bluuebunny/crossref_metadata_2025 huggingface dataset:
The position of the tongue during rooting reflexes elicited in newborn infants before the first suckle
Authors: Widström A‐M , Thingström‐Paulsson J
Published: January 2008

A common breast‐feeding problem is when the infant “places its tongue in its palate” and has difficulties in attaching to its mother's nipple. The aim of this study was to document the position of the tongue in the mouth cavity during rooting reflexes elicited in newborn infants before the first suckle. Eleven healthy, full‐term infants were videotaped 101 ± 31 min after birth during an evoked distinct rooting reflex before the first suckle. The videotaped rooting reflex was analyzed in detail concerning the degree of turning of the head, mouth opening and position of the tongue, in pictures that were “frozen” at specific intervals. “Licking movements” preceded and followed the rooting reflex in the alert infants. In 10 of the 11 infants the tongue was placed in the bottom of the mouth cavity during a distinct rooting reflex (p= < 0.05). It is suggested that forcing the infant to the breast might abolish the rooting reflex and disturb placement of the tongue. A healthy infant should have the opportunity of showing hunger and optimal reflexes, and attach to its mother's nipple by itself.
Urinary nitrite excretion in premature infants: effects of transfusion or indomethacin
Authors: Miller MJS , Eloby‐Childress S , Snapp B , Chotinaruemol S , Steen VL , Clark DA
Published: January 2008

Urinary nitrite excretion, an index of L‐arginine‐dependent nitric oxide formation, was quantified daily for two weeks, in very low‐birth‐weight (< 1500 g) premature infants. A transient 52%) reduction in nitrite excretion was noted on the day of transfusions (54±10 versus 26±6 μmol/mmol creatinine, before and during transfusion, respectively, n = 24, p<0.02). Indomethacin administration in six infants was associated with a dramatic increase in nitrite excretion from a basal median value of 3 to 76 μmol/mmol creatinine (p<0.05). Nitrite excretion returned to baseline on day 3 after indomethacin administration. In two infants who received indomethacin and transfusions on the same day, the stimulatory effect on nitrite excretion by indomethacin overwhelmed any depressive effect of transfusions. These results suggest that L‐arginine utilization is influenced by common therapeutic strategies in these high‐risk infants.
Early feeding of preterm infants and allergic symptoms during childhood
Authors: Savilahti E , Tuomikoski‐Jaakkola P , Jarvenpaa A‐L , Virtanen M
Published: January 2008

A follow‐up study of 69 premature infants showed that at a mean age of 11.4 years they had a cumulative incidence of allergic symptoms similar to that reported in unselected series. The 38 premature infants fed exclusively with human milk to the age of four months had more allergic symptoms than the 31 premature infants fed with adapted cow's milk formula from birth (mean number of symptoms 1.6 versus 0.6, p = 0.0025). The excess of symptoms was mostly cutaneous, and often associated with a specific food. In logistic regression models, the only variable with a statistically significant association (standardized odds ratio 3.15, 95% confidence interval 1.12–8.8, p = 0.03) with symptomatic allergy was the type of feed. The frequency of positive skin prick tests and the mean levels of serum IgE and antibodies to cow's milk were similar in the two groups. We infer that food allergy was more common in the group fed with human milk.
The association between preterm newborn hypotension and hypoxemia and outcome during the first year
Authors: Low JA , Froese AB , Galbraith RS , Smith JT , Sauerbrei EE , Derrick EJ
Published: January 2008

Ninety‐eight newborn infants, less than 34 weeks at birth, were studied to examine the relationship between newborn hypotension and hypoxemia and brain damage. Heart rate, blood pressure and oxygen tension were recorded continuously during the 96 h following delivery. Outcome measures included neuropathology in children who died, and motor and cognitive development at one year corrected age in children who survived. There were 22 children with a minor and 27 with a major abnormal outcome. There was a relationship between newborn hypotension, newborn hypoxemia and low birth weight, and a major abnormal outcome. The probability of a major abnormal outcome increased from 8% in newborns with no hypotension or hypoxemia, to 53% in children with both hypotension and hypoxemia. These findings support the contention that combinations of sustained newborn hypotension and hypoxemia are important factors in the development of brain damage, accounting for a major abnormal outcome.
Prediction of height achievement at five years of age in children born very preterm or with very low birth weight: continuation of catch‐up growth after two years of age
Authors: Qvigstad Elisabeth , Verloove‐Vanhorick S Pauline , Ens‐Dokkum Martha H , Schreuder Anneke M , Veen Sylvia , Brand Ronald , Oostdijk Wilma , Ruys Jan H
Published: January 2008

To predict height at five years in a cohort of 565 very preterm and/or very low‐birth‐weight children, hypothesized growth determinants were subjected to discriminant analysis. Many neonatal parameters were not significantly associated with short stature at five years of age. A correct classification of stature (smaller/larger than the 10th percentile at five years of age) could be obtained in 85% of children, using the following variables: height at two years of age; total (or mid) parental height; parental level of education; length at one year of age; hypertension during pregnancy; sex; weight at two years of age; length percentile at one year of age. However, when compared to actual longitudinal data, the false‐positive rate was 37%. The survey also demonstrated the continuing catch‐up growth in very preterm and very low‐birth‐weight infants after two years of age.
Follow‐up in patients with aspartylglucosaminuria. Part I. The course of intellectual functions
Authors: Arvio M
Published: January 2008

Progressive mental retardation is the main clinical symptom in aspartylglucosaminuria. The intellectual functions of 116 patients were studied. Based on cross‐sectional test results, an average longitudinal developmental profile consisted of three parts: a period of abnormally slow but positive development in childhood, a gradual loss of reached skills after the age of 13–16 years and a rapid decline after the age of 25–28 years. Only nine young patients had a developmental age higher than six years, and two higher than seven years. The mean age of the female group was seven years higher than that of the males, but the mean developmental ages were the same for both groups.
The covariation of common psychosomatic symptoms among children from socio‐economically differing residential areas. An epidemiological study
Authors: Alfvén Gösta
Published: January 2008

Psychosomatic symptoms among children are believed to be commonplace. In this investigation by questionnaire, 47% of 1333 schoolchildren reported one or several symptoms, such as recurrent abdominal pain, headache, chest pains, loss of appetite and disturbances in bowel function. Coexistence of such symptoms was considerable and if a child had one of these, the probability that it would have one or more other symptoms was significantly increased. This correlation may strengthen both the suspicion that these symptoms are often psychosomatic and the idea that they have common CNS origin. There were appreciable differences in the frequency of the symptoms, between children at the more socially stable schools and schools with social problems. In the latter, the frequencies of symptoms differed between Swedish and immigrant children, which was not the case in the more socially stable schools.
Acute renal failure complicating diabetic ketoacidosis
Authors: Murdoch IA , Pryor D , Haycock GB , Cameron SJ
Published: January 2008

Two previously healthy children, aged 13 and 14 years, respectively, presented with diabetic ketoacidosis. Both children developed acute renal failure, a rare complication of diabetic ketoacidosis and required dialysis.
Neuronal migrational disorders: diffuse cortical dysplasia or the “double cortex” syndrome
Authors: Lannetti P , Raucci U , Basile LA , Spalice A , Biasi C Di , Trasimeni G , Gualdi GF
Published: January 2008

We report a 10‐year‐old girl who presented with a single episode of partial complex seizure. Neurological examination and psychological evaluation were normal. Electroencephalogram showed abnormalities in the left temporo‐occipital region. Magnetic resonance imaging revealed a bilateral layer of tissue iso‐intense with gray matter, between the wall of the lateral ventricle and the cortex, extending from the frontal to the occipital region, and enlarged left lateral ventricle. The images indicated diffuse cortical dysplasia, also known as band heterotopia or “double cortex”, and left cortical hemiatrophy.
A comparison between nebulized terbutaline, nebulized corticosteroid and systemic corticosteroid for acute wheezing in children up to 18 months of age
Authors: Daugbjerg P , Brense E , Forchhammer H , Frederiksen B , Glazowski MJ , Ibsen K Kaas , Knabe N , Leth H , Marner B , Pedersen F Karup , Østergaard G Zahle
Published: January 2008

One hundred and twenty‐three children, aged 1.5–18 months, participated in a randomized, double‐blind, placebo‐controlled multicentre study comparing different treatments for acute wheezing. The children were admitted to one of five participating paediatric departments. They were randomized into one of four treatment groups: (I) soluble prednisolone +placebo inhalation + terbutaline inhalation; (2) soluble placebo + budesonide inhalation + terbutaline inhalation; (3) soluble placebo+placebo inhalation + terbutaline inhalation; and (4) soluble placebo + placebo inhalation + normal saline inhalation. On admission, measurements of temperatures, respiratory rate and heart rate were made and once‐a‐day thereafter. Wheezing, accessory respiratory muscle use, prolonged expiration and general condition were scored on a scale ranging from 0 to 3. Significantly more treatment failures were recorded in the placebo group. Children from both steroid groups were discharged earlier than children from the terbutaline group. Compared with children from the placebo group, children from all three treatment groups had a greater improvement in symptom score, but this was significant for the budesonide group only.
Anti‐alpha‐gliadin antibodies are not predictive of celiac disease in juvenile chronic arthritis
Authors: Lepore L , Pennesi M , Ventura A , Torre G , Falcini F , Lucchesi A , Perticarari S
Published: January 2008

Some authors have recently reported an increased level of antigluten antibodies in rheumatoid arthritis, both in the adult and juvenile form. The real meaning of these antibodies is still unclear. We ascertained the levels of antigluten antibodies in a group of children with juvenile chronic arthritis to determine if these antibodies were linked with celiac disease and/or to increased intestinal permeability. In 18 of 53 patients (33.9%), the levels of antigluten antibodies (IgA or IgG) were higher than normal. No correlation was found between the increase in antigluten antibodies and the positive lactulose/ mannitol test, used for determining increased intestinal permeability. In all eight patients undergoing intestinal biopsy due to abnormal levels of antigluten antibodies (IgA class), intestinal mucosa was normal. In conclusion, our study shows that in patients with juvenile chronic arthritis, immunological response to gluten is neither related to celiac disease nor to increased intestinal permeability.
Severe retinopathy in systemic lupus erythematosus associated with IgG anticardiolipin antibodies
Authors: Ravelli A , Fuccia G Di , Caporali R , Malvezzi F , Montecucco C , Martini A
Published: January 2008

A six‐year‐old boy with systemic lupus erythematosus developed insidiously a monolateral serous retinal detachment leading to severe visual loss. Serial determinations of anticardiolipin antibodies showed the presence of IgG anticardiolipin antibodies only at the time of ocular involvement. This case underlines the need for regular ophthalmologic evaluation in children with active systemic lupus erythematosus and supports the previous hypothesis of a relationship between antiphospholipid antibodies and retinal involvement in systemic lupus erythematosus.
Intake and growth of breast‐fed and formula‐fed infants in relation to the timing of introduction of complementary foods: the DARLING study
Authors: Heinig M Jane , Nommsen Laurie A , Peerson Janet M , Lonnerdal Bo , Dewey Kathryn G
Published: January 2008

We examined if the timing of introduction of solid foods was related to growth, intake, morbidity, activity or motor development among infants either breast fed or formula fed until 12 months of age. Breast‐fed infants given solids before 6 months of age (earlysol) consumed less breast milk at 6 and 9 months of age than those given solids 6 months (latesol); thus total energy intake did not differ between groups. Z scores for weight, length and weight‐for‐length at 1–18 months did not differ between groups. Latesol infants gained less weight from 6 to 9 months but not during any other interval. Neither activity level nor morbidity differed between groups, but several developmental milestones occurred earlier in the earlysol versus the latesol group, probably due to reverse causation. Among formula‐fed infants, timing of introduction of solid foods was not related to intake, growth, activity or morbidity. We conclude that solid foods given before 6 months of age generally replace the milk source among breast‐fed but not formula‐fed infants.
Maternally acquired immunity in newborns from women infected by the human immunodeficiency virus
Authors: Moraes‐Pinto MI de , Farhat CK , Carbonare SB , Curti SP , Otsubo MES , Lazarotti DS , Campagnoli RC , Carneiro‐Sampaio MMS
Published: January 2008

Maternally acquired immunity was studied in 16 pairs of human immunodeficiency virus (H1V)‐seropositive women and their newborns, and was compared to 18 control mother‐newborn pairs. The HIV‐infected women had higher IgG levels than the control subjects, but no difference was observed between newborn samples, presumably due to the limited placental IgC transfer in the HIV group. A poor type 2 poliovirus antibody transfer was also noted in this group. The population of newborns lacking demonstrable measles antibodies was higher in the HIV group than in the control group, probably because many of the HIV‐infected mothers lacked measles antibodies also. These results show that maternally acquired immunity may be affected to newborns from HIV‐infected women, either because of low maternal serum antibody levels or deficient transplacental transfer. If so, the measles vaccine schedule should be revised for these children and the same should be done for future passive immunization regarding fetus protection in pregnant HIV‐seropositive women.
Early child health in Lahore, Pakistan: II. Inbreeding
Authors: Yaqoob M , Gustavson K‐H , Jalil F , Karlberg J , Iselius L
Published: January 2008

The prevalence of consanguineous marriages was studied in 940 families belonging to four different socio‐economic groups in and around Lahore, Pakistan. The births occurring in these families from September 1984 to March 1987 were also investigated for birth defects. The overall prevalence of consanguineous marriages was 46%. The first cousin marriages were most common (67%), followed by the marriages between second cousins, 19%. The prevalence of consanguineous marriages was clearly associated with the socio‐economic status of the study groups; 50% of the marriages was related in the periurban slum, 49% in the village, 44% in the urban slum and 31% in the upper middle class. The birth defects were also more prevalent in the poorer areas, being highest in the periurban slum (17.7%) followed by the urban slum (15.6%) and then the village (14.8%) and lowest in the upper middle class (12.3%). Although, the frequency of both consanguinity and birth defects were related with the socio‐economic levels of the study groups, there was no association between inbreeding and birth defects. Perhaps, deleterious recessive genes for birth defects have been “bred out”, because of continuous inbreeding over generations in this population. There was a significant predilection of major birth defects in boys without clear sex linkage. The conclusion is that the rate of consanguineous marriages was high, especially in the poorer areas, but the relationship between consanguineous marriages and birth defects was little or none. However, other child health indicators may be affected by consanguineous marriages.
Early child health in Lahore, Pakistan: XI. Growth
Authors: Karlberg J , Ashraf R N , Saleemi M , Yaqoob M , Jalil F
Published: January 2008

This work gives growth reference values at birth to 24 months of age for Pakistan based on upper middle class infants. Growth rate reference values are also included and they are given for various interval lengths. The growth was differently affected in infants living in three poorer areas; the stunting incidence at 24 months of age was 63% in periurban slum, 54% in the village and 26% in the urban slum. Less differences could be seen between the areas in weight for length. There was an age dependency in the incidence of reduced growth; a normal length gain was seen at birth to about six months of age, but they were highly reduced at 6 to 18 months of age. The weight gain was to some degree reduced during the first 12 months of life, followed by a catch‐up growth period. The seasonal influence was also age dependent; weight was highly affected during the summer at birth to 24 months of age, but not in the winter. The seasonal effect in length was marginal at birth to 6 months, little at 6 to 12 months (although, constant below the normal) and large at 12 to 24 months of age. We did not see any seasonality of growth in the reference group. The incidence of reduced growth reflects the socio‐ economic differences in one restricted geographic area, i.e. in the city of Lahore, Pakistan.
Early child health in Lahore, Pakistan: XII. Milestones
Authors: Yaqoob M , Ferngren H , Jalil F , Nazir R , Karlberg J
Published: January 2008

Psychomotor development was assessed in 1476 infants from four different levels of urbanization in and around Lahore, Pakistan. Development was assessed monthly at birth to 24 months of age by using a set of 10 milestones selected from the Denver Developmental Screening Test and the Developmental Screening Inventory. The psychomotor development of children in the upper middle (Um) class was consistent with reference population groups in Europe and North America, hence this group was used as control. There was significant delay in the psychomotor development of infants belonging to the poorer areas compared to the Um class. There was no sex difference in the development of the milestones in any study area, except for girls in the Um class who were earlier for about one month than boys in talking. Infants in the poorer areas were, on average about 3 months, delayed in their walking and fine motor activity (building a tower of 3 cubes) in comparison with the Um class. Observed disturbance in psychomotor development at an early age may affect the abilities and achievements in later life.
Auxology and response to growth hormone treatment of patients with intrauterine growth retardation or Silver‐Russell syndrome: analysis of data from the Kabi Pharmacia International Growth Study
Authors: Chatelain PG ,   Kabi Pharmacia International Growth Study
Published: January 2008

Using the database from the Kabi Pharmacia International Growth Study, 105 patients with intrauterine growth retardation (IUGR) (82 males, 23 females) and 45 with Silver‐Russell syndrome (SRS) (32 males, 13 females) with persistent postnatal growth failure were studied. Patients with IUGR had a birth length and birth weight more than 2 SD below the mean for gestational age. Their height deficit at the start of GH treatment was ‐3.0 SDS at a median chronological age of 8.7 years and a median bone age of 7.0 years. Mean paternal and maternal heights were 166 and 153 cm, respectively. The median dose of GH was 0.5 IU/kg/week, given at a median frequency of five injections/week. The median height SDS for chronological age after 1, 2 and 3 years of GH treatment were ‐2.5, ‐2.1 and ‐1.9, respectively. In the 45 patients with SRS, median chronological age and median bone age at the start of treatment were 6.7 and 3.2 years, respectively, and mean paternal and maternal heights were 167.5 and 160 cm, respectively. The median dose of GH was 0.7 IU/kg/week, given at a median frequency of six injections/week. The median height SDS for chronological age at the start of treatment and after 1, 2 and 3 years were ‐3.5, ‐2.9, ‐2.8 and ‐2.2, respectively. Although the criteria used by physicians when diagnosing SRS were not controlled or verified in this study, it appears that patients with SRS can be differentiated from those with IUGR with persistent growth failure by their reduced bone age for chronological age at the start of treatment, and by the fact that patients with SRS tended to be born to parents of normal height. GH treatment in both groups induced catch‐up growth, though long‐term follow‐up studies will be required to assess the effects of treatment on final height.
Cells, bilirubin and light: formation of bilirubin photoproducts and cellular damage at defined wavelengths
Authors: Christensen T , Kinn G , Granli T , Amundsen I
Published: January 2008

Christensen T, Kinn G, Granli T, Amundsen I. Cells, bilirubin and light: formation of bilirubin photoproducts and cellular damage at defined wavelengths. Acta Paediatr 1994;83:7–12. Stockholm. ISSN 0803–5253

Cultured cells from one human and one murine cell line were treated with bilirubin and irradiated with visible light of different wavelengths, either from phototherapy lamps or from a Xenon/Mercury lamp equipped with a monochromator. Bilirubin bound to human serum albumin was also irradiated with light. After irradiation, the bilirubin and its photoisomers were extracted and analysed with High Pressure Liquid Chromatography. The formation of single strand breaks in the DNA of treated cells was studied using a fluorescence marker. Cytotoxicity in the mouse skin cell line was measured by loss of the ability to form visible colonies in vitro. Green light exposure favours the production of lumirubin, while blue light causes more DNA damage and cytotoxicity. Green light may be more efficient and safer than shorter wavelength exposure when treating jaundiced newborns with phototherapy.
Incidence and prediction of bronchopulmonary dysplasia in a cohort of premature infants
Authors: Farstad T , Bratlid D
Published: January 2008

Farstad T, Bratlid D. Incidence and prediction of bronchopulmonary dysplasia in a cohort of premature infants. Acta Pzdiatr 1994;83:19–24. Stockholm. ISSN 0803–5253

A prospective study on the incidence of bronchopulmonary dysplasia (BPD) in premature infants is reported. A cohort of premature infants with gestational ages 32 weeks, treated during 1989, was followed for one year. Of a total study population of 117 infants, 23 (19.6%) developed BPD, defined as oxygen dependence at 28 postnatal days. However, only 15 infants (12.8%) needed supplementary oxygen at the age of 36 gestational weeks and 5 infants (4.2%) needed supplementary oxygen periodically at one year of age. BPD was found to account for a significant part of both the total and late mortality in the cohort. Measurements of pulmonary mechanics were performed at 3 ± 1 and 12(13) ± 1 days of life in a subgroup of 26 infants with RDS who required assisted ventilation for 4 days or longer. No significant difference in lung compliance or resistance could be found during the first examination between infants who later devleoped BPD and infants with RDS only. At the second examination, infants who later developed BPD had significantly lower lung compliance (0.48 ± 0.23 ml/cmH2O) than infants in the RDS group (1.50 ± 0.72 ml/cmH2O) (p<0.001). Measurements of pulmonary mechanics could be of importance for early prediction of infants at risk of BPD.
Children with early refusal to eat: follow‐up during primary school
Authors: Dahl M , Rydell A‐M , Sundelin C
Published: January 2008

Dahl M, Rydell A‐M, Sundelin C. Children with early refusal to eat: follow‐up during primary school. Acta Paediatr 1994;83:54–8. Stockholm. ISSN 0803–5253

Twenty‐five children, previously investigated at 3–12 months of age for refusal to eat for at least four weeks with no apparent medical cause, have been followed‐up prospectively with respect to feeding characteristics, general behaviour, somatic health and growth. In the present study, 18 of these children, still resident in Uppsala, were reinvestigated during the primary school period. Comparisons were made with 240 classmates. Information was obtained from school health records and from questionnaires completed by teachers and parents concerning the children's current eating behaviour and general behaviour. Compared with the controls, the children who refused to eat at an early age presented more eating problems both at home (p < 0.01) and at school (p< 0.01), but were not different with respect to general behaviour, somatic health or growth. We conclude that children with previous periods of refusal to eat continue to show problematic eating behaviour, not only at home but also at school.
Clinical criteria for estimating recovery from childhood bacterial meningitis
Authors: Anttila M
Published: January 2008

Anttila M. Clinical criteria for estimating recovery from childhood bacterial meningitis. Acta Pædiatr 1994;83:63–7. Stockholm. ISSN 0803–5253

A comparison study was conducted between 105 children (aged 3 months to 15 years) who had recovered from bacterial meningitis uneventfully and 29 children who had suffered from subsequent neurological complications or sequelae. The objective was to find a potential correlation between easily measurable clinical variables and the risk of developing neurological complications. Sixteen clinical signs and measurements routinely registered in patients with bacterial meningitis were recorded daily during the first 14 days of hospitalization. Dif Terences found between the two groups were mean morning temperature, presence of neck rigidity and willingness to leave the supine position. The results indicate that if a child recovering from bacterial meningitis continues to be feverish, has neck rigidity, or is reluctant to leave the supine position over seven days. she: he runs a special risk of developing neurological complications or sequelae. which should be actively sought for using all available measures.
Cerebral blood flow velocity in term newborns following intrapartum fetal asphyxia
Authors: Low JA , Galbraith RS , Raymond MJ , Derrick EJ
Published: January 2008

Twenty‐six term newborns with intrapartum fetal asphyxia, determined biochemically (umbilical artery base deficit < 12mmol/1), were compared with 59 normal newborns to determine the effect of intrapartum fetal asphyxia on newborn blood pressure and cerebral blood flow velocity following delivery. Cerebral blood flow velocity observations with concurrent measures of blood pressure and heart rate were obtained during the 24 h after delivery and after 24 h. After delivery, diastolic blood pressure in the newborns of the asphyxia group was significantly greater than that of the newborns of the normal group and this difference persisted after 24 h. Cerebral blood flow velocity in the newborns of the asphyxia group was of the same order as that of the newborns of the normal group during the 24 h after delivery. However, there was a significant increase in both peak systolic and end‐diastolic blood flow velocity after 24 h. The duration of metabolic acidosis may be a factor in the occurrence of this delayed cerebral blood flow velocity response. Observations of cerebral blood flow velocity should be continued for more than 24 h following delivery to determine the effect of intrapartum fetal asphyxia.
Growth impairment, IGF I hyposecretion and thyroid dysfunction in children with perinatal HIV‐1 infection
Authors: Matarazzo P , Palomba E , Lala R , Ciuti E , Altare F , Sanctis L de , Tovo PA
Published: January 2008

We evaluated the growth pattern, bone age, insulin‐like growth factor I (IGF I) secretion and thyroid function in 24 perinatally infected children: 9 asymptomatic or paucisymptomatic (group 1) and 15 with a more advanced disease state and treated with zidovudine (group 2). Statural and ponderal growth were compared with those of 37 at‐risk children who seroreverted. During the two‐year follow‐up, 22% of children in group 1 had impaired growth, 33% bone age delay, 45% reduced IGF I levels but none had thyroid dysfunction. In group 2, 53% had growth failure, 53% bone age delay, 86% reduced JGF I levels and 40% thyroid dysfunction. Among seroreverters, none showed growth impairment; statistically significant differences were found for height, weight and height velocity between perinatally infected children and seroreverters. Since auxological and hormonal evaluations run parallel to the clinical course of infection, these indices may be useful in monitoring disease progression.
Growth as a parameter of inflammation in Crohn's disease, using roentgen stereophotogrammetric analysis
Authors: Hildebrand H , Aronson S , Selvik G
Published: January 2008

Growth rate was measured in 12 children with Crohn's disease and growth retardation, using roentgen stereophotogrammetric analysis. The method was chosen as it provides an opportunity to record growth rate accurately during short periods of time. Growth was followed at variable intervals of 4–12 weeks depending on the clinical situation. Growth rate was shown to correlate with symptoms, laboratory tests and nitrogen balance. These findings indicate that growth, when it is affected, fluctuates in a similar way as albumin, acute phase proteins and symptoms, all assumed to reflect the disease activity. Short‐term growth measurements appear to be helpful in monitoring the disease progress or response to therapy in children with Crohn's disease, particularly when growth retardation is the only manifestation of the disease.
Depressed concentrations of oxytocin and cortisol in children with recurrent abdominal pain of non‐organic origin
Authors: Alfvén G , Torre Bdela , Uvnäs‐Moberg K
Published: January 2008

The purpose of the present study was to measure plasma concentrations of oxytocin, cortisol and prolactin in children with recurrent abdominal pain of non‐organic origin (RAP). Forty children with RAP and 34 controls, matched for age and sex, participated in the study. A blood sample was collected after an overnight fast in association with clinical examinations. Oxytocin, cortisol and prolactin levels were determined by radioimmunoassay (RIA). Oxytocin and cortisol concentrations in the children with RAP were found to be significantly reduced compared with those of the controls (approximately 24 versus 63 pmol/l for oxytocin and 160 versus 300 nmol/l for cortisol, respectively). The low oxytocin and cortisol levels persisted at a second examination 3 months later. No significant differences in the prolactin levels were observed between RAP and controls.
Intrathoracic extra‐mediastinal cystic hygroma in infancy
Authors: Kirk JMW , Delahunty C , Nicolaides KH , Dykes EH , Gamsu HR
Published: January 2008

An infant with intrathoracic extra‐mediastinal cystic hygroma is described. Fluid collection within the fetal chest was noted on routine antenatal ultrasound scan and this was subsequently drained. Postnatally, echocardiogram and thoracic CT scan demonstrated a cystic space between the pericardium and right mediastinal pleura. Thoracotomy performed at six weeks of age showed a multiloculated cystic mass adherent to the right pericardium and to the medial aspect of the diaphragm. Histology revealed the tumour to be a cystic hygroma (lymphangioma). Intrathoracic cystic hygroma occurring outside the mediastinum is extremely rare and has never been diagnosed previously in infancy.
Gut intraepithelial lymphocyte counts in neonates, infants and children
Authors: Machado CSM , Rodrigues MAM , Maffei HVL
Published: January 2008

Intraepithelial lymphocyte (IEL) counts were histologically assessed in the jejunum, ileum and appendix of 39 neonates (0–28 days), 32 infants (1–9 months) and 13 children (1–9 years). Small intestinal mucosa samples were obtained from 73 autopsies, and from 8 surgical and 3 aspirative biopsies. IEL counts of specimens from the jejunum, ileum and appendix gave similar results in the same patient. The number of IEL counts was significantly lower in neonates for all three segments. The difference between infants and children was more marked in the jejunum than in the ileum, although this was not significant. In the appendix, there was no difference between the different age groups. Our results indicate that postnatal expansion of IEL occurs homogeneously along the gut after the neonatal period.
Normal final height after treatment for acute lymphoblastic leukemia without irradiation
Authors: Holm K , Nysom K , Hertz H , Müller J
Published: January 2008

In order to evaluate the influence of chemotherapy on linear growth, 28 children treated for acute lymphoblastic leukemia without irradiation were evaluated before, during and after the end of therapy. Median age at diagnosis was 4.4 years (range 2.2–12.7 years) and treatment was discontinued after a median period of 3.1 years (3.0–5.2 years). We observed a significant decrease in height SDS (p= 0.006) from diagnosis to the end of chemotherapy, followed by catch‐up in height SDS from the end of chemotherapy to final observation. Catch‐up growth took place mainly within the first 2 years after cessation of therapy. In 22 patients final height was reached. Final height was normal (median height SDS‐0.035) and even significantly higher than mid‐parental height SDS (p= 0.012). In those patients who attained adult stature, the sitting height to standing height ratio was also normal. In conclusion, in children treated for acute lymphoblastic leukemia, chemotherapy exerted a negative influence on growth, but catch‐up occurred within 2 years after cessation of therapy, resulting in normal final height and body proportions.
A reply to Brambilla et al.
Authors: Kasa N , Heinonen KM
Published: January 2008

The Editor has asked N Kasa and KM Heinonen to comment on the letter by P Brambilla et al. in this issue. Here are their comments:
Prediction of respiratory morbidity in the third year of life in children born prematurely
Authors: Giffin F , Greenough A , Yuksel B
Published: January 2008

We have tested the hypothesis that recurrent respiratory symptoms in the third year of life in patients born prematurely were more likely to reflect a family history of atopy rather than adverse neonatal events. Comparison of 28 symptomatic and 72 asymptomatic children revealed that a family history of atopy (p<0.01), prolonged dependencc on respiratory support in the neonatal period (p<0.01) and extreme immaturity (p<0.02) were significantly commoner in the symptomatic group. The relative risk of having symptoms was 2.27 for a family history of atopy, 2.48 for prolonged dependence on respiratory support and 1.7 for low gestational age. We conclude that respiratory morbidity in the third year of life following premature delivery has a multifactorial aetiology.
Standardizing the assessment of diarrhea in clinical trials: results of an interobserver agreement study
Authors: Allen Upton D , Deadman Lyn , EL Wang Elaine
Published: January 2008

Interobserver agreement was determined between nurses and parents using a standard method of assessing diarrheal stools. The study population consisted of patients less than three years of age hospitalized at The Hospital for Sick Children, Toronto, Canada. Stool samples were independently categorized by observer pairs within minutes of being obtained from children with and without diarrhea as: watery—liquid, no solid elements; loose—liquid with solid elements; pasty—like a paste; formed—normal solid. Watery and loose stools were regarded as abnormal and indicative of diarrhea. Teaching sessions were conducted for nursing shifts, while parents were instructed prior to each observation. In the nurses' agreement study, each stool specimen was examined by the nurse providing care to the patient from whom the stool was obtained and a nurse not looking after the patient. Parents' assessments were also compared with nurses' assessments. Finally, parents' assessments were compared with each other. In the first group, agreement beyond chance for presence or absence of diarrhea measured by kappa was 0.78 (95% confidence intervals (CI) 0.55–1.0). The observed agreement on 148 pairs of observations between parents and nurses was 75% (kappa = 0.5; 95% CI 0.36–0.64). Between‐parent agreement on 30 other paired observations was 77% (kappa = 0.54; 95% CI 0.24–0.84). Teaching parents about the four categories is a potentially useful adjunct for assessment of diarrheal stools in children.
Influence of MPR revaccination on tuberculin and sensitin skin reactions in children
Authors: Kröger Liisa
Published: January 2008

ABSTRACT. Many viral diseases, as well as viral vaccines, have a transient effect in depressing cell‐mediated immunity. The study group consisted of 52 children, aged 6.0–6.3 years. Thirty (57%) of them had been revaccinated against measles, parotitis and rubella (MPR vaccination). In MPR‐revaceinated children, the mean skin reaction sizes were 4.7 mm, 4.1 mm, 4.3 mm and 2.1 mm to tuberculin, Mycobacterium avium, M. scrofulaceum and M. fortuitum sensitins, respectively. In non‐revaceinated children (n= 22), the respective mean skin reaction sizes were 3.0 mm, 2.8 mm, 2.9 mm and 0.8 mm. The difference between re‐ and non‐revaccinated children was statistically significant with regard to reactions to M. fortuitum sensitin (p<0.05). These results suggest that the influence of viral revaccination is different from natural infection or primary vaccination. The mechanism of stimulation of cell‐mediated immunity—ither specific or non‐specific—is unknown.
MRI changes and deficits of higher brain functions in preterm diplegia
Authors: Goto M , Ota R , Iai M , Sugita K , Tanabe Y
Published: January 2008

Goto M, Ota R, Iai M, Sugita K, Tanabe Y. MRI changes and deficits of higher brain functions in preterm diplegia. Acta Pædiatr 1994;83:506–11. Stockholm. ISSN 0803–5253

Forty‐one preterm children (29 with spastic diplegia and 12 without motor deficits) who had a normal verbal IQ were studied to clarify the clinical significance of neuroanatomical abnormalities disclosed by TI‐weighted and T2–weighted magnetic resonance imaging (MRI). Both types of images clearly showed abnormalities in the frontal corona radiata of the children with spastic diplegia, while there were no abnormalities in the children without motor deficits. We compared the T1–weighted imaging findings with deficits of higher brain functions, evaluated by the performance subtests of the Wechsler Intelligence Scale. Thinning of the parietal and/or occipital white matter was noted in children with visuospatial cognitive deficits. Thus, MRI may be helpful in confirming early clinical suspicions of visuospatial cognitive deficits as well as motor deficits in preterm children, especially those with spastic diplegia.
Clinical picture of nephropathia epidemica in children
Authors: Mustonen J , Huttunen N‐P , Brummer‐Korvenkontio M , Vaheri A
Published: January 2008

Mustonen J, Huttunen N‐P, Brummer‐Korvenkontio M, Vaheri A. Clinical picture of nephropathia epidernica in children. Acta Paediatr 1994;83:526–9. Stockholm. ISSN 0803–5253

The clinical picture of nephropathia epidernica (NE) among children is poorly understood. We made a retrospective analysis of 32 patients aged 4–15 years treated in hospital for serologically verified recent NE. The most common clinical findings were high fever (100%), nausea (81%), vomiting (72%), tenderness in the kidney area (63%), abdominal pains (59%) and headache (59%). A peculiar symptom of NE, transient visual abnormalities, was found in 25% of patients. Four children had clinical bleeding and 1 had encephalitis. 44% were transiently hypertensive. Renal function was impaired in 84%, proteinuria was present in 97%, hematuria in 73% and leukocyturia in 44%). Other common laboratory findings were thrombocytopenia (87%), lcukocytosis (41%), elevated ERS (74%, up to 76 mm/h) and CRP level (89% up to 97 mg/l), elevated liver enzymes (53%) and hypoalbuminemia (50%). No child needed dialysis therapy and all recovered. NE seems to be less severe in children than in adults.
Early neonatal sudden death or near death syndrome. An epidemiological study of 29 cases
Authors: Rodríguez‐Alarcón Justino , Melchor Juan Carlos , Linares Alberto , Aranguren Gabriel , Quintanilla Maribel , Fernández‐Llebrez Luis , de la Grindara Antonio , Rodríguez‐Soriano Juan
Published: January 2008

Early neonatal sudden death syndrome (SIDS) is a rare but well known disease entity. Between January 1975 and December 1991, 29 full‐term newborn infants delivered in our maternity unit and, considered healthy at birth, suffered early SIDS (n= 15) or early apparent life threatening events (ALTE) (n= 14). Data from the whole population of live full‐term infants born in our hospital during the past five years have been used as a reference (n = 27 841). The general rate of early SIDS was 0.14 per 1000 (15/107 263). Combining early ALTE cases, the overall rate was 0.27 per 1000 (291107263). A postmortem examination was performed for all infants who died (20/29): no cause of death could be determined, and we did not observe a single case with evident sequelae. There were 9 deaths (31 %) within the first hour after delivery and 12 deaths occurred in the early morning hours (04:00–08:00; RR = 3.76; p= 0.0008). The lowest incidence was in the spring (RR = 0.21; p= 0.03). There was a tendency for an increased incidence during the weekend and the summer. No influence of sex, maternal age, gestational age, infant weight presentation, delivery, anesthesia or presence of meconium‐stained fluid was found. In our opinion, SIDS can take place even during the first hour of life and it is not possible to predict when a baby might be affected. Pediatrically trained caregivers, close observation by the mother during the first few days and resuscitation facilities in maternity wards may be the most important preventive measures to reduce the risk of early SIDS and the consequences of ALTE in the early newborn period.
Breast feeding and acute lower respiratory infection
Authors: Pisacane Alfredo , Graziano Liberatore , Zona Gregorio , Granata Giorgio , Dolezalova Hana , Cafiero Maurizio , Coppola Angelo , Scarpellino Benedetto , Ummarino Massimo , Mazzarella Gianfranco
Published: January 2008

The association between breast feeding and acute lower respiratory infection (ALRI) was studied in a case‐control study in southern Italy. Two groups of children were studied: the first group comprised 73 infants, aged 0–6 months, whose diagnosis was pneumonia or bronchiolitis; the second group included 88 infants less than 12 months of age with a diagnosis of pertussis‐like illness. Control infants were two groups of infants admitted to the same ward. Compared with controls, infants in the first group were less likely to have been breast fed (odds ratio 0.42, 95% CI 0.19–0.90). The protection conferred by breast feeding was stronger among infants who were receiving human milk at the time of admission (odds ratio 0.22, 95% CI 0.09–0.55) and was absent among those infants who had stopped breast feeding for two or more weeks before admission. Among infants who were severely ill, breast feeding was less likely than among those with milder illnesses. There was evidence in the stratified analysis of effect modification by the presence of other children in the family. Among the infants with pertussis‐like illness, the incidence and duration of breast feeding were not different compared with controls. The results suggest that breast feeding has a strong protective effect against ALRI in industrialized countries also. No protection seems to be conferred by human milk against pertussis‐like illness.
Can renal handling of phosphate predict response to growth hormone therapy in normal variant short children by short‐term treatment?
Authors: Tomoeda Shinichi , Nishiyama Soroku , Nakamura Toshiro , Matsuda Ichiro
Published: January 2008

We investigated if renal handling of phosphate could predict height velocity in 28 normal variant short children (16 boys and 12 girls). Before and after human growth hormone was given for four consecutive days, the ratio of maximum tubular reabsorption rate for phosphorus to glomerular filtration rate (TmP/GFR) was calculated. Based on increments in TmP/GFR (4TmP/GFR) with growth hormone administration, the patients were divided into two groups; children in whom the levels of ΔTmPiGFR were 0.8 mg/dl GF or more (group A, n= 7) and those with levels less than 0.8 mg/dl GF (group B, n= 21). All children in group A and some in group B (n= 9) were injected with 0.5 IU/kg/week of recombinant human growth hormone for over one year. Height velocity during therapy was significantly greater in treated children in group A than in group B and was similar among treated (n = 9) and untreated (n= 12) children in group B. The present study suggests that change in renal handling of phosphate during short‐term growth hormone administration can serve to select normal variant short children who will respond well to growth hormone therapy.
Hypothyroidism secondary to topical iodine treatment in infants with spina bifida
Authors: Barakat M , Carson D , Hetherton AM , Smyth P , Leslie H
Published: January 2008

Four infants with spina bifida, who had not undergone surgical closure of a lumbar myelomeningocele, were assessed and investigated for hypothyroidism. From birth, all were treated once daily with an iodine‐containing ointment (Betadine) as a local antiseptic applied to the spina defect. All infants showed excess urinary iodine concentration. Two infants, without clinical evidence of hypothyroidism or goitre, showed low serum free thyroxine and high thyroid stimulating hormone concentrations at a mean age of four weeks and were started on thyroxine replacement treatment. Betadine ointment and thyroxine were stopped simultaneously at a mean age of nine months, following which all infants remained euthyroid. Thyroid function tests should be monitored routinely if iodine is applied as a topical antiseptic to infants.
Partial complement deficiencies in idiopathic thrombocytopenia of childhood
Authors: Nielsen HE , Truedsson L , Donner M
Published: January 2008

We have examined the classical complement activation pathway in 36 children with idiopathic thrombocytopenia (ITP) in a retrospective study. An increased prevalence of congenital, partial complement deficiencies is found in ITP. Homozygous C4A deficiency was found in 5 patients (p < 0.05) and heterozygous C2 deficiency in 2 other patients (p= 0.05). We suggest that some cases of childhood ITP belong to the immune complex mediated diseases, such as systemic lupus erythematosus and that abnormal immune complex formation and clearance may lead to ITP.
Congenital varicella syndrome: studies of the virus‐specific humoral and cell‐mediated immune responses
Authors: Schuster Volker , Hofmann Gerhard , Pannenbecker Jürgen , Kreth Hans Wolfgang
Published: January 2008

We describe a three‐year‐old boy with congenital varicella syndrome. Persistent IgG antibodies to varicella‐zoster virus (VZV) were detected in the child's sera for a period of more than three years. Immunological studies performed at three months and at three years of age showed a VZV‐specific cellular immune response. The results suggest that intrauterine VZV infections in early pregnancy can induce adequate humoral and cellular immune reactions in the infected foetus.