
Vasopressin and gonadotropin deficiency in a boy with the ectrodactyly‐ectodermal dysplasia‐clefting syndrome
Authors: Maldergem L Van , Gillerot Y , Vamos E , Toppet M , Watillon P , Vliet G Van
Published: January 2008

A boy presented with ectrodactyly (lobster claw deformity), bilateral cleft lip and palate, semilobar holoprosencephaly and microcephaly, associated with congenital hypogonadotropic hypogonadism and central diabetes insipidus. Other aspects of pituitary function were normal. We suggest that the ectrodactyly‐ectodermal dysplasia‐clefting syndrome can be associated with a variety of hypothalamo‐pituitary dysfunctions, in addition to the already described isolated growth hormone deficiency.
Intrauterine growth in children with cerebral palsy
Authors: Uvebrant P , Hagberg G
Published: January 2008

The risk of cerebral palsy in connection with intrauterine growth retardation has been analysed in a case‐control study. The case series comprised 519 children with cerebral palsy born in 1967‐1982 in the west health‐care region of Sweden and the control series 445 children born during the same years in the same region. The risk of cerebral palsy in small‐for‐gestational‐age infants was significantly increased in term and moderately preterm infants. The highest proportion among infants with cerebral palsy born at term was found in tetraplegia, followed by diplegia and dyskinetic cerebral palsy. It was concluded that small for gestational age on the one hand reflects early prenatal brain damage, and on the other mediates prenatal risk factors compatible with foetal deprivation of supply and also potentiates adverse effects of birth asphyxia and neonatal hypoxia.
Reference values for radial bone width and mineral content using single photon absorptiometry in healthy children aged 4 to 10 years
Authors: Bishop NJ , DePriester JA , Cole TJ , Lucas A
Published: January 2008

Bone width and mineral content were measured in 420 healthy Cambridge children aged 4 to 10 years using single photon absorptiometry. The results are expressed first in the form of standard centile charts, with additional prediction charts which provide body‐size‐adjusted estimates for the measurements, and interpretation centiles for comparing these estimates with the actual measurements. The values obtained are similar to those reported for American children aged five to six years after adjusting for body‐size differences. We suggest that appropriate application of these prediction charts will facilitate the use of single photon absorptiometry in monitoring and treating children who have disorders of bone growth and mineralization.
Human milk components cross‐reacting with antibodies against bovine β‐lactoglobulin
Authors: Neuteboom B , Giuffrida MG , Cantisani A , Napolitano L , Alessandri A , Fabris C , Bertino E , Conti A
Published: January 2008

The human whey components cross‐reacting with antibodies raised against bovine and/or equine β‐lactoglobulin were screened systematically. The milk of six women on a normal diet was collected within 72 h of confinement and whey components were fractionated by high‐speed size exclusion chromatography and reversed‐phase techniques. The fractions which were immunoreactive in double diffusion experiments with antisera anti‐bovine and/or equine β‐lactoglobulin were subsequently purified by native PAGE and then electroblotted on Pro‐blott membrane (Western blotting). Pro‐blot membranes were stained in parallel with Coomassie and by immunostaining using antibodies against bovine and/or equine β‐lactoglobulin as first antibody solution. The immunoreactive bands were cut out from the membrane and N‐terminally sequenced; all the immunoreactive components were clearly identified as human β‐casein or its (mainly tryptic) fragments. The strong antigenic similarity between human β‐casein and β‐lactoglobulin (bovine and equine) might be of immunological importance; it could mean that breast‐fed neonates risk being sensitized to β‐lactoglobulin irrespective of the presence of cow's milk in the mother's diet.
Risk factors for early termination of breast feeding in Brazil
Authors: Giugliani ERJ , Issler RMS , Justo EB , Seffrin CF , Hartmann RM , Carvalho NM
Published: January 2008

A prospective study was undertaken to identify possible factors related to the duration of breast feeding. Two hundred and thirty‐eight mothers who had delivered normal single babies with birth weights greater than 2.5 kg and had initiated breast feeding were randomly selected at the maternity hospital, Hospital de Clinicas de Porto Alegre, Brazil, and followed by mail questionnaires until termination of breast feeding, or until the end of the first year. If no reply was received, telephone contact or home visits were made. The group of mothers who stopped breast feeding prior to the end of the third month was compared with those who extended breast feeding beyond three months with respect to socioeconomic, biological, environmental, medical and psychological factors. The variables with a significant coefficient of association with early termination of breast feeding were maternal education, past experience with breast feeding, help of a maid, help with housework provided by a relative, breast feeding orientation during prenatal care and encouragement from the husband. These factors act simultaneously, with interactions among them.
Follow‐up of nutritional status and dietary survey in children with cow's milk allergy
Authors: Paganus A , Juntunen‐Backman K , Savilahti E
Published: January 2008

The nutritional status of children with cow's milk allergy was followed during an elimination diet in 19 children (9 boys and 10 girls) beginning at the mean age of two years (range 0.6‐4.1 years). The cow's milk allergy had been verified in hospital by a challenge test at a mean age of 0.9 years (range 0.2‐1.9 years). Weight, height and laboratory indices to test protein, mineral and vitamin status were measured at three follow‐up visits at three‐month intervals. In addition to cow's milk allergy all these children had some other food allergies, and six of the 19 children were allergic to soy protein. Only two of the 19 children were given a soy‐based formula. In the diets of the other children, cow's milk was replaced by increasing amounts of other foodstuffs and supplementary calcium. At the beginning of the study the relative heights of the children were slightly retarded (– 0.6 SD) and remained unchanged during follow‐up (– 0.8 SD at the end of the study). The relative weights were found to be decreased during follow‐up (p < 0.05). There was a significant reduction in serum prealbumin values; eight of the 19 children showed abnormally low values. Low serum zinc values were seen in 12 children. Serum iron concentration was low in two children and two had high serum alkaline phosphatase values. Seven‐day food recording indicated that dietary intake of energy was below the recommendation in some children, but protein intake was high. Some children had low intakes of riboflavin. Correlations between dietary intake and nutritional status were not seen in the children with cow's milk allergy. Careful follow‐up of children with cow's milk allergy is indicated and should include the monitoring of relative height and weight, serum prealbumin, serum trace elements and individual diet prescriptions.
Recurrent parotid swelling in children: clinical features useful for differential diagnosis of Sjögren's syndrome
Authors: Hara T , Nagata M , Mizuno Y , Ura Y , Matsuo M , Ueda K
Published: January 2008

Immunological evaluations were performed in 59 children with at least five episodes of parotid swelling. Autoantibody(ies) was transiently or persistently detected in 12 (20%) of 59 patients with recurrent parotitis. Three of the 12 children with autoantibodies were diagnosed as having Sjögren's syndrome. The mean age at onset of parotid swelling in Sjögren's syndrome was significantly higher than that of recurrent parotitis of unknown etiology. The present study and the review of the literature suggest that patients with the onset of parotid swelling at age five years or over deserve screening for underlying systemic immune disorders.
Diabetes‐related autoantibodies do appear in children with coeliac disease
Authors: Mario U Di , Anastasi E , Mariani P , Ballati G , Perfetti R , Triglione P , Morellini M , Bonamico M
Published: January 2008

Humoral immune factors related to type 1 diabetes have been investigated in children with coeliac disease. Anti‐insulin (IAAb), immunoglobulin (αIgAb), islet cell (ICA) and glucagon autoantibodies were examined in 15 children with coeliac disease at diagnosis (group 1), in 15 children with coeliac disease following a gluten‐free diet (group 2) and in 30 control patients (groups 3 and 4). IAAb were present in 27% of group 1 and in 20% of group 2 patients and αIgAb were significantly increased in group 1 and 2 patients; two patients in group 2 were positive for ICA; none of the coeliac disease patients were positive for anti‐glucagon antibodies. The levels of anti‐gliadin antibodies in group 1 were positively correlated with those of αIgAb. Coeliac disease‐related HLA antigens were not correlated with antibody presence. The presence of diabetes‐related humoral immune factors in coeliac disease raises the question as to whether or not they are predictive of subclinical pancreatic damage or whether they are simply indicators of a more general autoimmune diathesis.
Hoarseness in a child with gastroesophageal reflux
Authors: Putnam PE , Orenstein SR
Published: January 2008

Hoarseness is not generally appreciated to be a manifestation of pediatric gastroesophageal reflux. We describe a case in which treatment of well‐documented gastroesophageal reflux and esophagitis in a young girl with hoarseness and nocturnal cough led to resolution of these symptoms. Possible pathogenetic mechanisms and the difficulty in associating hoarseness with reflux by standard reflux testing are discussed.