bluuebunny/crossref_metadata_2025 huggingface dataset:
Shortened and diminished pubertal growth in boys and girls treated for acute lymphoblastic leukaemia
Authors: Groot‐Loonen JJ , Setten P van , Otten BJ , van‘t Hof MA , Lippens RJJ , Stoelinga GBA
Published: January 2008

Statural growth during puberty was studied longitudinally in 28 patients treated for acute lymphoblastic leukaemia. All patients received prophylactic cranial irradiation. The age at diagnosis was below 7 years, the age at final investigation was above 16 years for girls and above 18 years for boys. Growth was analysed using the Kernel estimation. In girls the onset of puberty and menarche was at a younger age, as compared to reference values, and the duration of the pubertal growth spurt was shorter. Compared to early maturing girls, the growth velocity at peak height velocity was lower. This resulted in a final height which was shorter than expected on the basis of the height standard deviation score before the start of puberty. In boys the duration of the pubertal growth spurt was shorter and the height gain during the growth spurt less than in the reference population. In both sexes the bone age development was accelerated.
Adult height after cranial irradiation with 24 Gy: factors and markers of height loss
Authors: Adan L , Souberbielle J‐C , Blanche S , Leverger G , Schaison G , Brauner R
Published: January 2008

The decrease in adult height of children who have been given cranial irradiation (24 Gy) for acute lymphoblastic leukaemia is attributed to chemotherapy, growth hormone (GH) deficiency and early puberty. This study evaluates the factors involved in the height loss between irradiation and adult height and its markers in 43 patients irradiated at 5.8 ± 0.4 (SEM) years. The mean height loss was 0.9 ± 0.2 SD in the children with a normal GH peak (n= 11), 1.7 ± 0.2 SD in those with a low GH peak and untreated (n= 15) and 0.6 ± 0.2 SD in those treated with GH (n= 17). The adult height was significantly lower than target height in all three groups. The height loss correlated negatively with the GH peak (p < 0.02) and with the age at onset of puberty (p < 0.05) in the first two groups with spontaneous growth, but not with the chemotherapy regimen or its duration, or the plasma insulin‐like growth factor I (IGFI) and its GH‐dependent binding protein (BP‐3). Early puberty (onset at 8‐10 years) occurred in 6 girls from the first two groups. At the first evaluation, 5.6 ± 0.4 years after irradiation, the GH peak values after arginine‐insulin stimulation correlated with the age at irradiation (p < 0.03), taking into account the time since irradiation. The plasma 1GF1 and BP‐3 values were correlated with each other, but not with the GH peak. In conclusion, this study demonstrates the impact of GH deficiency and GH replacement therapy on adult height in children given cranial irradiation for leukaemia. They therefore should be evaluated for their GH secretion 1 2 years after the end of chemotherapy. GH therapy is indicated for those with low GH peak and decreased growth rate or no increase in growth rate despite puberty.
Changing trends in feeding policies for ventilated preterm infants
Authors: McClure RJ , Chatrath MK , Newell SJ
Published: January 2008

In 1987 and 1994 all UK regional neonatal intensive care units were questioned about their feeding policies for the ventilated preterm infant. Between 1987 and 1994 there was an increase in the use of milk feeds (59 versus 71%), fortified breast milk (5 versus 72%) and low birthweight formula (41 versus 69%) whilst use of donor breast milk declined (56 versus 22%). Units that gave enteral feeds used significantly less parenteral nutrition (p < 0.05). Overall there was a tendency towards greater uniformity in feeding policies.
Relation between gliadin structure and coeliac toxicity
Authors: Wieser H
Published: January 2008

Gliadin, the alcohol‐soluble protein fraction of wheat, contains the factor toxic for coeliac patients. The numerous components of gliadin can be classified according to their primary structure into ω5‐, ω1,2‐, α‐ and γ‐type. Both ω‐ types have almost entirely repetitive amino acid sequences consisting of glut amine, proline and phenylalanine, α‐and γ‐type gliadins contain four and five different domains, respectively, and are homologous within the domains III and V. Unique for each α‐and γ‐type is domain I, which consists mostly of repetitive sequences rich in glutamine, proline and aromatic amino acids. Coeliac toxicity of gliadin is not destroyed by digestion with gastropancreatic enzymes. In vivo testing established the toxicity of α‐type gliadins and in vitro testing of gliadin peptides revealed that domain I of α‐type gliadins is involved in activating coeliac disease. The sequences ‐Pro‐Ser‐Gln‐Gln‐ and ‐Gln‐Gln‐Gln‐Pro‐ were demonstrated to be common for toxic gliadin peptides. Most of the in vivo and in vitro studies of synthetic peptides confirmed the importance of one or both of these sequences. Cultivated hexaploid, tetraploid and diploid wheat species do not differ significantly in potential toxic sequences of α‐type gliadins.
Screening for coeliac disease—has the time come for mass screening?
Authors: Logan RFA
Published: January 2008

Several recent studies, in particular the Italian SIGEP study, have demonstrated that mass screening for coeliac disease using gliadin and endomysial antibody testing is now a realistic possibility. If mass screening is to receive serious consideration then it must be shown to be (i) effective, (ii) acceptable, and (iii) worthwhile (cost‐effective). At present there is insufficient evidence as to the health benefits from treating screen‐detected disease and as to the size of the risks associated with having undetected coeliac disease. It is also unclear whether truly asymptomatic screen‐detected coeliacs will accept long‐term dietary restriction. To answer these questions randomized trials of screening are needed. On current evidence, mass screening cannot be justified. Efficient case‐finding may prove as effective and more acceptable.
Chromosome instability in untreated adult celiac disease patients
Authors: Fundia A , Gómez JC , Mauriño E , Boerr L , Bai JC , Larripa I , Slavutsky I
Published: January 2008

Spontaneous chromosome aberrations (CAs) and induced fragile sites (FSs) were analysed in 12 untreated adult coeliac disease (CD) patients and 8 healthy controls. Blood lymphocytes from each individual were cultured for 72 h at 37°C in F‐10 medium with 5% fetal calf serum and 0.1 ml phytohemagglutinine. FSs were induced by FudR (10 μg/ml, 24h before harvesting) and caffeine (2.2 mM, 6 h before harvest). Spontaneous CAs and FSs were analysed on 30–50 Giemsa‐stained and G‐banded metaphases. The mean frequencies of spontaneous CAs (abnormal cells, gaps/cell and breaks/cell) of CD patients (0.24 ±0.02, 0.21 ±0.02 and 0.13 ±0.02, respectively) were significantly higher than those of controls (0.04±0.01, 0.02±0.01 and 0.02±0.01, respectively) (p < 0.001). Fourteen spontaneous CAs and 5 FSs specific for CD patients presented a strong coincidence (70%) with bands involved in T‐ and B‐cell malignant lymphoma rearrangements. These findings suggest that CD has chromosome instability affecting specific points that could be related to the high prevalence of malignancies in this disorder.
Perinatal stimulation and adaptation of the neonate
Authors: Ronca AE , Abel RA , Alberts JR
Published: January 2008

The present report describes psychobiological studies of behavior around the time of birth. An adaptive, ecological perspective is presented in which stimulation of the fetus and newborn is purported to instigate adaptive postpartum behavior. Studies describing the perinatal sensory environment are reviewed, with a consideration of emergent sensory function of the fetus. It is asserted that afferent input associated with parturition perturbs the fetus and neonate, producing a general arousal state that facilitates breathing, suckling, and early learning. The view developed herein is that perinatal sensory input induces and canalizes the newborn's behavior, thereby regulating adaptive postpartum function. Deviations in afferent input may alter ontogenetic trajectories and compromise developmental outcome by reducing availability of conditions necessary for adequate postpartum adaptation.
Fetal memory: Does it exist? What does it do?
Authors: Hepper PG
Published: January 2008

Whether fetal memory exists has attracted interest for many thousands of years. The following review draws on recent experimental evidence to consider two questions: does the fetus have a memory? And, if so, what function(s) does it serve? Evidence from fetal learning paradigms of classical conditioning, habituation and exposure learning reveal that the fetus does have a memory. By comparison little attention has been paid to the possible function of memory. Possible functions discussed are: practice, recognition of and attachment to the mother, promotion of breastfeeding, and language acquisition. It is concluded that the fetus does possess a memory but that more attention to the functions of fetal memory will guide future studies of fetal memory abilities.
Final height prediction models for pubertal boys
Authors: Zadik Z , Segal N , Limony Y
Published: January 2008

Accurate adult height prediction is of clinical importance in assessing the need for pharmacological intervention and in the evaluation of the outcome of therapy. The methods currently in use are subject to a wide range of error, one source of which is the use of bone age (BA) measurements. We have developed a computer model for predicting adult height in pubertal boys without using BA determinations. The model is based on the existing Infancy–Childhood–Puberty model and calculates the onset of the pubertal growth spurt. Predicted adult height was assessed using this new model and four others in a group of normal boys and in a group of short normal boys receiving growth hormone. Calculated final heights by all the methods were not significantly different. Incorporation of paternal height into the prediction equations increased the accuracy of the prediction. It was concluded that our new model is as accurate as existing methods of predicting final height that involve assessing BA.
Results and side‐effects of treating children with growth hormone after kidney transplantation – a preliminary report
Authors: Broyer M
Published: January 2008

The effect of growth hormone (GH) therapy on renal function was investigated in 203 children who had undergone kidney transplantation. In addition, the efficacy of GH in stimulating growth as well as other aspects of safety were assessed. The patients were randomized to receive either GH, 1 IU/kg/week, administered subcutaneously once daily, or no treatment during the first year (controls). During the second year, all patients received GH. The change in growth velocity and A height SD score during the first year of GH treatment was statistically significant compared with controls (p < 0.0001). During the second year, those patients who received GH during the first year continued to show an increased rate of growth compared with that during the pretreatment period; however, the mean growth rate was lower than that in the first year of treatment. The mean change in glomerular filtration rate did not differ between the treated and control groups during the first year of the study. However, acute rejection episodes tended to be more frequent during GH treatment, particularly in those patients who had a history of more than one episode. Close monitoring of renal function is therefore recommended.
Effects of malnutrition on the erythrocyte fatty acid composition and plasma vitamin E levels of Pakistani children
Authors: Smit EN , Dijkstra JM , Schnater TA , Seerat E , Muskiet FAJ , Boersma ER
Published: January 2008

Abstract Erythrocyte fatty acids and plasma vitamin E concentrations were determined in 47 grade 2 and 21 grade 3 malnourished Pakistani children (ages 4–56 months). Data were compared with those of 26 age‐ and sex‐matched apparently healthy controls. Evaluation with three statistical approaches revealed that both grade 2 and grade 3 malnourished children had decreased erythrocyte ω6 fatty acids and to a lesser extent decreased ω3 fatty acids. These decreases were compensated for by increased ω9 fatty acids. The patients tended to have lower plasma vitamin E concentrations. We conclude that malnourished Pakistani children have low essential fatty acid status, notably those of the ω6 series. The combination of low erythrocyte 22:6ω3 and a low 22:5ω6/22:4ω6 ratio in grade 2 patients suggests low Δ4‐desaturation activity, which may be due to impaired peroxisomal β‐oxidation.
Circadian blood pressure changes in untreated children with kidney disease and conserved renal function
Authors: Lingens N , Freund M , Seeman T , Witte K , Lemmer B , Schärer K
Published: January 2008

Abstract Ambulatory blood pressure monitoring over 24 h was applied in 31 children with kidney disease, aged 3–19 (median 11) years, in the absence of renal insufficiency and without antihypertensive therapy. Median creatinine clearance was 112ml/min/1.73m2. Ambulatory blood pressure monitoring revealed that eight patients (26%) were hypertensive during the daytime, compared to 62% through casual recordings obtained in the office and 38% when blood pressure was taken at home. Nocturnal hypertension was detected by ambulatory monitoring in six patients, two of whom had normal blood pressure in the daytime. Median nocturnal dipping was 13% for systolic and 21% for diastolic blood pressure, i.e. similar to healthy children. Rhythm analysis recognized a distorted circadian pattern for systolic and/or diastolic blood pressure in eight patients. In conclusion, ambulatory blood pressure monitoring allows the evaluation of hypertension more reliably than casual recordings in the office. Nocturnal hypertension, as a major risk factor for renal deterioration, is detected in a similar proportion as daytime hypertension in almost 20% of untreated children with kidney disease and normal renal function.
The contribution of developmental surveillance to early detection of cerebral palsy
Authors: Lindström K , Bremberg S
Published: January 2008

Abstract A retrospective study of the contribution of examinations at Child Health Centres (CHC) for early detection of cerebral palsy (CP) was performed in 23 924 children, born in 1986‐90, in the south‐western part of Stockholm County. The outcome assessed was age of referral to a habilitation unit. A total of 66 children with CP (2.76/1000) were identified through the register at the responsible habilitation unit. The age of referral was, median 8 months, mean 12.4 months and range 0.5–54 months. A peak of referrals at 8–9 months was produced by CHC checks at 6 months of age. No other examination at the CHC resulted in a significant number of referrals. Nineteen records from CHC concerning moderate and severe cases were reviewed. Out of all examinations with aberrant findings only 11/20 resulted in referrals or further examinations. No child with moderate or severe CP was referred due to developmental screening test findings only.
Clinical and echocardiographic evaluation of neonates with heart murmurs
Authors: Du Z‐D , Roguin N , Barak M
Published: January 2008

Abstract In this study, 116 neonates (58M, 58F), aged 12h to 14d, with heart murmurs were examined by echocardiography: 26 were preterm and 90 full‐term neonates. The clinical diagnosis was classified into definite heart disease, possible heart disease and innocent murmur. The final diagnosis was based on echocardiography and, in some cases, cardiac catheterization or surgery. The results showed that 97 (84%) neonates had heart diseases; 19(16%) had a normal heart, including 7 with tricuspid regurgitation and 9 with physiological peripheral pulmonic stenosis. Out of 88 neonates with clinically definite heart disease, the final diagnosis was changed to normal heart in 9 (10%) cases and the lesion‐specific diagnosis was changed in 9 (10%) neonates. In four cases, the clinical diagnosis of ventricular septal defect or pulmonary stenosis was changed to double‐outlet right ventricle, single ventricle, hypoplastic left heart syndrome or tetralogy of Fallot. The clinical diagnosis was correct in 77–85% for varying simple lesions. In 5 of 21 neonates with clinically possible heart disease, the diagnosis was changed to normal heart. In one of six neonates with clinically innocent murmurs, the diagnosis was changed to small muscular ventricular septal defect. We concluded that 84% of heart murmurs in neonates were due to heart diseases and only 16% were innocent murmurs. Although clinical evaluation could determine the presence or absence of heart disease in most neonates, the lesion‐specific diagnosis was not quite satisfactory. Echocardiography is necessary for neonates with a clinically diagnosed heart disease or possible heart diseases, and may be unnecessary for those with innocent murmurs diagnosed by paediatricians.
Gut hormone concentrations in preterm infants with necrotizing enterocolitis
Authors: Gounaris A , Alexiou N , Costalos C , Daniilidou M , Frangou E , Konstandellou E
Published: January 2008

Abstract Blood levels of gastrin, neurotensin and vasoactive peptide (VIP) were estimated in 14 premature infants with necrotizing enterocolitis (NEC) and in 12 controls. In comparison to the control group, infants with NEC had (a) significantly lower gastrin levels both before [9.3 (7.8) versus 33.7 (27.1)] and after [52.4 (48.1) versus 100.8 (50.9)] the development of NEC; (b) significantly lower neurotensin levels only after the development of NEC [37.8 (10.4) versus 54.5 (20.6)]; and (c) no significant difference in VIP values [25.4 (9.7) versus 18.9 (9.9) and 24.5 (15.7) versus 26.1 (19.1)]. It is concluded that NEC can adversely affect gastrin and neurotensin concentrations in the blood.
5‐Hydroxy‐3‐indole acetic acid levels in infantile colic: Is serotoninergic tonus responsible for this problem?
Authors: Kurtoglu S , üzüm K , Hallac IK , Coskim A
Published: January 2008

Abstract Levels of 5‐hydroxy‐3‐indole acetic acid (5‐OHIAA), a metabolite of serotonin, were studied in infants with infantile colic in order to investigate the aetiology of infantile colic pathogenesis. The study included 16 patients with infantile colic and 10 control subjects. Random urinary 5‐OH IAA levels of colicky infants were found to be higher than those in the control group. This finding suggested that high serotonin levels may be responsible for infantile colic.
Neonatal pleural empyema with group A Streptococcus
Authors: Thaarup J , Ellermann‐Eriksen S , Stjernholm J
Published: January 2008

Abstract A case of early neonatal septicaemia with pneumonia and pleural empyema is reported. The causal microorganism was β‐haemolytic Streptococcus pyogenes group A originating from the mother, who had a perineal infection and bacteraemia.
Effects of a low selenium state in patients with phenylketonuria
Authors: Jochum F , Terwolbeck K , Meinhold H , Behne D , Menzel H , Lombeck I
Published: January 2008

Abstract Eighty‐seven participants of the German Collaboratory Study for Children with Phenylketonuria (PKU) presented low plasma, whole blood and hair selenium (Se) values, reduced urinary selenium excretion, and decreased plasma and erythrocyte glutathione peroxidase activity in comparison with a healthy reference group (all figures p < 0.001). Aspartate amino transferase and thyroxine (T4) concentrations in plasma were inversely correlated with the selenium blood values of the PKU children. Somatic measurements showed a negative standard deviation score of body height in the PKU children compared with reference values. Despite the different Se supply, the infants did not present any specific Se deficiency symptoms.
Persistent growth faltering among Aboriginal infants and young children in northwest Australia: a retrospective study from 1969 to 1993
Authors: Rousham EK , Gracey M
Published: January 2008

The objective was to examine long‐term changes in the growth of Aboriginal infants and young children in the Kimberley region in the far northwest of Australia from 1969 to 1993. A retrospective analysis of anthropometric data (weight and length) routinely collected on 0–5‐year‐old children in 5‐year cohorts from 1969 to 1993 was carried out. From 1974‐78 to 1989‐93 there has been a significant increase in mean birthweight (ANOVA p < 0.05). The percentage of low birthweight infants (<2500g) declined from 14% in 197983 to 10% in 1989‐93 (p < 0.001). There were no consistent improvements in the growth patterns of infants from birth to 60 months. All cohorts displayed pronounced growth faltering in weightforage and heightforage from 6 to 12 months of age and fell significantly below both the NCHS reference values and mean values for healthy breastfed infants. In conclusion, reductions in Aboriginal infant mortality and infectious disease rates over the past 20 years have not been accompanied by improved growth. The persistence of child malnutrition in these communities may warrant a shift in attention from disease treatment and prevention to a better understanding of nutritional influences, particularly weaning practices, during infancy and early childhood.
Influences on breastfeeding in southeast England
Authors: Clements MS , Mitchell EA , Wright SP , Esmail A , Jones DR , Ford RPK
Published: January 2008

Factors associated with not exclusively breastfeeding at discharge from the obstetric hospital and with duration of breastfeeding were examined in 700 randomly sampled infants. Obstetric records were examined in 97.7% of the subjects and 73.0% of subject families were interviewed. There were 444 (66.5%) infants exclusively breastfed at discharge from the obstetric hospital. Factors associated with not exclusively breastfeeding at discharge from the obstetric hospital after adjusting for potential confounders were: mother leaving school aged less than 18 years, mother not attending antenatal classes and the use of a dummy in the 2 weeks before the interview. Bed sharing practice in the 2 weeks before the interview was associated with exclusively breastfeeding at discharge from the obstetric hospital. Factors associated with a shorter duration of breastfeeding were: mother leaving school before 18 years of age, smoking 20 or more cigarettes per day and use of a dummy. Dummy use may causally reduce breastfeeding or might be a marker for breastfeeding difficulties. There was a doseresponse relationship with smoking, with heavier smokers breastfeeding for the shortest time periods. Bed sharing was associated with a longer duration of breastfeeding. This may not necessarily be a causal relationship because breastfeeding may promote bed sharing. The effect of dummy use and bed sharing on breastfeeding warrants further study.
Physical fighting and associated health behaviours among Swedish adolescents
Authors: Grufman M , Berg‐Kelly K
Published: January 2008

Objective: To investigate the prevalence of physical fighting among Swedish adolescents and to compare the health profile and risk‐taking behaviour of the fighters with a non‐fighting “diplomatic” group. Methods: Results are based on 4516 self‐reports, representing 82% of available students with mean age of 13.5, 15.5 and 17.5 years. Results: Among 13.5‐year‐olds, 22% ofmalesand5% of females reported three or more fights. Fighting decreased with age. Significantly more fighters reported problem behaviours and fewer had healthy habits than the “diplomats”. Significantly more fighters also suffered from psychosomatic disorders and injuries requiring medical services. Twenty percent of the fighting males stated that they would definitely continue to fight. Conclusion: The data indicate that physical fighting is strongly associated with other problem behaviours, which needs to be considered when designing prevention and intervention.
Recording non‐nutritive sucking in the neonate. Description of an automatized system for analysis
Authors: Hafström M , Lundquist C , Lindecrantz K , Larsson K , Kjellmer I
Published: January 2008

A new method for automatic analysis of non‐nutritive sucking in newborn infants is described, which uses a specially designed computer program that analyses an analogue signal obtained from a pressure transducer inside a pacifier. Validation is done with four independent methods: electromyogram, visual identification, control of the automatic treatment and comparison of inter‐observer results. A high degree of correspondence is shown. The system was applied to 58 healthy full‐term neonates. Infants less than 24 h old demonstrated a significantly different sucking pattern compared with the 3‐day‐old infant. The duration of their bursts was longer (3.7 vs 2.8 s), the frequency of their sucking was lower (1.7 vs 2.0 Hz) and the variability of their sucking pattern was greater. These results also testify to the validity of the method inasmuch as the values for the different sucking parameters are similar to corresponding values presented earlier.
Cognitive function in Type 1 diabetic children with and without episodes of severe hypoglycaemia
Authors: Bjørgaas M , Gimse R , Vik T , Sand T
Published: January 2008

We assessed the effect of diabetes and of episodes of severe hypoglycaemia on cognitive function in 28 diabetic children. Fifteen diabetic children (age 12.9 (SD 2.0) years) had experienced 1–4 episodes of severe hypoglycaemia. Five of these children diseased before the age of 5 years (SH‐eod subgroup), and ten diseased after this age (SH‐lod subgroup). Thirteen diabetic children (age 13.1 (SD 2.0) years) had not experienced episodes of severe hypoglycaemia (non‐SH group). Each diabetic child was compared with a healthy control child of the same age and gender and with a similar social background. Neuropsychological assessment was blinded. The neuropsychological tests were grouped into one of seven cognitive domains. We found no effect on cognitive performance from diabetes per se or from severe hypoglycaemia in children with late‐onset diabetes. However, early‐onset diabetes was associated with low scores in two cognitive domains: psychomotor efficiency and attention. The SH‐eod subgroup had lower scores than the SH‐lod subgroup in psychomotor efficiency (p < 0.05) and also had lower scores than the SH‐lod subgroup and the non‐SH group in measures of attention (p < 0.05). Our results may indicate a slight cognitive dysfunction in children with early‐onset diabetes who have experienced episodes of severe hypoglycaemia early in childhood.
Car transportation conditions of preschool children: use of children's car safety seats
Authors: Kostaridou S , Anastasea‐Vlachou K , Sotiropoulou F , Panagopoulou G , Panagopoulou M , Papathanasiou‐Klontza D , Xipolita‐Zachariadi A
Published: January 2008

The objective of this study was to evaluate children's car safety seat usage in a non‐random study population of the Capital and surrounding area of Attica and a provincial region in Greece. One or both of the parents of 1556 children (aged 0–4 years) were interviewed. A questionnaire covering car safety seat usage by area of residence, age of parents, educational background, socioeconomic status and the number of siblings was completed. Optimal car safety seat restraint usage in the Attica region was 10.4% for infants 0–6 months old, 37.6% for infants 7–12 months old, 40.9% for children aged 1–2 years and 12% for children aged 3–4 years; the use of restraint systems in the provincial area was even lower at 4.9%, 15.2%, 24% and 6.6%, respectively. The mother's age, number of children and the socioeconomic status of the family seemed to influence the purchase and usage of the car safety seat. Such a high percentage of non‐usage of car safety restraint seats has led to the Paediatric Society's initiative to create informative general public educational programmes and to urge governmental legislation regarding mandatory usage of children's car safety seats.
Skin microcirculation before and after local warming in infants delivered vaginally or by caesarean section
Authors: Martin H , Norman M
Published: January 2008

To elucidate early postnatal changes in skin microcirculation, term newborn infants were studied at 2,6 and 24 h after vaginal delivery (VD, n= 20) or elective caesarean section (CS, n= 10). Laser Doppler technique was used to measure perfusion, rhythmical perfusion changes, i.e. vasomotion, and reactive hyperaemia of the dorsal hand, before and after local warming of the skin to 37°C. The skin perfusion and the magnitude of reactive hyperaemia (mean 85%) remained essentially unchanged, while vasomotion increased from 0–5 to 2–8 cycles/min (p < 0.001) during the first day of life. Local warming of the skin promoted microcirculation slightly at 2 h and more markedly at 24 h postnatal age. The CS group showed a higher degree of skin perfusion, vasomotion and reactive hyperaemia than did VD infants at 2 h postnatal age. Our findings most likely reflect skin microcirculatory effects of birth‐related events, such as a drop in body temperature, sympathoadrenal activation and placental transfusion.
Selenium status of preterm infants: the effect of postnatal age and method of feeding
Authors: Daniels L , Gibson R , Simmer K
Published: January 2008

Indicators of selenium (Se) status were measured in a longitudinal study of 63 preterm and 46 term infants. Se levels in both groups were similar in the first few days of life. Preterm infants fed parenteral nutrition (PN) for several weeks developed very low plasma Se levels (<10/μg/l). In those receiving either breast milk or formula in conjunction with PN, plasma Se also declined over the first 6 weeks. In the breastfed term infants plasma levels increased by 50%, but there was no increase in the term formula‐fed group. In healthy preterm infants who received mainly breast milk, plasma Se concentrations remained constant at newborn levels and were below those of breastfed term infants at 6 weeks. Erythrocyte GSHPx activity did not reflect plasma Se or Se intake. In conclusion, the type of feeding, and hence Se intake, influenced plasma Se concentration in preterm infants. Provision of enteral feeding in conjunction with PN was unable to prevent a decline in plasma Se and at 6 weeks levels were well below those of the reference breastfed term infants.
Effect of 1human milk prostaglandins and lactoferrin on respiratory syncytial virus and rotavirus
Authors: Grover M , Giouzeppos O , May JT
Published: January 2008

The effect of lactoferrin and prostaglandins E and F2α on the growth of rotavirus and respiratory syncytial virus in cell culture was investigated. Lactoferrin inhibited the growth of respiratory syncytial virus at a concentration tenfold lower than that normally present in human milk. The prostaglandins had no effect on either virus growth, even at a concentration of 100‐fold more than that found in human milk. Lactoferrin may have some antiviral properties in human milk in addition to its known antibacterial functions.
Double‐blind, randomized clinical trial for safety and efficacy of norfloxacin for shigellosis in children
Authors: Bhattacharya SK , Bhattacharya MK , Dutta D , Dutta S , Deb M , Deb A , Das KP , Koley H , Nair GB
Published: January 2008

In a randomized, double‐blind clinical trial, the efficacy and safety of norfloxacin were compared with nalidixic acid in the treatment of shigellosis in children. Out of 59 cases, Shigella spp. were isolated from 8 cases in the nalidixic acid group and 14 cases in the norfloxacin group. The norfloxacin group had significantly less duration of diarrhoea and presence of blood in stool as compared to the nalidixic acid group. No joint problem was encountered in this study at up to 4 months follow‐up. Norfloxacin is safe and effective and showed no cartilage toxicity on short‐term follow‐up.
Evaluation of full‐term infants fed an evaporated milk formula
Authors: Friel JK , Andrews WL , Simmons BS , L'Abbe MR , Mercer C , MacDonald A , McCloy UR
Published: January 2008

The objective of this prospective, cohort study was to compare the nutritional status of full‐term infants who were fed human milk (BF, n= 29). formula (FF, n= 30) or evaporated milk formulae (EM, n= 30) for at least 3 months. Infants were seen at enrollment, 3 and 6 months, at which times a blood sample, diet record and anthropometric data were collected. Infants in the EM group received solids earlier (12 ± 5 weeks) than did FF infants (15 ± 4 weeks), and both were earlier than BF infants (19 ± 4 weeks). Only 26% of the EM fed group received iron supplements as ferrous sulphate drops. Seven BF, 12 FF and 20 EM had abnormal ferritin values (<10ngml‐1) at 6 months. Copper intake was lower in the EM infants at 3 and 6 months. However, plasma copper and erythrocyte copper zinc superoxide dismutase (ZnCuSOD) levels did not differ between groups. Selenium intake was lower in the EM group (5 ± 1 and 10 ± 5 μg d‐1; 3 and 6 months) than in the FF infants (13 ± 4 and 19 ± 7 μgd‐1; 3 and 6 months). Erythrocyte SeGHSPx levels in EM infants were lower at 6 months (EM, 33.2 ± 3.4; FF, 35.2 ± 3.9; BF, 36.1 ± S.SmUmgHb‐1). Thiamin intake (0.99 ± 0.08 and 1.24 ± 0.32; 3 and 6 months, mg 1000 kcal‐1) was higher in the FF group than in EM infants (0.38 ± 0.39 and 0.66 ± 0.38; 3 and 6 months). There were more (13%) abnormal thiamin assays in the EM group at 6 months than in the BF and FF infants (0%). In conclusion, infants fed evaporated milk formula receive adequate copper but may not receive enough thiamin or selenium. Unless supplemented from birth with medicinal iron, intakes of iron will be inadequate.
Clinical use of acid steatocrit
Authors: Van den Neucker A , Pestel N , Tran T My Dung , Forget PPh , Veeze HJ , Bouquet J , Sinaasappel M
Published: January 2008

Malabsorption of fat is an important gastrointestinal cause of malnutrition and growth retardation in childhood. The gold standard for the evaluation of fat malabsorption is the faecal fat balance method. The acid steatocrit method has recently been introduced as a simple method to evaluate faecal fat. The present study was aimed at evaluating the acid steatocrit in clinical practice. Faecal fat excretion and acid steatocrit results were determined in 42 children, half with and half without fat malabsorption. Acid steatocrit results correlated significantly with both faecal fat excretion (p < 0.01) and faecal fat concentration (p < 0.001). Sensitivity and specificity of the acid steatocrit for the diagnosis of malabsorption were 90% and 100%, respectively. We consider the acid steatocrit method useful for the screening and monitoring of patients with steatorrhoea.
Linear growth in early treated children with congenital hypothyroidism
Authors: Heyerdahl S , Ilicki A , Karlberg J , Kase BF , Larsson A
Published: January 2008

Length/height was studied from birth to 6 years of age in 103 children with congenital hypothyroidism identified by the Norwegian or Swedish screening programs. We used the “infancy‐childhood‐puberty (ICP) growth model”. This model describes normal linear growth during the first 3 years of life by an infancy component with the addition of a childhood component, the latter acting from the second half of the first year. In comparison with reference children, children with hypothyroidism had reduced growth from 6 to 12 months, and increased growth after 12 months of age. Mean onset of the childhood component of growth was delayed from 8.1 months (SD 1.9) to 10.4 months (SD 2.2) in girls, and from 8.9 months (SD 2.0) to 11.0 months (SD 2.1) in boys. Age at onset of the childhood component was correlated with age at start of treatment (r= 0.24), and in children with more severe hypothyroidism (pretreatment serum thyroxine <40 nmol/l) inversely correlated with the L‐thyroxine dose at start of treatment (r= ‐0.40). Change in height standard deviation score from 1 to 3 years of age was correlated with the serum thyroxine concentration at age 1 year (r= 0.30). The delay in the onset of the childhood component of growth and the association with age at start of treatment and initial L‐thyroxine dose indicate that thyroid hormones during the first months of life are essential for normal onset of the childhood component of growth, which otherwise is assumed to be growth hormone‐dependent.
The Swedish national prospective study on extremely low birthweight (ELBW) infants. Incidence, mortality, morbidity and survival in relation to level of care
Authors: Finnström O , Olausson P Otterblad , Sedin G , Serenius F , Svenningsen N , Thiringer K , Tunell R , Wennergren M , Wesström G
Published: January 2008

In a 2‐year (1990‐92) prospective national investigation, comprising all stillborn and live‐born ELBW infants with a birthweight of ≤1000 g born at 23 completed weeks of gestation or more, we examined the incidence, neonatal mortality, major morbidity and infant survival in relation to level of care and place of residence. A total of 633 ELBW infants were live‐born, i.e. 0.26% of all live‐born infants, and 298 were stillborn. The average neonatal mortality was 37% and 91% at 23 weeks, 70% at 24 weeks, and 40% at 25 weeks of gestation. Of neonatal survivors, 8% had intraventricular haemorrhage grade 3,10% retinopathy of prematurity of stage ≥3, 2% necrotizing enterocolitis, and 28% were oxygen‐dependent at a time corresponding to 36 weeks of gestation. In all, 77% were treated with mechanical ventilation, whereas 19% survived without, almost all of them being CPAP treated. Infant mortality among infants born at level III (tertiary centres) was 30%, at level Ha (with full perinatal service) 46% and at level IIb (with basic neonatal service) 55 %. Only 1 % was born at hospital level I. Regarding the relation to place of residence, the mortality rates among infants residing in the areas served by levels III, IIa and lib hospitals were 36%, 45% and 41%, respectively. The referral system thus functioned well, but can be improved, and increased perinatal referral, at borderline perinatal viability, might provide a better quality of care and a better chance of survival.
Measurement of albumin and low molecular weight proteins in the urine of newborn infants using a cotton wool ball collection method
Authors: Fell JME , Thakkar H , Newman DJ , Price CP
Published: January 2008

Objective: The aim of this study was to investigate the inter‐relationship between urinary excretion of alpha‐1‐microglobulin (AIM), retinol‐binding protein (RBP) and albumin in term and premature neonates, with urine collected into cotton wool balls and extracted by a novel method. Subjects and methods: Sixty‐four infants were studied on the first day of life; 26 had been born at term (37–42 weeks gestation) and 38 prematurely (24–28 weeks n= 16, 29–36 weeks n= 22). Urine collected into cotton wool balls was analysed following a new detergent extraction method, which resulted in a recovery rate of 94–107% for albumin, AIM, RBP and creatinine. Results: Urinary protein excretion, expressed as a ratio to urinary creatinine, decreased significantly with increasing gestational age (24–28 weeks, 29–36 weeks, 37–42 weeks: albuminxreatinine ratio mg/mmol mean 96.9, 31.7, 19.3; AIM: creatinine ratio mg/mmol mean 99.3, 37.0, 7.8; RBP: creatinine ratio mg/mmol mean 16.2, 3.8, and <0.01, below the limit of detection, respectively). When results were corrected for birthweight, this gestation‐associated effect was still present for A1M and RBP, but not for albumin. In premature infants there was a significant positive correlation between AIM: creatinine ratio and RBP: creatinine ratio (r= 0.85), and also between albumin and both AIM and RBP (r= 0.82 and 0.77). Conclusion: Increased excretion of AIM, RBP and albumin at earlier gestational ages is probably due to proximal tubular immaturity, although tubular damage and also glomerular dysfunction cannot be excluded as possible explanations.
Serum lecithin: cholesterol acyltransferase activity and HDL2 and HDL3 composition in small for gestational age newborns
Authors: Merzouk H , Lamri M‐Y , Meghelli‐Bouchenak M , Korso N , Prost J , Belleville J
Published: January 2008

The aim of this study was to determine serum lecithin: cholesterol acyltransferase (LCAT) activity in parallel with HDL2 and HDL3 composition in cord sera of small for gestational age (SGA) newborns, and to compare them with those obtained from appropriate for gestational age (AGA) newborns. LCAT activity was assayed by conversion of [3H]cholesterol to labelled cholesteryl ester. HDL2 and HDL3 were separated by ultracentrifugation. Serum cholesteryl ester, apolipoprotein (apo) A‐I concentrations and LCAT activity were significantly lower (‐47%, ‐18% and ‐56%, respectively), whereas serum triglyceride amounts were twofold higher in SGA newborns than in AGA newborns. In SGA newborns, HDL2 and HDL3 levels were low, and HDL3 and HDL2 phospholipid and HDL2‐cholesteryl ester contents were diminished. HDL3‐apo A‐I, A‐fl, C‐III and E values were lower in SGA newborns. In HDL2, apo A‐I, A‐II and E concentrations were decreased. Therefore, in SGA newborns, the reduced LCAT activity was associated with quantitative and qualitative changes in HDL2 and HDL3 particles.
The influence of dietary nucleotides on erythrocyte membrane fatty acids and plasma lipids in preterm infants
Authors: Axelsson I , Flodmark CE , Räihä N , Tacconi M , Visentin M , Minoli I , Moro G , Warm A
Published: January 2008

Objective: The objective of this study was to evaluate whether a regular formula for premature infants supplemented with nucleotides has any influence on plasma lipids and erythrocyte membrane fatty acids. Methods: Preterm infants fed either human milk supplemented with human milk protein (HM, n= 14), nucleotide‐supplemented preterm formula (NF, n= 13), or a regular preterm formula (F, n= 13) were included in the study. The NF was supplemented with 18.2 mg cytidine monophosphate/1 (CMP), 7.0 mg uridine monophosphate/1 (UMP), 6.4mg adenosine monophosphate/1 (AMP), 3.0mg inosine monophosphate/1 (IMP) and 3.0 mg guanosine monophosphate/1 (GMP). Results: There were significantly higher concentrations of triglycerides (TG) in infants fed NF compared to those fed F (191.42 ± 79.58 vs 108.21 ± 43.73, p < 0.001, mean ± SD lipid concentrations, mg/100ml plasma). Infants fed F had significantly lower concentrations of total cholesterol (94.34 ± 11.71 vs 115.69 ± 39.29, p < 0.01) and TG in plasma (108.21 ± 43.73 vs 172.27 ± 68.19, p < 0.001, mean ± SD lipid concentrations, mg/100ml plasma) when compared to HM‐fed infants. There were no significant differences in any of the erythrocyte membrane fatty acids and total long‐chain polyunsaturated fatty acids (LC‐PUFA) between NF and F during the study period (6 weeks). Furthermore, total LC‐PUFA and docosahexaenoic acid (DHA) concentrations in red blood cell were not significantly different when infants fed NF were compared to those fed HM. In contrast, however, infants fed F had significantly lower concentrations of total n‐3 LC‐PUFA (p < 0.01) and DHA (p < 0.01) than those found in HM‐fed infants. Conclusions: These results do not suggest an effect of nucleotides on the red blood cell LC‐PUFA profile in preterm infants. However, the nucleotides may increase the concentrations of triglycerides in plasma.
Experimental milk formulae with reduced protein content and desialylated milk proteins: influence on the faecal flora and the growth of term newborn infants
Authors: Chierici R , Sawatzki G , Thurl S , Tovar K , Vigi V
Published: January 2008

We have assessed the growth, tolerance and the faecal flora composition in healthy infants on different feeding regimens. Four groups of infants were fed exclusively on mother's milk, a standard formula and two experimental formulae. The first experimental formula consisted of a milk with a reduced protein content (1.2 g/100 ml), the second in a formula with the same protein content and with milk proteins desialylated by mild acid hydrolysis. The aim of the study was to test whether lowering the protein content and/or modifying the proteins by desialylation would favour the development of a bifidus flora. A bifidus flora was detected in 60% of breastfed infants at 1 month of life. All formulae employed during the study failed to induce a prevalence of colonization with bifidobacteria at 1 month of age. The two experimental milk formulae were well tolerated, but the infant growth rate was slightly lower as compared to the breastfed infants and the infants fed the standard formula. The presence in milk formulae of pre‐digested and desialylated proteins can offer some advantages in term of digestibility and mimic a physiological intestinal mechanism of the infant.
Breastfeeding and catch‐up growth in infants born small for gestational age
Authors: Lucas A , Fewtrell MS , Davies PSW , Bishop NJ , Clough H , Cole TJ
Published: January 2008

Postnatal growth was prospectively measured from birth to 1 y in 54 term infants born small for gestational age (SGA), fed either breast milk or a standard term infant formula. Breastfeeding was associated with a 0.36 and 0.64 standard deviation (SD) increase in weight at 2 weeks and 3 months of age. respectively, which persisted beyond the breastfeeding period (0.64 SD at 1 y). Breastfed infants also showed greater catch‐up growth in head circumference [SD score (SDS) 0.53 higher at 3 months], and greater body length gain (SDS 0.68 higher at 6 months). This increased growth was independent of potentially confounding obstetric, social and demographic factors. Our findings suggest that breastfeeding may promote faster growth in infants compromised by poor growth in utero. SGA infants may be programmed for a number of adverse outcomes; the possibility that such events are altered by choice of postnatal diet is a key issue for future research.
Vitamin D metabolites (25‐hydroxyvitamin D, 24,25‐dihydroxyvitamin D and 1,25‐dihydroxyvitamin D) and osteocalcin in β‐thalassaemia
Authors: Moulas A , Challa A , Chaliasos N , Lapatsanis PD
Published: January 2008

Serum levels of the vitamin D metabolites 25‐hydroxyvitamin D, 24,25‐dihydroxyvitamin D, and 1,25‐dihydroxyvitamin D. and of osteocalcin. C‐tenninal parathyroid hormone and other biochemical indices related to bone metabolism, were determined in two groups of patients with β‐thalassaemia aged 5–10 years (summer 7.8 ± 0.4 years, mean ± SEM. and winter 7.7 ± 0.4 years, group A, n= 15) and 11–23 years (16.6 ± 0.9 and 15.7 ± 0.9 years in summer and winter, respectively, group B, n= 22). Emphasis was given to populations of school and adolescent ages and to the seasons of summer and winter when vitamin D status demonstrates the widest extremes. The mean serum levels of 25‐hydroxyvitamin D in patients aged 5–10 years did not differ from those of controls during both seasons studied. In contrast, in the age group 11–23 years these levels were found to be lower in patients than in controls both in winter (10.6 ± 0.9ng/ml vs 15.0 ± 2.0ng/ml, p < 0.05) and summer (20.2 ± 2.1 ng/ml vs 27.1 ± 2.0ng/ml, p < 0.05). The serum concentrations of 24,25‐dihydroxyvitamin D were lower in the thalassaemic patients than in controls in both age groups and both seasons. In the patients under 10 years of age the mean values of this metabolite in winter were 1.06 ± 0.17 ng/ml vs 1.68 ± 0.20 ng/ml in the respective controls (p < 0.05), and in summer 1.44 ± 0.11 ng/ml vs 2.35 ± 0.36 ng/ml in controls (p < 0.05). In the group of patients aged 11–23 years, the mean levels of 24,25‐dihydroxyvitamin D were in winter 0.65 ± 0.12 ng/ml vs 1.12 ± 0.19 ng/ml (p < 0.05) in controls and in summer 1.34 ± 0.12 ng/ml vs 1.84 ± 0.20 ng/ml (p < 0.05). The 1,25‐dihydroxyvitamin D concentrations in both thalassaemic patient groups were significantly no different from those in the respective control groups. Serum osteocalcin, C‐terminal parathyroid hormone, calcium, inorganic phosphate and alkaline phosphatase levels in the patients studied were not significantly different from those in controls, except for calcium and phosphate in the older group. In the older group of thalassaemic patients, serum calcium was lower than in the controls (2.26 ± 0.03 vs 2.37 ± 0.03 mmol/1, p < 0.05) in summer and serum phosphate higher than in the controls in winter (1.47 ± 0.05 mmol/1 vs 1.27 ± 0.06 mmol/1. p < 0.05).