bluuebunny/crossref_metadata_2025 huggingface dataset:
Persistent diarrhea in Vietnamese children: a preliminary report
Authors: Ngan Phan Kim , Khanh Nguyen Gia , van Tuong Chu , Quy Pham Phu , Anh Doan Ngoc , Thuy Hoang Thu
Published: January 2008

The clinical and laboratory features of persistent diarrhea were investigated in 83 children under three years of age who were treated in the Gastroenterology Division of the Institute for the Protection of Children's Health, Hanoi from August 1988 to August 1989. The number of cases of diarrhea was highest in the children aged 4‐5 months. The mean age of the children studied was 6.6 ± 3.4 months. The ratio of males to females was 2.6 and mean age of first episode of diarrhea was 4.3 ± 3.4 months; persistent diarrhea was more common in children under six months of age than in older children. Persistent diarrhea occurred in the first diarrheal episode in 66.5% of cases. Recent nonenteric infections were found in 30% of the study group. Of the 83 children studied, 36% had stool specimens positive for enteric pathogens; 24% had enterotoxigenic Escherichia coli isolated, 8% had enteropathogenic E. coli, 5% rotavirus, 6%Candida, and 4%Giardia lamblia. The duration of diarrhea was longer in children who received antibiotics than in those who did not (p<0.01).
Diagnosis of the carbohydrate‐deficient glycoprotein syndrome by analysis of transferrin in filter paper blood spots
Authors: Stibler Helena , Cederberg Birgitta
Published: January 2008

Carbohydrate‐deficient glycoprotein syndrome is a recently identified recessively inherited, multisystemic disease with severe nervous system involvement. It is characterized biochemically by carbohydrate‐deficient serum glycoproteins, and can be diagnosed by analysis of abnormal isoforms of serum transferrin. Using stored, neonatally collected filter paper blood spots from such patients, it was shown that neonatal diagnosis was possible by immune‐isoelectric focusing of transferrin eluted from up to 14‐year‐old samples. Freshly collected blood on filter paper was readily analyzed quantitatively for carbohydrate‐deficient isotransferrins by a rapid microchromatographic assay, revealing highly elevated values in all patients. The presently described methods thus provide a means for early diagnosis of the carbohydrate‐deficient glycoprotein syndrome in microliter volumes of capillary blood. Sampling on filter paper offers an important simplification in sample collection, storage and transport, and may make population studies possible.
Trunk asymmetry and screening for scoliosis: a longitudinal cohort study of pubertal schoolchildren
Authors: Nissinen M , Heliövaara M , Ylikoski M , Poussa M
Published: January 2008

A cohort of children was followed‐up annually from an average age of 10.8–13.8 years to assess various measures of trunk asymmetry for their predictive value in the screening of scoliosis. Of 1060 children, 855 (80.7%) participated in the final examination. Trunk asymmetry was measured by the forward bending test and moire topography. A posteroanterior standing radiograph of the spine was taken of those 250 (29.2%) children who had a trunk hump 8 mm. Only 8.3% of the children were found to be symmetric (hump 0–2 mm) in the forward bending test: 65.5% had a hump of 3–7 mm and 26.2% had a hump 8 mm at 13.8 years. Also, moiré fringe asymmetry proved to be common (prevalence of asymmetry > 1 fringe 47.3%), but its correlations with rib hump (r= 0.16) and Cobb angle (r= 0.12) were low. At the final examination, the prevalence of scoliosis (Cobb angle 10°) was 9.2%. Two girls (0.2%) needed brace treatment. The forward bending test is preferable to moiré topography in screening for scoliosis, and a hump size of 6 mm at an average age of 10.8 years is the nearest to optimal as a screening threshold.
Concentrations of nucleotides, nucleosides, purine bases and urate in cerebrospinal fluid of children with meningitis
Authors: Rodríguez‐Núñez A , Camiña F , Lojo S , Rodríguez‐Segade S , Castro‐Gago M
Published: January 2008

The release of agents mediating inflammation in meningitis may bring about neuronal hypoxia, under which circumstances ATP concentrations decrease and its degradation products increase and are released into the cerebrospinal fluid. In this study of alterations in neuronal energy metabolism in meningitis, AMP, IMP, inosine, adenosine, guanosine, adenine, guanine, hypoxanthine, xanthine and urate were determined by high performance liquid chromatography in the cerebrospinal fluid of 54 children aged between 1 month and 13 years suffering from meningitis (25 viral, 24 bacterial and 5 tuberculous cases) and 63 controls. Compared to the controls, patients with viral meningitis exhibited high concentrations of IMP, adenosine, guanosine, adenine, guanine and xanthine; patients with bacterial meningitis exhibited high concentrations of IMP, inosine, guanosine, adenosine, hypoxanthine, xanthine and urate; and patients with tuberculous meningitis exhibited high concentrations of AMP, guanosine, xanthine and uratc. Viral and bacterial cases did not differ significantly for any of the metabolites studied. AMP and urate concentrations were significantly higher in patients with tuberculous cases compared with viral or bacterial meningitis cases.
Autonomic response to auditory stimulation
Authors: Anderssen SH , Nicolaisen RB , Gabrielsen GW
Published: January 2008

Autonomic and behavioral response to fear stimulation (sudden noise 80 dB) was studied in 12 sleeping infants at ages 8–50 weeks. The aim of the present study was to identify a possible passive defense response in infants. The response, which is widespread in birds and mammals, is characterized by apnea and bradycardia with circulatory changes as seen during the forced diving response. Upon stimulation, two respiratory responses were elicited: apnea preceded by irregular respiration or simple irregular respiration. Apnea was elicited in 58% of stimulations at ages 8–16 weeks compared to 14% at 28–50 weeks. The mean duration of apnea decreased from 7.8 s(± 1.8 s) at 8–13 weeks to 4.7s (± 1.1s) at 17–20 weeks. The preceding irregular respiration increased from 5.3 s (± 4.4 s) to 10.6 s (± 5.4 s) at the same ages. The heart rate response was biphasic and were interpreted as the orienting response. The mean deceleration in relation to apnea was 16% at 8–16 weeks and was reduced to 8% at 28–50 weeks. Infants of smoking mothers were more prone to respond with apnea than infants of nonsmoking mothers (73% versus 38%). REM sleep and long postprandial sleep time increased the probability of apnea response (62% versus 38% and 66% versus 35%). The responses seen may be interpreted as expressions of the passive defense response.
Elevated cholecystokinin concentrations in plasma in children with recurrent abdominal pain
Authors: Alfvén G , Uvnäs‐Moberg K
Published: January 2008

The objective of the present study was to measure plasma Concentrations of the gastrointestinal hormones gastrin, somatostatin and cholecystokinin in plasma of children with recurrent abdominal pain. since these hormones affect gastrointestinal function. Forty‐four children (7–16 years old) with recurrent abdominal pain and 36 control children (matched for age and sex) participated in the study. In a blood sample collected after an overnight fast, gastrin, somatostatin and cholecystokinin concentrations werc measured by radioimmunoassay. The children with recurrent abdominal pain had higher plasma cholecystokinin levels (p<0.001) than the controls. Whether or not this aberration is related to the clinical symptoms of children with recurrent abdominal pain remains to be established.
Coronary risk factors in children of parents with premature coronary artery disease
Authors: Beigel Y , George J , Leibovici L , Mattityahu A , Sclarovsky S , Blieden L
Published: January 2008

In order to assess the value of family history of premature coronary artery disease as a criterion for coronary risk factor screening, a group of 53 children with such a family history was selected. We determined various coronary risk factors in these children in comparison to 33 controls. Statistically significant differences were observed in apoprotein concentrations but not in concentrations of lipids, lipoproteins or glucose, or in blood pressure or body mass index. The ratio between apoprotein B and apoprotein A1 was the best discriminator between the two groups. The predictive value of family history is more reliable for detecting abnormal apoprotein ratio than for detection of hypercholestero‐lemia. We conclude that if abnormal apoprotein levels during childhood are found to be a valued predictor of premature coronary artery disease, then family history of premature coronary artery disease can be used to select children for determination and assessment of their coronary risk.
Trichorhinophalangeal syndrome, type I, with avascular necrosis of the femoral head
Authors: Minguella I , Ubierna M , Escola J , Roca A , Prats J , Pintos‐Morell G
Published: January 2008

We report the case of a seven‐year‐old girl with peculiar facial traits who presented for right coxalgia of six weeks' duration. The phenotypic findings corresponded to a trichorhinophalangeal syndrome, type I, and the clinical, radiological and gammagraphic characteristics were indicative of avascular necrosis of the right femoral head, Legg‐Perthes‐Calvé disease.
Weight‐for‐length model in newborn Swedish infants
Authors: Niklasson Aimon , Karlberg Petter
Published: January 2008

A new methodology for evaluation of weight in relation to length normalized for sex and gestational age (leanness/fatness) in the newborn infant is presented. Using standard deviation scores (SDS) for weight and length in a linear regression model, a new continuous variable called LEANSDS has been constructed with intercept = zero, regression coefficient = 0.7152, SD = 0.6988 and r2= 0.51, irrespective of gender and gestational age within the range 34–43 weeks’gestation. The model is based on the Swedish 1986 Medical Birth Register and was tested on the 1985 year cohort. The reference material consisted of live‐born, singleton infants considered “healthy”. This new variable is independent of length. A chart is presented which simplifies visual evaluation. Using — 2 SD as the cut‐off limit, approximately one‐third of light‐for‐dates infants are also lean, while two‐thirds of the lean infants are not light for dates. Proportions of “not healthy” live‐born infants and still births are given. Using another method, based on weight and length, and with some approximations needed for calculation of a comparable BW/BLSDS, the correlation was 0.9974, but this calculation is more elaborate and the comparable chart more complex. This method reveals the influence of gestational age on the relationship between weight and length, indicating a “prenatal puberty”. Empirically, the logarithmic relationship found between weight and length indicates a ponderal index exponent of 2.4–2.5 instead of 3. LEANSDS, with its continuous nature, also gives the degree of deviation in each individual and in groups of infants, and can be added together and further analysed with improved sensitivity.
Effect of growth hormone treatment on craniofacial growth in Turner's syndrome
Authors: Rongen‐Westerlaken C , Born E vd , Prahl‐Andersen B , Teunenbroek A v , Manesse P , Otten BJ , Tweel I vd , Kuijpers‐Jagtman AM , Delemarre vd Waal HA , Drayer NM , Wit JM , Brande JL vd
Published: January 2008

A cephalometric study was performed in 19 patients with Turner's syndrome, aged 8.7–16.5 years. A lateral roentgencephalogram was taken before and after two years of treatment with biosynthetic growth hormone in a dose of 24 IU/m2/week. During two years of growth hormone treatment, the mandibular length increased mainly due to vertical growth. The initially posteriorly rotated mandible showed an anterior rotation, although the normal position was not reached. The other linear measurements and angles did not change during treatment. No indications were found for an increase in the disproportionate growth or for excessive chin growth as a sign of acromegaly during growth hormone treatment. In conclusion, growth hormone treatment in patients with Turner's syndrome resulted in an increase in mandibular length, mainly due to vertical growth of the ramus and in the anterior rotation of the mandible.
Efficacy of low‐dose dopamine infusion
Authors: Emery EF , Greenough A
Published: January 2008

Urine output following administration of a low‐dose dopamine infusion was assessed in 20 very immature infants (median gestational age 27 weeks). Prior to the infusion, all infants had had a period of anuria. Urine output improved significantly during the second 24 h after commencing the infusion but, at that time period, urine output was greater than 2 ml/kg/h (designated a good response) in only 13 infants. There was no significant difference in gestational age, birth weight, period of anuria or fluid input of infants who had a good or a poor response to dopamine. Although the baseline blood pressure did not differ significantly between these two groups, the increase in blood pressure resulting from dopamine administration was significantly greater in those infants with a good response in urine output (p<0.02). We conclude that low‐dose dopamine infusion can improve urine output in very immature infants. Our results suggest that there may be inter‐individual variation in the sensitivity to dopamine.
Failure of ursodeoxycholic acid to dissolve radiolucent gallstones in patients with cystic fibrosis
Authors: Colombo Carla , Bertolini Emanuela , Assaisso Maria Luisa , Bettinardi Nora , Giunta Annamaria , Podda Mauro
Published: January 2008

Ursodeoxycholic acid has been used widely to dissolve cholesterol gallstones and more recently was shown to improve clinical symptoms and biochemical indices in different chronic liver diseases, including that associated with cystic fibrosis. We treated 10 cystic fibrosis patients (5 males, 5 females, age range 2–22 years) with pancreatic insufficiency and normal liver function with ursodeoxycholic acid 15–20 mg/kg/day. Seven patients had radiolucent gallstones (in 3 cases associated with biliary sludge) and 3 had sludge; all were asymptomatic. Before treatment, the gallbladder was well opacified in oral cholecystogram. The gallbladder was scanned by ultrasound in similar conditions and by the same operator before administration of ursodeoxycholic acid and after a median period of treatment of 16 months (range 11–32 months). During treatment, all patients remained asymptomatic and the relative proportion of ursodeoxycholic acid in duodenal bile increased from 4.7 ± 3.2% at baseline to 34.7 ± 8.6%. Complete or partial dissolution of gallstones was never observed and the maximum diameter of stones increased from a mean of 6.1 ± 3.4 to 8.0 ± 5.3 mm; in one case the development of biliary sludge occurred during bile acid therapy. Sludge disappeared in 1 of the 6 patients who initially had it, while in 2 cases its volume increased. We conclude that ursadeokycholic acid is not effective in most CF patients with gallstones, probably because cholesterol is not the main component of stone or sludge.
Transient erythroblastopenia of childhood in Sweden: incidence and findings at the time of diagnosis
Authors: Skeppner G , Wranne L
Published: January 2008

All cases of transient erythroblastopenia in children less than 10 years of age, diagnosed in Sweden during the years 1987–89, were identified. Almost all (51/53) were less than 3 years of age. In this group, the incidence was 4.3/100000, which is the same as that of acute lymphatic leukaemia. No geographical, but a possible temporal, cluster was seen in 1989. The anaemia was severe in some cases; haemoglobin concentration was less than 40 g/1 in 8 oc53 children. Thrombocytosis and neutropenia were common and were attributed to high endogenous erythropoietin activity. Thirty‐seven of 53 children were given a blood transfusion. All children recovered and no complications or relapses were seen. Transient erythroblastopenia of childhood is a benign disease, and it is important to make a correct diagnosis to prevent unnecessary anxiety for leukaemia or aplastic anaemia.
School performance and intellectual outcome in adolescents with phenylketonuria
Authors: Weglage J , Fünders B , Wilken B , Schubert D , Ullrich K
Published: January 2008

In a retrospective study, 34 treated adolescents with phenylketonuria and their relatives were tested with scale 2 of the Culture Fair Intelligence Test (CFT 20) and self‐developed questionnaire concerning their development in school. The patients also filled in the Anxiety Questionnaire for Children. With an IQ of 93.6, the patients reached a normal mean intellectual performance but this was significantly below the mean IQ of the general population (100, p< 0.01), the IQ of their mothers (98.2, p< 0.05), their fathers (105.4, p<0.05) and their siblings (110.3, p<0.05). The patients' IQs correlated significantly with the IQs of their mothers, the socio‐economic status of their families, the quality of dietary control since birth and the serum phenylalanine concentration at the moment of testing. With respect to age at which the patients started school, type of school attended and number of school years which had to be repeated, there were no significant differences between the patients and their siblings. The patients did not display a markedly higher degree of general anxiety, nervousness at examination time or a greater reluctance to attend school.
Pulmonary vascular resistance in complete atrioventricular septal defect. A comparison between children with and without Down's syndrome
Authors: Hals J , Hagemo PS , Thaulow E , Sørland SJ
Published: January 2008

Invasive data obtained in children with complete atrioventricular septal defect over the last three years are presented to determine the age at which pulmonary vascular obstructive disease develops. Comparisons were made between children with (n = 21) and without Down's syndrome (n= 12). The investigation was restricted to patients less than one year of age at initial catheterization. Patients with complicated associated heart defects were excluded. Patients with Down's syndrome had a higher ratio of pulmonary to systemic vascular resistance than children without Down's syndrome in the basal situation. This difference almost disappeared after 100% oxygen had been given to patients with elevated pulmonary vascular resistance, indicating that hypoxia and/or hypoventilation is of importance, especially in children with Down's syndrome. Fixed elevated pulmonary vascular resistance was found in 11% of Down patients under one year, with the youngest patient being 5.5 months old. One child without Down's syndrome may have had fixed elevated pulmonary vascular resistance. It is concluded that all children with complete atrioventricular septal defect should be evaluated and operated on at a very young age.
Additional water is not needed for healthy breast‐fed babies in a hot climate
Authors: Ashraf RN , Jalil F , Aperia A , Lindblad BS
Published: January 2008

In Lahore, Pakistan, a community‐based study was conducted to investigate whether or not it was necessary to give water to breast‐fed infants. From May to November 1986,2–4‐month‐old, breast‐fed infants (n= 26) were selected. During the study period the maximum temperature ranged between 27.4 and 40.7 °C and humidity varied between 24 and 77%. Each infant was followed up for 15 days. Water was not allowed from day 1 today 8 and water was allowed ad libitum from day 8 today 15. All infants were subjected to a DDAVP test to estimate the renal concentrating capacity on day 15. A significant gain in weight (p < 0.001) was observed between day I to 8 and 8 to 15. The differences in the values of haematocrit and serum sodium between day 8 and 1 and between day 15 and 8 were not significant. This indicates that the infants were not dehydrated when water was withheld. Furthermore, no significant difference was observed for urine specific gravity between day 8 and 1, but urine specific gravity increased significantly after the administration of DDAVP (p<0.001), indicating that, if needed, the infants could concentrate urine when water was restricted. It was concluded that 2–4‐month‐old, breast‐fed, healthy infants showed no signs of dehydration if additional water was not given during the summer season.
Neuroblastoma IV‐S in a patient with bilateral microphthalmia
Authors: Haupt Riccardo , Dolci Antonio , Nantron Marilina , Priolo Enrico , Vittone Paolo , Garaventa Alberto
Published: January 2008

Neuroblastoma, a tumor of post‐ganglionic sympathetic neurons, may be associated with a variety of genetic defects and congenital malformations (I). We report a case of neuroblastoma (NB) stage IV‐S (2) in an infant with bilateral microphthalmia and other ocular malformations.
In vitro effects of growth hormone and other hormones on chondrocytes and osteoblast‐like cells
Authors: Saggese G , Federico G , Cinquanta L
Published: January 2008

The influence of growth hormone (GH), insulin‐like growth factor I (IGF‐I), parathyroid hormone(1–34) (PTH(1–34)), 1,25‐dihydroxycholecalciferol (1,25(OH),D3) and 17P‐oestradiol on proliferation and on production of cytokines, such as interleukin‐lp (IL‐1β), IL‐6, IL‐8 and transforming growth factor‐β (TGF‐β), was studied in chondrocytes obtained from the growing cartilage of the iliac crest and in the osteoblast‐like cell clone SaOS‐2. GH and IGF‐I were mitogenic for chondrocytes and SaOS‐2 cells, as indicated by the dose‐related increase in uptake of [3H]thymidine. PTH(1–34) was also mitogenic, while 1,25(OH)2D3 inhibited the proliferation of both chondrocytes and SaOS‐2 cells in a dose‐dependent manner. 17β‐oestradiol was stimulatory in SaOS‐2 cells, but gave a biphasic pattern in chondrocytes; it was stimulatory at low concentrations (0.1 nmol/1) and inhibitory at supraphysiological doses (10 nmol/l). Using the cDNA polymerase chain reaction, specific mRNAs for IL‐1β, IL‐6, IL‐8 and TGF‐β were found in chondrocytes, while SaOS‐2 cells had a positive signal only for TGF‐β. Specific enzyme immunoassays revealed detectable levels of IL‐1β, IL‐6 and IL‐8 only in chondrocytes. IL‐6 was increased by GH and IGF‐I, and lowered by 1,25(OH)2D3 and supraphysiological doses of 17β‐oestradiol, while PTH(1–34) had no effects. IL‐8 was not influenced by GH or IGF‐I, was slightly but not significantly increased by PTH(1–34) and was reduced by 1,25(OH)2D3 and 17β‐oestradiol at supraphysiological doses. No detectable amounts of TGF‐β were found either in chondrocytes or in SaOS‐2 cells using an enzyme immunoassay specific for TGF‐β2; it is likely that the cells produce TGF‐β in a latent form that needs to be activated. These results show that hormones involved in growth, sexual maturation and calcium metabolism possess in vitro stimulatory or inhibitory effects on cell proliferation. Furthermore, these hormones may regulate certain cytokines that are thought to influence some chondrocyte and osteoblast‐like cell functions, but the roles of these in bone growth need to be further elucidated.
Is there a role for a twins clinic? An evaluation of parents'responses
Authors: Bendefy Ilona M , Elliman Alison , Prior Susan , Bryan Elizabeth M
Published: January 2008

Bendefy IM, Elliman A, Prior S, Bryan EM. Is there a role for a twins clinic? An evaluation of parents'responses. Acta Pædiatr 1994;83:40–5. Stockholm. ISSN 0803–5253

To evaluate parental responses to the Twins Clinic, postal questionnaires were sent to the parents of 141 pairs of twins, born outside the maternity hospital who were referred to the clinic in the first three years. The main outcome measures were: the sources of, and reasons for, referral; previous attempts to find help; experiences at the clinic and outcome of the visit. One hundred and thirteen families (80%) replied, of whom 101 (89%) were self‐referred. The most common problems for which twins were referred related to behaviour (34) and development (28). In 99 (88%) cases, parents had already sought assistance from other sources (39 from health professionals) but only 29 had found this helpful. In 95 (84%) cases, parents felt there had been a positive outcome from attending the clinic, in the form of reassurance (87), change of management (39), successful support for applications (19) or information (11). Parents' responses indicate that the Twins Clinic meets the needs of families with multiples who are inadequately served by existing sources of help. These will only be improved through education of health professionals (and of the community as a whole) so as to obviate the need for Twins Clinics.
X‐linked agammaglobulinemia, growth hormone deficiency and delay of growth and puberty
Authors: Buzi F , Notarangelo LD , Plebani A , Duse M , Parolini O , Monteleone M , Ugazio AG
Published: January 2008

Buzi F, Notarangelo LD, Plebani A, Duse M, Parolini O, Monteleone M, Ugazio AG. X‐linked agammaglobulinemia, growth hormone deficiency and delay of growth and puberty. Acta Paediatr 1994;83:99–102. Stockholm. ISSN 0803–5253

Coinheritance of X‐linked agammaglobulinemia and growth hormone deficiency (XLA/GHD) has been classified as an independent primary immune deficiency. We evaluated the pattern of growth and endocrine function in seven XLA subjects (ages 10.9–20.1 years); four belonged to two different XLA pedigrees and three represented sporadic XLA cases. Three had reached adulthood (final stature 176.0, 173.5 and 165.0 cm, respectively) and their retrospective growth showed delay in growth and puberty during adolescence. In the other four subjects, growth hormone production was measured by growth hormone pharmacological stimulation tests (clonidine, arginine): three of four patients had insufficient growth hormone responses (peak growth hormone < 10 μg/l); all three had delayed puberty; their growth hormone responses increased after “priming” with testosterone, reaching values > 10 μg/l in two of them and allowing diagnosis of “true” growth hormone deficiency in the third. The fourth was a normally growing subject who showed a normal growth hormone response both before and after testosterone priming. Six out of the seven subjects showed a growth pattern consistent with delay in growth and puberty. Our results suggest that true XLA/GHD is rarer than previously supposed and that subnormal responses to growth hormone stimulation tests may be found without sex steroid priming of the test in adolescence. The most probable growth pattern in XLA appears to be delay in growth and puberty, as has already been described for other chronic diseases.
Decreased growth hormone response to dexamethasone stimulation test in obese children
Authors: Pineda J , Dieguez C , Casanueva FF , Martul P
Published: January 2008

Pineda J, Dieguez C, Casanueva FF, Martul P. Decreased growth hormone response to dexamethasone stimulation test in obese children. Acta Pædiatr 1994;83:103–5. Stockholm. ISSN 0803–5253

Acute administration of glucocorticoids is a recently described stimulus for growth hormone secretion. The aim of the present study was the assessment of dexamethasone‐induced growth hormone secretion in obese children. Dexamethasone iv tests were carried out in 14 normal control and 8 obese children. Growth hormone was measured by radioimmunoassay up to 5 h after dexamethasone administration. Dexamethasone elicited clear growth hormone secretion in normal children (mean peak 12.3 ± 1.6; area under the curve 682.3 ± 74.3). In the obese children, dexamethasone induced a slight but significant (p<0.01) increase in growth hormone over basal values. However, the growth hormone response in this group was significantly lower than in the normal controls, when comparing both mean peak (5.5 ± 2.3, mean±SEM) (p<0.01) and area under the curve (306.8±44.5) (p<0.001).
Maximal aerobic power during running and cycling in obese and non‐obese children
Authors: Maffeis C , Schena F , Zaffanello M , Zoccante L , Schutz Y , Pinelli L
Published: January 2008

Maffeis C, Schena F, Zaffanello M, Zoccante L, Schutz Y, Pinelli L. Maximal aerobic power during running and cycling in obese and non‐obese children. Acta Pædiatr 1994;83:113–16. Stockholm. ISSN 0803–5253

The maximal aerobic capacity while running and cycling was measured in 22 prepubertal children (mean age±SD 9.5 ± 0.8 years): 14 obese (47.3±10 kg) and 8 non‐obese (31.1±6.1 kg). Oxygen consumption (VO2) and carbon dioxide production were measured by an open circuit method. Steady state VO2 was determined at different levels of exercise up to the maximal power on the cycloergometer (92 W in obese and 77 W in non‐obese subjects) and up to the maximal running speed on the treadmill at a 2% slope (8.3 km/h in obese and 9.0 km/h in lean children). Expressed in absolute values, the VO2max in obese children was significantly higher than in controls (1.55 ± 0.291/min versus 1.23 ± 0.221/ min, p < 0.05) for the treadmill test and comparable in the two groups (1.4 ± 0.21/min versus 1.16 ± 0.2 l/min, ns) for the cycloergometer test. When VO2max was expressed per kg fat free mass, the difference between the two groups disappeared for both tests. These data suggest that obese children had no limitation of maximal aerobic power. Therefore, the magnitude of the workload prescribed when a physical activity program is intended for the therapy of childhood obesity, it should be designed to increase caloric output rather than to improve cardiorespiratory fitness.
Morphine pharmacokinetics in premature and mature newborn infants
Authors: Mikkelsen S , Feilberg VL , Christensen CB , Lundstrøm KE
Published: January 2008

The pharmacokinetics of a single dose of morphine was investigated in five term infants (gestational age 37–40 weeks) and eight preterm infants (gestational age 25–32 weeks). In the five term infants, median (range) volume of distribution at steady state (Vdβ) was 1758 (634–2700) ml/kg, plasma clearance (Cl) was 4.73 (1–75–6.61) ml/kg/min and terminal half‐life (T1/2) was 224 (107–394) min. In the eight preterm infants, Vdβ was 2366 (1662–2876) ml/kg, Cl was 2.82 (1.88–6.60) ml/kg/min and T1/2 was 556 (248–834) min. No correlation was found between clearance and gestational age, but we found a significant negative correlation between T1/2 and gestational age. We conclude that there is considerable variation in the pharmacokinetic properties of morphine in both term and preterm newborn infants. Because of this variation, careful individual assessment of the clinical effect of therapy with morphine in newborn infants should be exercised.
Palpable lymph nodes of the neck in Swedish schoolchildren
Authors: Larsson LO , Bentzon MW , Kelly K Berg , Mellander L , Skoogh B‐E , Strannegård I‐L , Lind A
Published: January 2008

We studied 3592 Swedish schoolchildren, 8 or 9 years old, examined for palpable submandibular, cervical and supraclavicular lymph nodes. All children were skin tested with 2 TU PPD RT23 and with 0.1 μg of Mycobacterium avium sensitin or 0.1 μg of M. scrofulaceum sensitin. A total of 991 children had palpable lymph nodes in any of the three locations. Among them, 811 had lymph nodes in one location, 162 in two locations and 18 in three. In 312 children, the lymph nodes were ± 5 mm in size in any location. The most common location was submandibular. Boys had a significantly higher prevalence of palpable lymph nodes than girls. There was also seasonal variation. Children infected by atypical mycobacteria (sensitin reaction ±6 mm) did not have a higher prevalence of palpable lymph nodes than those not infected.
A mathematical model describing catch‐up growth in celiac disease
Authors: Boersma B , Wynne HJA , Wit JM
Published: January 2008

Celiac disease may lead to various degrees of growth retardation. In general, catch‐up growth is completed in the first 2 years after the start of therapy. A mathematical model for catch‐up growth in celiac disease can be useful as a reference to which the growth pattern observed during treatment of other conditions can be compared. In this study we performed a non‐linear regression analysis on individual growth data of 16 celiac disease patients using a monomolecular growth function. The goodness of fit was significant in all cases (p < 0.05), which illustrates that this function adequately describes catch‐up growth in individuals with celiac disease. From the individual models we have composed a cross‐sectional curve and a longitudinal description of the pattern of catch‐up growth for the entire population.
Seasonality in lower leg length velocity in prepubertal children
Authors: Gelander L , Karlberg J , Albertsson‐Wikland K
Published: January 2008

Despite low measuring error, annual growth is poorly predicted by short‐term measurements of the lower leg. In order to study if this low correlation can be explained by seasonal changes in lower leg length (LLL) velocity, we followed short‐term growth longitudinally in 50 prepubertal children with normal height and growth velocities. Height measurements were performed at 4‐week intervals and LLL measurements at 1–2‐week intervals. Analysis of annual growth showed seasonality in the monthly mean height velocity values: 5.06 (SD 5.02) cm/year during the autumn and 8.15 (SD 5.22) cm/year in the spring. Similarly, the monthly mean LLL velocity values changed from 1.80 (SD 1.07) cm/year in the autumn to 2.63 (SD 0.92) cm/year in the spring. The correlation between monthly LLL and annual height velocity was low (r = 0.27). The technical error of the LLL measurement was 7–8% of the mean monthly LLL velocity, while the mean values changed by 31 % over the seasons. The annual height velocity was virtually independent of the variation in growth rate over the seasons. It is concluded that there is significant seasonality both in height and LLL velocity and that it takes place at the same time for both measures. Seasonality in LLL has not been reported previously and must be considered when studying short‐term growth, for example when LLL is used for prediction of annual height velocity or when a short‐term treatment effect is examined using LLL.
Effect of dietary nucleotide supplementation on diarrhoeal disease in infants
Authors: Brunser O , Espinoza J , Araya Magdalena , Cruchet Sylvia , Gil A
Published: January 2008

The effects of a nucleotide‐supplemented formula on diarrhoeal disease was studied in 141 infants (group 1) who belonged to the low socioeconomic stratum; 148 controls (group 2) received the same formula but unsupplemented. Group 1 experienced less episodes of diarrhoea (109 versus 140), including less first episodes (74 versus 102; chi‐square = 8.19, p < 0.004; odds ratio 2.01) and for a lesser number of days (807 versus 996 days); 45.0% and 31.1% of infants in groups 1 and 2, respectively, never developed episodes of diarrhoea. There were no differences in the clinical characteristics of the episodes or in the enteropathogens isolated from symptomatic or asymptomatic infants. The mechanisms through which nucleotides decrease the incidence of diarrhoeal disease in infants remain unclear.
Lignocaine gel used for lubrication of intranasal and endotracheal tubes in premature neonates
Authors: Bendixen D , Halvorsen A‐C , Hjelt K , Flachs H
Published: January 2008

Bendixen D, Halvorsen A‐C, Hjelt K, Flachs H. Lignocaine gel used for lubrication of intranasal and endotracheal tubes in premature neonates. Acta Prediatr 1994;83:493–7. Stockholm. ISSN 0803–5253

In this study, we have measured the plasma concentration of lignocaine and its metabolite, monoethylglycinxylidin, in 19 premature neonates (gestational age 33 weeks) when lignocaine gel was used for lubrication of an intranasal tube (during continuous positive airway pressure treatment) or an endotracheal tube (for intubation). We did not find any correlation between plasma concentration of lignocaine or monoethylglycinxylidin and weight of the infant (range 795–2530 g). None of the neonates had toxic levels of lignocaine. One neonate had an exceptionally high but not toxic plasma level of monoethylglycinxylidin. However, this neonate had been treated for severe seizures with an iv infusion of lignocaine up to 13 h before the study. In conclusion, we found it safe to use moderate amounts of lignocaine (i.e. 0.3 ml/kg of lignocaine gel 20 mg/ml) for lubricating both intranasal and endotracheal tubes.
Abnormalities of lung volume at follow‐up after antenatal rhesus iso‐immunization
Authors: Greenough A , Yuksel B , Nicolaides KH
Published: January 2008

Greenough A, Yuksel B, Nicolaides KH. Abnormalities of lung volume at follow‐up after antenatal rhesus iso‐immunization. Acta Pzdiatr 1994;83:498–500. Stockholm. ISSN 0803 5253

Rhesus iso‐immunization is associated with fatal pulmonary hypoplasia. We have examined the hypothesis that abnormalities of lung volume, as an index of lung growth, may also be found in survivors. At a median age of nine months, lung volume was assessed by measurement of functional residual capacity in 23 patients affected antenatally by rhesus iso‐immunization. Seventeen of the patients had required at least one intrauterine transfusion. Five patients (group A) had an FRC < 24 ml/kg (mcdian 21 ml/kg, range 19–22 ml/kg) and the other 18 (group B) an FRC 24 ml/kg (median 27 ml/kg, range 24–36 ml/kg) (p < 0.01). The only significant difference between these two groups was the timing of the first foetal blood sampling and intrauterine transfusion, being a median of 22 weeks (range 20–23 weeks) in group A and 30 weeks (range 17–36 weeks) in group B (p< 0.01). 0
Motilin in children with recurrent abdominal pain: a controlled study
Authors: Christensen Mogens Fjord
Published: January 2008

Fjord Christensen M. Motilin in children with recurrent abdominal pain: a controlled study. Aeta Pædiatr 1994;83:542–4. Stockholm. ISSN 0803–5253

The aim of this study was to compare serum motilin levels in children with and without recurrent abdominal pain, based on the assumption that recurrent abdominal pain in children is a gut motility disorder. In this controlled study, 19 children between 6 and 15 years or age with recurrent non‐organic abdominal pain and 20 control children between 6 and 15 years of age without abdominal pain or other functional somatic complaints were evaluated. No slatistical significant difference was found in serum motilin levels between children with and without abdominal pain. Median difference between the groups was II pmol/1 (95% confidence limits of median difference ‐9 to +33). This investigation could not support the assumption that motilin might be a pathogenic factor in children with recurrent abdominal pain. It is suggested, however, that future research should compare serum motilin levels during and between attacks of pain.
Evaluation of a maize‐cowpea‐palm oil diet for the dietary management of Nigerian children with acute, watery diarrhea
Authors: Grange AO , Santosham M , Ayodele AK , Lesi FEA , Stallings RY , Brown KH
Published: January 2008

A randomized clinical trial was carried out to compare a locally available maize‐cowpea‐palm oil diet (group MCP) with a commercially produced lactose‐free, soy protein isolate formula (group SF) for the dietary management of 69 Nigerian boys, 6–24 months of age, hospitalized for acute, watery diarrhea. Although the treatment groups were generally similar initially, the children in group SF had slightly lower mean weight‐for‐age z scores (p= O.OS), lower serum bicarbonate levels (p= 0.04) and greater stool outputs during the period of rehydration before the diets were initiated (p= 0.01). Rates of treatment failure in group MCP (5.7%) and group SF (8.8%) were similar (p= 0.67). There were no significant differences in the adjusted mean stool outputs by study group on days 1–5, but the children in group SF had slightly lower fecal weights on day 6 (p= 0.05). Children in group MCP had a substantially reduced duration of liquid stool excretion (estimated median duration 42 h versus 140 h; p < 0.001). On the other hand, children in group SF consumed considerably more of their diet, had greater net absorption of macronutrients and greater rates of weight gain than those in group MCP. We conclude that children can safely consume the MCP diet during acute, watery diarrhea without increasing their risk of treatment failure or augmenting stool output. However, the diet may not be adequate as a sole source of nutrients beyond the period of acute illness.
Reliability of subjective estimates of exercise capacity after total repair of tetralogy of Fallot
Authors: Rogers R , Reybrouck T , Weymans M , Dumoulin M , der Hauwaert L Van , Gewillig M
Published: January 2008

Sixty‐nine patients (age 10 × 3.5 years, median 9.7 years) operated on for tetralogy of Fallot, underwent excercise testing 5.1 × 2.5 years after total correction. Aerobic capacity was assessed by the ventilatory threshold method. After the exercise test, parents completed a validated standardized questionnaire to evaluate the habitual level of physical activity of their child. They were then asked to place their child into one of three groups, describing their child's activity level, compared to normals (below average, average and above average). In the average and above‐average groups, 73% and 65% of the patients were misclassified when compared to objective exercise testing. However, in the below‐average group, no misclassifications were found. Subjective estimates of activity level, and consequently exercise tolerance, were poorly associated with objective measurements of exercise performance in these patient groups. Our results question the reliability of self‐reported estimates of physical activity level and consequently exercise capacity in children after surgical correction of tetralogy of Fallot.
Carbohydrate‐deficient glycoprotein syndrome with previously unreported features
Authors: Eyskens F , Ceuterick C , Martin J‐J , Janssens G , Jaeken J
Published: January 2008

A boy with carbohydrate‐deficient glycoprotein syndrome died at five months of age in status epilepticus. Postmortem examination failed to show the classically observed olivopontocerebellar atrophy. Two previously unreported features were present: cataracts from the first week of life and lysosomal storage affecting mainly the anterior horn neurons of the spinal cord.
Cardiovascular changes during sustained lung inflations in premature newborn lambs
Authors: Klöpping‐Ketelaars WAA , Maertzdorf WJ , Blanco CE
Published: January 2008

We studied the effect of sustained inspiratory inflations (SI) on the cardiovascular system by measuring mean central venous pressure (MCVP), mean arterial blood pressure (MABP) and heart rate (HR), before and during sustained lung inflations in premature lambs (128–133 days' gestation). SI consisted of four inflations of 5 s at a peak inspiratory pressure of 35 cmH2O, with a mixture of 5 % carbon dioxide and 95% oxygen. Each inflation was followed by a positive end‐expiratory pressure of 5 cmH2O for 5 s. Percentage change from baseline was ‐3.88% for MABP and ‐2.55% for HR during the first inflation. The changes in MCVP fluctuated with each inflation (mean 9.61%;p < 0.01 versus baseline) and deflation (mean ‐3.87%; p < 0.05 versus baseline). These changes were dependent on the time after birth and the pressure used for SI. The observed cardiovascular changes produced by this procedure are considered clinically relevant when managing premature infants with a high risk of intraventricular haemorrhage.
Inter‐relationship between serum concentrations of glucose, glucagon and insulin during the first two days of life in healthy newborns
Authors: Swenne I , Ewald U , Gustafsson J , Sandberg E , Östenson C‐G
Published: January 2008

The relationship between serum concentrations of glucose, insulin and glucagon during the first two days of life was studied in healthy newborns. The first capillary blood sample was obtained at 3–15 h of age (median 6h; day 0) and a second sample approximately 24 h later (day 1). Serum glucose concentrations in the first sample averaged 2.1 ± 0.07mmol/l (mean ± SEM; n= 60) and were positively correlated with postnatal age (p < 0.01). Serum glucagon concentrations in the first sample averaged 570 ± 32pg/ml and were inversely correlated with glucose concentrations (p < 0.0001). At the second sampling, serum glucose concentrations had increased to 2.9 ± 0.07mmol/l (p < 0.001; n= 57) and serum glucagon concentrations had decreased to 403 ± 22pg/ml (p < 0.001). Serum insulin concentrations were 11.7 f 0.3 μU/ml and 10.2 ± 0.3 μU/ml at the two samplings and did not correlate with serum glucose concentrations. The relationship of serum glucose and hormone concentrations to maternal and infant characteristics was studied by stepwise regression analysis. Serum glucose concentration on day 0 was positively correlated with postnatal age (p < 0.01) and birth weight (p 0.05) but inversely correlated with duration of labour (p < 0.05). Serum glucose concentration on day 1 was positively correlated with birth weight (p < 0.0001) and inversely correlated with maternal prep‐pregnancy weight (p < 0.05). Similar analyses of serum hormone concentrations did not demonstrate any relationships with maternal or infant characteristics. It is suggested that glucagon secretion is part of the counter‐regulation against hypoglycaemia in healthy newborns and that neonatal energy stores, as indicated by birth weight, influence the ability to increase circulating glucose concentrations in response to counter‐regulatory hormones.
Neonatal Ureaplasma urealyticum colonization and chronic lung disease
Authors: Jonsson B , Karell A‐C , Ringertz S , Rylander M , Faxelius G
Published: January 2008

We studied Ureaplasma urealyticum colonization in 93 intubated infants (gestational ages 23–40 weeks) in our neonatal intensive care unit by obtaining cultures from endotracheal aspirate and nasopharynx during their first week of life. Eighteen infants had positive cultures, giving a colonization rate of 19%. No infant more than 30 weeks' gestation had a positive culture. The infants with positive cultures had a significantly lower gestational age and birth weight (p < 0.009 andp < 0.005), with a colonization rate of 33% in infants less than 1000 g. Among the infants with positive cultures, 10 of 17 developed chronic lung disease in contrast with 21 of 72 infants with negative cultures. The development of chronic lung disease and duration of oxygen requirement was strongly associated with immaturity but only weakly with Ureaplasma urealyticum.
The psychological development of children of epileptic parents. I. Study design and comparative findings
Authors: Steinhausen H‐C , Lösche G , Koch S , Helge H
Published: January 2008

We studied the genetic, neurobiological, teratogenic and psychosocial risks for the development of children born to epileptic parents in (a) children of epileptic mothers with intrauterine exposure to anticonvulsants, (b) children of epileptic mothers without intrauterine exposure to anticonvulsants and (c) children of epileptic fathers. In addition, three matched control groups were also considered. The longitudinal design of the study covered newborns to children of six years of age. A wide range of developmental and psychological tests and a structured interview for the assessment of psychiatric symptoms were used. It was shown that teratogenic factors are operant, whereas there was no indication that the condition of epilepsy in the parents per se had any effect on the developmental outcome of the children. The possible teratogenic effect of anticonvulsants should be studied in more detail.