bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of thyroidal “C” cell secretion in osteoporotic girls with Turner's syndrome. Basal and calcium‐stimulated levels of total calcitonin, extractable calcitonin and katakalcin
Authors: Saggese G , Bertelloni S , Baroncelli GI , Federico G
Published: January 2008

Osteoporosis is a common finding in Turner's syndrome. To test the hypothesis that calcitonin deficiency may contribute to bone mineral loss in Turner's syndrome, we studied basal and calciumstimulated (2 mg/kg body weight in 5 min) levels of total calcitonin, extractable calcitonin and katacalcin in 15 girls with Turner's syndrome and osteoporosis. Fifteen age‐matched healthy girls were studied as controls. Both basal calcitonin (total and extractable) and katacalcin values were not significantly different in patients with Turner's syndrome in comparison with those of the controls. The calcium stimulation test showed a similar “C” cell secretory reserve in both groups. The calculation of ΔCT/ΔiCa of total and extractable calcitonin and ΔKC/ΔiCa, which accounts for individual variations in serum ionized calcium increases, did not show any significant difference between girls with Turner's syndrome and controls. We conclude that calcitonin deficiency is not a causative factor of osteoporosis in girls with Turner's syndrome and that in this syndrome long‐life estrogen deficiency does not impair “C” cell secretory activity.
Cigarette smoke exposure and development of infants throughout the first year of life: influence of passive smoking and nursing on cotinine levels in breast milk and infant's urine
Authors: Schulte‐Hobein Barbara , Schwartz‐Bickenbach Doris , Abt Susanne , Plum Claudia , Nau Heinz
Published: January 2008

The effects of smoke exposure via mothers' milk and/or via passive smoking during the first year of life were investigated in a prospective longitudinal matched‐pair study. The somatic and mental development of 69 infants whose mothers smoked more than five cigarettes per day throughout pregnancy and continued smoking after childbirth were compared with 69 children of non‐smoking mothers. At birth, mean body weight of neonates from smoking mothers was significantly lower than the weight of neonates from non‐smoking mothers. This weight difference between the two groups was no longer significant in infants at 12 months of age. With the methods employed by the authors, neither psychomotor nor mental development was affected by smoke exposure during pregnancy and early infancy. Infections of the lower respiratory tract were more frequent in the children of smoking mothers. These mothers weaned their babies earlier than non‐smokers, but the different feeding behaviour did not influence any of the clinical parameters that were investigated in this study. In order to evaluate the extent of smoke exposure, cotinine was measured in children's urine and in breast milk once a month throughout the first year of life. Cotinine in the urine was significantly dependent on feeding behaviour: infants breast fed showed concentrations 10‐fold higher than those who were bottle fed. Cotinine excretion in urine of infants from smoking mothers, who were not breast fed (nicotine exposure via passive smoking only) was even higher than that of adult passive smokers. If infants from smoking mothers were breast fed, their urinary cotinine excretion was in the range of adult smokers. During the nursing period a clear‐cut effect of mother's nicotine consumption on cotinine excretion of the infants could be demonstrated which was no longer discernible after weaning.
Feeding problems in an affluent society. Follow‐up at four years of age in children with early refusal to eat
Authors: Dahl M , Sundelin C
Published: January 2008

Twenty‐four children, previously investigated at 3–12 months of age for refusal to eat during at least four weeks with no apparent medical cause, were followed up prospectively and reinvestigated at four years of age. Comparisons were made with 38 controls, selected from the same child health care districts. Information was obtained from parental interviews, medical records and assessments by a speech therapist. At four years of age, 17 of the 24 children with early refusal to eat (71%) were reported by the parents to still have feeding problems and 10 (42%) were reported as hyperactive. Compared to the controls, the children with early refusal to eat seemed to have an equally good prognosis with respect to health, growth and development, but were at risk of later problems with their eating patterns and behaviour.
Obstructive sleep apnea in Arnold‐Chiari malformation treated with acetazolamide
Authors: Milerad J , Lagercrantz H , Johnson P
Published: January 2008

We studied respiratory patterns and transcutaneous gas pressures in two infants with Arnold‐Chiari type II malformation referred to us due to repeated episodes of stridor and cyanosis. During both active and quiet sleep, respiration was irregular and absent or inverse thoracic breathing movements and frequent decreases in oxygen saturation to below 80% were observed. When breathing air with 2% CO2 or when given acetazolamide 10 mg/kg, chest wall movements normalized and oxygenation increased to near normal levels. After three months of treatment with acetazolamide 20 mg/kg/24 h no further episodes of hypoventilation or hypoxemia were observed and further treatment could be discontinued. We conclude that stimulation of respiration by CO2 or by acetazolamide appears to recruit chest wall muscles and promote upper airway patency in Arnold‐Chiari malformation. A treatment trial with acetazolamide seems justifiable in these infants when respiratory problems are present.
Sleep and wakefulness in preadolescent children with deficits in attention, motor control and perception
Authors: Palm L , Persson E , Bjerre I , Elmqvist D , Blennow G
Published: January 2008

In 10 children with deficits in attention, motor control and perception (DAMP), the relation between daytime vigilance and night‐time sleep quality was examined with polygraphic sleep recordings, multiple sleep latency tests and measurements of reaction times. Two girls and eight boys, 6–12 years of age were studied. Eighteen normal children served as controls. Normal sleep regulation and sleep quality was found, but the children with DAMP tolerated the recording procedure less well than the controls. Most patients did not suffer from increased daytime sleepiness, but at MSLT 3, patients had short sleep latencies as in daytime hypersomnolence. Reaction times were significantly longer among the patients than among the controls. It is proposed that the findings may be related to functional changes in the forebrain.
Vitamin K status in cystic fibrosis
Authors: Cornelissen EAM , van Lieburg AF , Motohara K , van Oostrom CG
Published: January 2008

Appearance of PIVKA‐II (protein induced by vitamin K absence‐II) in serum is a biochemical sign of insufficient vitamin K‐dependent carboxylation of prothrombin. Plasma concentrations of PIVKA‐II and vitamin K1, were determined in 24 children with cystic fibrosis. Eight were supplemented with vitamin K1. The purpose of the study was to determine the occurrence of vitamin K deficiency in cystic fibrosis and to evaluate the effect of vitamin K supplementation. PIVKA‐II was detectable in only one unsupplemented child. In this patient, the concentration of vitamin K1 was below the limit of detection of 60 ng/l. Vitamin K1 levels in the other unsupplemented children were normal (mean 476 ng/l= 1 mmol/l). The supplemented patients showed extremely high levels of vitamin K1 (mean 22 445 ng/l = 50 nmol/l). In conclusion, vitamin K deficiency occurs infrequently in cystic fibrosis. Checking the coagulation system is advised, but routine vitamin K supplementation is not recommended. If additional vitamin K is needed, the starting dose should not exceed 1 mg daily.
Atrial natriuretic peptide in the diagnosis of patent ductus arteriosus
Authors: Weir FJ , Smith A , Littleton P , Carter N , Hamilton PA
Published: January 2008

The aim of this study was to measure plasma atrial natriuretic peptide in preterm infants with a patent ductus arteriosus before and after closure with indomethacin. Atrial natriuretic peptide was measured in 28 preterm infants with clinical and echocardiographic evidence of a patent ductus arteriosus and in eight preterm infants who did not develop clinical evidence of a patent ductus arteriosus. Plasma concentration of atrial natriuretic peptide was measured by radioimmunoassay. In 18 infants the patent ductus arteriosus closed after one course of indomethacin; atrial natriuretic peptide levels decreased from median 1240 pg/ml (range 201–5483 pg/ml) to 266 pg/ml (range 62–1108 pg/ml). In four infants the patent ductus arteriosus closed after two courses of indomethacin and two infants had surgical ligation after indomethacin treatment failed. The patent ductus arteriosus closed spontaneously in four infants (atrial natriuretic peptide median level 152 pg/ml, range 61–495 pg/ml). In the eight infants without patent ductus arteriosus, atrial natriuretic peptide level was median 224 pg/ml (range 38–876 pg/ml). Measurement of plasma atrial natriuretic peptide concentration has a role in predicting when indomethacin treatment is indicated.
Single daily doses of trimethoprim/sulphadiazine for three or 10 days in urinary tract infections
Authors: Gaudreault P , Beland M , Girodias JB , Thivierge RL
Published: January 2008

We conducted a prospective randomized study to evaluate the efficacy of a single daily dose of 4 mg/kg of trimethoprim coupled with 17.5 mg/kg of sulphadiazine for three (group 1) or 10 days (group 2) in the treatment of uncomplicated urinary tract infections in children. Forty patients (nine boys and 31 girls) aged 2.5‐18 years, presenting with a urinary tract infection were allocated to one of the two groups. Patients were seen three, 10, and 38 days after the initiation of treatment. Control urine cultures were negative in all patients at days 3 and 10. Two patients in group 1 and one patient in group 2 suffered a relapse within a month. Single doses of trimethoprim/sulphadiazine for three or 10 days are effective in the treatment of uncomplicated urinary tract infections in children.
The role of the duodenal microflora as a determinant of persistent diarrhoea
Authors: Penny ME
Published: January 2008

It has been suggested that proliferation of enterobacteriaceae and/or anaerobes in the duodenum of some children with acute diarrhoea determines whether the episode becomes persistent. A review of published studies and the comparison of cultures of duodenal aspirates from Peruvian children with acute and persistent diarrhoea and diarrhoea‐free children did not support this hypothesis. Although many children had enterobacteriaceae and/or anaerobes cultured there was no correlation with clinical and nutritional outcome. Age, nutritional status, the environment and the aetiology of the episode were determinants of the duodenal microflora independent of diarrhoea. Culture of the duodenal aspirates did not increase the yield of enteropathogens which were isolated more frequently from stools than from the duodenum. Despite the presence of a single strain or serotype of enterobacteriaceae suggesting that these bacteria were colonizing the duodenum, we were unable to demonstrate any adherence mechanisms in the majority of them. Two often bacteria with no other evidence of virulence caused diarrhoea in the RITARD rabbit model.
Lactose feeding during persistent diarrhoea
Authors: Penny Mary E , Brown Kenneth H
Published: January 2008

Lactose intolerance is a recognized complication of some episodes of diarrhoea. Whereas it is of clinical importance in relatively few children with acute diarrhoea it seems to be a more common problem in children presenting with persistent diarrhoea, especially in malnourished children with severe diarrhoea. We describe a recent study which also demonstrated adverse clinical and nutritional consequences in the majority of children with mild but persistent diarrhoea consuming 6 g lactose/kg body weight/d. It is desirable to identify these children who need to reduce their lactose intake in order to limit unnecessary dietary changes which are expensive to implement and/or nutritionally disadvantageous. Admission clinical characteristics were analyzed for their ability to predict clinical outcome in a group of 33 children with persistent diarrhoea taking a lactose‐containing diet. The results of tests of stool reducing substances and a lactose breath hydrogen test (LHBT) were analyzed in the same group whose clinical management had been independent of the test results. Eighty‐nine percent of children who deteriorated had one of the following characteristics: age <12 months, weight‐for‐height less than ‐2 SD below NCHS norms or fever >37°C. Children who unequivocally improved while continuing to take lactose could not be selected without the risk of including children who deteriorated. Neither tests of stool reducing substances nor the LBHT improved the predictive value of simple clinical parameters. Reduction of lactose in the diet of children with persistent diarrhoea who have any of these parameters is recommended, but mixing of milk with cereal or substituting with fermented milk products is preferable to milk withdrawal or dilution with water.
A community‐based prospective incidence study of epileptic seizures in children
Authors: Sidenvall R , Forsgren L , Blomquist H K:son , Heijbel J
Published: January 2008

During a 20‐month period, an attempt was made to find all children with unprovoked non‐febrile seizures. The first attendance and incidence rates were 95 and 89/100 000, respectively, in the age group 0–15 years. These figures are lower than those found 10 years earlier in the same area. The highest incidence was during the first year of life and there was a higher proportion of girls (male: female ratio 1:1.4). Generalized seizures dominated in the first year of life. The incidence of benign childhood epilepsy with centro‐temporal spikes was 10.7/100 000 and was the most common epilepsy syndrome found. The incidence of partial seizures increased with age up to the age of 10 yeqars. One in 10 children had a history of febrile convulsions.
Diffuse neonatal haemangiomatosis in a newborn child
Authors: Stenninger E , Schollin J
Published: January 2008

Diffuse neonatal haemangiomatosis is a severe disease with a high mortality. It is characterized by multiple haemangiomas at birth affecting the skin and visceral organs. A case of diffuse neonatal haemangiomatosis in a newborn child with a favourable outcome after steroid treatment is described.
Influence of dietary taurine on vitamin D absorption
Authors: Zamboni G , Piemonte G , Bolner A , Antoniazzi F , Dall'Agnola A , Messner H , Gambaro G , Tatò L
Published: January 2008

To evaluate the influence of dietary taurine supplementation on vitamin D absorption, we studied three groups of infants: 21 (11 preterm) were fed a taurine‐free formula, 21 (10 preterm) were fed a taurine‐supplemented formula (50 mg/100 g of powder) and 20 (9 preterm) were fed human, not heat‐treated milk. Taurine, total bile acids, glyco‐(GBA) and tauro‐(TBA) conjugated bile acids, 25–hydroxyvita‐min D3 (250HD3) and 1,25–dihydroxyvitamin D3 (1,250H2D3) were determined in all infants at birth in blood cord and at one and three months of life. In preterm infants fed a taurine‐free formula, we found lower plasma taurine levels than in infants of other groups at one and three months of life. In these infants, GBA predominated, with a G/T ratio of 1.1 and 1.4 at one and three months of life, whereas in all other infants TBA predominated with a G/T ratio always < I. Also, 250HD3 and 1,250H2D3 levels were significantly lower in preterm infants fed a taurine‐free formula than in infants fed a taurine‐enriched formula or human milk. Term infants fed a taurine‐free formula did not show differences in the parameters studied in comparison to infants of other groups. Low taurine dietary intake appears to compromise vitamin D absorption in preterm infants, and therefore taurine supplementation of preterm infant formulas should be encouraged.
Protection against Campylobacter diarrhea: role of milk IgA antibodies against bacterial surface antigens
Authors: Torres O , Cruz JR
Published: January 2008

In developing countries, Campylobacter jejuni causes diarrhea and dysentery, especially in children less than one year of age. Breast feeding protects against infectious diarrhea, with milk IgA antibody playing a determining role. Therefore, it has been proposed to increase the protective effect of human milk by vaccinating women of child‐bearing age. To identify antigens which may induce protective breast‐milk IgA, we analyzed 60 strains of C. jejuni isolated from asymptomatically‐ and symptomati‐cally‐infected breast‐fed children less than 12 months of age. Surface antigens of c. jejuni, separated by polyacrylamide gel electrophoresis, were probed with breast milk collected concurrently with the fecal sample from which C. jejuni was isolated, and specific IgA was developed by immunoblotting. Our results indicate that milk antibodies against three high molecular weight bacterial surface antigens of 95, 110 and 185 kDa are involved in protection of infants infected with C. jejuni (p = 0.00964 for one‐tailed Fisher's cxact test).
Urinary albumin excretion rate and puberty in non‐diabetic children and adolescents
Authors: Bangstad H‐J , Dahl‐Jørgensen K , Kjæxsgaard P , Mevold K , Hanssen KF
Published: January 2008

Slightly elevated urinary albumin excretion rate (microalbuminuria) is a marker of early diabetic nephropathy, but it is unclear if the established definition of microalbuminuria (20–200 μg/min) is correct for children and adolescents. We investigated the albumin excretion rate, albumin/creatinine ratio and urinary albumin concentration in 150 healthy schoolchildren and adolescents to (a) obtain a reference value for albumin excretion rate, (b) relate albumin excretion to pubertal stages and (c) evaluate albumin/creatinine ratio and morning albumin concentration as screening methods for elevatcd albumin excretion rate. Albumin concentration was measured by immunoturbidimetry in timed overnight urine samples. The albumin excretion showed a skewed distribution (geometric mean 3.2 μg/min, 95 percentile 15.1 μg/min). In girls, a peak in the albumin excretion rate was found at the pubertal stage 4 (Tanner) and in boys at stage 5. Albumin/creatinine ratio of 2.5 mg/mmol as a scrccning level for elevatcd albumin cxcrction (15 μg/min) showed a high positivc (0.88) and negative (0.99) predictive value.
Value of absent or retrograde end‐diastolic flow in fetal aorta and umbilical artery as a predictor of perinatal outcome in pregnancy‐induced hypertension
Authors: Eronen Marianne , Kari Anneli , Pesonen Erkki , Kaaja Risto , Wallgren Eric Ivar , Hallman Mikko
Published: January 2008

There is insufficient data on the value of absent or retrograde end‐diastolic flow (AREDF) in the fetal umbilical artery, descending aorta and aortic arch to predict perinatal outcome. In this prospective investigation, 65 pregnant women between 24 and 34 weeks' gestation with pregnancy‐induced hypertension were studied by color Doppler echocardiography. Pregnancies leading to birth at or before 34.0 gestational weeks (23 with and 19 without AREDF) were included in the outcome analysis. Fetuses with AREDF were delivered at earlier gestational ages (p = 0.006). They had a higher incidence of gastrointestinal complications (p= 0.01), bronchopulmonary dysplasia (p= 0.03), intraventricular hemorrhage (p= 0.03) and vascular hypotension (p= 0.03) than those without AREDF. The presence of AREDF was associated with a mortality rate of 30%, whereas in fetuses without AREDF there was no mortality (p= 0.61). Using logistic regression and taking into consideration various perinatal factors, the presence of AREDF (p= 0.03) and early gestational age (p= 0.0001) were associated with serious neonatal diseases or death. A reverse diastolic flow in the aortic isthmus was registered in five fetuses; three died during the perinatal period and one was severely damaged. According to our results, AREDF, particularly with the appearance of reverse diastolic flow in the isthmus of the aortic arch, is a predictor of poor neonatal outcome.
Excitatory amino acids in the cerebrospinal fluid of asphyxiated infants: relationship to hypoxic‐ischemic encephalopathy
Authors: Hagberg Henrik , Thornberg Eva , Blennow Mats , Kjellmer Ingemar , Lagercrantz Hugo , Thiringer Klara , Hamberger Anders , Sandberg Mats
Published: January 2008

Asphyxiated (n = 27) and control infants (n = 25) were subjected to spinal taps. Amino acids were measured with liquid chromatography and the degree of hypoxic‐ischemic cncephalopathy was determined in each case. In asphyxiated infants, the concentrations of aspartate and glutamate were 286% and 387% (p≤0.01 and p≤ 0.05) of the control values. respectively. The Cerebrospinal fluid aspartate levels were significantly (p≤ 0.05) higher in the group with severe (3.4 μmol/l) compared with the group with mild hypoxic‐ischemic encephalopathy (1.0 μmol/l). Glutamate was also higher in the group with severe (12.3 μmol/l) than in the groups with mild (2.7 μmol/l) or moderate (3.2 μmol/l) hypoxic‐ischemic enccphalopathy (p≤ 0.05). High concentrations of excitatory amino acids were present in the CSF of asphyxiated infants which may exert excitotoxic effects.
Treatment of renal anemia by subcutaneous erythropoietin in children with preterminal chronic renal failure
Authors: Scharer K , Klare B , Braun A , Dressel P , Gretz N
Published: January 2008

Eleven children aged 0.6–17 years with preterminal chronic renal failure and anemia (mean serum creatinine concentration 4.8 mg/dl; mcan hemoglobin concentration 7.9 g/dl) were treated with sc injections of recombinant human crythropoictin (EPO, initial dose 150 U/kg/week) over a mean period of 13 months. When a target hemoglobin concentration of 11.5–13.5 g/dl was reachcd, the dose was adapted. Iron deficiency was corrected. Hemoglobin concentration increased by > 2 g/dl in all patients within 14–119 (mean 45) days. The last maintenance dose ranged between 75 and 300 (mean 133) U/kg/ wcek. No major adverse effects were observed, except for hypertension which occurred in about half of the patients and necessitated interruption of EPO in one child with advanced renal failure. Additional antihypertensive drugs were given to five patients. Body height increascd in two patients by 0.6 and 1.3 SDS/year, respectively. In six patients with a mean observation period of 14 months before and 16 months after the start of EPO, the mean slope of the reciprocal serum creatinine concentration curve improved slightly (p = 0.05). The proposed schedule appears to be safe for the treatment of renal anemia in most pre‐dialysis paticnts. Frequent monitoring of hemoglobin, blood pressure, serum crcatinine and ferritin is required.
Sudden natural death in childhood. A review of forensic autopsy protocols in cases of sudden death between the ages of one and five years, 1982–1991, with a special view to sudden unexplained death
Authors: Helweg‐Larsen Karin , Garde Ellen
Published: January 2008

All cases of sudden death of individuals between the ages of one and five years examined at the Forensic Institute, Copenhagen, in a 10‐year period were identified to assess the impact of sudden unexplained death in this age group. Of a total of 68 cases, 27 cases were due to accidents, there were 13 cases of homicide, 27 cases were sudden natural deaths and in 1 case the manner of death was uncertain. The autopsy records and histological sections in the 27 cases of natural death were reviewed; the cause of death was not explained in 11 of these cases (40%). Seven cases were previously considered to be caused by infectious disease or aspiration. Criteria for classification are discussed.
Silver‐like syndrome and a small deletion on chromosome 13
Authors: Wahlström Jan , Holmgren Gösta , Albertsson‐Wikland Kerstin , Törnhage Carl‐Johan
Published: January 2008

A female child is described with features of Silver's syndrome, including pre‐ and postnatal growth delay, triangular face, hypertelorism, clinodactyly and developmental delay. In all lymphocytes analyzed, a small deletion was found in chromosome 13. The karyotype was 46,XX,del(13)(q22–32).
Carnitine metabolites in infants with cystic fibrosis: a prospective study
Authors: Lloyd‐Still John D , Powers Catherine A , Wessel Hans U
Published: January 2008

Acylcarnitine is low in cord blood in patients with cystic fibrosis, suggesting that fatty acid metabolism is disturbed in utcro. Carnitine metabolites (total, free, short‐ and long‐chain acylcarnitine) were measured prospectively in 23 newly diagnosed infants with cystic fibrosis treated with a carnitine‐containing, predigested formula for 6–12 months. Total (p< 0.002), free (p< 0.004), and long‐chain (p < 0.001) plasma concentrations of carnitines were significantly less than controls (n = 48) at diagnosis. Total and free concentrations were corrected with nutritional management, whereas short‐and long‐chain acylcarnitines remained unchanged. By three years of age all plasma concentrations of carnitine metabolites were significantly less than controls despite a carnitine‐containing diet. Urinary carnitine metabolites were increased at diagnosis and follow‐up. The physiological significance of these observations in cystic fibrosis is unknown, but could be compatible with disturbed regulatory control with resultant increased utilization.
Diabetes mellitus in cystic fibrosis: genetic and immunological markers
Authors: Lanng S , Thorsteinsson B , Pociot F , Marshall MO , Madsen HO , Schwartz M , Nerup J , Koch C
Published: January 2008

Family history, as well as genetic and immunological markers of diabetes mellitus, were studied in cystic fibrosis (CF) patients with and without diabetes mellitus. Positive family history of diabetes mellitus in first‐degree relatives was found in only 6 of 210 (3%) CF patients, with no difference between non‐diabetic and diabetic patients. The frequency distributions of the HLA types DR3, DR4 and DR3/4, which normally confer susceptibility to insulin‐dependent diabetes mellitus and of HLA‐DR2, which normally confers resistance to insulin‐dependent diabetcs mellitus, were not different in non‐diabetic CF patients, diabetic CF patients and normal subjects. The genotypic frequencies of tumor necrosis factor‐β and of heat shock protein 70, located within the HLA region on chromosome 6, in CF patients with diabetes were not different from those in patients with insulin‐dependent diabetes mellitus, while non‐diabetic CF patients and normal subjects shared other patterns. The frequencies of the interleukin‐1β alleles, located on chromosome 2, were not different in non‐diabetic and diabetic CF patients, insulin‐dependent diabetic patients and normal subjects. Islet cell cytoplasmic antibodies. measured before, at and after the diagnosis of diabetes in 33 diabetic CF patients and in 32 matched non‐diabetic CF patients, were detected in only 2 of 236 (0.8%) serum samples; m a pre‐diabetic patient and in a non‐diabetic control patient. Birth weights were not different in diabetic and non‐diabetic CF patients, arguing against the importance of the intrauterine environment as a determinant in the transmission of diabetes mellitus in CF patients. We conclude that diabetes mellitus in CF is without family history of diabetes mellitus, HLA‐DR association, and serological evidence for autoimmune destruction of the β‐cells. The significance of similar frequcncies of tumor necrosis factor‐β and heal shock protein 70 alleles in insulin‐dependent diabetic patients and diabetic CF patients remains to bc determined.
Early treatment with nasal continuous positive airway pressure in very low‐birth‐weight infants
Authors: Kamper J , Wulff K , Larsen C , Lindequist S
Published: January 2008

During 1988 and 1989, a regional cohort of 81 infants with birth weights less than 1501 g were treated with oxygen only (n= 11), early continuous positive airway pressure (CPAP) (n = 68) or mechanical ventilation from birth (n = 2). We used an easily applicable lightweight CPAP system with nasal prongs and a gas jet supplemented with ventilator treatment if necessary, but with conservative criteria for ventilator treatment with tolerance of high PCO2. A total of 65 infants (80%) survived to discharge, 61 of whom were supported solely with CPAP or oxygen. Nineteen infants (26%) developed periventricular‐intraventricular haemorrhage, but only 4 survivors (6%) developed prognostically significant bleedings grade 2–4. No survivors had bronchopulmonary dysplasia. Follow‐up at 12–39 months of age revealed definite disabilities in 6 (10%) and suspected disabilities in 2 of 62 long‐term survivors. The results suggest that treatment by early CPAP with nasal prongs with tolerance of high PCO2 may be effective and lenient in most infants more than 25 weeks' gestation.
Urinary malondialdehyde concentration in preterm neonates: is there a relationship to disease entities of neonatal intensive care?
Authors: Schlenzig J‐S , Bervoets K , Loewenich V von , Böhles H
Published: January 2008

In a retrospective study, urinary malondialdehyde concentration in 45 preterm neonates (25–35 weeks' gestation) during their first month of life was measured by HPLC. Urine was collected on different days of life as a 3‐h sample. The frequency of urine collection and measurement varied between one (n = 22) and seven times (n = 8) per child. The study group was divided into three categories according to birth weight: low‐birth‐weight infants (LBW) (n= 16), very low‐birth‐weight infants (VLBW) (n = 17) and extremely low‐birth‐weight infants (ELBW) (n=12). Urinary malondialdehyde concentration was highest in the ELBW group: 1.15 (0.66, 2.12) μmol/l (median and quartiles) versus 0.58 (0.34, 1.18) μmol/l in the VLBW and 0.60 (0.40, 1.06) μmol/l in the LBW groups (ELBW versus VLBW, p < 0.005; ELBW versus LBW, p<0.02). In oxygen‐treated neonates, significantly higher malondialdehyde values were found compared to those without supplementary oxygen (0.89 (0.48, 1.74) versus 0.58 (0.32, 0.89) μmol/l; p < 0.005). Likewise, a higher malondialdehyde concentration was found in infants requiring mechanical ventilation (intermittent mandatory IMV or high frequency ventilation) compared to those breathing spontaneously (intermittent mandatory ventilation: 0.80 (0.42, 1.66); p < 0.05 and high frequency ventilation: 1.20 (0.83, 2.13); p < 0.001 versus 0.57 (0.33, 0.88) μmol/l). Malondialdehyde concentrations correlated significantly with FiO2 yalues of the individual patients (r = 0.22; p<0.02). Comparing urinary malondialdehyde concentrations in infants with and without bronchopulmonary dysplasia, a significantly higher malondialdehyde concentration was found in the former group (0.96 (0.51, 2.07) versus 0.60 (0.32, 0.98) μmol/l;p<0.005)). Infants with patent ductus arteriosus had a higher urinary malondialdehyde concentration than those without patent ductus arteriosus (1.04 (0.58, 3.78) versus 0.64 (0.36,1.20) μmol/l;p 0.05)). Malondialdehyde concentrations were also higher in infants with intracranial bleeding compared to those without (0.83 (0.46, 1.42) versus 0.56 (0.33, 1.10) μmol/l; p<0.02)). No significant differences in urinary malondialdehyde concentration were seen, either in relation to i v feeding with or without lipid emulsion or to medication administered. Native malondialdehyde concentration in seven commercial preparations of lipid emulsion after various periods of storage was fairly constant (12.3 ± 0.4 μmol/l) (mean ± SD).
Longitudinal evaluation of glucose tolerance and insulin secretion in non‐diabetic children and adolescents with cystic fibrosis: results of a two‐year follow‐up
Authors: Arrigo T , Cucinotta D , Nibali S Conti , Cesare E Di , Benedetto A Di , Magazzù G , De Luca F
Published: January 2008

Thirty‐two patients with cystic fibrosis and repeatedly normal fasting blood glucose underwent oral glucose tests and islet‐cell antibody assessments on two occasions approximately two years apart. Fourteen patients underwent two iv glucose tolerance tests also. Although in the group as a whole mean glucose areas in response to the oral test remained substantially unmodified over the two‐year period, the prevalence of glucose tolerance abnormalities increased from 37.5 to 50%. Insulin output in response to both oral and iv tolerance tests decreased over time. Worsening of insulin secretion and/or of glucose tolerance was never accompanied by deteriorating clinical status. Islet‐cell antibodies were detected in no patients, even in those who developed a diabetic glucose tolerance. These results support, on a longitudinal basis, the view of a progressive impairment of B‐cell function in cystic fibrosis, which may precede the onset of metabolic abnormalities and is not triggered by autoimmunity.
Successful trimethoprim‐sulfamethoxazole therapy in a patient with hyperimmunoglobulin E syndrome
Authors: Hattori Kazuhiro , Hasui Masafumi , Masuda Kiyokazu , Masuda Midori , Ogino Hirotaro , Kobayashi Yohnosuke
Published: January 2008

A male patient with hyperimmunoglobulin E syndrome is described. Recurrent lymphadenitis and cutaneous staphylococcal abscesses were resistant to various antibiotics, and chemotaxis and hydrogen peroxide production of polymorphonuclear leukocytes were impaired. Following trimethoprim‐sulfamethoxazole therapy, he was free from the above infections, and impaired polymorphonuclear leukocyte functions recovered and serum IgE decreased to approximately one‐fifth of its initial level. Subsequent irregular medications, however, resulted in impairment of polymorphonuclear leukocyte functions and an increased serum IgE concentration, which recovered after regular resumption of trimethoprim‐sulfamethoxazole treatment. From these results, the beneficial effects of trimethoprim‐sulfomethoxazole in hyperimmunoglobulin E syndromgak clinically apparent, but in vitro studies failed to demonstrate the positive effect of trkethoprim‐sulfamethoxazole on polymorphonuclear leukocytes and their mechanism still remains to be elucidated.
Clinical and sonographic assessment of liver size in normal Chinese neonates
Authors: Chen Chung‐Ming , Wang Jian‐Jia
Published: January 2008

Liver size and midclavicular line were measured by clinical and sonographic methods in 145 normal Chinese neonates with gestational ages of 34–42 weeks. The liver span, measured by clinical methods with percussion and percussion/palpation methods, correlated well with that measured by sonography (r= 0.73 and r= 0.76, respectively) for the entire sample. The liver spans (mean ± SD) obtained by sonography were 4.24 ± 0.63 cm and 4.58 ± 0.56 cm in the preterm and term neonates, respectively. The liver span (sonography) and the distance of the liver edge below the right costal margin were weakly related in the term neonates (r= 0.36), but unrelated in the preterm neonates. We conclude that the liver span is a better estimate of liver size than the distance below the right coastal margin in normal neonates. We also found that the mean liver span is approximately 1 cm smaller in Chinese neonates than in Western neonates.
Comparison of radiological findings and microbial aetiology of childhood pneumonia
Authors: Korppi Matti , Kiekara Olavi , Heiskanen‐Kosma Tarja , Soimakallio Seppo
Published: January 2008

Sixty‐one children were treated in hospital from 1981 to 1982 because of both radiologically and microbiologically verified viral or bacterial pneumonia. The chest radiographs were interpreted by two radiologists, not familiar with the clinical data, on two occasions three years apart, and only those patients with a definite alveolar (n= 27) or interstitial (n= 34) pneumonia at both evaluations were included in the present analysis. In addition, all patients had viral (n= 20), mixed viral‐bacterial (n = 21) or bacterial (n= 20) infections diagnosed by viral or bacterial antibody or antigen assays. Viral infection alone was seen in 7 (26%), mixed viral‐bacterial infection in 8 (30%) and bacterial infection alone in 12 (44%) of the 27 patients with alveolar pneumonia. The respective figures were 13 (38%), 13 (38%) and 8 (24%) for the 34 patients with interstitial pneumonia. C‐reactive protein concentration was greater than 40 mg/l (a screening limit for viral and bacterial infections) in 15 (56%) of the patients with alveolar and in 11 (32%) of the patients with interstitial pneumonia. Thus 74% of the patients with alveolar and 62% with interstitial pneumonia had bacterial infection, either alone or as a mixed viral‐bacterial infection. Our results suggest that the presence of an alveolar infiltrate in a chest radiograph is a specific but insensitive indicator of bacterial pneumonia. We conclude that patients with alveolar pneumonia should be treated with antibiotics. In patients with interstitial pneumonia, however, both viral and bacterial aetiology are possible. In those, the decision concerning antibiotic treatment should be based on clinical and laboratory findings.
Familial hemophagocytic lymphohistiocytosis and viral infections
Authors: Henter Jan‐Inge , Ehrnst Anneka , Andersson Jan , Elinder Göran
Published: January 2008

A retrospective study was performed in 32 children with hemophagocytic lymphohistiocytosis, 16 of whom had affected siblings. Altogether 22 of these children, of whom the majority (13/22) were familial cases, had clinical or laboratory signs of infection. Laboratory analysis demonstrated Epstein‐Barr virus in five children, cytomegalovirus in three and human parvovirus in two. Two siblings with onset of familial hemophagocytic lymphohistiocytosis within one month of each other, both of whom demonstrated serological indications of a recent human parvoviral infection at onset, are described. It is concluded that a viral infection cannot serve as the sole criterion for distinguishing a virus‐associated hemophagocytic syndrome as an entity separate from familial hemophagocytic lymphohistiocytosis. Instead, it is suggested that viral infections may elicit a bout of the familial hemophagocytic lymphohistiocytosis disorder in genetically predisposed individuals.
Early determinants of cardiovascular risk factors in adults. B. Blood pressure
Authors: Kolaček S , Kapetanovic T , Lužar V
Published: January 2008

The aim of this follow‐up study was to investigate the effect of birth weight, infant nutrition, past and contemporary social status and anthropometry on systolic and diastolic blood pressure in adult subjects. There were 465 boys and girls, originating from three different regions of Croatia, examined in the first three years of life, and again approximately 18 years later. The analyses showed that birth weight was inversely related to systolic blood pressure in adult subjects. The highest systolic pressure was found in subjects with the lowest birth weight and the greatest current body mass index. Relative weight in the first three years of life was also inversely related to systolic blood pressure, but only in adult males. Neither the type of milk given, nor the duration of breast feeding and the time of weaning had any significant influence on blood pressure in adult subjects. According to multivariate regression analyses, the significant predictors of higher systolic and diastolic pressure in adult males were: lower father's height, greater current body mass index, lower birth weight and low original social status. In female subjects, the significant predictors were: lower birth weight, greater current body mass index and lower social class of origin. In conclusion, influences of poor environment acting in early childhood may be important determinants of blood pressure in adulthood.
Choledochal cysts: a nine‐year review
Authors: Shian Wen J , Wang Yng J , Chi Ching S
Published: January 2008

Hospital records of 24 Chinese infants and children (7 males and 17 females) with choledochal cysts were reviewed. The patients were aged 1 day to 17 years. Abdominal pain, palpable abdominal mass and jaundice, either alone or in combination, accounted for most of the initial presentations. Twenty‐two patients were classified as type I with surgery, while the other two patients were type V without surgery. Ultrasonography is a rapid and accurate diagnostic method in the initial evaluation. Cyst excision wth Roux‐en‐Y hepaticojejunostomy was the treatment of choice in this series. Chronic cholecystitis with or without inflammation of choledochal cyst was the most common pathological finding. Five patients underwent liver biopsies, showing four biliary cirrhosis and one portal fibrosis. So far, there is no evidence of malignancy in any patient.
Subependymal pseudocysts: ultrasound diagnosis and findings at follow‐up
Authors: Rademaker KJ , Vries LS De , Barth PG
Published: January 2008

During a two‐year period, subependymal pseudocysts were diagnosed in 24 infants using cranial ultrasound: 8 were located at the external angle of the lateral ventricle and 16 at the caudothalamic notch. Associated congenital anomalies were present in six infants and CMV was isolated in one case. Four of the eight infants with pseudocysts at the external angle were one half of twins. As all but one of the surviving infants with pseudocysts were normal at follow‐up (at 3–24 months of age), it is important to make a distinction between pseudocysts and extensive cystic periventricular leukomalacia, as the latter condition invariably leads to cerebral palsy and/or visual impairment.
Abnormal responses of common variable immunodeficiency patients’B cells to Staphylococcus aureus Cowan I and interleukin‐2
Authors: Inoue Yuko , Kondo Naomi , Motoyoshi Fumiaki , Inoue Ryosuke , Orii Tadao
Published: January 2008

Responses of common variable immunodeficiency patients’B cells to Staphylococcus aureus Cowan I (SAC) and recombinant interleukin‐2 (rIL‐2) varied in our study T‐cell function and IL‐2 production were normal, and intrinsic B‐cell defects were suggested. Some patients showed no increase in expression of IL‐2 receptors on B cells with SAC stimulation, which may be due to impaired maturation stages. Two patients showed an increased level of B cells with IL‐2 receptors, suggesting blocked development of intracellular mechanisms. One patient may have a defect in immunoglobulin isotype switching.
Congenital hypopituitarism and microphthalmia. Report of two cases
Authors: Kaplowitz PB , Bodurtha J
Published: January 2008

Two children are described who had microphthalmia (one with unilateral and one with bilateral) noted at birth, and whose early onset of poor linear growth and weight gain led to a diagnosis of hypopituitarism prior to two years of age. Both children had growth hormone and thyroid‐stimulating hormone deficiencies, and evidence of partial ACTH deficiency. Administration of growth hormone resulted not only in rapid linear growth but it also reversed the poor weight gain and head growth noted in these children. These cases suggest that hypopituitarism and microphthalmia may be associated with each other more frequently than has been recognized previously.
Lead encephalopathy mimicking a cerebellar tumor
Authors: Perelman S , Hertz‐Pannier L , Hassan M , Bourrillon A
Published: January 2008

Encephalopathy is a rare but severe complication of lead poisoning, mainly due to cerebral edema. Usually diffuse, symptoms and signs are sometimes focal, suggesting a false diagnosis of tumor, particularly cerebellar tumor. We report such a case diagnosed by MR imaging in which early treatment for edema avoided neurosurgical exploration. Only six cases have been published since Biemond and Van Creveld's first report in 1939. Several data—clinical and experimental—providing specific involvement of cerebellum in lead poisoning are emphasized.
Weight to length ratio—a good parameter for determining nutritional status in preterm and full‐term newborns
Authors: Yau Kuo‐Inn Tsou , Chang Mei‐Hwei
Published: January 2008

To identify which parameter showed the strongest correlation with neonatal body fat store, when the ratios for assessing both weight‐for‐length and the mid‐arm circumference to head circumference (MAC/HC) were included in the analysis, body anthropometrics and skinfold thickness were measured in 250 full‐term and 125 preterm infants. Among the study cases, 66.7% were appropriate for gestational age, 26.7% were small for gestational age and 6.7% were large for gestational age. Sum of the skinfold thickness measured at the midtricepital and subscapular areas correlated well with body anthropometrics, weight/length ratio, body mass index, ponderal index and mid‐arm circumference to head circumference ratio. Multiple stepwise regression analysis revealed that the weight/length ratio correlated best with skinfold thickness in both full‐term and preterm newborn infants. Therefore, the simple weightllength ratio might be useful for evaluation of the nutritional status of intrauterine growth, and in the prediction of metabolic complications in both full‐term and preterm newborns with abnormal intrauterine growth.
Longitudinal follow‐up of growth in children born small for gestational age
Authors: Albertsson‐Wikland K , Wennergren G , Wennergren M , Vilbergsson G , Rosberg S
Published: January 2008

Postnatal growth was followed in a population‐based group of 123 small‐for‐gestational‐age (SGA, birth weight < ‐2 SD) children (66 boys and 57 girls) to four years of age in order to determine the incidence and time of catch‐up growth. Gestational age was determined by ultrasound in gestational weeks 16–17 in all pregnancies, thus eliminating the problem of distinguishing between SGA and preterm infants. Infants with well‐defined causes for slow growth rate, i.e. those infants with chromosomal disorders, severe malformations, intrauterine viral infections or cerebral palsy, were excluded. The boys showed an extremely fast weight catch‐up, 85% of them reaching weights greater than ‐2 SD at the age of three months and remaining above this level to the end of the study period. Such a fast catch‐up growth was observed in only two‐thirds of the girls, but at four years of age 85?4 of the girls were also above ‐2SD. Length catch‐up was more gradual than weight catch‐up. Of the boys, 54% had lengths below ‐2 SD at birth, 26% at 1 year of age, 22% at 2 years of age, 17% at 2.5 years of age and 11% (n= 8) at 4 years of age. Corresponding figures for girls were: 69% at birth, 28%) at 1 year, 15% at 2 years, 12% at 2.5 years and 5%) (n = 3) at 4 years. At 4 years of age, only six boys and three girls remained below ‐2 SD for both weight and height. We conclude that in Sweden the prognosis for catch‐up growth for an SGA child, when children with well‐defined causes of growth disturbances are excluded, is very good and it is extremely rare for the child still to have a height below ‐2 SD by the age of 4 years.
Gender difference in aerobic capacity in adolescents after cure from malignant disease in childhood
Authors: Matthys D , Verhaaren H , Benoit Y , Laureys G , Naeyer A De , Craen M
Published: January 2008

The aim of this study was to document gender difference in aerobic capacity after cure from malignant disease in childhood. We studied 18 males and 17 females aged 11–19 years and 10–18 years, respectively. They had all completed their treatment at least two years previously. Twelve males and 11 females received anthracyclines in comparable doses (range 150–500 mg/m2). Maximal exercise tests were performed on a cycle ergometer. Maximal oxygen consumption (ml/min/kg) was significantly (p < 0.001) lower only in females when compared to their controls. We postulate two causes: girls are smaller than their controls, possibly related to their higher vulnerability to cranial irradiation than boys; and girls were less involved than boys in sports. The influence of anthracycline treatment on aerobic capacity was only observed in males and not in females. This could be related to the higher exercise level in boys than in girls.