bluuebunny/crossref_metadata_2025 huggingface dataset:
Congenital Renal Tubular Dysfunction Associated with Maternal Sniffing of Organic Solvents
Authors: LINDEMANN R.
Published: January 2008

ABSTRACT. Two cases of neonatal renal tubular dysfunction and metabolic acidosis due to maternal sniffing of a product containing toluene are reported. Both mothers had been sniffing regularly throughout their pregnancies. The infants were dysmature and had some dysmorphic features. They had hyperchloraemic acidosis and exhibited amino‐aciduria. The metabolic changes were however transient. It is suggested that the sniffing of tohene containing solvents daring pregnancy may change membrane permeability in both the proximal as well as distal renal tubules and may also enhance liver enzyme activity in the foetus.
Control of Vitamin A Deficiency and Blindness
Authors: REDDY VINODINI
Published: January 2008

Vitamin A deficiency and its obvious consequences, xerophthalmia and blindness, are endemic in large parts of Asia and Africa. The prevalence of this deficiency is particularly high in countries of South‐East Asia like India, Bangladesh, Nepal, Indonesia and Philippines. In African countries, most cases of childhood blindness are attributed to measles. It is most likely, however, that measles precipitates severe xerophthalmia in children whose vitamin A status is marginal.
Salt and Fluid Homeostasis in Protein Energy Malnutrition
Authors: ZETTERSTRÖM ROLF
Published: January 2008

Protein energy malnutrition (PEM) during early childhood is very often associated with edema. In fact, the well‐known Wellcome classification of PEM from 1970 is based upon the reduction in weight in relation to age and whether edema is present or absent. In this presentation our knowledge of the disturbance in fluid and electrolyte homeostasis as seen in PEM will be reviewed. The implication of this disturbance for the treatment of acute dehydration in children with PEM will also be discussed.

A balanced fluid and salt homeostasis is the prerequisite of physiological compartment volumes and efficient nutritional supply. Under physiological conditions water requirement is related to the requirement of salt at the same time as water balance is regulated by antidiuretic hormone.
The Nature of Nutritional Deficiency in Relation to Growth Failure and Poverty
Authors: GOLDEN MICHAEL H. N.
Published: January 2008

A new classification of essential nutrients is proposed based on whether the major response to a deficiency is either (a) specific defects which lead to loss of particular functions and characteristic clinical signs and symptoms or (b) a primary cessation of growth. Diagnosis of deficiency of the nutrients which give rise to growth failure (nitrogen, essential amino acids, potassium, sodium, phosphorus, sulphur, zinc, magnesium) is particularly difficult because of the nature of the response and the lack of a body store. The implications of the differences in the types of deficiency are explored in relation to assessment of the likelihood that widespread deficiency exists. Poverty is particularly likely to be associated with unrecognised deficiency of these “growth” nutrients because of the monotony of the diet. This will lead to slow growth. There is probably a difference in the nutrient requirements for longitudinal and ponderal growth. Of the growth nutrients sulphur is likely to be required in much higher amounts for skeletal growth than soft tissue growth.
Immunocompetence Is a Sensitive and Functional Barometer of Nutritional Status
Authors: CHANDRA RANJIT KUMAR
Published: January 2008

Nutrition is a critical determinant of immunocompetence and risk of illness. Young children with protein‐energy malnutrition exhibit increased mortality and morbidity, due largely to infectious disease. Recent work has demonstrated that undernourished individuals have impaired immune responses. The most consistent abnormalities are seen in cell‐mediated immunity, complement system, phagocytes, mucosal secretory antibody response, and antibody affinity. Many of these immunologic changes occur early in the course of nutritional depletion and therefore can serve as sensitive functional indices of nutritional status.
Liver Pathology in the Carbohydrate‐deficient Glycoprotein Syndrome
Authors: CONRADI NILS , VOS RITA DE , JAEKEN JAAK , LUNDIN PER , KRISTIANSSON BENGT , HOOF FRANCOIS VAN
Published: January 2008

Liver biopsies were examined in seven Swedish and four Belgian children with the recently described carbohydrate‐deficient glycoprotein (CDG) syndrome. Light microscopical findings included fibrosis, which was generally slight to moderate and without obvious cirrhotic remodelling of the parenchyma, and intracellular lipid vacuoles and glycogen. The most characteristic electron microscopical finding was lysosomal vacuoles with concentric electron‐dense membranes and variable electron‐lucent and electron‐dense material. In a minority of the parenchymal cells, the smooth endoplasmic reticulum showed an abundance of small rounded elements. A comparison of findings in children of different ages and the examination of a second biopsy in 5 children indicated that there was no progression of the liver lesions.
Postmortem Findings in Two Patients with the Carbohydrate‐deficient Glycoprotein Syndrome
Authors: STRØMME P. , MAEHLEN J. , STRØM E. H. , TORVIK A.
Published: January 2008

The postmortem findings in a pair of twins with the carbohydrate‐deficient glycoprotein syndrome are reported. Rapidly progressive olivopontocerebellar atrophy associated with retinopathy, were the most significant findings within the central nervous system. Additional observations were cerebral infarction, evidence of immune deficiency, steatosis and cirrhosis of the liver, pericarditis, renal cysts and fibrosis of the testes.
Neuroendocrine Alterations in the Somatotropic Axis in Chronic Renal Failure
Authors: VELDHUIS J.D. , JOHNSON M.L. , WILKOWSKI M.J. , IRANMANESH A. , BOLTON W.K.
Published: January 2008

Both secretion and metabolic clearance of GH in health and disease are subject to regulation by an array of metabolic, nutritional, physical activity, age, and body composition cues. Moreover, both GH and its mediators (e.g. IGF‐I) are bound in plasma by one or more high‐affinity binding proteins. Accordingly, carefully designed clinical and basic investigations are required to examine and clarify the diverse alterations in the dynamics of the somatotrophic axis that accompany the syndrome of CRF with its attendant attenuation of normal anabolism, growth and development.
Effects of Two Years of Growth Hormone Treatment in Short Children with Renal Disease
Authors: TÖNSHOFF B. , DIETZ M. , HAFFNER D. , TÖNSHOFF C. , STÖVER B. , MEHLS O. , Ruder H.
Published: January 2008

The effect of 1‐2 years of growth hormone (GH) treatment (28‐30 IU/m2/week) on growth rate, bone age, renal function and metabolic parameters was studied in 61 short, slowly growing children with chronic renal disease (20 with preterminal chronic renal failure (CRF), 24 with end‐stage renal failure (ESRF) and 17 with functioning renal transplants). Height velocity (2‐year data) significantly increased in children with preterminal CRF from a baseline median of 4.1 cm/year to 9.2 cm/year after 1 year and to 6.6 cm/year after 2 years of treatment. In patients with transplants, the corresponding values were 2.6 cm/year before GH treatment and 8.6 and 7.2 cm/year after 1 and 2 years, respectively. This resulted in normalization of height in 8 of the 16 children who completed 2 years of treatment. The growth response after 1 year in children with preterminal CRF was significantly higher than that in children with ESRF. Bone maturation was in proportion to the increase in chronological age; the expected final height of the children therefore increased by approximately 8‐10 cm. In children with preterminal CRF, the decrease in glomerular filtration rate was not affected by 2 years of treatment with GH. The incidence of acute rejection in children with transplants was low; however, a slight stimulatory effect of GH could not be excluded. The major metabolic change induced by exogenous GH was an increase in serum levels of insulin in the three treatment groups, though all glucose tolerance tests remained stable over the 2‐year period.
Growth Hormone Treatment and Diabetes: Survey of the Kabi Pharmacia International Growth Study
Authors: CZERNICHOW P. , ALBERTSSON‐WIKLAND K. , TUVEMO T. , GUNNARSSON R.
Published: January 2008

Out of a total of 8136 children registered in the Kabi Pharmacia International Growth Study, 12 have been reported to have diabetes either before or during treatment with growth hormone (GH). Two of these have non‐insulin‐dependent diabetes mellitus (NIDDM), of whom one had risk factors for the development of his condition, namely gross obesity and familial occurrence of NIDDM. One is a rare case of McCune‐Albright's syndrome with insulin‐dependent diabetes mellitus (IDDM), and 9 other patients have IDDM. Of these 9, 6 have idiopathic GH deficiency. In 8 of the 9 patients with IDDM, the condition was diagnosed before GH therapy was commenced, at ages ranging from less than 2 years to 16 years. The association is probably fortuitous, however, as the onset of IDDM in 7 patients was immediately before or during puberty, as often occurs in IDDM in general.
Growth Response in Prepubertal Children with Idiopathic Growth Hormone Deficiency During the First Two Years of Treatment with Human Growth Hormone. Analysis of the Kabi Pharmacia International Growth Study
Authors: RANKE M.B. , GUILBAUD O.
Published: January 2008

From the large database of patients enrolled in the Kabi Pharmacia International Growth Study (KIGS), 289 prepubertal patients with idiopathic growth hormone deficiency (GHD), treated for 2 years with growth hormone (GH) substitution therapy, were selected. A multiple regression analysis was performed to determine both the auxological factors characterizing the patients at the beginning of the first and second years on GH therapy and the respective treatment modalities relevant to the magnitude of the growth response. It was observed that during the first year on GH therapy the magnitude of the growth response was negatively correlated with chronological age and height SDS, and positively correlated with target height SDS, GH dose (IU/kg/week) and frequency of GH injections. During the second year the growth response was negatively correlated with chronological age and the first‐year GH dose (IU/kg/week), and positively correlated with height velocity during the first year, GH dose (second year), and injection frequency (second year). The data suggest that the forces of‘catch‐up’‐ auxologically entrenched within the distance between target height SDS and height SDS ‐ no longer prevail during the second year of GH therapy. The inverse influence of the first‐year GH dose in the two yearly phases of growth suggests that optimizing GH treatment must be attempted by analysing growth in response to GH over longer periods of time and considering that the growth process is influenced by interactive factors.
Familial history of cardiovascular disease and blood lipid pattern in newborn infants
Authors: Bellù R , Ortisi MT , Agostoni C , Incerti P , Besana R , Riva E , Giovannini M
Published: January 2008

The levels of atherogenic lipid fractions are higher in children with a family history of ischemic cardiovascular disease (CD). This study was designed to examine this relationship in neonates. A total of 1276 newborns were investigated; 400 cord blood samples were collected for measurement of triglycerides (TG), total cholesterol (TC), LDL cholesterol (LDL‐C) and HDL cholesterol (HDL‐C); on day 4, 1200 capillary samples were taken for TC and TG measurements. Male newborns with a positive history of CD had higher concentrations of cord blood TC (P < 0.04) and LDL‐C (P < 0.02). On day 4 this difference in TC was no longer detectable (LDL‐C not determined). A coronary heart disease (CHD) risk factor family history is sensitive (0.87) in predicting high cord blood concentrations of LDL‐C, the specificity being 0.46 and the positive predicting value 0.08.
Visual acuity and visual field development after cryocoagulation in infants with retinopathy of prematurity
Authors: Fetter WPF , van Hof‐van Duin J , Baerts W , Heersema DJ , de Blécourt‐Devilée M Wildervanck
Published: January 2008

Visual development was studied in 10 very‐low‐birth‐weight infants (less than 1500 g) with retinopathy of prematurity (ROP) stage 3 + who had been treated with cryocoagulation in both eyes. Binocular visual acuity (acuity cards method) and binocular visual fields (kinetic perimetry) were assessed repeatedly in the first year of life. At 12 months corrected age, visual acuity was normal in seven and impaired in three infants, who appeared to be severely myopic. Normal visual fields were found in eight infants at this age. The results indicate that cryotherapy in cases of ROP stage 3 + does not interfere with visual acuity development. The effect on visual field development needs further investigation.
Elevated short chain fatty acid concentrations in anaerobic small bowel contamination
Authors: Lloyd DR , Brown JD , Brown GA , Booth IW
Published: January 2008

Viable bacteria were identified and counted, and short chain fatty acid concentrations measured in small intestinal fluid from 74 fasting children. In nine children with anaerobic small bowel contamination, individual and total short chain fatty acid concentrations were significantly higher than the remainder of the group (p < 0.01). Using 100 μmol/I as the upper reference limit for total short chain fatty acid concentration, the sensitivity and specificity as a test for anaerobic small bowel contamination was 89% and 98%, respectively. Measuring luminal short chain fatty acid concentrations in proximal small intestinal fluid is an accurate method for detecting anaerobic small bowel contamination in children.
Dyskinetic and dystonic cerebral palsy and birth
Authors: Foley John
Published: January 2008

Two hundred and nineteen cases of the dyskinetic and dystonic forms of cerebral palsy which were seen in the course of three decades at a single clinic have been analysed. Fifty‐seven patients had kernicterus. In the remaining 162, 71% of whom were born at term, birthweight was below the expected mean in two‐thirds. There was no relationship between birth weight, or abnormal birth, or asphyxia, and the ultimate clinical severity of the children. We conclude that abnormal birth and asphyxia are not direct causes of the cerebral damage, but are expressions of a pre‐existing condition resulting in susceptibility to the stress of birth, whether it is normal or abnormal.
Longitudinal anthropometric study in children with acute lymphoblastic leukaemia
Authors: Tamminga RYJ , Kamps WA , Drayer NM , Humphrey GB
Published: January 2008

In four groups of patients with acute lymphoblastic leukaemia, anthropometric variables were investigated every 3 months for 2 years. Group 1 (n= 7) was treated with a high‐risk protocol, group 2 (n= 13) with a standard‐risk protocol including cranial irradiation, group 3 (n= 13) with a standard‐risk protocol without cranial irradiation and group 4 (n= 8) was followed after completion of treatment. A height retardation of 0.4–0.6 SD was observed during therapy in groups 1–3. A catch‐up of 0.5 SD was found in group 4. The retardation of armspan was significantly larger than the retardation of sitting height when groups 1–3 were taken together. Head circumference was not affected. The anthropometric variables reflecting nutritional status showed a growth above normal during and after treatment. Corticosteroid medication and not cranial irradiation is the most likely explanation for our findings.
Carnitine deficiency: a possible cause of gastrointestinal dysmotility
Authors: Weaver LT , Rosenthal SR , Gladstone W , Winter HS
Published: January 2008

An infant with delayed development and peripheral myopathy, nourished on a soy‐based liquid diet deficient in carnitine, had gastrointestinal dysmotility manifested by postprandial vomiting, oral drooling, delayed gastric emptying and infrequent bowel movements. Oesophageal manometry showed a reduced lower oesophageal sphincter pressure for age with abnormal distal motility. Serum carnitine concentration was 9.9 μmol I‐1. After dietary supplementation of carnitine the gastrointestinal symptoms resolved, oesophageal manometry returned to normal, and serum carnitine increased to 37.2 μmol I‐1. Dietary carnitine deficiency in infancy may be a cause of smooth muscle dysmotility of the gastrointestinal tract.
Meningitis and midline facial deformity
Authors: Wilson DC , Cunningham MJ , Reid MMcC , Johnston SS , Fannin TF
Published: January 2008

A baby with unilateral cleft lip, midline cleft palate and hypertelorism developed meningitis in the first 48 h of life. Examination of the nasopharynx showed a soft tissue mass, which was confirmed as a basal encephalocele by computed tomography. There was also congenital hydrocephalus and the corpus callosum was absent. Surgical treatment included repair of the anterior basal skull defect, repair of the lip and palate, and ventriculo‐peritoneal shunt. There is currently evidence of developmental delay and right‐sided visual impairment due to Morning Glory syndrome. This case demonstrates that basal encephalocele should be considered in any baby with midline facial deformity who develops meningitis.
The effect of early and late cord‐clamping on blood viscosity and other hemorheological parameters in full‐term neonates
Authors: Linderkamp Otwin , Nelle Mathias , Kraus Martina , Zilow Eugen P
Published: January 2008

This study was done to compare postnatal alterations in blood viscosity (capillary viscometer) and its determinants: hematocrit, plasma viscosity (capillary viscometer), red cell aggregation (Myrenne aggregometer) and red cell deformability (rheoscope) in the first five days of postnatal life in full‐term neonates with early (< 10 s) and late (3 min) cord‐clamping. The fetal blood volume of the placenta (“residual placental blood volume”) decreased from 52±8 ml/kg of neonatal body weight after early cord‐clamping to 15±4 ml/kg after later cord‐clamping. Neonatal blood volume, calculated as the difference between an assumed total feto‐placental blood volume of 115 ml/kg and the measured fetal blood volume of the placenta, was 50% higher in the late cord‐clamped infants than in the early cord‐clamped infants. Both groups showed similar viscosity, hematocrit and other rheological parameters in cord blood. In the infants with early cord‐clamping, the hematocrit decreased from 0.48±0.04 1/1 at birth to 0.43±0.61/1 after 24 h (p < 0.05). Whole blood viscosity did not change significantly with age. After late cord‐clamping, the hematocrit rose from 0.50±0.04% at birth to 0.63±0.051/1 at 2 h of age (p < 0.005) and dropped to 0.59±0.51/1 (p < 0.05) at 24 h. Blood viscosity increased by 40% (p < 0.001) within the first 2 h, but did not change significantly during the following five days. In both groups, plasma viscosity and red cell aggregation increased significantly (p < 0.05) on day 5 due to significant increases in total plasma protein and fibrinogen concentrations (p < 0.01). Red cell deformation was not affected by the mode of cord‐clamping and did not change with age. We conclude that late cord‐clamping results in marked rise in blood viscosity due to increasing hematocrit. The postnatal rise in plasma viscosity and red cell aggregation may keep the blood viscosity at a high level despite falling hematocrit.
Neurodevelopmental outcome in very‐low‐birth‐weight infants with or without periventricular haemorrhage and/or leucomalacia
Authors: Fazzi E , Lanzi G , Gerardo A , Ometto A , Orcesi S , Rondini G
Published: January 2008

The aim of the study was to verify the predictive value of ultrasound performed in the neonatal period for short‐term neurodevelopmentafprognosis in 122 preterm very‐low‐birth‐weight infants followed‐up at 36 months. Neuromotor development was favourable in 53 (87%) subjects with normal ultrasound findings and in 21 (81%) subjects presenting uncomplicated haemorrhage. However, sensory and/or cognitive sequelae developed in 13% and 19% of the two groups, respectively. Outcome was unfavourable in 14 (50%) of 28 patients with ultrasound findings of complicated cerebral haemorrhages and in 5 (71%) of those (7) with ultrasound findings of parenchymal lesions without haemorrhage. Neonatal ultrasound examination seems to be fundamental in predicting neuromotor, but not cognitive, outcome in very‐low‐birth‐weight infants.
Comparison between tape‐recorded and amplitude‐integrated EEG monitoring in sick newborn infants
Authors: Hellström‐Westas L
Published: January 2008

In 15 ill newborn infants a comparison between long‐term multichannel and single‐channel recordings of simultaneously tape‐recorded (Medilog system) and amplitude‐integrated EEG (Cerebral Function Monitor) was made. There was good agreement between the main type of background activity diagnosed with the tape‐recorded and the amplitude‐integrated EEG for all recordings. Two infants had repetitive subclinical and subtle seizure activity, lasting for several hours, which was detected by both techniques. Short, single seizures were diagnosed in the recordings of nine infants. When a single electrographic seizure appeared in an otherwise stable recording, it was identified by both the tape‐recorded and the amplitude‐integrated EEG. Very short (5‐30 s) seizure patterns, which were diagnosed with the tape‐recorded EEG, were not identified in the cerebral function monitor recordings. In the single‐channel recordings of both the EEG and the cerebral function monitor there were, on some occasions, difficulties in distinguishing single seizures from interference due to external artefacts. In the multichannel recordings the diagnosis of seizure patterns was facilitated by comparison with the other channels. Both the Medilog EEG and the cerebral function monitor are feasible techniques for following cerebral electrical activity in sick neonates, although neither technique is specifically constructed for this purpose. For clinical use in the neonatal intensive care unit the advantage with the cerebral function monitor is the immediately available recording. The tape‐recorded EEG offers possibilities of more channels and a higher reliability when diagnosing short subclinical seizures, however, only after offline analysis.
Growth and motor performance in preterm children at 8 years of age
Authors: Forslund M
Published: January 2008

At 8 years of age 41 preterm and 24 term children were followed up in a long‐term prospective study of 46 unselected infants born before 35 completed weeks of gestation and of 26 term infants. The two groups were comparable in physical growth and there was no significant difference between them in motor performance, as evaluated with the Test of Motor Impairment. Only minor motor problems were found (in 22% of the preterm and 17% of the term group). In the preterm group, motor impairment was correlated to birthweight. The preterm children had less developed postural control and manifested more compensatory movements during the balance tasks than the term children.
A case of familial nesidioblastosis: prenatal diagnosis of foetal hyperinsulinism
Authors: Bianchi Cesare , Corbella Enzo , Beccaria Luciano , Bolla Patrizia , Chiumello Giuseppe
Published: January 2008

Persistent neonatal hyperinsulinaemic hypoglycaemia due to nesidioblastosis is a rare condition probably transmitted by an autosomal recessive inheritance. Recurrent hypoglycaemic episodes become evident after birth and cause severe neurological damage without intensive treatment. The intrauterine detection of hypoglycaemia and hyperinsulinism in newborns subsequently diagnosed as affected by nesidioblastosis has not yet been reported. We describe a case of familial nesidioblastosis in which an intrauterine diagnosis could be suggested by high levels of insulin and C‐peptide and low values of glucose in the amniotic fluid.
Neonatal Salmonella panama infection with meningitis
Authors: Kostiala AAI , Westerstråhle M , Muttilainen M
Published: January 2008

Three full‐term neonates contracted a hospital infection with Salmonella panama derived from the mother of one. Two had bacteraemia and meningitis; one developed a brain abscess and the other recurrent meningitis at two months. The third neonate had gastroenteritis only. Six months later they had developed normally and two were still excreting salmonellae in the stools.
Effect of post‐delivery care on neonatal body temperature
Authors: Johanson RB , Spencer SA , Rolfe P , Jones P , Malla DS
Published: January 2008

A prospective observational study of post‐delivery care and neonatal body temperature, carried out at Kathmandu Maternity Hospital, was followed by a randomized controlled intervention study using three simple methods for maintaining body temperature. There were 500 infants in the initial observation study and 300 in the intervention study. In the observation study, 85% (420/495) of infants had temperatures < 36°C at 2 h and nearly 50% (198/405) had temperatures < 36°C at 24 h (14% were < 35°C). Most of the infants who were cold at 24 h had initially become cold at the time of delivery (only seven infants had been both well dried and wrapped). In the intervention study, all infants were dried and wrapped before random assignment to one of the three methods: the “kangaroo” method, the traditional “oil massage” or a “plastic swaddler”. All three were found to be equally effective. Overall, 38% (114/298) of the infants had temperatures < 36°C at 2 h and 18% (41/231) at 24 h (when none was < 35°C).
Giardiasis causing chronic diarrhoea in suburban Copenhagen: incidence, physical growth, clinical symptoms and small intestinal abnormality
Authors: Hjelt Karsten , Pærregaard Anders , Krasilnikoff Peter A
Published: January 2008

During a six‐year period, 29 children (aged 0.7–13.5 years, mean 3.3 years) suffering from chronic diarrhoea due to giardiasis were studied. The incidence of this illness was 81 per 1 000 000 children aged 0– < 7 years per year. According to growth charts, relative height and weight of the patients decreased significantly (approximately 0.5 SD) from before the onset of diarrhoea to the time of diagnosis and subsequently increased up to the end of catch‐up growth. Small intestinal mucosal specimens were studied. Two patients had severe villous atrophy, 8 moderate abnormalities, 6 only light changes and 13 biopsies were normal. D‐xylose or lactose malabsorption was detected in 25% of the patients. The lactose malabsorption was due to hereditary low lactase levels. None of the patients with a Danish ethnic background showed lactose malabsorption. D‐xylose absorption and the relative weight loss of the patients correlated with the degree of mucosal damage. Patients with persistent diarrhoea (n= 19) were younger and had a shorter duration of diarrhoeal illness and a more significant weight reduction than those with intermittent diarrhoea (n= 10). However, the age at onset of symptoms was similar in the two groups (medians 1.3 years). Seven patients contracted the disease abroad. They all developed persistent diarrhoea and had a more severe course of the illness than those who acquired the disease in Denmark.
Skin test reactivity to atypical mycobacteria among healthy Finnish preschool children vaccinated with BCG vaccine at birth
Authors: Kröger L , Katila ML , Korppi M. , Pietikäinen M
Published: January 2008

Skin test reactivity to three mycobacterial sensitins (M. avium, M. fortuitum and M. scrofulaceum) was studied in 353 healthy children vaccinated with the BCG vaccine at birth. A significant waning of reactivity to all of the three sensitins was found to occur with increasing age. Revaccination against measles, parotitis and rubella had been given to 31 (9%) of the children, all aged > 5.5 years. They had significantly larger reactions sizes, which was contrary to what was expected. Children with atopic dermatitis (n=19) had significantly smaller reaction sizes to the M. fortuiturn sensitin. Neither respiratory viral infections during the preceding six months nor contact with pets or farm animals had any influence on reaction sizes. The variation of sensitin reactions was large in preschool children vaccinated with the BCG vaccine at birth. The diagnostic value of sensitin reactions in preschool children needs to be elaborated in clinical studies in children with clinically demonstrable mycobacteriosis.
Proliferative responses of CD4+ T‐cell population to ovalbumin in patients with atopic dermatitis who are sensitive to hen eggs
Authors: Shinoda Shinji , Rondo Naomi , Fukutomi Osamu , Agata Hiroatsu , Orii Tadao
Published: January 2008

Proliferative responses of peripheral blood mononuclear cells and T cells with monocytes to ovalbumin were significantly higher than those of B cells with monocytes to ovalbumin in patients with atopic dermatitis (AD) who were sensitive to hen eggs. The CD4+ T‐cell/CD8+ T‐cell ratios (the values obtained by dividing the maximum stimulation index of CD4+ T cells with monocytes to ovalbumin by the maximum stimulation index of CD8 + T cells with monocytes to ovalbumin) were significantly higher in AD patients sensitive to hen eggs than in non‐atopic healthy controls. The proliferative responses of CD4+ T cells with monocytes to ovalbumin were more intensive than those of CD8+ T cells with monocytes in patients with AD sensitive to hen eggs compared with non‐atopic healthy controls. These results suggest that the cells responding to ovalbumin are predominantly CD4+ T cells. However, there was no relationship between the stimulation index of proliferative responses of peripheral blood mononuclear cells to ovalbumin and RAST scores for hen eggs. Thus it is possible that the majority of the CD4+ T cells which respond to ovalbumin are not CD4+ helper T cells for IgE production.
Urinary glycylprolyl dipeptidyl aminopeptidase (GP‐DAP) in insulin‐dependent diabetic patients
Authors: Nukada O , Kobayashi M , Moriwake T , Kanzaki S , Himei H , Yoda T , Seino Y
Published: January 2008

Urinary glycylprolyl dipeptidyl aminopeptidase (GP‐DAP) concentrations were determined in 36 insulin‐dependent diabetic children aged 4–18 years with a duration of diabetes ranging from 1 month to 14 years. Abnormal urinary GP‐DAP concentrations were found in 19 of the 36 patients. Twelve of 27 patients without microalbuminuria also had increased urinary concentrations of GP‐DAP. There was a significant correlation between urinary GP‐DAP and plasma fructosamine (r= 0.52, p < 0.001). Our data suggest that urinary GP‐DAP may be used as a marker for diabetic nephropathy. However, there is also a possibility that increased urinary GP‐DAP concentrations are functionally related to poor metabolic control. Longitudinal studies are needed to establish the clinical usefulness of urinary GP‐DAP.
Implantable central venous catheter facilitates prophylactic treatment in children with haemophilia
Authors: Ljung R , Petrini P , Lindgren A‐K. , Berntorp E
Published: January 2008

Twelve children with a severe form of haemophilia A received a totally implantable venous access system (Port‐A‐Cath) to facilitate regular prophylactic treatment with factor VIII. The indication for implantation was difficulty in obtaining regular access to a peripheral vein. Postoperative bleeding around the portal site occurred in two of 12 cases. After a median duration of follow‐up of 26 months (range 5–79 months), none of the systems had needed replacement due to bleeding, septicaemia or thrombosis. One child, with an inhibitor against factor VIII, had an infection at the portal site and this system was removed. None of the other children had any serious side effects. Nine of the 12 children's parents learned how to use the Port‐A‐Cath system, thus enabling optimal prophylactic home treatment with factor VIII to be begun early in life.
The influence of scoliosis brace treatment on function in children with myelomeningocele
Authors: Müller E Berned , Nordwall A , von Wendt L
Published: January 2008

The influence of Boston brace treatment on the functional and motor ability of children with scoliosis secondary to myelomeningocele was studied in a consecutive series of 20 children of 5–19 years of age. Motor activity, ADL function and ambulation ability were assessed before brace treatment and then annually during the treatment period, which lasted an average of 2.7 years (range 0.6–8.7 years). Thirteen children were folio wed‐up one year after braces were removed. The effect of brace treatment on the scoliosis was favourable as is reported elsewhere. The children's motor activity and ADL function remained unchanged during brace treatment, but brace wearing was accompanied by a decreased ambulatory skill. This may partly be explained by a slight increase of flexion contractures of the hips during treatment. Patients with useful ambulation ability kept this ability up even during brace treatment. Considering the favourable effect of brace treatment on the scoliosis curve and the few complications encountered, we recommend brace treatment for scoliosis in patients with myelomeningocele.
Elevated calcitonin gene‐related peptide in polycythemic newborn infants
Authors: Saggese Giuseppe , Bertelloni Silvano , Baroncelli Giampiero I , Cipolloni Carlo
Published: January 2008

In this study, calcitonin gene‐related peptide levels were measured in cord and at 16‐36 h of extrauterine life in 43 polycythemic newborns; 20 healthy term infants were also studied as controls. Calcitonin gene‐related peptide values were significantly higher in polycythemic neonates in comparison with controls both at delivery and at 16‐36 h after birth. Five polycythemic (11.6%) infants who develop hypocalcemia had greater elevated calcitonin gene‐related peptide concentrations. Our data suggest that calcitonin gene‐related peptide may be implicated in the circulatory adaptation to extrauterine life. In polycythemic neonates, calcitonin gene‐related peptide is probably increased to compensate for blood hyperviscosity; in some cases, high calcitonin gene‐related peptide concentrations may induce hypocalcemia.
Role of Moraxella (Branhamella) catarrhalis as a respiratory pathogen in children
Authors: Korppi M , Katila ML , Jääskeläinen J , Leinonen M
Published: January 2008

During a 12‐month surveillance period in 1981‐1982, Moraxella catarrhalis was detected in cultures from nasopharyngeal aspirates from 76 (17%) of 449 children hospitalized with middle or lower respiratory tract infection. Seroconversion to M. catarrhalis was positive in 4(5%) of the 76 patients with M. catarrhalis present in nasopharyngeal aspirates and in 4(1%) of 373 patients with a negative finding. Although children with respiratory tract infections were often colonized by the organism, this was rarely the infective agent of the middle or lower airways. Four of 8 patients with seroconversion to M. catarrhalis exhibited a concomitant RSV infection. The carriage of this species was more closely associated with parainfluenza virus infections. Serological responses to M. catarrhalis were not associated with acute otitis media, and were also rare in children with pneumonia. It is concluded that bronchopulmonary infections caused by M. catarrhalis are rare in children, and that M. catarrhalis aetiology need not be considered in the selection of antibiotics in cases of community‐acquired pneumonia or other infections of the middle or lower respiratory tract affecting primarily healthy children.
Ten‐year prognosis for generalized infantile eczema
Authors: Linna O , Kokkonen J , Lahtela P , Tammela O
Published: January 2008

Forty children treated in our hospital for generalized infantile eczema were re‐examined at 11‐13 years of age. In 7(18%) children the eczema had disappeared and in 26(65%) it had become less severe. Unrelated to dermatological status or gender, allergic rhinitis was diagnosed in 31(78%) and asthma in 21(53%) children. Only 8 children continued without either of these two conditions. All 32 children with allergic rhinitis and/or asthma showed at least one positive skin test reaction in a test panel of 11 common inhalant and food allergens compared with only 4 of 8 children without either allergic rhinitis or asthma (p<0.001). Our results showed an improvement of dermatological status in most children with generalized infantile eczema but there was a high risk of a concomitant respiratory allergy and development of allergic rhinitis or asthma.
Low back pain and disability in 14‐year‐old schoolchildren
Authors: Salminen JJ , Pentti J , Terho P
Published: January 2008

In this cross‐sectional prevalence study in 1503 14‐year‐old Finnish schoolchildren (n=1503) low back pain was found to be the third most common form of pain interfering with schoolwork or leisure time during the past 12 months. The lifetime cumulative incidence of low back pain was 30% and that of sciatica 1.8%. Of the 417 pupils who had experienced low back pain at some time, 39% had suffered during the past month; 65% recovered in one month from the last pain episode, while 35.2% of those reporting disabling low back pain during the past year were aware of recurrent or continual pain. Thus, 7.8% (n=107) of the whole population could be classified as “low back pain chronics“: 86% of the low back pain chronics had trouble with at least one of the daily activities listed, most commonly with sitting at school. Excluding pain in the extremities or sciatica, girls reported various pains more commonly than boys. Moreover, girls reporting recurrent low back pain had more trouble with their daily activities due to pain than boys (p<0.001), even though the recovery from the last pain episode took the same time in boys and girls. The pupils who had had sciatica at some time, in addition to recurrent low back pain, had more trouble with the 10 daily activities than others with recurrent low back pain (p=0.014).
Microphthalmos with bilateral colobomatous orbital cyst accompanied by polycystic kidney disease and vacuolization of myeloid progenitor cells
Authors: Bakir M , Sarialiöglu F , Bilgic S , Akhan O
Published: January 2008

A case of microphthalmos with bilateral colobomatous orbital cyst accompanied by polycystic kidney disease and vacuolization of myeloid progenitor cells is presented. Association of these three entities has not been described previously in the literature.
Regressed retinopathy of prematurity: the relationship between clinical risk factors of the newborn period and regressed retinopathy of prematurity severity in a preterm born population of Stockholm county 1976‐81
Authors: Gallo JE , Lennerstrand G , Broberger U
Published: January 2008

In a retrospective study, clinical risk factors of the neonatal period were correlated with the severity of regressed retinopathy of prematurity (ROP) in a population of preterm infants (bw< 1500 g and or gestational age <33 weeks). At the age of 5‐11 years 134 out of 528 preterm born infants (25.4%) were found to be under ophthalmic care. Reliable information on eye fundus status could be obtained in 105 of them. Regressed ROP was found in 61, the moderate form in 48 (9.1 %) and the severe form in 13 (2.5%) patients. Twelve patients (2.3%) had visual acuity of <0.3 on the worst eye and two (0.4%) of these patients were blind from ROP. Twenty‐four clinical factors of the newborn period were correlated with the severity of regressed ROP. The results suggest that long oxygen exposure in combination with other factors interfering with retinal vasotonus are associated with the degree of the disease developed.
Immunoglobulin G subclasses in human colostrum, milk and saliva
Authors: Kim Kyuchan , Keller Margaret A , Heiner Douglas C
Published: January 2008

Previous studies have suggested local production of IgG4 in human colostrum and mature milk. We extended these observations to examine all IgG subclasses in mammary secretions and in saliva, a mucosal secretion. In human colostrum and milk, the geometric mean percentages of IgG contributed by IgG2 were 44% and 43%, respectively, and by IgG4, 6% in both. These percentages are significantly increased compared to the contributions in matched plasma, 29% for IgG2 and 2% for IgG4. The contribution of IgG1 (47%) and IgG3 (<4%) were decreased compared to plasma which contained 64% IgG1 and 6% IgG3. Similarly, in salivary secretions the percentages of IgG contributed by IgG2 and IgG4 were increased compared to serum while the percentage of IgG1 was decreased. IgG3 was not measurable in any saliva specimen by the technique used. These data demonstrate that IgG subclass distribution in two separate mucosal secretions is uniquely different from that in matching plasma or serum.
High density lipoprotein cholesterol and total cholesterol in children with asthma and allergic rhinitis
Authors: Shenoi Arvind , Kumar Lata , Sarihyan Shaily , Gangully NK
Published: January 2008

Serum high density lipoprotein cholesterol and total cholesterol were studied in 15 children with allergic rhinitis, 45 asymptomatic asthmatic children and 16 children with acute asthmatic attacks. The latter were also studied in their asymptomatic phase. Two control groups of children with minor anatomical defects and those with acute pneumonia with respiratory distress were also studied. The serum concentrations of high density lipoprotein cholesterol were significantly higher (p< 0.001) and those of total cholesterol lower (p< 0.001) in children with respiratory allergy when compared to controls. The concentration of high density lipoprotein cholesterol increased and that of total cholesterol decreased during acute asthma.
A follow‐up study of the diet of Finnish diabetic adolescents
Authors: Virtanen SM , Räsänen L , Tumme R , Laitinen S , Mäenpää J , Virtanen M , Åkerblom HK
Published: January 2008

Changes with age and time in energy‐adjusted food consumption and nutrient intake of 74 diabetic subjects initially aged 12‐17 years were studied. Food consumption was measured by the 48‐h recall method. During the three‐year follow‐up (from 1985 to 1988), the proportion of carbohydrate of total energy intake decreased from 49% to 47%, that of fat increased from 33% to 36% and that of protein decreased slightly. The densities of fibre and several vitamins decreased in the diet of the diabetic adolescents. These unfavourable changes in the diet of diabetic adolescents took place with increasing age and duration of diabetes, while virtually no changes with time were detected.
Fluid restriction for preventing bronchopulmonary dysplasia? Reduced fluid intake during the first weeks of life improves the outcome of low‐birth‐weight infants
Authors: Tammela Outi KT , Koivisto Maila E
Published: January 2008

One hundred consecutive low‐birth‐weight infants (< 1751 g) were randomized equally into “dry” and “control” groups. Fluid administration in the dry group followed the schema 50, 60, 70, 80, 90, 100 and 120 ml/kg/day during the first week and 150 ml/kg/day until aged four weeks and that of the control group 80, 100, 120 and 150 ml/kg/day during the first week and 200 ml/kg afterwards. The diagnosis of bronchopulmonary dysplasia was based on typical roentgenographic findings, clinical symptoms and a supplemental oxygen requirement at age one month. Mean weight loss was greater in the dry group than in the control group (8.8 vs 6.2%), but there was no difference in weight between the groups at the age of four weeks. Twelve of the patients died, one in the dry group and 11 in the control group (five died during the first 24 h and the remaining six between three days and three months). Twenty‐seven subjects in the dry group and 15 in the control group were alive and had no signs of bronchopulmonary dysplasia at age 28 days (p < 0.05), the numbers at term being 28 and 14, respectively (p < 0.01). These results suggest that fluid restrictions can reduce the mortality and morbidity of low‐birth‐weight infants. Infants of this kind, with respiratory distress, show poor tolerance to fluids, especially during the first weeks of life.
Treatment with hypertonic dextrose and insulin in severe hyperkalaemia of immature infants
Authors: Lui Kei , Thungappa Udayabhanu , Nair Arun , John Elizabeth
Published: January 2008

Over a three‐year period, 12 infants received dextrose/insulin infusions for severe hyperkalaemia from a mean age of 24 h. The infants were born after 24 to 26 weeks of gestation and weighed 730 ± 172 g (mean ± SD) at birth. Serum potassium concentration ranged from 7.4 to 8.4 mmol/l(7.7 ± 0.4 mmol/l; mean ± SD). Four had cardiac arrhythmias. All infants showed an initial response, serum potassium concentration decreased below 6.5 mmol/l in 5 ± 2 h. In two infants, rebound hyperkalaemia occurred and was resistant to treatment; both infants died, one during an exchange transfusion. In the other 10 infants, infusions were ceased at a mean postnatal age of 53 h. Hyperglycaemia was the major problem during infusion and was resistant to increases in insulin concentrations. Normoglycaemia was achieved in 10 infants. The hypertonic solution consisted of a dextrose/insulin ratio of 2.2 ± 0.6 g/IU, which delivered glucose at a rate of 0.46 ± 0.15 g/kg/h, in addition to the pre‐existing stable maintenance glucose intake.
Doppler echocardiographic and morphologic evaluation of patients following operative repair of aortic coarctation
Authors: Wendel H , Teien D , Human DG , Nanton MA
Published: January 2008

Sixty‐six patients operated on previously for coarctation of the aorta were included in the study. There were 50 children and 16 adults. Invasive and non‐invasive gradients were recorded. Anatomical obstruction was evaluated by angiography in 54 patients and the numbers and size of collaterals were quantified. The closest correlation was found between Doppler‐estimated gradients and invasive peakinstantaneous gradients (r= 0.87). The relation between anatomical obstruction and invasive peak‐to‐peak gradients, Doppler gradients and diastolic flow were discouraging (r ‐ 0.64, 0.54 and 0.35). Liberal indications for angiography or magnetic resonance tomography are recommended.
The value of peritoneal dialysis in the treatment of severe ethanol intoxication in childhood revised
Authors: Woelfel D , Zeilinger G , Wendt‐Göeknur MAV
Published: January 2008

We treated a girl aged 3.5 years (15 kg) with ethanol intoxication, using peritoneal dialysis. The blood ethanol concentration was 6.4 g/l (640 mg/dl; 138.9 mmol/l). It was calculated that the child drank a total amount of 67.2 g of ethanol (4.5 g/kg). The spontaneous ethanol elimination rate before peritoneal dialysis was 0.27 g/l (5.86 mmol/l) per hour; during peritoneal dialysis we found an ethanol elimination rate of 0.32 g/l (6.94 mmol/l) per hour, which was lower than expected. In childhood the ethanol elimination rate with peritoneal dialysis is only slightly faster in comparison to the high spontaneous elimination rate. We conclude that treatment of severe ethanol intoxication should include mainly the maintenance of the vital functions and the meticulous control of blood sugar levels and acid‐base disturbances, especially in children. Indications for dialysis are complications caused by ethanol and resistant to supportive therapy, such as seizures, metabolic disturbances, persistent hypoglycemia and the possibility of combined intoxication with other dialy sable drugs.