bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparison of secretory antibodies in breast‐fed and formula‐fed infants over the first six months of life
Authors: Avanzini MA , Plebani A , Monafo V , Pasinetti G , Teani M , Colombo A , Mellander L , Carlsson B , Hanson LÅ , Ugazio AG , Burgio GR
Published: January 2008

In the present study salivary IgA, anti‐Escherichia coli, anti‐β‐lactoglobulin and anti‐poliovirus type 1 IgA and IgM in serum and saliva were evaluated longitudinally in 13 breast‐fed and 14 formula‐fed infants over the first six months of life. Salivary IgA was quantified by electroimmunodiffusion; specific IgA and IgM antibodies were determined in serum and saliva by ELISA. Salivary IgA was significantly lower at age one month in breast‐fed compared with formula‐fed infants but in breast‐fed infants salivary IgA increased with age and was significantly higher at six months than at one month. In both groups of infants, at the age of six months, salivary IgA levels were significantly lower than in adult controls. No significant differences in secretory anti‐E. coli were observed between the two groups of infants. Salivary anti‐poliovirus IgA and IgM antibodies increased transiently only to disappear in most babies at age six months, while anti‐β lactoglobulin IgA and IgM, present in saliva at all ages, showed a wide scatter. No important differences in specific serum IgA or IgM antibodies were observed either between the groups or at different times within the groups.
Hyperinflation in premature infants at preschool age
Authors: Thompson PJ , Greenough A
Published: January 2008

Functional residual capacity was measured by helium gas dilution in 12 children born very preterm (gestational age 25–29 weeks). The children were studied at between 4.0 and 4.6 years of age. Their results were compared to those of 12 control children who were born at term without neonatal problems. The controls were matched to the children born preterm for age, race and gender. The children born preterm had significantly increased functional residual capacity values when compared to the control subjects (p < 0.01). Eight children born preterm were hyperinflated (functional residual capacity > 120% of that predicted for height) compared to only one control subject (p <0.01). Five children born preterm and one control had a positive response to bronchodilator administration. These results suggest infants born very preterm may suffer from chronic hyperinflation.
Home intravenous antibiotic treatment of patients with cystic fibrosis
Authors: Strandvik B , Hjelte L , Malmborg A‐S , Widén B
Published: January 2008

We report one‐year's experience of home iv antibiotic treatment in 31 patients with cystic fibrosis chronically colonized with Pseudomonas aeruginosa. The patients were aged 4–67 years and had a mild to severe disease as indicated by a Shwachman score of 46–95 (mean 77). Ninety‐two courses of iv antibiotic therapy were given (mean 3.0 per patient). The mean duration of the courses was 15.4 days. The entire antibiotic course, except for the first dose, was administered at home in 70% of the courses. Most patients (94%) were given a combined treatment of a β‐lactam and an aminoglycoside, administered by the patients themselves or their parents. One inserted venous cannula could be used for the whole treatment period in 30% of the courses. There were no complications. The clinical and bacteriological outcome was good to excellent in 89% of the courses, with temporary eradication or semi‐quantitative decrease of Pseudomonas growth in sputum. Lung function (forced expiratory volume at 1 s) and blood gases improved significantly (p < 0.001 and p < 0.01, respectively). Most patients were able to attend work or school as usual, and 96% of the patients preferred this type of treatment to hospitalization. Apart from the psychosocial advantages, the economical savings were substantial. In comparison to traditional treatments in hospital (21 patients, 41 courses) home iv antibiotic treatment was safe and effective.
Rapid onset of severe retinopathy, cataracts and neuropathy in young patients with diabetes mellitus
Authors: Carroll Patricia B , Herskowitz Raymonde D , Goodman A David , Busch Robert S , Beaser Richard S
Published: January 2008

It is rare for young diabetic patients to develop severe complications in the first years of their disease. We describe three patients, aged 14–23 years who developed cataracts and severe retinopathy within one to five years of diagnosis of diabetes. During the same period, one patient developed peripheral neuropathy and a second severe autonomic neuropathy. Rapid development of chronic complications in these patients raises the possibility that there may be a subset of patients with unusual susceptibility to complications. We re‐emphasize the need for vigilant monitoring for complications in young diabetic patients, even in the first few years of their disease. In particular, young patients with visual complaints should be evaluated carefully for evidence of treatable eye disease.
Hyperthyroidism accelerates growth in Turner's syndrome
Authors: Massa G , Zegher F de , Dooms L , Vanderschueren‐Lodeweyckx M
Published: January 2008

Graves' disease in a girl with Turner's syndrome (karyotype 46,Xdel(Xp)) is described. Hyperthyroidism led to a pronounced acceleration of height velocity. During treatment with methimazole and L‐thyroxine, height velocity normalized. The patient also developed spontaneous puberty with a clear‐cut pubertal growth spurt. Final height, however, did not appear to be influenced either by Graves' disease or by spontaneous puberty.
Intrauterine diagnosis and evolution of a cardiomyopathy in a fetus with Noonan's syndrome
Authors: Sonesson Sven‐Erik , Fouron Jean‐Claude , Lessard Manon
Published: January 2008

We report on a newborn infant with a typical form of Noonan's syndrome. Because of the presence of a fetal cystic hygroma and normal karyotype the diagnosis was suspected before birth. A progressive hypertrophic cardiomyopathy was also found following fetal echocardiographic scanning. We conclude that in addition to cystic hygroma with normal karyotype, the presence of functional or morphological evidence of myocardial abnormality should be included also as prenatal features of Noonan's syndrome.
Danish primary schoolteachers' knowledge about asthma: results of a questionnaire
Authors: Madsen LP , Storm K , Johansen A
Published: January 2008

We present an anonymous questionnaire inquiry involving 334 primary schoolteachers in the Randers area with the purpose of elucidating teachers' knowledge about asthma. To a series of statements about asthma, the teachers answered yes, no or don't know. A limited knowledge of different aspects of asthma in children was found, although 57% had asthma children in their classes. Specially limited was knowledge about medical treatment. Five percent had received proper instruction about asthma and had a significantly better knowledge of medical treatment (p < 0.001‐0.05). Only 57% knew that wheezing after physical exertion is a strong indicator of asthma and only 33% knew that exertion in cold weather increases the risk of an attack. It is recommended that instruction in children's diseases, especially asthma, is introduced in teacher training colleges.
Growing up in Uppsala. The role of public services in identification and treatment of health and adjustment problems. Part I. Definition and classification of dependent variables
Authors: Mellbin T , Sundelin C , Vuille J‐C
Published: January 2008

A comprehensive prospective longitudinal study of health, development and social adjustment from the age of four to 18 years has been carried out in Uppsala, Sweden. This report presents the accumulated psychosocial burden up to 18 years of age for all 1715 children born in 1965 and resident in Uppsala from age 10 to 18 years. The psychosocial burden up to 18 years of age was assessed through analysis of records and register information from school health services, authorities for care of the handicapped, the Department of Child Psychiatry, social agencies and legal authorities. The analysis showed that 11.8% of the adolescents had a severe psychosocial burden up to the age of 18 years which could hamper their future life as adults. It was possible to categorize the whole birth cohort into one subgroup without manifest psychosocial problems and five different subgroups with serious problems: the six groups (severe mental or physical handicap, antisocial behaviour, psychiatric problems, social support, multiple problems, “normal”) had specific profiles concerning sex distribution, symptoms, social background, utilization of care services and delinquency.
Genetic analysis of cystic fibrosis in Denmark. Implications for genetic counselling, carrier diagnosis and prenatal diagnosis
Authors: Schwartz M , Brandt NJ , Koch C , Lanng S , Schiøtz PO
Published: January 2008

Cystic fibrosis is the most common, severe, inherited disease in the Caucasian population. As a consequence, the demand for genetic counselling of patients with cystic fibrosis and their families is large. In Denmark the incidence of cystic fibrosis is 1: 4700, which is quite low compared to other European countries. We have investigated 268 Danish cystic fibrosis patients with respect to DNA markers (haplotypes) and the most common mutation Δ F508. The Δ F508 mutation is found on 88% of all cystic fibrosis chromosomes, the highest frequency reported so far. This has had an important impact on genetic counselling, prenatal diagnosis and eventually population screening. In the Danish population 78% of all couples at risk will be informative for Δ F508 and will be identifiable by simple screening methods.
Hypoxaemia in infants with respiratory tract infections
Authors: Poets CF , Stebbens VA , Alexander JR , Arrowsmith WA , Salfield SAW , Southall DP
Published: January 2008

Nineteen infants who were graduates from special care baby units underwent two overnight tape recordings of oxygen saturation (SaO2) and breathing movements; one during an upper (n= 12) or lower (n=7) respiratory tract infection and the other when free of infection. Baseline SaO2 was lower during infection (median 99.6 vs 100%, p <0.01), with four patients having values (84.3‐95.5%) below the normal lower limit for full‐term infants (97%). The median number of apnoeic pauses was also lower during respiratory tract infection (4.7 vs 15.7/h, p <0.02). The median number of episodic desaturations (SaO2≤ 80%) did not change significantly (1.3 vs 1.9/h, p >0.05), with the exception of one patient who had extremely increased values during infection for both apnoeic pauses (63/h) and desaturations (112/h). No infant, however, was considered clinically hypoxaemic. Clinically unsuspected hypoxaemia may thus occur during respiratory tract infection in a proportion of infants graduating from special care baby units. Such hypoxacmia may have potentially deleterious effects.
Enhanced basal and stimulated PMN chemiluminescence activity in children with atopic dermatitis: stimulatory role of colonizing staphylococci?
Authors: Hoeger PH , Niggemann B , Schroeder C
Published: January 2008

In adults, intense staphylococcal skin colonization and hyperactivity of polymorphonuclear leukocyte (PMN) oxidative metabolism are characteristic features of atopic dermatitis. Precise data on childhood atopic dermatitis are lacking. In a prospective study we analysed the PMN chemiluminescence activity with special reference to staphylococcal stimuli in 19 children (mean age 6.2 years) with mild to moderate atopic dermatitis. Staphylococcus aureus was isolated from 17/19 (90%) of children with atopic dermatitis and 13/45 (29%) of healthy age‐matched controls (p<0.001). The mean (SEM) chemiluminescence activity of unstimulated atopic dermatitis‐PMN was 0.34 (0.009) (controls: 0.092 (0.003) × 106 cpm/106 PMN/min (p <0.02). Staphylococcal antigens (S. aureus, S. epidermidis, S. haemolyticus) induced a 1.9‐3.1‐fold higher peak chemiluminescence response in children with atopic dermatitis than in controls (p <0.05). The time interval until peak chemiluminescence activity was considerably shorter for all stimuli in atopic dermatitis. We conclude that PMN of children with atopic dermatitis are “primed”, showing enhanced release of reactive oxygen metabolites even in the “resting” state, and are easily stimulated by staphylococcal antigens present on the skin of patients with atopic dermatitis from early childhood on. We speculate that PMN hyperreactivity may contribute to chronic skin damage in atopic dermatitis.
Normal Y sequences in Smith‐Lemli‐Opitz syndrome with total failure of masculinization
Authors: Fukazawa R , Nakahori Y , Kogo T , Kawakami T , Akamatsu H , Tanae A , Hibi I , Nagafuchi S , Nakagome Y , Hirayama T
Published: January 2008

We report an infant with characteristics of Smith‐Lemli‐Opitz syndrome who had anteverted nostrils, apparently low‐set ears, micrognathia, high‐arched palate, cleft palate, growth and psychomotor retardation, hypotonia, poor suck, cerebral hypotrophy and double renal pelvis and ureter. An EEG showed spike waves in the right temporal area. The patient appeared to have normal internal and external genitalia of the female type. Both ovaries were dysplastic. The karyotype was 46, XY. All of 26 loci on the Y chromosome were positive including SRY, a candidate gene for TDF.
Impairment of the activity of the hepatic microsomal glucose‐6‐phosphatase system in three preterm infants
Authors: Hume R , Lyall H , Giles M , Burchell A
Published: January 2008

Three preterm infants born at 26–30 weeks' gestation who died between 103 and 266 days after birth were found to have elevated hepatic glycogen levels. Kinetic analysis of the hepatic microsomal glucose‐6‐phosphatase system demonstrated that one infant had abnormally low levels of activity of the glucose‐6‐phosphatase enzyme (partial type 1 a glycogen storage disease) and two had deficiencies of T2, a microsomal phosphate/pyrophosphate transport protein (type lc glycogen storage disease). In all three cases glycogen storage disease was not suspected prior to death even though both hypo‐ and hyperglycaemic episodes were recorded in the first 15 days after birth indicating that they had somewhat disordered blood glucose regulation. In the infant with low glucose‐6‐phosphatase enzyme activity, abnormal development of the glucose‐6‐phosphatase enzyme cannot be ruled out. This is the first description of abnormalities in the glucose‐6‐phosphatase system in preterm infants.
Vitamin K prophylaxis and vitamin K deficiency bleeding (VKDB) in early infancy
Authors: von Kries Rüdiger , Göbel Ulrich
Published: January 2008

The efficacy of vitamin K prophylaxis (1 mg im or sc, or 1–2 mg orally both given as a single dose at birth) in the prevention of vitamin K deficiency bleeding in early infancy was estimated in Germany during a 15‐month period between 1988 and 1989. Cases were identified by a survey of all paediatric hospitals and population denominators by a survey of all obstetric hospitals. Response rates were 85% and 68%, respectively. Thirteen cases of vitamin K deficiency bleeding in early infancy with confirmed prophylactic states were confirmed, seven of whom had intracranial haemorrhage. The estimated efficacy of single parenteral administration of vitamin K versus no prophylaxis was 96.7% (95% confidence interval: 74–99.6%) and for single oral administration versus no prophylaxis 80.4% (9.1–95.6%). Single parenteral vitamin K prophylaxis gave substantial protection against vitamin K deficiency bleeding in early infancy. Single oral prophylaxis appeared to be less effective, although the difference was not significant, as indicated by the wide overlap of the respective 95% confidence intervals.
Does growth hormone treatment of patients with Turner's syndrome cause an abnormal body shape?
Authors: Gerver WJM , Drayer NM , van Es A
Published: January 2008

The effect of human growth hormone on the body shape of 51 patients with Turner's syndrome (aged 6–19 years) was evaluated. Biosynthetic growth hormone was given in a dose of 24 IU/m2 body surface/week for two years. Karyotype analysis on peripheral blood was performed. Patients older than 12 years also received 0.1 μg ethinyl oestradiol/kg body weight/day orally. Body shape was characterized by studying pairs of measurements expressed as SD scores (z scores). As reference data, our own locally obtained data from normal children were used. After two years of growth hormone therapy, height, sitting height, biacromial and biiliac diameter increased from –3.7, –2.9, –1.7 and –1.2 to –1.3, –2.5, –0.6 and +0.5 z scores, respectively. The shape of the patients, expressed as height/biiliac diameter and also as sitting height/biiliac diameter became more abnormal. As no difference could be noted between the prepubertal and pubertal groups or between the XO and mosaic groups, it is suggested that growth hormone treatment causes a relatively wide pelvis in patients with Turner's syndrome.
Acute renal failure in a neonate due to pelviureteric candidal bezoars successfully treated with long‐term systemic fluconazole
Authors: Bergman KA , Meis JF , Horrevorts AM , Monnens L
Published: January 2008

Systemic candidiasis with renal involvement is a rare but well‐recognized complication during intensive care treatment in very‐low‐birth‐weight infants. We report a term neonate who developed anuria associated with bilateral bezoar formation in the renal pelvis and candidemia. The treatment consisted of placement of a nephrostomy tube in the left kidney, short‐term irrigation with amphotericin B and iv, and later, oral administration of fluconazole.
Noma neonatorum: an unusual case of noma involving a full‐term neonate
Authors: Lin Jin‐Yao , Wang Daw‐Wen , Peng Ching‐Tain , Tsai Fun‐Jen , Chiou Yong‐Ming , Tsai Chang‐Hai
Published: January 2008

Noma neonatorum is a gangrenous process that occurs in the oral, nasal or anal area and occasionally the eyelids and scrotum of the newborn. The disease is caused by Pseudomonas aeruginosa and usually affects premature ill babies during the first few weeks of life. A full‐term neonate with nasal and scrotal noma is uncommon and is therefore reported.
Developmental pathways through childhood for children treated in a neonatal intensive care unit
Authors: ELLISON PATRICIA , FOSTER MARK
Published: January 2008

We report the findings of a longitudinal study of children who were treated in the neonatal intensive care units in 1975–78. Relationships are described between measures of conditions and treatments of both mothers and newborns during the perinatal period and measures representing motor, neurological, developmental, and ability functions of the children at 15 months, 4 years and 7 years. The results of multivariate and path analyses are presented in which a latent variable approach is used to characterize the covariation between signs, symptoms, and treatment in the perinatal period and the major dimensions of functioning at the follow‐up occasions. Included among several noteworthy pathways between the latents of the various periods were ones from fetal distress, asphyxia, early crisis, intraventricular hemorrhage, anemia of prematurity, and number of days in the unit
Persistent diarrhea as a cause of childhood mortality in rural Bangladesh
Authors: Fauveau Vincent , Henry Fitzroy J , Briend André , Yunus Mohammed , Chakraborty Jyotsnamoy
Published: January 2008

To determine the importance of persistent diarrhea in childhood mortality a multiple‐step verbal autopsy method was used to study 1934 deaths in Matlab, Bangladesh. We found that most of the deaths from acute watery diarrhea occurred in infancy, whereas the peak of non‐watery diarrhea deaths was in children over 12 months of age. Children suffering from persistent diarrhea and malnutrition were at highest risk of dying during their third year of life. Children with infectious diseases have a two to four times higher risk of dying if they are malnourished, and for diarrhea the risk is 17 times as high. Forty‐nine percent of the diarrheal deaths were in children with malnutrition associated with persistent diarrhea. These results imply that fluid and dietary management are key aspects in the treatment of diarrhea, particularly for those episodes which persist. We conclude that attempts to reduce diarrhoeal deaths with vertical ORT programmes will not have a major impact unless other interventions are directed to the persistent diarrhoea‐malnutrition complex.
Epidemiology of persistent diarrhea among Guatemalan rural children
Authors: Cruz JR , Bartlett AV , Mendez H , Sibrian R
Published: January 2008

A prospective, longitudinal two‐year study to determine the epidemiology of persistent ( 14 days’duration) diarrhea in rural children of Guatemala was undertaken. Three‐hundred and twenty‐one children aged 0‐35 months were kept under surveillance by twice‐a‐week home visits. The overall incidence of diarrhea was 0.147 per child‐week; the incidence of persistent diarrhea was 0.014 per child‐week. The peak of persistent diarrhea was observed in infants below six months of age, with a continuous decline thereafter. This trend in incidence of persistent diarrhea was associated with a higher proportion (16%) of illnesses persisting for more than 13 days in children younger than six months of age as compared to children 30‐35 months old (4%). Males had more diarrhea (0.156 per child‐week) than females (0.139 per child week). Among children above 18 months of age, the proportion of episodes that lasted for more than 13 days was lower in females than in males.
Etiologic agents in acute vs persistent diarrhea in children under three years of age in peri‐urban Lima, Perú
Authors: Lanata Claudio F , Black Robert E , Maúrtua Dora , Gil Ana , Gabilondo Ana , Yi Augusto , Miranda Elba , Gilman Robert H , León‐Barúa Raul , Sack R Bradley
Published: January 2008

In a longitudinal study of acute and persistent diarrhea in 677 children less than three years old in a peri‐urban community of Lima, Perú, during 27 months of surveillance, stools were cultured at the beginning of each diarrheal episode and on each subsequent week of illness. Analyzing stool cultures only from children who had not received antibiotic treatment in the 48 h prior to the culture, no association was found between any enteropathogen and persistent diarrhea. We did not find any increase in mixed infections in persistent diarrhea episodes as compared with acute diarrhea, controlling for age, season and anthropometric status. The isolation rate for any given enteropathogen was similar during the first, second, third or later week of illness, but when the presence of a specific enteropathogen was sought in sequential stools within a single episode, no evidence of persistent infection was found. This study shows that in developing countries with a high incidence of diarrheal diseases frequent re‐infections with enteropathogens prevalent in the population are one reason for prolonged illnesses. Host factors that increase susceptibility to infection or decrease recovery from illness may also play a role. Further studies of these factors, such as micronutrient deficiencies, are needed to identify a public health intervention to control persistent diarrhea, a condition associated with mortality in many developing countries.
Zinc and diarrhea
Authors: Hambidge K Michael
Published: January 2008

Malnutrition is a major factor in the etiology, management and prognosis of persistent diarrhea in young children. Apart from inadequate energy intake, deficiencies of several specific nutrients have been implicated. Zinc is a micronutrient that appears to be of special interest, at least in some communities. Zinc deficiency has been documented in otherwise normal children. The risk of deficiency, however, is enhanced by diarrhea which is associated with variable but sometimes gross increases in zinc losses in the feces. These losses could contribute to a vicious circle, as there is now evidence that mild as well as severe zinc deficiency states can contribute to the duration and severity of diarrheal disease. During rehabilitation, impaired zinc nutriture could be responsible for slow growth, especially if the rehabilitation diet is high in phytate, a recognized inhibitor of zinc absorption. Research should be directed to a better understanding of zinc metabolism and homeostasis during diarrhea disease, to the consequences of zinc deficiency and to the benefits to be derived from zinc supplementation programs.
Type of milk feeding during acute diarrhoea and the risk of persistent diarrhoea: a case control study
Authors: Sazawal S , Bhan MK , Bhandari N
Published: January 2008

The role of feeding breast milk, unmodified bovine milk or adapted infant formula during acute diarrhoea in protecting against or causing persistence of the episodes was investigated in a population‐based case control study in an urban area of north India. After adjustment for confounding variables, exclusive breast‐feeding was associated with an odds ratio of 0.06 (95% CI 0.002‐2.1), a 16.5 times lower odds in favour of developing persistence of an episode. Infants fed unmodified bovine milk in addition to breast milk had an odds of 2.5 times (95% CI 1.0‐9.9) in favour of developing persistence of acute diarrhoea (p= 0.04). In infants receiving unmodified bovine milk and no breast milk, this odds ratio was 11.1 (95% CI 1.0‐228.8) (p= 0.05). This study indicates that promoting exclusive breastfeeding may reduce the persistence of diarrhoea over and above its effect in decreasing the incidence of acute diarrhoea. In urban areas of the developing countries where working mothers often use milk supplementation beyond the age of three months, our findings suggest that use of adapted spray dried formula may be safer than unmodified bovine milk with respect to the risk of developing persistent diarrhoea.
Clinical aspects of acute vs persistent diarrhea in Ho Chi Minh City, Vietnam
Authors: Thanh Pham N , Ly Dao‐T , Dung Pham‐T , Le Pham‐D
Published: January 2008

A retrospective clinical study of acute and persistent diarrhea in children younger than three years of age was conducted for 12 months (October 1989 to September 1990) in a Pediatric Hospital in Ho Chi Minh City, South Vietnam. Most of the 3833 episodes of diarrhea identified were of short duration, with 77.7% lasting only 1‐7 days. Only 5.3% of episodes lasted more than 14 days. Episodes of longer duration were associated with young age (0‐5 months). Bloody stool was present in more than 40% of persistent episodes. Severe malnutrition was associated with persistent episodes that lasted 14‐21 days (33%) or more than 22 days (59%). It is important that all patients with diarrhea have appropriate dietary management in addition to fluid therapy, and that future analysis examines etiologic factors to determine the optimal treatment of bloody diarrhea.
Inhibition of adhesion of S‐fimbriated E. coli to buccal epithelial cells by human skim milk is predominantly mediated by mucins and depends on the period of lactation
Authors: Schroten H , Plogmann R , Hanisch FG , Hacker J , Nobis‐Bosch R , Wahn V
Published: January 2008

Expression of S‐fimbriae is frequent in Escherichia coli strains causing sepsis and meningitis in the newborn period. We analysed the ability of human skim milk to inhibit adhesion of S‐fimbriated E. coli to human buccal epithelia. Adhesion was inhibited by up to 90% using colostrum (5%) and up to 50% with mature milk (5%), indicating that this anti‐infective mechanism depends on the period of lactation. Elimination of up to 99% of immunoglobulins and 91% of lactoferrin by affinity chromatography had no effect on the inhibition of adhesion. After separation of high‐ (> 10 kD) and low‐molecular‐weight fractions of skim milk, only the fraction > 10 kD was found to be able to inhibit bacterial adhesion. In order to further characterize receptor molecules for bacteria, we investigated binding of isolated S‐fimbriae to glycoprotein bands on Western blot strips. Fimbriae mainly bound to a high‐molecular‐weight band (> 200 kD). According to molecular weight and staining behaviour, this band most likely represents mucins. We conclude that carbohydrate residues on secreted mucins of human skim milk are able to inhibit bacterial adhesion to mucosal surfaces. This could provide protection against neonatal sepsis and meningitis caused by E. coli.
D‐Lactic acidosis: a treatable encephalopathy in pediatric patients
Authors: Gurevitch J , Sela B , Jonas A , Golan H , Yahav Y , Passwell JH
Published: January 2008

A 20‐month old infant, who had short bowel syndrome following extensive surgery for a mid gut volvulus, developed hyperchloremic acidosis, with a large anion gap after enteral feeding was instituted. The organic acidosis was at least partly due to an increased concentration of D‐lactic acid. This patient, as did five other pediatric patients, presented with a typical encephalopathy syndrome. Early recognition of this syndrome and treatment with an intestinal antibiotic and discontinuation of enteral feeding enabled prompt correction of the hyperchloremic acidosis and a rapid clinical recovery.
Renal function in sick, very low‐birth‐weight infants
Authors: Vanpée M , Ergander U , Herin P , Aperia A
Published: January 2008

Renal immaturity is pronounced in very low‐birth‐weight infants with a gestational age ≤ 30 weeks. We attempted to elucidate if conditions requiring mechanical ventilation, including patent ductus arteriosus, might further compromise renal function due to decreased renal perfusion. Forty infants studied between 4 and 28 days of age were divided into four groups: Control with no patent ductus or mechanical ventilation (n= 8); PDA + MV, with both patent ductus and mechanical ventilation (n=17); PDA, with patent ductus (n= 6); MV, with mechanical ventilation (n= 9). The groups PDA + MV and MV had significantly lower creatinine clearances and significantly higher fractional sodium excretions than controls. Mean arterial pressure was significantly lower in all groups compared to controls and correlated significantly with creatinine clearance (r = 0.47, p < 0.02). In conclusion, low renal function in these infants is further compromised by a patent ductus arteriosus and/or the use of mechanical ventilation.
Core‐peripheral temperature gradient in children: does it reflect clinically important changes in circulatory haemodynamics?
Authors: Murdoch IA , Qureshi SA , Mitchell A , Huggon IC
Published: January 2008

Following open heart surgery, changes in core and peripheral skin temperature and changes in the core‐peripheral temperature gradient were measured in 10 children. These were correlated with changes in cardiac index, systemic vascular resistance index, mean arterial pressure and urinary output. During the study intervals, which lasted 1 h each, no changes in medical management were made. Using Spearman's rank correlation, only a change in central venous pressure was found to correlate with a change in the core‐peripheral temperature gradient. We conclude that a change in the core‐peripheral temperature will give valuable information about the patient's intravascular volume.
Kala‐azar in a one‐year‐old Swedish child. Diagnostic difficulties because of active hemophagocytosis
Authors: Granert Carl , Elinder Göran , Öst Åke , Henter Jan‐Inge
Published: January 2008

A one‐year‐old Swedish boy developed kala‐azar six months after a holiday in Spain. Upon visiting the hospital after one week of illness he demonstrated clinical and laboratory findings of fever, splenomegaly and cytopenia. A fine‐needle aspiration biopsy of the spleen revealed hemophagocytosis and he had increased serum levels of the cytokines tumor necrosis factor‐alpha and interferon‐gamma. Initially, a diagnosis of hemophagocytic lymphohistiocytosis was made. Re‐evaluation of the spleen smears and of the bone marrow aspiration revealed Leishmania parasites and subsequent therapy with sodium stibogluconate was successful. This patient illustrates the interesting similarities between these two disorders involving the mononuclear phagocyte system as well as the problems involved in differential diagnosis. This case also reminds us of the possibility of contracting visceral leishmaniasis in Mediterranean countries.
Increase in T cells bearing the gamma/delta receptor associated with lymphoproliferative disease of granular lymphocytes in an infant with intractable diarrhea
Authors: Imashuku S , Ohmizono Y , Itoi T , Kataoka Y , Ikushima S , Hibi S , Matsumura T , Yagi K , Kawa‐Ha K , Ueno Y , Yachie A , Miyawaki T
Published: January 2008

A two‐year‐old infant with intractable diarrhea and lymphoproliferative disease of granular lymphocytes attributed to a persistent cytomegalovirus infection showed an increase in cells bearing the gamma/delta T‐cell receptor (TCR), which accounted for approximately 20% of total peripheral blood lymphocytes and 40% of CD3+ T cells. Of the gamma/delta TCR+ cells, two‐thirds were double negative (CD4–/CD8–) and the other one‐third CD8 positive. The majority of gamma/ delta + cells were delta TCS 1 positive. The predominance of delta TCS 1 positive cells was also confirmed on biopsy of lymphoid tissues from the colon. After improvement of watery diarrhea and malnutrition following three‐month hyperalimentation, the number of gamma/delta TCR+ cells decreased. The patient subsequently died of pneumonia at the age of 2 years and 11 months. A possible site‐specific role for the gamma/delta TCR + cells, particularly delta TCS 1 + cells, in the human intestine is discussed.
Feeding and nutritional problems in children with cerebral palsy and myelomeningocoele
Authors: Dahl M , Gebre‐Medhin M
Published: January 2008

This study was undertaken to characterize the food intake, current feeding situation and nutritional status of children with cerebral palsy and myelomeningocoele. Thirty children with cerebral palsy and 14 with myelomeningocoele were investigated. The children with cerebral palsy were subgrouped into those with diplegia (11 children), dystonia (10 children), hemiplegia (6 children) and ataxia (3 children). Information was obtained from medical records, current dietary recording and clinical and anthropometric examinations. Feeding problems, low energy intake and wasting were frequent among the children with cerebral palsy, particularly those with the dystonic form. Children with myelomeningocoele gave the impression of being overnourished, despite a seemingly relatively low energy intake. It is clear that nutritional and feeding aspects should receive particular attention in the habilitation of children with various disabilities.
Long‐term treatment with growth hormone in Noonan's syndrome
Authors: Thomas BC , Stanhope R
Published: January 2008

Five children (four boys, one girl) with Noonan's syndrome were treated with growth hormone for a mean of 2.9 (range 1.8 to 4.6) years. Treatment was commenced at a mean age of 3.9 (range 2.5 to 6.0) years. After one year of treatment, height velocity SDS increased from a mean of ‐2.1 (range ‐4.1 to ‐ 0.3) to a mean of +3.1 (range +2.0 to +3.5). Subsequently, height SDS increased significantly from ‐3.3(range ‐4.2 to ‐2.2)to ‐2.4(range ‐3.3 to ‐ 1.6). Although in all patients a marked decrease in height velocity was observed in the following years of treatment, compared to the first year, height SDS continued to improve in comparison to pretreatment (mean height SDS in the third year for four patients was ‐2.1) (range ‐3.1 to ‐ 1.4). In the four patients who had completed their second year of treatment, height SDS for bone age had increased from ‐1.8 (range ‐ 2.8 to ‐ 09) to ‐1.2 (range ‐ 1.6 to ‐0.6).
Obstructed breathing in children during sleep monitored by echocardiography
Authors: Shiomi T , Guilleminault C , Stoohs R , Schnittger I
Published: January 2008

Six 3 to 14‐year‐old boys with snoring and obstructive sleep apnea syndrome were monitored polygraphically during sleep with and without nasal continuous positive airway pressure with simultaneous recording of esophageal pressure (Pes) and M‐mode and two‐dimensional echocardio‐grams. Continuous non‐invasive blood pressure monitoring was performed in two older children. Three of the six children demonstrated a diastolic leftward shift of the interventricular septum related to the negativity of Pes. Progressively more negative Pes correlated significantly with an increase in right ventricular internal end‐diastolic dimension and a decrease in left ventricular internal end‐diastolic dimension, with at times left ventricular “collapse”. One of the subjects with blood pressure monitoring demonstrated pulsus paradoxus with leftward shift of the interventricular septum. Nasal continuous positive airway pressure normalized all changes. Pulsus paradoxus and leftward shift of the interventricular septum are related to the mechanical changes associated with heavy snoring during sleep, regardless of the amount of oxygen desaturation.
Acute accidental overdosage of haloperidol in children
Authors: Yoshida Ichiro , Sakaguchi Yusuke , Matsuishi Toyojiro , Yano Eiji , Yamashita Yushiro , Hayata Satoshi , Hitoshi Taizo , Yamashita Fumio
Published: January 2008

We report the details of an accidental overdosage of haloperidol in 24 children in one hospital in Kyushu, Japan. Evidence of acute toxicity included disturbances in consciousness (24/24), tremors in the extremities (16/24), an oculogyric or similar crisis (14/24), dysarthria (9/17), drooling (8/24), akathisia (6/20), hyperreflexia (6/24) and opisthotonos (3/24). Laboratory examinations revealed late‐onset transient thrombocytosis (5/24), elevated AST and GPT (1/24) and abnormal ECG with prolonged QT interval in 2 of 8 children. We detected haloperidol in 11 of 18 children whose blood was specifically examined within four days after the final haloperidol administration. The maximum serum haloperidol level was 28.9 ng/ml. The mean half‐life of haloperidol in the serum of five children (age range 2–10 years) was 18.6 ± 12.2 h (mean ± SD) (range 9.1–39.4 h).
Oral administration of arginine enhances the growth hormone response to growth hormone releasing hormone in short children
Authors: Loche S , Carta D , Muntoni AC , Corda R , Pintor C
Published: January 2008

We have evaluated the effect of oral administration of arginine chlorhydrate on the growth hormone response to growth hormone releasing hormone in a group of nine short prepubertal children (six boys and four girls). Arginine chlorhydrate 10 g, administered orally 60 min before an iv bolus injection of growth hormone releasing hormone 1–29, 1 μg/kg, significantly enhanced the growth hormone response to the neuropeptidc, confirming the results of previous studies which used the iv route. Furthermore, our data strengthen the view that the effects of arginine chlorhydrate on growth hormone secretion are mediated by inhibition of endogenous somatostatin release.
Changes in lipid profile observed in children over the course of infectious disease
Authors: Garbagnati Ersilia
Published: January 2008

Lipid profile was evaluated prospectively in 23 consecutive children, aged 3.2–14.9 years, admitted to the hospital with a febrile illness (pneumonia, upper respiratory tract infection, diarrhea, pyelonephritis, mononucleosis, appendicitis). The degree of dyslipidemia associated with fever was assessed using each child as his/her own control and by comparison with 93 non‐febrile children who had no evidence of fever during the past six months. Total cholesterol decreased during the symptomatic phase of the disease. The magnitude and duration of its decrease appeared to be related to the degree and duration of fever. Low HDL‐cholesterol and hypertriglyceridemia were observed during the late stage of the febrile disease and were still detected in the convalescent phase. This study suggests that in children, transient and sometimes prolonged lipid changes may occur in association with an infectious febrile disease. This effect is important for defining the appropriate timing for screening for dyslipidemias.
Systemic absorption of salbutamol following nebulizer delivery in acute asthma
Authors: Penna AC , Dawson KP , Manglick P , Tam J
Published: January 2008

We measured plasma salbutamol concentrations in 35 children with acute asthma attacks before and after nebulizer therapy. The main finding was that older children had higher concentrations than younger children, despite similar dosage regimens. There was no influence of severity of the asthma attack on the following measures: pre‐ and post‐nebulizer concentrations, absolute and percentage change in salbutamol levels with therapy. We conclude that the theoretical risks of high concentrations in young children were not found and we suggest that the very young may indeed require higher doses due to possible problems in nebulizer technique or differences in kinetics.
Progress in the treatment of biliary atresia: a plea for surgical intervention within the first two months of life in infants with persistent cholestasis
Authors: Emblem R , Stake G , Monclair T
Published: January 2008

During the period 1984–1991. 21 infants with biliary atresia were treated with Kasai's portoentcr‐ostorny. The median survival in infants operated on before the age of 60 days (55 (range 5–82) months) was significantly longer than the survival of children operated on after the age of 60 days (15 (1.5 38) months). At present there arc 10 survivors with a median age of 54 (17–96) months: 6 with portoenterostomy and 4 after liver transplantation. Eight patients died of progressive liver failure and 3 died of causes not related 10 biliary atresia. Apart from blood tests, ultrasonography was the most important investigation bcfore laparotomy in infants with cholestatic jaundice. Scintigraphy and liver biopsy added no further decisive information. Because early diagnosis and surgical treatment is important. only the well documented presence of a normal gallbladder can warrant postponement of an operation.
Treatment of isolated growth hormone deficiency type IA due to GH‐I gene deletion with recombinant human insulin‐like growth factor I
Authors: Nishi Y , Hamamoto K , Kajiyama M , Fujiwara M , Miyagawa S , Hasegawa Y , Hasegawa T
Published: January 2008

Biosynthetic insulin‐like growth factor I (IGF‐I) was administered subcutaneously twice a day for one year to a patient with isolated growth hormone deficiency (IGHD) type IA with high titres of anti‐GH antibody (up to 1:1 000 000). During IGF‐I therapy he showed good linear growth without any side effects, such as hypoglycemia and anti‐IGF‐I antibody formation. Administration of IGF‐I to IGHD type IA with poor response to GH therapy appears to have a beneficial effect on growth.
Lower body temperatures in infants delivered by caesarean section than in vaginally delivered infants
Authors: Christensson K , Siles C , Cabrera T , Belaustequi A , De La Fuente P , Lagercrantz H , Puyol P , Winberg J
Published: January 2008

Clinical experience suggests that infants delivered by caesarean section have difficulties maintaining normal body temperature during the first hours after birth. To test this hypothesis, body and skin temperatures were measured and compared in healthy full‐term caesarean section and vaginally delivered newborn infants. The babies were studied during the first 90 min after birth. Axillary and skin temperatures were significantly higher in the vaginally delivered group than in infants delivered by caesarean section. Infants born by non‐elective caesarean section were slightly warmer during the first 90 min after birth compared to infants born by elective caesarean section. There were no significant differences in temperatures between infants cared for in a cot as compared to those cared for in an incubator. An incubator creates a physical barrier between babies and parents and incubator care might cause parental anxiety. Thus the routine of putting healthy, full‐term caesarean section infants in incubators can be abandoned from a thermoregulatory point of view.
The chemoluminescence response of human polymorphonuclear leukocytes to Escherichia coli O and K antigens
Authors: Miyata Hiroshi , Moriguchi Naohiko , Kinoshita Tomohiro , Kataoka Satoru , Kanazaki Michiharu , Maki Sunao
Published: January 2008

The interactions between Escherichia coli O or K antigens and polymorphonuclear leukocyte function were studied. Five types of O antigen and three types of K antigen were extracted from E. coli. These included O1, O6, O75 and K1 antigens from pyelonephritopathogenic strains, O44 and K74 antigens from an enteropathogenic strain and O14 and K7 antigen from a standard strain. The antigens all reacted specifically to their specific antisera and no cross‐reactions were observed. The O1 or O44 antigen stimulated a significantly greater chemoluminescence response in polymorphonuclear leukocytes obtained from normal volunteers than O75, O6 or O14 antigen. In addition, the K1 or K74 antigen stimulated polymorphonuclear leukocytes significantly more than K7 antigen. These results suggest that pyelonephritopathogenic or enteropathogenic E. coli may produce severe tissue damage as a result of the response to their O or K antigens, as well as via adhesive agents such as pyelonephritopathogenic P‐pili or the enteroadhesive factor, and exotoxins such as hemolysin or verotoxin.
One‐sided high‐frequency oscillating ventilation in the treatment of neonatal unilateral pulmonary emphysema
Authors: Rettwitz‐Volk W , Schlösser R , Loewenich V von
Published: January 2008

We describe a preterm infant (31 weeks' gestation) with unilateral pulmonary emphysema. Bronchoscopy showed no bronchial obstruction. After 20 days of right‐sided high‐frequency oscillating ventilation, the emphysema in the left lung had completely resolved and the patient could be extubated.
Compliance in teenagers with coeliac disease—a Swedish follow‐up study
Authors: Ljungman G , Myrdal U
Published: January 2008

A group of 47 children with coeliac disease, born between 1973 and 1978 in the Swedish county of Västmanland, participated in a controlled questionnaire study. Health, self‐esteem, knowledge of the disease and dietary compliance were investigated. The children with coeliac disease were otherwise just as healthy as the control children. Growth and self‐esteem were normal. Good knowledge of coeliac disease and dietary treatment was found in 87% of children and dietary compliance was 81%. Girls and younger children (12–14 years) were more compliant than boys and older children (15–17 years). Compliance correlated positively to knowledge.
Growth velocity and serum aminoterminal propeptide of type III procollagen in precocious puberty during gonadotropin‐releasing hormone analogue treatment
Authors: Saggese G , Bertelloni S , Baroncelli GI , Nero G Di , Battini R
Published: January 2008

Growth velocity and serum aminoterminal propeptide of type III procollagen (P‐III‐NP) were evaluated in 11 girls (age 3.8–8.5 years) with central precocious puberty during luteinizing hormone releasing hormone (LH‐RH) analogue treatment (D‐Trp6‐LH‐RH, 60 μg/kg im for 28 days, n = 7; D‐ser(TBU)6‐LH‐RH, 1600 μg/day intranasally, n = 4). Before treatment, growth velocity (10.2 ± 1.9 cm/ year) and P‐III‐NP concentrations (12.8 ± 4.3 μg/l) were in the pubertal range. During therapy, growth velocity significantly decreased to the prepubertal levels. P‐III‐NP concentrations decreased significantly after six months of therapy (7.9 ± 3.7 μg/l, p< 0.001). Three girls with low growth velocity (< 4 cm/year), stimulated growth hormone peak < 10 μg/l, and altered 12‐h nocturnal growth hormone secretion at 12 and/or 18 months of treatment, had a more marked decrease in P‐III‐NP concentrations (patient 3: −65.9%; patient 5: −58.7%; patient 10: −61.0%) after 6 months of therapy. Our results suggest that LH‐RH analogue treatment in central precocious puberty may impair growth. In these cases, measurement of serum P‐III‐NP levels may be an additional marker to‐ monitor growth.