bluuebunny/crossref_metadata_2025 huggingface dataset:
Growth, puberty and obesity after treatment for leukaemia
Authors: Davies HA , Didcock E , Didi M , Ogilvy‐Stuart A , Wales JKH , Shalet SM
Published: January 2008

Final height, body proportions, pubertal growth and body mass index were studied retrospectively in 142 survivors of acute lymphoblastic leukaemia (ALL). Treatment consisted of combination chemotherapy and cranial irradiation (18 or 24 Gy). Significant standing height loss and disproportion, with a relatively short back, was seen in both radiation dose groups. Girls were more severely affected than boys. Pubertal growth was adversely affected, with a reduction in peak height velocity in both sexes. Puberty occurred early in girls but at the normal time in boys. Nearly half the group were obese at final height, with no significant difference in incidence between the sexes. The relative roles of cranial irradiation and chemotherapy in the disturbance of growth, puberty and body composition observed in survivors of childhood ALL remain unclear. The aetiology is almost certainly multifactorial, with radiation‐induced growth hormone insufficiency, early puberty, steroids and chemotherapy all having a role.
Clinical and microbiological analysis of six children with acute suppurative parotitis
Authors: Chiu C‐H , Lin T‐Y
Published: January 2008

Six children including two neonates with acute suppurative parotitis are described. They presented typical symptoms and signs of fever (4/6) and swelling (6/6), tenderness (6/6), erythema (4/6) and local warmness (4/6) of the parotid gland affected. Leucocytosis and an elevated erythrocyte sedimentation rate and serum amylase level may be seen. The presence of purulent discharge from the Stensen duct when the parotid gland is externally compressed is pathognomonic of the disease, and the microbiological diagnosis can be made by culture of the pus. Microbiologically, this series highlights the polymicrobic nature and importance of Streptococcus viridans in paediatric suppurative parotitis, indicating, therefore, that the causative bacteria entered the gland from the oral cavity. Our data also suggest that initial antibiotic therapy for such patients should provide adequate coverage for streptococci and staphylococci as well as for anaerobic bacteria.
Herpetic croup: two case reports and a review of the literature
Authors: Mancao MY , Sindel LJ , Richardson PH , Silver FM
Published: January 2008

Croup is an acute infectious illness usually occurring in children; it is characterized by brassy cough and stridor. The main pathogens include mainly parainfluenza and influenza viruses. Recently there have been reports of prolonged croup caused by the herpes simplex viruses. We report two cases of prolonged croup due to herpes simplex types 1 and 2. We also review and summarize the reported pediatric cases of herpetic croup.
Intestinal pseudo‐obstruction syndrome in a child with myotonic dystrophy
Authors: Bruinenberg JFM , Rieu PNMA , Gabreëls FM , Tolboom J
Published: January 2008

Gastrointestinal symptoms in myotonic dystrophy are increasingly observed, but major intestinal movement disorders such as intestinal pseudo‐obstruction appear to be an infrequent complication. We describe a 13‐year‐old boy who, after appendectomy, developed intestinal pseudo‐obstruction syndrome as the first clinical manifestation of myotonic dystrophy. He developed several similar episodes thereafter, which responded to conservative measures. When a child with myotonic dystrophy presents with an ileus, the diagnosis of intestinal pseudo‐obstruction should be considered and therapy should then be conservative.
Pulmonary artery pressure in term and preterm neonates
Authors: Randalal M , Eronen M , Andersson S , Pohjavuori M , Pesonen E
Published: January 2008

Systolic pulmonary artery pressure (PAP) during the first 4 days after birth was determined in 41 healthy term and 46 preterm infants by measuring ductal Doppler flow velocity and systemic arterial pressure (SAP). Among preterm infants, 21 had respiratory distress syndrome (RDS) and 25 did not. Sequential indices within 96 h of age were presented respectively. At the ages of 2 and 12 h the ratio between pulmonary and systemic arterial pressure was significantly higher in term than in preterm infants without RDS (p < 0.05). At the age of 24 h, PAP to SAP ratio was similar in all study groups. Between 48 and 72 h, PAP to SAP ratio was significantly higher in preterm infants with RDS than in infants without RDS (p < 0.05). Our findings indicated that: (1) in healthy fullterm infants pulmonary artery pressure fell to subsystemic level during the first 12 h. indicating the critical time in circulatory transition; (2) prematurity did not affect ductal closure times significantly; and (3) RDS was associated with prolonged ductal patency and delayed postnatal circulatory adaptation characterized by pulmonary hypertension.
Environmental pollution and delivery outcome in southern Sweden: a study with central registries
Authors: Landgren O
Published: January 2008

Objective: To study whether differences in delivery outcome correlated with pollution levels in the municipalities of a county in southern Sweden (Malmöhus). Methods: The effects of air and ground pollution on delivery outcome were studied in 38 718 women who lived, and were delivered, in Malmöhus county in southern Sweden during the period 1985‐90. Delivery outcome was compared between different municipalities arranged according to the degree of pollution. Results: Neither air nor ground pollution affected the odds ratios for short gestation or low birthweight. No significant effect was seen on perinatal deaths or non‐trivial malformations, but in the municipality with the highest arsenic concentration, 14 infants died perinatally versus the expected 7.4, and the odds ratio for stillbirths reached formal statistical significance. Conclusions: Environmental pollution in this county docs not seem to be a major determinant of delivery outcome.
Maternal smoking and feto‐infant mortality: biological pathways and public health significance
Authors: Cnattingius S , Nordström M‐L
Published: January 2008

Smoking during pregnancy has in many countries replaced poverty as the most important preventable risk factor for an unsuccessful pregnancy outcome. Maternal smoking induces fetal hypoxia and morphological changes of the placenta, which increase the risks of intrauterine growth retardation and placental abruption, which may cause late fetal death and possibly also neonatal mortality. Smoking influences post‐neonatal mortality through increased risk of sudden infant death syndrome (SIDS), but why maternal smoking increases the risk of SIDS is essentially unknown. In reducing the overall smoking prevalence in society, general preventive measures have been successful. Such measures. which aim at preventing young girls from starting to smoke are in the long run the most effective way to reduce smoking during pregnancy.
Taurine supplementation prevents hyperaminoacidemia in growing term infants fed high‐protein cow's milk formula
Authors: Räihä NCR , Fazzolari‐Nesci A , Boehm G
Published: January 2008

Blood urea nitrogen (BUN) and plasma and urine amino acid concentrations were compared between three cohorts of healthy growing term infants who were breast‐fed (BF) or randomly assigned to one of two formulas either taurine non‐supplemented (FF) or taurine supplemented (FF + T). The infants were studied from 2 to 12 weeks of age. Weight gain and growth in length was normal and similar in all three feeding groups during the study interval. At 12 weeks BUN was significantly higher in the FF group than in the BF and FF + T groups, 16.5 mg/dl vs 7.0 and 7.3 mg/dl, respectively. Total plasma amino acids (FF group: 240.5 ± 110.1 μmoles/dl; BF group: 180.1 ± 28.7 μmoles/dl; FF + T group: 182.3 ± 89.4 μmoles/dl) and total essential amino acids (FF group: 89.8 ± 37.3 μmoles/dl; BF group: 56.1 ± 16.3 μmoles/dl; FF + T group: 53.0 ± 24.2 μmoles/dl). The urine amino acid concentrations reflected the plasma levels in all groups. These results indicate that taurine supplementation to a high protein formula lowers BUN levels and the plasma and urine amino acid concentrations by some yet unknown mechanism to concentrations similar to those found in breast‐fed infants with a much lower protein intake.
Dose‐dependent effects of oral acyclovir in the incubation period of varicella
Authors: Suga S , Yoshikawa T , Yazaki T , Ozaki T , Asano Y
Published: January 2008

Dose of acyclovir (ACV) and clinical features of varicella were evaluated in 65 household contacts (0.8‐9 y) who received oral ACV (5‐80 mg/kg daily in four divided doses) during the latter half of the incubation period of varicella. The severity of the disease was compared with that of 23 children who did not receive ACV. Infection was confirmed by a fluorescent antibody to membrane antigen assay. The antibody titers and the rate of apparent infection increased as the dose of ACV administered decreased. The number of skin lesions in patients who received ACV was significantly reduced when compared to the control group. These data suggest dose‐dependence of ACV for modification of varicella during secondary viremia in the incubation of the disease.
Home visiting the newborn baby as a basis for developmental surveillance at child welfare centres
Authors: Larsson J‐O , Aurelius G , Nordberg L , Rydelius P‐A , Zetterström R
Published: January 2008

Home visiting is a part of the Swedish child health surveillance programme. In the present study, part of a longitudinal prospective project, the predictive power of observations at home visits to 338 newborn babies was evaluated. The regular home visit was made by the nurse at the Child Welfare Centre also using a check‐list developed for this project. Her check‐list assessments seemed valid in identifying families with stressful psychosocial conditions. When the general home situation was judged as “poor” or “dubious”, the boys showed signs of a delayed mental development at 4‐5 years of age. Assessments of “feeding problems” among boys were associated with behavioural problems at 4‐5 years of age. The results underline the importance of an early home visit as a base for the developmental surveillance at Child Welfare Centres. However, the results of the home visit observations were not followed by any extra interventions at CWC. It seems the nurse should feel confident in her check‐list judgement and initiate interventions where appropriate.
An investigation into the physical stability of a neonatal parenteral nutrition formulation
Authors: Murphy S , Craig DQM , Murphy A
Published: January 2008

The physical stability of a neonatal parenteral nutrition formulation has been examined using differential interference contrast (DIC) microscopy. In vitro studies indicated that particle size increases occur immediately after mixing the Intralipid emulsion with the amino acid/glucose solution, while simulation of clinical administration indicated that larger droplets were observed at the end of the catheter approximately 1 h after administration commenced. Microscopic observation of adjacent droplets of the two fluids showed reversible aggregation occurring almost immediately. It was concluded that the current method of administering this neonatal emulsion does not prevent droplet coalescence.
Transient hypertriglyceridemia of infancy
Authors: Nilsson A , Örtqvist E , Lagercrantz H , Nilsson–Ehle P , Henter J‐I
Published: January 2008

A premature boy who had suffered from IRDS, bronchopulmonary dysplasia and retinopathy of prematurity developed massive hypertriglyceridemia (48.1 mmol/L) together with moderate hypercholesterolemia (12.6 mmol/L) at 5 months of age. Lipoprotein electrophoresis revealed a marked elevation of the level of the very low density lipoprotein fraction. There was a moderate decrease in the activity of a lipolytic enzyme, lipoprotein lipase (LPL). The child had neither liver or renal disorder nor any inflammatory disease. The hyperlipidemia disappeared spontaneously at the age of 3 years. The cause of the decreased LPL activity could not be established. A partial genetic deficiency in lipoprotein lipase appears the most likely explanation, since no signs of secondary lowering of LPL activity could be found.
Passive immunity against diarrhoea
Authors: Bogstedt AK , Johansen K , Hatta H , Kim M , Casswall T , Svensson L , Hammarström L
Published: January 2008

Passive immunity against a variety of respiratory and gastrointestinal pathogens has recently been increasingly used clinically, and oral administration of antibodies of both human and non‐human origin has been tried both for prophylaxis and treatment of infections. Although the former type of therapy has been shown to be effective, data on the latter are still scarce. This commentary focuses on recent studies on successful oral therapeutic administration of bovine immunoglobulins.
Nebulized budesonide for the treatment of moderate to severe asthma in infants and toddlers*
Authors: Wennergren G , Nordvall SL , Hedlin G , Möller C , Wille S , Nilsson E Åsbrink
Published: January 2008

Maintenance treatment with nebulized budesonide was studied in young children with asthma not controlled without steroids. In a blind parallel‐group study for 18 weeks, 102 children, mean age 22 (5–47) months, were randomized for treatment starting with 0.25 or 1 mg b.i.d. The patients were reviewed every 3 weeks, and if symptom control had been achieved the dose was reduced, otherwise it was kept. The clinical effect was very good with both dose regimens. The median time to 7 consecutive days without any asthma symptoms was about 1 month with both, highlighting the importance of the duration of therapy rather than the benefits of a high starting dose. In 18 of 24 children who attained the placebo stage, symptoms had reappeared at the last visit. Although an overall minimal effective maintenance dose could not be demonstrated, 47% achieved symptom control on 0.25 mg b.i.d., i.e. fulfilled criteria for further dose reduction. No significant side effects were seen. On average, 25% of the nominal dose reached the patients.
Maternal smoking and body composition of the newborn
Authors: Zaren B , Lindmark G , Gebre‐Medhin M
Published: January 2008

The influence on neonatal anthropometry of maternal cigarette smoking in pregnancy was investigated in 933 parous women. Anthropometric growth parameters including skinfold measurements were studied in the newborns. After adjustment for maternal age, pre‐pregnancy weight, height and pregnancy weight gain, smoking had a clear dose‐dependent negative effect on all anthropometric characteristics in the infant. In contrast to the results obtained in other investigations, the reduced birth weight of the infants of smoking mothers was not found to be primarily due to a reduction in lean body mass; nor was fat deposition found to be reduced. Fetal anthropometry was also negatively affected in infants born to mothers who stopped smoking during pregnancy.
Ultrasonographic evaluation of breech presentation as a risk factor for hip dysplasia
Authors: Holen KJ , Tegnander A , Terjesen T , Johansen OJ , Eik‐Nes SH
Published: January 2008

In order to gain more information of breech position as a risk factor for congenital hip dysplasia or dislocation, the hips of 408 newborns delivered in the breech position were examined by ultrasound. Clinical examination was performed by both experienced paediatricians and orthopaedic surgeons. The infants were re‐examined by ultrasound at 2–3 months of age. Twenty‐five newborns (6.1%) had neonatal hip instability. Breech presentation as a risk factor was confirmed, with first borns, breech position with extended knees, and high birthweight as special high‐risk groups. Ultrasound showed subluxation in most of the unstable hips. The main benefit of using ultrasound was that direct visualization permitted more reliable evaluation, especially when the clinical findings were uncertain. Normal ultrasound findings in false positive and uncertain Ortolani tests reduced the frequency of unnecessary treatment. Because ultrasound was used in follow‐up, the need of radiography was reduced. There were no late‐detected cases of hip dysplasia or dislocation, indicating that routine follow‐up is not necessary in breech infants with normal hips at birth, provided that the neonatal screening is optimal.
Focal intestinal perforation in preterm infants is an emerging disease
Authors: Raghuveer G , Speidel B , Marlow N , Porter H
Published: January 2008

In order to elicit the pathogenesis of focal intestinal perforation in preterm infants we contrasted 8 infants who developed this disease with 16 gestation‐matched controls. The cases were found to have lower birthweights for gestation (median standard deviation score of −1.02 in cases versus −0.08 in controls), and more frequently had preexisting patent ductus arteriosus and intraventricular haemorrhage (88 and 63% in cases versus 25 and 6% in controls, respectively). There were similar rates of other perinatal variables in the two groups, including indomethacin and umbilical arterial catheter use. Conditions associated with fetal or neonatal hypoxia are important antecedents for this emerging distinct clinical entity.
Accidents in childhood: relation to psychosocial conditions and mental development
Authors: Larsson J‐O , Aurelius G
Published: January 2008

In a longitudinal cohort study we investigated if children experiencing psychosocial stress and exhibiting certain psychopathological symptoms run a higher risk of having accidents than other children. In 366 children the number of hospital‐treated casualties during the first 10 years of their lives was related to the physical and mental characteristics of the children and to the social conditions in their families. Boys had a higher number of accidents when one or both of the parents were known to have alcohol problems. Girls exhibiting symptoms of depression, anxiety and problems in social relationships at 4–5 years of age had more accidents than girls without such symptoms. However, the differences in accident rates were small, perhaps due to the physical environment in the housing areas and the general attitude, both aiming towards reducing childhood accidents.
Fibreoptic phototherapy in the management of jaundice in low birthweight neonates
Authors: Donzelli GP , Moroni M , Pratesi S , Rapisardi G , Agati G , Fusi F
Published: January 2008

A fibreoptic phototherapy device has been compared with conventional white and special blue fluorescent phototherapy lamps to evaluate its efficacy in lowering serum bilirubin levels in low‐birthweight neonates. Fibreoptic phototherapy was found to be as effective 21s white light and less effective than blue light, as assessed by (i) the bilirubin concentration after 24 h of phototherapy and at the end of phototherapy, (ii) the duration of phototherapy, (iii) the percentage daily decline rate and (iv) the overall percentage decline rate (p < 0.05). There were no failures of phototherapy and the need for re‐exposure was low (4.7% of the total sample), with no difference between groups. The fibreoptic approach represents a promising way to aggregate synergically the most recent optical technologies and develop a modern, efficient and caring phototherapy system for low‐birthweight infants.
Peripheral intravenous infusion—another cause of air embolism
Authors: Levy I , Mosseri R , Garty B
Published: January 2008

We report an unusual complication of intravenous infusion. A 4–week‐old baby developed acute cardiopulmonary distress because of air embolism caused by improper preparation of peripheral intravenous set. The estimated amount of infused air was 12 ml (approximately 3.5 ml/kg). The infant recovered promptly after short supportive treatment.
Treatment of pituitary resistance to thyroid hormone (PRTH) in an 8‐year‐old boy
Authors: Pohlenz J , Knöbl D
Published: January 2008

We report on an 8‐year‐old boy with pituitary resistance to thyroid hormone (PRTH) having a cysteine for arginine substitution at codon 320 in the TR‐β gene who was presented because of thyrotoxicosis. Due to its suppressive effect on the pituitary thyrotropin secretion, treatment with u‐thyroxine (D‐T4) was started. After a few days, clinical euthyroidism was achieved but thyroid stimulating hormone secretion was not suppressed. Symptoms of thyrotoxicosis relapsed when therapy was interrupted so that therapy with D‐T4 was reinstituted and continued to date. Symptoms did not recur, and the psychomotor development proceeded normally. D‐T4 should therefore be considered in the treatment of thyrotoxicosis in PRTH.
Correlation of toddlers' serum lipoprotein(a) concentration with parental values and grandparents' coronary heart disease: the STRIP baby study
Authors: Routi T , Rönnemaa T , Jokinen E , Viikari J , Niinikoski H , Leino A , Simell O
Published: January 2008

The correlation between lipoprotein(a) (Lp(a)) concentrations in children aged 7‐24 months and their family members was determined and the association between the Lp(a) values of the children and a family history of coronary heart disease (CHD) was assessed. The Lp(a) values of the children correlated strongly with midparent Lp(a) values as early as at 7 months of age (r= 0.54 to 0.59, p < 0.0001). This correlation was stronger than the correlation of serum total cholesterol and total cholesterol corrected for Lp(a) ‐ cholesterol between children and parents. None of the parents had CHD. The median Lp(a) concentration of the parents with a family history of CHD was significantly higher than that of parents with no such history (111 vs 87 mg/l,p = 0.024). However. the children's Lp(a) levels were not associated with CHD in their grandparents. The genetic dependence of the Lp(a) concentration is already evident in infancy. The Lp(a) concentration in young parents, but not in their 24‐month‐old children, is associated with CHD in grandparents. This may be explained by a dilution of the genetic influence on Lp(a) over two generations.
Linear growth of very young asthmatic children treated with high‐dose nebulized budesonide
Authors: Reid A , Murphy C , Steen HJ , McCovern V , Shields MD
Published: January 2008

The aim of this open study was to observe linear growth in young children with asthma treated with nebulized budesonide. Infants and young children (< 3 years old) with severe uncontrolled asthma were studied. They were treated with nebulized budesonide (1‐4mgday‐1) and treated for at least 6 months. Height standard deviation scores (HtSDS) were measured before (“pre‐measurements”) immediately prior to commencing nebulized budesonide therapy (baseline) and after at least 6 months of therapy (“post‐measurements”). The mean HtSDS score at pretreatment was ‐0.21 and at baseline had fallen further to ‐0.46. The mean HtSDS increased to ‐0.17 when the post‐measurements were made (p= 0.035) after at least 6 months of nebulized budesonide therapy. Treatment with nebulized budesonide for longer than 6 months in very young children with severe asthma was not associated with reduced linear growth.
Ventilator‐associated sinus arrhythmia in a preterm neonate—an indicator for a mature autonomic nervous system?
Authors: Zernikow B , Michel E
Published: January 2008

According to control theory, the interactions between respiration and heart rate (i.e. respiratory sinus arrhythmia, RSA, and breath amplitude sinus arrhythmia, BASA) reflect the inner workings of the physiological control systems of respiration and circulation. This paper reports on a preterm neonate (28.5 weeks old, 940 g) who showed the presence of ventilation‐associated sinus arrhythmia (VASA) under moderate artificial ventilation. His heart rate variability was entrained to the ventilatory stimulus. VASA and entrainment suggest that the parasympathetic part of the autonomic nervous system might be more mature than expected in some preterm neonates.
Burkholderia (Pseudomonas) cepacia epidemiology in a cystic fibrosis population: a genome finger‐printing study
Authors: Cazzola G , Amalfitano G , Tonolli E , Perazzoli C , Piacentini I , Mastella G
Published: January 2008

In patients with cystic fibrosis, infection with Pseudomonas cepacia is associated with poor outcomes. However, the epidemiology of Burkholderia cepacia is still unclear. The aim of this study was to investigate the epidemiology of Burkholderia (Pseudoomonas) cepacia colonization among cystic fibrosis patients attending the Verona CF Centre, a large specialized unit to which patients from different parts of Italy are admitted. We used a genome finger‐printing system to analyse the nucleotidic structure of B. cepacia isolates from 60 colonized cystic fibrosis patients. Forty‐two different finger‐printing patterns were identified. Thirty‐two patients were colonized by individual B. cepacia strains (53.3%). The remaining 28 subjects were divided into 10 different subgroups, each exhibiting a distinct strain of B. cepacia (46.7%). Nevertheless, direct, person‐to‐person transmission was evident in only 10 cases (16.7%). The stability, up to 12 months, of the B. cepacia colonizing strain was documented in 36 individuals. Consistent with other reports, risk of B. cepacia transmission between cystic fibrosis patients through intimacy or nosocomial contact was found in our study. However, besides low contagiousness, our data suggest that the environmental reservoir of B. cepacia outside the hospital seems to play an important role in B. cepacia infection of our cystic fibrosis population.
Beat‐to‐beat blood pressure and heart rate responses to active standing in Japanese children
Authors: Yamaguchi H , Tanaka H , Adachi K , Mino M
Published: January 2008

Some pubertal children are susceptible to orthostatic stress but little is known about mechanisms of circulatory adjustment to the posture change in children. We investigated beat‐to‐beat blood pressure (BP) and heart rate (HR) responses to active standing in 173 schoolchildren, 92 boys and 81 girls, aged 6–18 years (mean age: 13.4 years) using a non‐invasive continuous monitoring system (Finapres 2300, Ohmeda). The subjects were divided into four age groups: prepubertal 1 (7–9 years), prepubertal II (10–12 years), pubertal (13–15 years) and young adult (16–18 years). Supine BP increased and HR decreased with age. At the onset of active standing two older groups showed a significantly larger initial drop than the prepubertal groups (‐36 ± 15 versus ‐15 ± 16% reduction for systolic BP and ‐36 ± 14 versus ‐20 ± 19% for diastolic BP, respectively, p < 0.01). Moreover, the pubertal group had a significantly smaller vasoconstrictor index than prepubertals and two older groups had a significantly more prolonged BP recovery time. In keeping with this the pubertal group most frequently had hypotensive symptoms during active standing. The rise in HR at the peak was higher in two older groups than in prepubertals (34 ± 9 versus 29 ± 8 beats/min‐1, respectively, p < 0.001), whereas the baroreflex index was almost identical for the four groups. The effect of body proportion on BP responses was not found. There was no significant difference in BP and HR changes in the later stage during 7min of standing. These results indicated that pubertal children were more susceptible to orthostatic stress, probably due to abnormal BP responses in the initial phase of active standing, which seemed to reflect enhanced cardiopulmonary reflexes and diminished sympathetic activation associated with the age. Moreover, BP reduction at an initial drop of more than 60% or a recovery time of more than 25 s might be postulated to be an abnormal circulatory response.
Antiphospholipid antibodies in children
Authors: Kontiainen S , Miettinen A , Seppälä I , Verkasalo M , Mäenpää J
Published: January 2008

Sera from children (n= 173) were tested for antiphospholipid antibodies (aPL) using an enzyme immunoassay detecting IgG anti‐cardiolipin antibodies (GPL). Sera from adults (n= 100) were also tested. GPL were detected more frequently and at higher levels in children than in adults. Eighty‐two percent of the children and 27% of the adults tested positive (≥ 10 GPL Uml‐1) for aPL (p <0.001). Values of 45 GPLUml‐1 or higher were detected in about 5% of the children, and 25 GPLUml‐1 or higher in about 5% of the adults. Normal values should be adjusted accordingly.
Pyruvate dehydrogenase deficiency in a child responsive to thiamine treatment
Authors: Pastoris O , Savasta S , Foppa P , Catapano M , Dossena M
Published: January 2008

We report the clinical features in a 4‐year‐old child who was investigated for a suspected metabolic disorder but was subsequently diagnosed as having a pyruvate dehydrogenase deficiency. A muscle biopsy was performed and the data obtained suggested thiamine treatment which resulted in a regression of the clinical findings and a return to normal values of blood lactic and pyruvic acids. The interruption of thiamine supplementation after 1 year of treatment led to a prompt recurrence of the previous clinical and biochemical symptoms.
Synthetic protein analogues in artificial surfactants
Authors: Johansson J , Curstedt T , Robertson B
Published: January 2008

Today, airway instillation of surfactant preparations is a generally used treatment for respiratory distress syndrome in premature infants. Most commercially available surfactants are purified from animal lungs and contain lipids, mainly phospholipids, and about 2% of the hydrophobic surfactant proteins B and C (SP‐B and SP‐C). During the last half‐decade the main structural properties of these proteins have been clarified and this knowledge now makes it possible to design synthetic analogues for future use in artificial surfactants.
Relationships between wasting and linear growth in stunted children
Authors: Walker SP , Grantham‐McGregor SM , Himes JH , Powell CA
Published: January 2008

Height‐for‐age and weight‐for‐height are commonly used indicators of nutritional status; however, their precise interrelationship remains unclear. We examined the relationship between weight‐for‐height and linear growth in 127 stunted Jamaican children aged 9‐24 months. The children were measured every 6 months over a 2‐year period. The initial weight‐for‐height status was positively associated with linear growth in the following 6‐month interval. The change in weight‐for‐height in the preceding interval was a better predictor of linear growth in the next interval than attained weight‐for‐height at the beginning of the interval. The results suggest that variations in weight‐for‐height may influence the rate of linear growth.
Prevalence of headache in schoolchildren: relation to family and school factors
Authors: Carlsson J
Published: January 2008

The purpose of the study was to determine the prevalence of recurrent headaches among schoolchildren in Göteborg and the relation of headache to school and family variables. A stratified sample of 1297 pupils was selected to be representative of the Göteborg population. Data were obtained by means of questionnaires. Twenty‐six per cent had “headache once a month or more” and 6% had “headache several times a week or daily” (frequent headache). There was a gradual increase of headache with age. In the third grade there was a marked increase of frequent headache. In the highest school level (grades 7‐9), girls had significantly more headache than boys. In the lower school level (grades 1–3), a greater number of pupils in the class increases the risk of frequent headache. Pupils in the intermediate school level (grades 4–6) reported more frequent headache in districts with high unemployment. It is concluded that headache among schoolchildren is a health problem which merits increased attention.
Chemiluminescence activity of phagocytes from tracheal aspirates of premature infants after surfactant therapy
Authors: Schrod L , Hornemann F , Stockhausen H‐B von
Published: January 2008

The effect of surfactant on the respiratory burst of phagocytic cells was studied in the tracheobronchial tract of 40 mechanically ventilated neonates (gestational age 24–37 weeks) over the first week of life. We measured the luminol‐dependent chemiluminescence (CL) activity of granulocytes and macrophages isolated from tracheal aspirates in 23 preterm infants 1–6 days after administration of bovine surfactant and in 17 untreated controls. Following stimulation by the chemotactic peptide N‐for‐mylmethionylleucylphenylalanine, CL activity was not or only slightly impaired in the surfactant group. In contrast, treatment with exogenous surfactant significantly reduced CL response to opsonized zymosan (OPZ), which involves phagocytosis, for up to 6 days (P < 0.05). The impairment of CL activity seemed to be dose dependent, as repeated surfactant applications (cumulative phospholipid dose of 200 mg/kg) reduced OPZ‐elicited CL activity to a greater extent than application of a single dose of 100 mg/kg. In agreement with in vitro studies, our data suggest that high‐dose application of exogenous surfactant may affect the antibacterial function of phagocytic cells in the lung.
Does the classification system fit disease progression in perinatal human immunodeficiency virus infection?
Authors: Martino M de , Zappa M , Galli L , Rossi ME , Vierucci A
Published: January 2008

The objective was to test the applicability of the new classification for paediatric human immonodeficiency virus infection. The person‐time of each state, transition probabilities and survival (± standard errors) at 5 years, and median sojourn‐time were calculated on 39 perinatally infected children followed up from the first month of life for a median of 64.5 (1.2‐120.1) months. The person‐times of the N2, N3, B1, C1, and C2 states were low. The transition probabilities and sojourn‐times were similar for A (48.1 ± 10.8%; 63.5 months), B (50.5 ± 15.5%; 44.9 months) and C (74.6 ± 15.1%; 43.1 months) clinical categories, which differed (p < 0.025) from the N category (87.9 ± 5.5%; 12.05 months). The survival probabilities after 5 years of entering the A, B and C categories were 84.8 ± 10.7%, 60.5 ± 19.8% and 14.8 ± 13.5%, respectively (p < 0.001). Immunological category 3 had lower transition probabilities and longer sojourn‐times (58.8 ± 16.6%; 53.3 months) than categories 1 (71.3 ± 8.1%; 33.2 months) and 2 (75.6 ± 10.5%; 19.8 months) (p < 0.01). The transition probabilities to C3 for states N3, A3 or B3 were 52.5 ± 13.5%. In conclusion, the classification tits the clinical history better than the immunological history.
Serum levels of CD14 in neonatal sepsis by Gram‐positive and Gram‐negative bacteria
Authors: Blanco A , Solis G , Arranz E , Coto GD , Ramos A , Telleria J
Published: January 2008

The purpose of this study is to measure soluble CD14 (sCD14) levels in sera from newborn with sepsis, to compare it with other markers, and to study its evolution in Gram‐negative and Gram‐positive sepsis. Forty normal newborns were included (26 were full term and 14 were preterm infants), 20 babies had a positive blood culture (11 Gram‐positive and 9 Gram‐negative) and 16 cases were suspected of having sepsis based on clinical and laboratory findings, but a negative blood culture. Interleukin‐6 (IL‐6), sCD14, and tumour necrosis factor‐α (TNFα) were measured by enzyme immunoassay, and fibronectin (FN) and C‐reactive protein (CRP) by radial immunodiffusion. Neonates with a positive blood culture had increased levels of sCD14(3.20 ± 1.26μgml‐1, p < 0.001), CRP(69 ± 46 μgml‐1, p < 0.001)and IL‐6 (134 ± 150 pg ml‐1, p < 0.001), and decreased values of FN (12.3 ± 6.6 mg ml‐1, p < 0.001). TNFα levels were also high (160 ± 37 pg ml‐1), but this increase was not statistically significant. Newborn infants suspected of having sepsis but a negative blood culture had similar but milder abnormalities. Soluble CD 14 levels correlated with CRP values; however, there was no correlation between sCD 14, TNFα and IL‐6. Neonates with sepsis by Gram‐positive bacteria had lower sCD14 levels than patients with Gram‐negative sepsis (2.63 ± 1.2 versus 4.04 ± 1.0μgml‐1, p < 0.05). In conclusion, the sCD14 level is increased in newborn infants with sepsis, and this is higher in infections by Gram‐negative bacteria, suggesting a different contribution of monocyte and macrophage cells. In contrast, IL‐6, TNFα, CRP and FN values are similar in infections by Gram‐positive and Gram‐negative bacteria.
Very late presentation of vertically transmitted HIV‐1 infection
Authors: Español T , Figueras MC , Soriano V , Caragol I , Hernandez M , Bertran JM
Published: January 2008

We describe a 13‐year‐old boy with a very late presentation of vertically transmitted HIV‐1 infection. The mother, an intravenous drug user before pregnancy, was diagnosed with AIDS in 1987 when the boy was 6 years old. HIV infection in her son was never suspected or investigated. No other risk factors for this infection can be attributed to the boy. On diagnosis of the infection the boy had moderately severe respiratory symptoms, as classified in category B2 of the 1994 paediatric HIV infection definition, and virological replicalive kinetics and the phenotype have been determined. Standard AZT therapy has improved the clinical symptoms, with negativization of plasma p24 Ag and HIV RNA. Clinicians should be aware of this form of presentation of HIV‐1 infection to avoid further delay of proper therapy.
Respiratory morbidity in preschool children born prematurely. Relationship to adverse neonatal events
Authors: Greenough A , Giffin FJ , Yüksel B
Published: January 2008

Respiratory morbidity, recurrent cough and/or wheeze and lung function abnormalities are common even outside infancy in preschool children born prematurely. Throughout the first 5 years of life, adverse neonatal events such as immaturity at birth and a requirement for prolonged respiratory support are significantly associated with positive symptom status. In the older preschool child, however, there is some evidence to suggest that other factors, such as a family history of atopy, may be equally important. The development of recurrent symptoms even at 4 years of age can be predicted accurately from the results of lung function measurements made in infancy, and hopefully such data will facilitate the introduction of effective intervention strategies. Lung function abnormalities are more marked in symptomatic patients and, in older children, seem to reflect increased airway responsiveness rather than having a significant relationship to adverse neonatal events. The hospital readmission rate for respiratory disorders, however, is certainly adversely affected by extremely low birthweight and neonatal chronic lung disease, as well as current symptom status. These data highlight that strategies to reduce extremely premature delivery and its consequences should favourably influence respiratory morbidity in preschool children.
Shunt nephritis associated with Moraxella bovis
Authors: Bogdanović R , Marjanović B , Nikolić V , Ognjanović M , Marković M , Djordjević M , Sindjić M
Published: January 2008

Moraxella bovis was repeatedly isolated from cerebrospinal fluid in a girl with two episodes of shunt nephritis. Clinical remission of nephritis was achieved only after shunt replacement. A list of about 20 infectious agents reported to date in patients with shunt nephritis is given. M. bovis is yet another agent previously not reported in patients with shunt nephritis.
Low urinary GH levels in normal statured obese children
Authors: Sartorio A , Conti A , Ferrero S
Published: January 2008

Urinary GH (u‐GH) levels were evaluated in 240 children (age range 5‐14 years; 136M, 104F) of normal height (25‐90th centile); 165 children were defined as “non‐obese” (body mass index (BMI) < 75th centile for their chronological age (CA)) and 75 as “obese” (BMI > 75th). U‐GH levels were determined using a two‐site enzyme immunometric assay and calculated as the mean obtained from the values of three consecutive first morning voidings; results were expressed as both u‐GH concentration (ng1−1) and u‐GH excretion (ng per night). Multiple regression analysis revealed that in all children (non‐obese and obese) most of the variation in u‐GH levels (ngl 1 and ng night−1) was explained by BMI (coefficient: −0.72, p < 0.0001 and coefficient: −0.10, p < 0.001, respectively) and chronological age (coefficient: 1.03, p < 0.01 and coefficient: 0.27, p < 0.001, respectively), whereas sex and pubertal stage did not add significance to the variance. In obese children, mean u‐GH concentration and u‐GH excretion (per night) levels were significantly lower than those recorded in non‐obese children both before and during puberty. A similar trend towards higher u‐GH levels at puberty was found in non‐obese and obese children. In conclusion, our study shows that u‐GH levels are (a) related to CA and BMI in the general population and (b) significantly lower in obese than in non‐obese children, in spite of their comparable normal height. The measurement of u‐GH excretion in the assessment of children with short stature needs to take into consideration the role of marked ponderal excess, which is associated “per se” with significantly lower u‐GH levels.
Body composition, atherogenic risk factors and apolipoproteins following growth hormone treatment
Authors: Hassan HMS , Kohno H , Kuromaru R , Honda S , Ueda K
Published: January 2008

We studied the change in atherogenic risk factors in 27 children, 21 boys and 6 girls, 6 to 14 years of age. with growth hormone deficiency during 12 months of growth hormone replacement therapy. Changes in body composition and lipid profile during growth hormone treatment were evaluated. The atherogenic index was calculated using the equation [(total cholesterol ‐ high‐density lipoprotein cholesterol)(apolipoprotein B)] / [(apolipoprotein A1)(high‐density lipoprotein cholesterol)]. Body fat decreased (p < 0.01), associated with an increase in lean body mass (p < 0.01). Total cholesterol and high‐density lipoprotein cholesterol showed no significant changes. The atherogenic index significantly decreased from 1.44 ± 0.60 to 1.09 ± 0.52 (p < 0.01) after 12 months. Apolipoproteins Cu and Cm increased throughout the study period (p < 0.01). Lipoprotein(a) and apolipoproteins A1, B and B/A1 ratio did not change significantly. In conclusion, growth hormone treatment improved body composition and reduced atherogenic risk factors in children with growth hormone deficiency.
HLA DP antigens and post‐streptococcal acute glomerulonephrius
Authors: Mori K , Sasazuki T , Kimura A , Ito Y
Published: January 2008

We have typed 58 Japanese patients with post‐streptococcal acute glomerulonephritis (PSAGN) for HLA DRB1, DQA1, DQB1, DPA1 and DPB1 genes by the HLA‐DNA typing method using a polymerase chain reaction (PCR)‐sequence specific oligonucleotide probe (SSOP) technique. The control subjects were 317 healthy unrelated individuals. Frequencies of HLA DPA 1*02022 and DPB 1*0501, which are in linkage disequilibrium and encode HLA‐DP5 antigen, were significantly increased in patients with PSAGN than those in control (pc < 0.0005 and pc < 0.005, respectively). Frequencies of HLA DPA1*01 and DPA1*0201 were significantly decreased in patients when compared with controls (pC < 0.05, for both). No significant difference in allele frequencies between the two groups was observed in the DRB1, DQA1 and DQB1 genes. This is the first report documenting the association of HLA‐DP alleles with PSAGN. We speculate that H LA‐ DP5 antigens may be involved in the development of PSAGN.
Chronic diarrhoea as a dominating symptom in two children with cerebrotendinous xanthomatosis
Authors: van Heijst AFJ , Wevers RA , Tangerman A , Cruysberg JRM , Renier WO , Tolboom JJM
Published: January 2008

The objective of this study was to describe diarrhoea as a dominating symptom of cerebrotendinous xanthomatosis (CTX), a lipid storage disease, and investigate its cause. Two children with chronic diarrhoea as the dominating symptom of CTX are presented. Before and after therapy with orally administered chenodeoxycholic acid (15 mg kg−1 24 h, in three divided doses) bile alcohol excretion in urine, serum cholestanol level, serum bile acid patterns and faecal bile acids were measured. All routine gastro‐intestinal investigations before therapy were normal. Diarrhoea ceased immediately after starting treatment with chenodeoxycholic acid. Abnormal bile alcohol excretion in urine decreased rapidly during the first days and elevated serum cholestanol level normalized in 2 years. We postulate the presence of bile alcohols in the lumen of the gut as most likely cause for diarrhoea in CTX, since the rapid decrease of bile alcohol excretion is associated with prompt cessation of diarrhoea after starting treatment with chenodeoxycholic acid.
Maternal hyperphenylalaninaemia as a cause of microcephaly and mental retardation
Authors: Jardim LB , Palma‐Dias R , Silva LCS , Ashton‐Prolla P , Giugliani R
Published: January 2008

We attempted to evaluate the role of maternal hyperphenylalaninaemia (HPA) as an isolated cause of mental retardation and microcephaly in children. This transversal study observed the plasma phenylalanine from mothers of 161 children with mental retardation and/or microcephaly of unknown origin. In this sample, we found two women with previously undiagnosed HPA, a frequency (2/161) higher than expected for our general population (1:12 500) (p < 0.001). We concluded that the plasma phenylalanine levels should be determined during preconceptional evaluation of every woman of reproductive age that already has had a child affected either by mental retardation or microcephaly of unknown cause. It is particularly significant where women currently having their pregnancies have not been screened for phenylketonuria as newborns, as happens in most developing countries.
The changing panorama of cerebral palsy in Sweden. VII. Prevalence and origin in the birth year period 1987‐90
Authors: Hagberg B , Hagberg G , Olow I , Wendt L V
Published: January 2008

This seventh Swedish population‐based cerebral palsy (CP) report comprises 216 children born between 1987 and 1990. The crude live birth prevalence was 2.36 per 1000, indicating a break in the continuous increase since 1970. Excluding 10 postnatally‐derived cases, gestational‐age specific prevalences were 80 for extremely, 54 for very and 8 for moderately preterms and 1.4 for term children per 1000. Birth weight‐specific prevalences were 57 for birth weights <1000 g, 68 for 1000–1499 g, 14 for 1500–2499 g and 1.4 for ≥2500 g per 1000. The aetiology was considered prenatal in 8%, peri/neonatal in 54% and unclassifiable in 38% of preterms and 33, 28 and 39% of term children. Hemiplegic, diplegic and tetraplegic syndromes accounted for 22, 66 and 7% of preterms and 44, 29 and 10% of term children. Non‐walking, mental retardation, epilepsy, severe visual impairment and infantile hydrocephalus were present in 39, 39, 26, 18 and 23% of preterms; and 38, 44, 36, 14 and 5% of term children, respectively. The entire series of 1408 cases born in 1954–90 revealed three distinct trend eras for preterms, clearly related to changes in perinatal care and shifts in type of CP manifestations.
Serum vitamin A in relation to socio‐economic, demographic and dietary characteristics in Bangladeshi children
Authors: Hussain A , Kvåle G
Published: January 2008

The purpose of this study was to examine socio‐economic conditions, demographic factors, use of vitamin A capsules and dietary practices in relation to the risk of low serum vitamin A. One hundred and twenty four night blind cases were identified by parents in a cross‐sectional survey in Bangladesh in 1992. Age‐, sex‐ and neighbourhood‐matched controls were selected. Venous blood was collected from 87 cases and 97 controls for the determination of serum vitamin A. Information about socio‐economic conditions, demographic factors, use of vitamin A capsules and dietary practices was obtained by interview. The level of serum vitamin A was strongly related to age and consumption of β‐carotene rich foods. The preschool years (2‐6 years) are important risk periods for vitamin A deficiency among children. We conclude that long‐term prevention of vitamin A deficiency should rely on efforts to improve local diet.