bluuebunny/crossref_metadata_2025 huggingface dataset:
Glycine, Glycyl–Glycine and Maltodextrin Based Oral Rehydration Solution Assessment of Efficacy and Safety in Comparison to Standard ORS
Authors: BHAN M. K. , SAZAWAL S. , BHATNAGAR S. , BHANDARI N. , GUHA D. K. , AGGARWAL S. K.
Published: January 2008

ABSTRACT. We evaluated the efficacy and safety of an oral rehydration solution containing glycyl‐glycine, glycine, and maltodextrin (GGG‐ORS), in comparison to the glucose based ORS (standard ORS). The osmolality of the GGG‐ORS (305 mOsm/1) and standard ORS (311 mOsm/1) was similar. Ninety‐two children presenting with acute gastroenteritis and moderate dehydration, aged 3 months to 3 years, were randomly assigned to receive standard ORS or GGG‐ORS. All the patients were successfully rehydrated orally. The two groups were comparable for baseline characteristics including the microbial etiology. Rotavirus (49%, 36%), ETEC (11%, 18%) or a combination of rotavirus and ETEC (15%, 9%) were the main stool pathogens isolated. There was no significant difference in the mean stool output or duration of diarrhoea between the two groups. Patients in the GGG‐ORS group had higher urine output (p<0.01) and weight gain (p<0.05) in the initial 6 hours when feeding was withheld, but no such differences were observed beyond this period. Hypernatremia did not develop in any patient during the study. We conclude that glycine and glycyl‐glycine supplemented oral rehydration solution does not have any therapeutic advantage in the treatment of acute gastroenteritis with moderate dehydration caused predominantly by rotavirus.
Lipid Levels in Very Low Birthweight Preterm Infants
Authors: DECSI T. , MOLNÁR D. , KLUJBER L.
Published: January 2008

ABSTRACT. Free fatty acid (FFA), triglyceride (TG), total cholesterol (T‐C), VLDL + LDL‐C, HDL‐C and its subfractions were determined in 18 very low birthweight (birthweight: 1064 ± 179 g; gestational age: 28.7 ± 1.6 weeks, mean ± SD) preterm infants on postnatal days 1, 14, 28, 42 and 56 (data are given in mmol/l). FFA levels remained low throughout the study (day 1: 0.13 ± 0.09…day 28: 0.15 ± 0.06…day 56: 0.16 ± 0.06). TG levels increased significantly from day 1 to 14 and from day 14 to 28 (day 1: 0.61 ± 0.06, day 14: 1.14 ± 0.28, day 28: 1.70 ± 0.89), thereafter they remained unchanged. T‐C levels increased significantly from day 1 (2.29 ± 0.83) to day 14 (3.05 ± 0.71), continued to increase up to day 28 (3.34 ± 1.58), subsequently decreasing to the level of day 1 (day 56: 2.63 ± 0.87). More marked alterations were seen in VLDL + LDL‐C (day 1: 1.51 ± 0.70, day 28: 2.32 ± 1.34, day 56: 1.76 ± 0.74), whereas in HDL‐C it was HDL2‐C that changed significantly.
Immunogenicity and Safety of Low Doses of Recombinant Yeast‐Derived Hepatitis B Vaccine
Authors: TAN K. L. , OON C. J. , GOH K. T. , WONG L. Y. M. , CHAN S. H.
Published: January 2008

ABSTRACT. The immunogenicity and safety of recombinant yeast‐derived hepatitis B vaccine given in doses of 0.6 μg, 1.25 μg, 2.5 μg and 5.0 μg were studied in 4 comparable groups of children aged 1–12 years. All children received three doses of vaccine at time 0, 1 month and 5 months. Immunogenicity appeared to be satisfactory in all 4 groups of children. In the early phase of the study, a dose‐response relationship was observed but there was no significant difference in the geometric mean titre among all 4 groups for any period studied. Antibody levels peaked at 9 months, declining thereafter. The geometric mean titre one year after the first vaccine dose was not significantly lower than that at the peak (9 months) in any individual group studied. The second year geometric mean titre was similar in all 4 groups and lower than that of the first year. Sero‐conversion with antibody titres > 10 mIU/ml was 100% in the 5.0 μg group and > 90% in the other 3 groups. There were no adverse reactions of any significance. The immunogenicity of recombinant yeast‐derived hepatitis B vaccine was found to be adequate even at as low a dosage as 0.6 μg when administered in a 3‐dose regimen.
Sensory‐Motor and Cognitive Functioning in Children Who Have Undergone Bone Marrow Transplantation
Authors: SMEDLER ANN‐CHARLOTTE , RINGDÉN KRISTINA , BERGMAN HANS , BOLME PER
Published: January 2008

ABSTRACT.Sensory‐motor and cognitive functioning was investigated in a group of 32 children treated with bone marrow transplantation (BMT), 1–6 years after treatment. Twenty‐five of the patients had suffered from leukemia. The BMT procedure had involved a regimen of cytostatic drugs and, for leukemia patients, total body irradiation at a dose of 10 Gy, administered in one session. Cytostatic drugs and irradiation are known to be potentially neurotoxic, particularly when combined. The examination involved four neuropsychological tests of sensory‐motor and cognitive functioning, as well as an age‐appropriate intelligence test. For control the bone marrow donors (n=32), siblings of the patients, were also investigated. A pronounced delay in motor development was found in four children, who had been treated with BMT including total body irradiation before 3 years of age. Patients between 3 and 11 years of age at BMT were at a slight disadvantage, compared to donors, on tasks involving perceptual and fine motor speed. In older patients no deficits were observed.
Nephrocalcinosis, Hypercalciuria and Elevated Serum Levels of 1,25‐Dihydroxyvitamin D in Children Possible Link to Vitamin D Toxicity
Authors: MISSELWITZ J. , HESSE V. , MARKESTAD T.
Published: January 2008

ABSTRACT. Ten children, age 1 1/2 to 14 years, had bilateral nephrocalcinosis and hypercalciuria, but normal serum calcium (Ca) and phosphate (P) concentrations. Patients with hypercalciuria were divided into absorptive (n=4) and renal (n=6) subgroups, and in the latter four patients had a primary Ca‐leak and two had a P‐leak. All the children had received intermittent high dose vitamin D prophylaxis during infancy. At the time of investigation all had normal serum levels of 25‐hydroxyvitamin D, yet all but one had elevated values of 1, 25‐(OH)2D. Although the hypercalciuria was indistinguishable from the various known forms of idiopathic hypercalciuria, the previous clinical course and the pattern of bone mineral homeostasis suggest that both clinical features, namely nephrocalcinosis and hypercalciuria were related to vitamin D toxicity through various pathogenetic pathways.
Accidents among Children below Schoolage Changes of incidence after intervention
Authors: SAHLIN Y. , LEREIM I.
Published: January 2008

ABSTRACT. Children aged 0 to 6 years old admitted to hospital due to an accident were registered. Registration was carried out for two yearly periods; September 1982 to September 1983 and June 1985 to June 1986. The incidence of accidents dropped from 125 per 1000 a year to 116 accidents per 1000 children a year. The youngest children showed the most significant decrease in incidence. Home accidents were the most common type of accidents in both registration periods. Accidents due to falling from heights and poisoning accidents increased in the second period. Children injured during the second registration period required 3.4 times fewer days of hospitalization compared with the first period. Fractures and thermal injuries demanded most hospital care in both registration periods.
Growth and Growth Hormone Therapy in Hypochondroplasia
Authors: APPAN S. , LAURENT S. , CHAPMAN M. , HINDMARSH P. C. , BROOK C. G. D.
Published: January 2008

ABSTRACT. The growth of 84 patients with hypochondroplasia (56 male, 28 female) was studied. A wide spectrum of severity was found from quite severe short limbed dwarfism to short apparently normal prepubertal children who manifested disproportion only at puberty when growth failed. The onset of puberty was at the normal time but the pubertal growth spurt appeared not to materialize and it is this lack which resulted in severely compromised adult heights of 145‐165 cm in boys and 133–151 cm in girls. Twenty (12 M, 8 F) hypochondroplastic children aged between 4.3 and 12.8 years were recruited to a study of the effects of biosynthetic growth hormone. All had normal growth hormone responses (> 15 mU/I) to a pharmacological test of growth hormone secretion. Biosynthetic growth hormone in doses between 12‐32 u/m2/week produced a significant acceleration in height velocity standard deviation score (SDS) for chronological age (CA) from a pretreatment mean of ‐ 1.66 (SD 1.36) to + 1.62 (SD 1.52) (p < 0.001). Significant increases were also observed in the height SDS for bone age (BA), sitting height (SH) SDS and subischial leg length (SILL) SDS. A longer period will be required to assess the effect of treatment on adult height prognosis.
Fibrosing Alveolitis in Childhood A Long‐Term Follow‐up
Authors: STEINKAMP GRATIANA , MÜLLER K.‐M. , SCHIRG E. , HARDT H. VON DER
Published: January 2008

ABSTRACT. A retrospective analysis of 14 pediatric cases with fibrosing alveolitis, proved by lung biopsy, was carried out. The children were initially 6‐16 years old (mean: 9.8 years) and were observed for 2 to 7 years. Symptoms had been present prior to diagnosis for 1 to 156 weeks (median: 11 weeks). The most prominent clinical findings were dyspnoea (100%), dry cough (91 %), tachypnoea (85%), and weight loss (70%). Open (n=9) or transbronchial (n=5) lung biopsy specimens had predominantly cellular appearances in 8 children (group A) and showed predominantly fibrotic changes in 6 cases (group B). Lung function tests revealed a marked ventilatory impairment in all children. Mean vital capacity was 44% (SD 16%), and total lung capacity 58% (SD 14%) of the predicted normal values. Specific lung compliance was significantly lower in children with fibrotic changes (mean: 0.016 vs. 0.030 ml/cmH2O/ml in patients of group A, p<0.05). Results from 200 lung function measurements were evaluated during the follow‐up. Corticoisteroid treatment improved vital capacity in all children after 6 and 12 months of treatment to 64% and 62% of the predicted normal, respectively. Deterioration of pulmonary function was observed in 7 children when prednisone was tapered to below 10 mg per day. Only 4 children had a normal vital capacity at their last visit to the clinic. We conclude that children with fibrosing alveolitis experience severe alterations in lung function, and that the overall outlook is quite unfavorable.
The Course of Biological Parameters and 6‐Mercaptopurine Pharmacokinetics during Maintenance Treatment of Children with Acute Lymphoblastic Leukaemia
Authors: HAYDER S. , BJÖRK O. , LAFOLIE P.
Published: January 2008

ABSTRACT. Twenty patients on maintenance therapy (MT) for acute lymphoblastic leukaemia (ALL) with oral 6‐mercaptopurine (6‐MP) and methotrexate (MTX) were studied. White cell and red cell indices and platelets counts were monitored every second week as were drug levels. Mean values for 6‐MP and MTX doses, and blood component parameters were calculated for each 6‐month period for the whole patient group. 6‐MP plasma concentrations and liver‐function tests were determined once every six months and mean values calculated. 6‐MP and MTX mean doses did not change significantly during MT. The mean area under the concentration versus time curve (AUC) 0‐4 hours varied slightly from the start to the end of the MT (257 and 296 ng/ml‐h, respectively). The mean plasma peak concentration increased from 98 ng/ml to 195 ng/ml (p<0.01) during the same period. There were significant decreases betwen the initial white blood cell counts (WBC) and red blood cell counts (RBC) as compared to levels at the end of therapy (p<0.01 and 0.02, respectively). A linear correlation was found between 6‐MP peak concentrations and both WBC (r=0.96) and RBC (r=0.87). At the end of MT liver function tests became normal in all except 6 patients. In conclusion, MT have moderate effects on bone marrow and liver and monitoring 6‐MP plasma concentration might be of value for determination of the optimal WBC levels during MT.
Necrotizing Bowel Disease with Candida Peritonitis Following Severe Neonatal Hypothermia
Authors: KAPLAN M. , EIDELMAN A. I. , DOLLBERG L. , ABU‐DALU K.
Published: January 2008

ABSTRACT. Peritonitis due to Candida albicans is rare in the newborn infant. Three low birth‐weight, extremely ill premature infants who were severely hypothermic at the time of admission developed perforation of the gastrointestinal tract. C. albicans was cultured from the peritoneal fluid in each case. In view of the rareness of C. albicans peritonitis in newborns, this cluster of infants suggests a relationship between severe neonatal hypothermia, and bowel perforation with peritonitis due to this fungus.
Effects of 3 Years of Growth Hormone Therapy in Short Normal Children
Authors: HINDMARSH P.C. , PRINGLE P.J. , SILVIO L. DI , BROOK C.G.D.
Published: January 2008

ABSTRACT. The effect of 3 years of growth hormone (GH) treatment on growth rate, predicted height, carbohydrate and metabolic status, and thyroid function was studied in 16 short prepubertal children growing with a normal pretreatment growth rate. The height velocity SDS increased from a pretreatment value of ‐0.44 ± 0.33 (mean ± SD) to a value of +2.20 ± 1.03 during the first year of treatment. It was maintained at a value above zero over the subsequent 2 years. By the end of the third year of treatment, the predicted final height had increased by 6.8 cm in the boys and by 4.2 cm in the girls (p < 0.001 and p < 0.01, respectively). Increasing the dose of GH on a body surface area basis reduced the deceleration of growth observed during the second year of treatment, leading to an improvement in height prognosis over that year. Glucose homoeostasis was achieved initially at the expense of an elevation in fasting serum insulin concentration, but this had returned to pretreatment values by the end of the second year of therapy. No effects on thyroid function were observed.
Effects of Growth Hormone in Short, Slowly Growing Children without Growth Hormone Deficiency
Authors: COWELL C.T.
Published: January 2008

ABSTRACT. The aim of the study was to measure the real effect of growth hormone (GH) treatment compared to the effect of placebo, since a placebo effect has been shown in other studies involving interventional growth therapy. Changes in height velocity and insulin‐like growth factor I (IGF‐I), relative to pretreatment variables, were examined during a 12‐month, double‐blind study.
High‐Dose Growth Hormone Treatment of Non‐Growth Hormone‐Deficient Children: Preliminary Results after 2 Years
Authors: BOUGNÈRES P.F.
Published: January 2008

ABSTRACT. The growth response to high‐dose growth hormone (GH) therapy was investigated in 10 short, prepubertal, slowly‐growing children. Two years treatment with recombinant human GH at a dose of 0.3 IU/kg daily 7 days per week resulted in a mean height increase of 19.5 cm (range 17–23 cm). There was a slight but not significant acceleration of bone age maturation. The treatment also induced a sustained increase in insulin secretion without detectable changes in glucose tolerance.
Anabolic and Tissue Repair Functions of Recombinant Insulin‐Like Growth Factor I
Authors: SKOTTNER A. , ARRHENIUS‐NYBERG V. , KANJE M. , FRYKLUND L.
Published: January 2008

ABSTRACT. Recombinant human insulin‐like growth factor I (rhIGF‐I) has been produced in yeast and purified using conventional biochemical techniques. It has been shown to have receptor‐binding properties and in vitro growth‐promoting activities comparable to those of plasma‐derived IGF‐I. The anabolic actions of IGF‐I can be studied using both systemic and local administration in vivo. The growth‐promoting activity and systemic anabolic actions of recombinant IGF‐I were studied in mutant dwarf rats. IGF‐I was infused intravenously for 9 days and resulted in a significant gain in body weight and significant bone growth, though the effects were not as great as those observed with human growth hormone (hGH). IGF‐I also had selective effects on specific organs which were not observed in hGH‐treated animals. The results indicate that the growth‐promoting effects of IGF‐I show a different pattern compared to hGH. The effects of local administration of recombinant IGF‐I on tissue regeneration and maintenance were also studied in hypophysectomized and normal rats. After hypophysectomy, the regeneration processes were impaired when both peripheral nerve regeneration and incision wound healing were considered. The results indicate that local administration could have significant effects on regeneration of, for example, peripheral nerves.
The Infancy–Childhood Growth Spurt
Authors: KARLBERG J.
Published: January 2008

ABSTRACT. Early normal human linear growth is unstable and oscillates owing to an increase in growth rate between 6 and 12 months of age. This defines the onset of the infancy‐childhood growth spurt (IC spurt). The onset is identical with the onset of the childhood component of the infancy‐childhood—puberty growth model. The IC spurt is completed when the infancy component of this model has virtually ceased, at around 3 years of age. Additional observations suggest that its onset represents the age at which growth hormone (GH) begins to regulate growth significantly. The negative impact of late onset of the IC spurt on attained height is illustrated and discussed. A delayed spurt is observed in 30—50% of children with growth‐related disorders and of infants living in a poor area of a developing country. The IC spurt is absent in children with GH deficiency who receive no hormonal therapy.
Antigenic Epitope Mapping of the Human Growth Hormone Molecule: A Strategy to Standardize Growth Hormone Immunoassays
Authors: STRASBURGER C.J.
Published: January 2008

ABSTRACT. The antigenic surface of the human growth hormone (hGH) molecule has been characterized by means of monoclonal antibodies (MAbs) and their specific binding sites. From a panel of MAbs raised against the 22 kDa variant of hGH, ten distinct antigenic entities could be identified as binding sites for specific MAbs in an epitope mapping experiment. The experiment was based on combinations of the MAbs in two‐site assays. By investigating the cross‐reactivity of the MAbs with growth hormone (GH) variants and fragments of hGH, the underlying protein structure of some of the partially overlapping epitopes could be identified. By using antibodies of known epitope specificity as competitors in receptor binding assays of hGH, it was demonstrated that the lactogenic and somatogenic biological effects of hGH are mediated through different portions of the hormone. These observations may explain some of the differences between the various immunoassays for hGH. A strategy for selecting antibodies of known epitope specificity and biological relevance for the design of plasma GH immunoassays is outlined. The results of such an immunoassay should closely reflect the biological activity of circulating plasma hGH.
Who is Treated with Growth Hormone Today?
Authors: VANDERSCHUEREN‐LODEWEYCKX M. ,   The Executive Scientific Committee of the Kabi International Growth Study
Published: January 2008

ABSTRACT. The present demographic data from the Kabi International Growth Study (KIGS) database are summarized. Of the 2580 patients included, 85% have growth hormone deficiency (GHD) and 15% have other causes of growth failure. Idiopathic GHD is present in 78.5% of the patients, the remaining 21.5% have organic GHD. Isolated GHD is common in idiopathic GHD whereas multiple pituitary hormone deficiencies occur in at least 50% of the organic GHD patients. A preponderance of boys is observed in most groups of patients. Median chronological age (CA) at start of treatment is 10 years and median duration of therapy is 2.3 years. However, a wide range is observed. In most cases growth retardation is severe. In most patients with GHD height SDS for chronological age at start of therapy is at or below ‐3. The median difference between idiopathic and organic GHD is 1 SDS. Most patients have 6 or 7 injections of growth hormone (GH) per week. The median total weekly dose is approximately 0.5 IU/kg/week, but it is lower in older patients. It is concluded that steadily increasing numbers of patients with idiopathic and organic GHD are being treated with human GH (hGH). In addition, many patients with other growth disorders not necessarily associated with GHD receive hGH therapy. Chronological age at start of treatment still appears to be (too) high in most patients and growth retardation severe. The frequency of hGH injections has been increased to nearly daily administration. However, the total weekly dose appears to be low, especially in the older patients. It is hoped that KIGS will contribute to improving the efficacy of treatment and hence the quality of life for all patients with growth disorders.
Birth Data for Patients Who Later Develop Growth Hormone Deficiency: Preliminary Analysis of a National Register
Authors: ALBERTSSON‐WIKLAND K. ,   The Executive Scientific Committee of the Kabi International Growth Study and the Swedish Paediatric Study Group for Growth Hormone Treatment, NIKLASSON A. , KARLBERG P.
Published: January 2008

ABSTRACT. This study analyses gestational age, mode of delivery and size at birth in children who later developed idiopathic or organic growth hormone deficiency (GHD). A data register of children on growth hormone (GH) treatment in Sweden was compared with the Swedish Medical Birth Register during a 14‐year period (1973‐1986) comprising 1.4 million newborn children. Size at birth was evaluated using a new Swedish reference standard based on data from around 500,000 newborn children. It was found that the children who later develop idiopathic GHD (IGHD) were born with a normal distribution of gestational age. They were more often born with breech delivery (7.1%versus 2.8%) or caesarean section (16.6%versus 10.4%) compared with normal children. The children's condition at birth was poorer than normal, as shown by the frequency of Apgar scores below 7 at 5 minutes (5.2%versus 1.2%). Finally, it was found that children who later develop IGHD (n = 220) had a median birth length of 0.87 SDS below the mean and a median birth weight of 0.60 SDS below the mean of the standard. In contrast, both the birth length and weight of the children who later develop organic GHD (OGHD) (n = 92) did not differ from that of the reference.
Intact Parathyroid Hormone Levels during Pregnancy, in Healthy Term Neonates and in Hypocalcemic Preterm Infants
Authors: SAGGESE G. , BARONCELLI G.I. , BERTELLONI S. , CIPOLLONI C.
Published: January 2008

ABSTRACT. We measured parathyroid hormone levels in pregnant and nonpregnant women and at 1, 2 and 5 days of life in healthy term neonates and in hypocalcemic preterm infants using a new immunoradiometric assay which measures only biologically active intact parathyroid hormone and by a mid‐molecule parathyroid hormone radioimmunoassay. During pregnancy intact and mid‐molecule parathyroid hormone levels did not show any modification and were not different from parathyroid hormone levels of nonpregnant age‐matched controls. Serum calcium and phosphorus levels did not vary during each trimester of pregnancy. In cord serum intact and mid‐molecule parathyroid hormone values were low in both term and preterm infants. In term neonates intact and mid‐molecule parathyroid hormone levels peaked on day 1; in preterm infants intact parathyroid hormone levels peaked on day 1 while mid‐molecule parathyroid hormone values peaked on day 2. Intact parathyroid hormone levels showed a more marked increase in preterm (19‐fold) than in term neonates (7.5‐fold) on day 1. Our data do not confirm the previously reported “physiologic” hyperparathyroidism in pregnancy. Moreover we found a normal parathyroid gland responsiveness to decreasing serum calcium levels in the first days of life in term and preterm infants. Our results suggest that measurement of intact parathyroid hormone 1‐84 by immunoradiometric assay in the first days of life is a more sensitive index of parathyroid gland secretory function than the measurement of middle or carboxyl‐terminal parathyroid hormone fragments allowing the detection of the dynamic changes of parathyroid hormone which occur in hypocalcemic preterm infants.
Evaluation of the PEP Mask in Cystic Fibrosis
Authors: STEEN H. J. , REDMOND A. O. B. , O'NEILL D. , BEATTIE F.
Published: January 2008

ABSTRACT. Twenty‐eight patients suffering from cystic fibrosis, with an age range of 8‐21 years entered a randomised cross‐over trial to study the efficacy of the Positive Expiratory Pressure (PEP) mask as a method of chest physiotherapy, both on its own and in conjunction with other physiotherapy techniques. Twenty‐four of these patients completed the trial consisting of 4 treatment programmes each lasting one month and with no wash‐out period between them. Five of these patients went on to a fifth programme of Forced Expiratory Technique (FET) alone. At the end of the trial, no significant difference was found between the programmes as regards growth, Shwachman score, Chrispin—Norman score or pulmonary function tests. Twenty‐three patients chose to continue using the PEP mask in conjunction with FET long‐term as their chest physiotherapy programme as they felt it was an effective treatment allowing increased independence, with postural drainage being kept to a minimum.
Alloimmune Neonatal Neutropenia in Monozygous Twins: High‐dose Intravenous Gammaglobulin Therapy
Authors: YOSHIDA NAOKO , SHIKATA TAKUMA , SUDO SHIGEYUKI , MATSUMURA ATSUKO , TSUJII HISASHI , DOI YASUO , KINUGASA AKIHIKO , SAWADA TADASHI , SAITO KENJI , MIYAMOTO MITSUKO
Published: January 2008

ABSTRACT. An indirect immunofluorescence test using a flow cytometer (FACS420) was useful for detection of antineutrophil antibodies (anti‐NA2 antibodies) in a case of monozygous twins with alloimmune neonatal neutropenia. When high‐dose intravenous gammaglobulin (300 mg/kg for five consecutive days) was given to one twin, the increase in neutrophils was not obvious. Although neutropenia persisted for about three months, no infections were observed in either of the twins.
Sudden Infant Death Syndrome in Hamburg: An Epidemiological Analysis of 150 Cases
Authors: VEELKEN N. , ZIEGELITZ J. , KNISPEL J. D. , BENTELE K. H. P.
Published: January 2008

ABSTRACT. A retrospective analysis was carried out of 150 SIDS cases seen in the five year period between 1979 and 1983 in Hamburg, Germany. The overall incidence was 2.3 per 1000 live births. 82% of all infants and 100% of the preterm infants (corrected according to gestational age) dying of SIDS, died within the first 6 months of life. Infants of mothers < 18 years of age, infants with more than 2 siblings, infants with birthweight < 1500 g and SGA‐preterm infants were found to be high‐risk subgroups. A high percentage (20% of all cases, 43% of infants with mothers < 18 years) were underweight at death (under the 3rd weight‐percentile). The study emphasizes the complexity of internal and external factors in the etiology of SIDS.
Unique Brain Anomalies in an Infant of a Diabetic Mother
Authors: KOUSSEFF B. G. , VILLAVECES C. , MARTINEZ C. R.
Published: January 2008

ABSTRACT. An offspring of a class F diabetic primigravida with marginal control during the first 8 weeks of the gestation had a level II sonogram at 23 weeks. It showed polyhydramnios and “hydrocephaly”. Macrosomia, right hydroureter, megacystis and premature birth corroborated the diagnostic impression of diabetic embryopathy. At age 3 years, the child functions within the moderate range of mental retardation. Angiography, choanogram, CT and MRI scans showed unique CNS abnormalities that appeared secondary to a hamartomatous growth within the left cerebral hemisphere. Such anomaly, most likely a part of the phenotype of the diabetic embryopathy, implies a growth disturbance secondary to dysregulated paracrine growth factors (somatomedins, nerve growth factor, panregulin and/or their receptors in this case). It also indicates a possibility of interaction between two dysregulated major growth mechanisms; the endocrine in the mother considered responsible for the overall phenotype of the diabetic embryopathy/fetopathy and the paracrine fine tuning mechanism in the embryo incriminated by the hamartomatous ove/undergrowth.
High‐dose Intravenous Gammaglobulin for Neonatal Alloimmune Thrombocytopenia in Twins
Authors: PIETZ J. , KIEFEL V. , SONTHEIMEK D. , KOBIALKA B. , LINDERKAMP O. , MUELLER‐ECKHARDT C.
Published: January 2008

ABSIRACT. Pietz J., Kiefel V., Sontheimer D., Kobialka B., Linderkamp O and Mueller‐Eckhardt C. (Division of Neonatology, Children's Hospital, University of Heidelberg, and Institute of Clinical Immunology and Transfusion Medicine, University of Giessen, FRG). High‐dose intravenous gammaglobulin for neonatal alloimmune thrombocytopenia in twins. Acta Paediatr Scand 80: 129, 1991.

We report the successful treatment of neonatal alloimmune thrombocytopenia with repeated infusions of high‐dose immunoglobulin G (400 mg/kg/d for 5 days) in twins. Platelet counts increased within 3 days from less than 20×109/1 to more than 70 × 109/1. The first twin survived without neurological or other sequelae. The second twin had probably developed intracranial hemorrhage (ICH) in utero. This infant developed long‐term neurological sequelae with blindness, cerebral palsy and infantile spasms. Implications of the therapeutic approach and prevention of severe complications in pregnancies with known risk for neonatal alloimmune thrombocytopenia are discussed.
Ampicillin–Aminoglycoside Combinations as Initial Treatment for Neonatal Septicaemia or Meningitis:A Retrospective Evaluation of 12 Years' Experience
Authors: TESSIN I. , TROLLFORS B. , THIRINGER K. , LARSSON P.
Published: January 2008

ABSTRACT. In a retrospective study covering the years 1975–1986, 341 episodes of invasive infections in 338 newborn infants were evaluated. Of the 365 pathogens isolated from blood and/or cerebrospinal fluid, 91% were sensitive to either ampicillin or aminoglycosides or both. Ampicillin resistance was mainly found in very low and low birth‐weight infants with late‐onset infections, in which aerobic Gram‐negative rods were common pathogens. In contrast, aminoglycoside resistance was common in early‐onset infections, due to the dominance of group B streptococcal infections. The ampicillin‐aminoglycoside combination had been given as initial treatment in 189 cases of septicaemia or meningitis. Treatment failed in 36 infections (20%), although all organisms were sensitive to one or both antibiotics. Treatment failed in 6 of 34 patients with meningitis but the failure was not related to ampicillin or aminoglycoside resistance. In conclusion, both in vitro and clinical results show that the ampicillin–aminoglycoside combination can be used as initial treatment of invasive infections in neonates.
Roentgen Stereophotogrammetric Short‐Term Analysis of Growth Rate in Children Operated for Crohn's Disease
Authors: HILDEBRAND H. , ARONSON S. , KULLENDORFF C.‐M. , SELVIK G.
Published: January 2008

ABSTRACT. Roentgen stereophotogrammetry is a new method for short term analysis of growth rate. Growth is measured over the growth zone in the distal fibula and is a fraction of the total statural growth. Normal growth rate in the distal fibula is about 15 μm/day at a total growth rate of 5 cm/year. The method was used to follow growth six months before and six months after surgery in six growth retarded children with Crohn's disease. Growth rate increased significantly (p<0.01) within three months after surgery from 5.8 μm/day before operation to 15.8 μm/day three months after operation and six months postoperatively had reached 18.0 μm/day. Improved growth could be recorded as early as four weeks after operation. The Roentgen stereophotogrammetric analysis (RSA) gives a unique possibility to follow short‐term changes in growth rate in children with disturbed growth and to use growth rate as a quick assessment of response.
Treatment for Stage III–IV Neuroblastoma Patients: Initial Response to Chemotherapy Evaluated by Biochemical Parameters
Authors: IMASHUKU S. , TODO S. , NAKAJIMA F. , FUJITA K. , HIBI S. , MIYAKE M.
Published: January 2008

ABSTRACT. Fourteen patients with stage III–IV neuroblastoma were treated with alternating combination chemotherapy consisting of (a) VP16/cisplatin and (b) doxorubicin/vincristine/cyclophosphamide. The initial response to induction chemotherapy, especially to VP16/cisplatin was evaluated by determining t 1/2 for urinary vanillylmandelic acid (VMA), homovanillic acid and serum neuron specific enolase (NSE). The period prior to normalization of these parameters was also determined. The patients could be classified as 7 rapid responders, with less than 3 weeks oft 1/2 VMA, or t 1/2 NSE, and 7 slow responders longer than 4 weeks of t 1/2 VMA. An analysis of the data indicates that an initial rapid response correlated with subsequent high complete response rate, but did not necessarily predict better prognosis in these patients.
Monitoring of Drug Prescriptions for Children in the County of Jämtland and in Sweden as a Whole in 1977–1987
Authors: WESSLING A. , SÖDERMAN P. , BOËTHIUS G.
Published: January 2008

ABSTRACT. One individual‐based (Jämtland) and one population‐based (Sweden) monitoring system provided information on the prescription sales of drugs for children in ambulatory care. The overall prescription rate decreased between 1977 and 1987 and it was 20–25% lower in Jämtland than in Sweden as a whole. Antibiotics, drugs for ear, nose and throat diseases and respiratory drugs accounted for three out of four prescriptions. Penicillin V dominated among antibiotics and the prescription rate was stable whereas that of other antibiotics increased. During their first year of life one out of ten children in Jämtland had at least one prescription of antibiotics, during their first five years three out of four children. Prescribing of decongestants, especially systemic, decreased during the study period whereas that of anti‐asthmatics increased, partly due to the non‐approved use of these drugs for common cough. The results from our study underline the need for pharmaco‐epidemiological studies linking prescription data to clinical data in order to answer questions on the rational of present drug treatment practices.
Twenty‐Nail Dystrophy Associated with Hematologic Abnormalities
Authors: GERMAIN‐LEE EMILY L. , ZINKHAM WILLIAM H.
Published: January 2008

ABSTRACT. This report describes a 15 1/2 year old white male with twenty‐nail dystrophy who has had recurrent episodes of immune thrombocytopenic purpura, autoimmune hemolytic anemia, and mild depression of immunoglobulin levels. The concurrence of these events suggests that each shares a common pathophysiologic mechanism, possibly an autoimmune process.
Congenital Hypothyroidism and Cystic Fibrosis
Authors: DEPASSE C. , CHANOINE J. P. , CASIMIR G. , van VLIET G.
Published: January 2008

ABSTRACT. We report a case of dysgenetic congenital hypothyroidism associated with cystic fibrosis. Impaired exocrine pancreatic secretion and/or transit abnormalities secondary to the treatment of meconium ileus resulted in decreased absorption of l‐thyroxine and difficulties in management of hypothyroidism.
Decreased Renal Clearance of Sodium in Cystic Fibrosis
Authors: STENVINKEL P. , HJELTE L. , ALVÁN G. , HEDMAN A. , HULTMAN E. , STRANDVIK B.
Published: January 2008

ABSTRACT. In 10 patients with cystic fibrosis (CF) and 10 controls of similar age quantitative segmental handling of sodium was estimated by lithium clearance. In the CF group, there was tendency for an increased glomerular filtration rate (GFR) and increased absolute proximal sodium reabsorption. The fractional distal sodium reabsorption was significantly (p=0.015) increased and sodium clearance was significantly (p≤0.01) decreased in CF.
Psychological Development at 7 Years of Age in Children with Congenital Hypothyroidism: Timing and Dosage of Initial Treatment
Authors: ILICKI ADAM , LARSSON AGNE
Published: January 2008

ABSTRACT. Sixty of 68 consecutive patients detected during the first two years of the Swedish screening programme for congenital hypothyroidism were Griffiths tested at the age 6.5–7.5 years. The test quotients of the patients could not be distinguished from those of reference population. Replacement therapy with 8.7 ± 2.8 μg of l‐thyroxine (mean±SD)/kg/d had been started at 15.0 ± 7.1 days of life. Furthermore, normal results on Griffiths tests were also found in 13 patients with delayed normalization of serum TSH, i.e. ≥ 19 mU/l at the age of six weeks, as well as in patients with retarded skeletal maturity and/or very low neonatal serum levels of thyroxine, i.e. < 18 nmol/l and tri‐iodothyronine, i.e. <0.92 nmol/l. Our findings indicate that replacement dose of 6–11 μg l‐thyroxine/kg/d is adequate and allows normal psychological development if treatment is started early.
Adrenal Function in Asthmatic Children Treated with Inhaled Budesonide
Authors: BISGAARD H. , PEDERSEN S. , NIELSEN M. DAMKJÆR , ØSTERBALLE O.
Published: January 2008

Bisgaard, H., Pedersen S., Damkjær Nielsen M and Østerballe O. (Department of Paediatrics, University Hospital of Copenhagen, County of Gentofte, Copenhagen; Department of Paediatrics, County Hospital of Kolding; Department of Clinical Physiology, University Hospital of Copenhagen, County of Glostrup, Copenhagen; Department of Paediatrics, County Hospital of Viborg, Denmark). Adrenal function in asthmatic children treated with inhaled budesonide. Acta Paediatr Scand 80: 213, 1991

The effect of the inhaled topical steroid budesonide on adrenal function was evaluated in 33 children (aged 7–15 years) with moderate bronchial asthma. The trial was designed as a prospective single‐blind study of the effect of budesonide in daily doses of 200 μg through 400 μg to 800 μg in three randomized consecutive periods of 8 weeks. The unstimulated diurnal production of cortisol was assessed by measurement of free cortisol in 24‐hour urine samples at the end of each period. No significant dose‐related suppression was found. The cortisol production did not differ significantly during treatment with 800 μg budesonide as compared to treatment with 200 μg budesonide (95% confidence interval: 74%–112%). It is concluded, that budesonide is a topical steroid with a favourable ratio between topical and systemic effects in asthmatic children.
Vitamin K to Neonates: Peroral versus Intramuscular Administration
Authors: JØRGENSEN FINN STENER , FELDING PETER , VINTHER SØREN , ANDERSEN† GUNNAR EG
Published: January 2008

ABSTRACT. In a randomized study of 300 infants, the effect of 1 mg of peroral vitamin K given at birth was compared to the same dose given as an intramuscular injection. The combined activity of coagulation factor II + VII + X taken after 48 and before 72 hours after delivery served as the primary endpoint. Prothrombin (antigen) and PIVKA II (acarboxyprothrombin) were also measured. All infants were observed for events of bleeding until discharge from the hospital, normally on the fifth day. No significant differences between the groups in any of the biochemical markers were observed. The 95% confidence limits of the differences were very narrow for all factors. No cases of bleeding were observed. We conclude that administration of 1 mg peroral vitamin K is as efficient as intramuscular administration of the same dose in the prevention of classical hemorrhagic disease of the newborn.
The Effect of Aminophylline on the Excursions of the Diaphragm in Preterm Neonates: A Randomized Double‐Blind Controlled Study
Authors: HEYMAN E. , OHLSSON A. , HEYMAN Z. , FONG K.
Published: January 2008

ABSTRACT. Aminophylline is used to treat apnoea and to facilitate weaning from assisted ventilation in preterm infants. Aminophylline is thought to increase respiratory drive centrally. We performed a randomized controlled double‐blind study to determine if aminophylline increases the excursions of the diaphragm indicating a possible direct peripheral effect. Twenty‐two neonates were randomized to treatment with intravenous aminophylline (n= 11) or to no treatment (n= 11). An ultrasonographer, who was blinded to the group assignment, studied the diaphragmatic excursions using a real time sector scanner. The posterior one‐third of the right hemidiaphragm was localized and M‐mode was used to record the diaphragmatic excursions on paper. The neonates were studied in an awake but quiet state. Aminophylline resulted in an increase (43%) in the excursions of the diaphragm (p= 0.012) with no change in respiratory rate or pCO2. These findings indicate that aminophylline had a measurable effect on the diaphragmatic motion. Further studies combining this technique with other techniques are needed to determine if the main effect of aminophylline in the prevention of apnoea is mainly central or peripheral.
Initial Electroencephalographic Findings in Children with Acute Lymphoblastic Leukaemia
Authors: VAINIONPÄÄ L. , SAUKKONEN A.‐L. , LANNING M.
Published: January 2008

ABSTRACT. Electroencephalography (EEG) was performed on 66 children with acute lymphoblastic leukaemia, 45 before treatment and 21 during the first 5 days of chemotherapy. The patients, aged 7 months to 16 years, 33 boys and 33 girls, had been admitted to the Department of Paediatrics, University of Oulu, between March 1976 and January 1987. The EEG findings were compared with those in 66 age and sex‐matched control children chosen at random from the local population. The patients had significantly more frequent and more severe disturbances in background activity (p < 0.001) than the controls and increased slow waves in the occipital (p < 0.001) and temporal regions (p < 0.01). The patients who had received chemotherapy before the EEG recording had EEG disturbances significantly more frequently than the other patients (p < 0.01), but the latter still had EEG abnormalities significantly more frequently than their matched controls, although they did not have severe changes (grade 3). The results suggest that chemotherapy increases EEG changes during the early days of induction therapy and possibly induces long‐term disturbances in brain function. The associations between EEG changes and clinical findings were also analysed and the results show that a long duration of leukaemic symptoms or an aggressive disease may lead to EEG abnormalities.
Children in Sauna: Electrocardiographic Abnormalities
Authors: JOKINEN EERO , VÄLIMÄKI ILKKA
Published: January 2008

ABSTRACT. We studied changes in ECG in 81 children and 20 adolescents and young adults when they were exposed to heat stress in a climatic chamber, which resembled an ordinary Finnish sauna. Changes were similar to those caused by increased sympathetic activity in 57% of the subjects during the bath and in 23% during the recovery period. Three children had extrasystoles during and four after sauna. One previously healthy 5‐year‐old girl with wandering pacemaker sacred a 3.3 sec sinus arrest and had reversible junctional rhythm during the heat exposure. We conclude that, although these changes were transient and benign, the sinus arrest suggest that heat stress in sauna is considerable and may be risky for those children who have disorders of the sinoatrial node.
Neonatal Dubin‐Johnson Syndrome with Severe Cholestasis: Effective Phenobarbital Therapy
Authors: KIMURA A. , USHIJIMA K. , KAGE M. , MAHARA R. , TOHMA M. , INOKUCHI T. , SHIBAO K. , TANAKA N. , FUJISAWA T. , ONO E. , YAMASHITA F.
Published: January 2008

ABSTRACT. We described Dubin‐Johnson syndrome (DJS) with severe cholestasis in a 20‐day‐old Japanese boy. Although neonatal DJS has been sporadically reported, DJS with severe cholestasis has not to our knowledge been described in the English literature. The ratio of urinary coproporphyrin isomer I to urinary total coproporphyrin in our patient was high (93%). Liver histology showed cytoplasmic pigment granules in the liver cells. Administration of phenobarbital (PB) significantly decreased the levels of bilirubin and bile acids in the serum. There was a significant elevation of 1β‐hydroxylated bile acids in the urine. It is predicted that severe cholestasis in neonatal DJS may cause metabolic abnormalities in both bilirubin and bile acids transport.
Intestinal Perforation in a Two‐Year‐Old Child with Eosinophilic Gastroenteritis
Authors: AGERTOFT ARNE , HUSBY STEFFEN , HØST ARNE
Published: January 2008

ABSTRACT. A two‐year‐old boy underwent a laparatomy for an intestinal perforation due to eosinophilic gastroenteritis. He had marked peripheral blood eosinophilia and a small duodenal biopsy showed heavy eosinophilic infiltration in the mucosa. After 1 1/2 year on a restricted diet, a control duodenal biopsy showed only slight eosinophilia. Perforation of the small intestine is a rare but serious complication in eosinophilic gastroenteritis.
Pneumococcal Infections in Splenectomized Children Are Preventable
Authors: KONRADSEN H. B. , HENRICHSEN J.
Published: January 2008

ABSTRACT. Through the Danish National Patient Registry we identified all children 0–15 years old who had been splenectomized during the period 1979–87 and all children of the same age who, during the same period of time, had been admitted to a hospital because of either meningitis or bacteraemia caused by Streptococcus pneumoniae. We wanted to see whether any of the splenectomized children had developed invasive pneumococcal infection during the observation period.

A similar Danish study covering the period 1969–78, when pneumococcal vaccine was not available, has already been published (3). Four per cent of the children splenectomized during that period developed invasive pneumococcal infection in contrast to none of the children splenectomized and vaccinated during the period 1979–87. Since 1982 antibiotic treatment of splenectomized patients running a fever has been recommended, and we show that the program of pneumococcal vaccination and defined antibiotic prophylaxis has been highly efficacious in preventing post‐splenectomy infections in children.
The Risk of X‐Ray Examinations of the Lungs in Neonates
Authors: ARRØE M.
Published: January 2008

ABSTRACT.X‐ray examinations of the lungs is an important element in the evaluation of the neonates and their respiratory function. It is often necessary to perform a large number of X‐ray examinations depending upon the infant's birthweight, gestational age and respiratory problems. To estimate the risk of X‐ray examinations of the lungs the radiation dose to 18 infants at the Neonatal Intensive Care Unit, Hvidovre Hospital, was measured by means of a thermoluminescent dosimeter placed on the nipple of the infant. The radiation dose to various organs was estimated and the risk weighted whole body radiation dose calculated to 40 microsievert per examination (AP‐ and lateral). Using the latest increased risk factors this means an excess cancer mortality of 5 × 10‐1for boys and 11 × 10‐5for girls per millisievert, corresponding to 25 X‐ray examinations (AP‐ and lateral) of the lungs. It is concluded, that even using the latest increased risk factors, the radiation risk of repeated X‐ray examinations of the chest in prematures will be very low considering the benefit for the infant.