bluuebunny/crossref_metadata_2025 huggingface dataset:
Anti‐annexin 1 antibodies: A new diagnostic marker in the serum of patients with discoid lupus erythematosus
Authors: Kretz Cosima C. , Norpo Maria , Abeler‐Dörner Lucie , Linke Björn , Haust Merle , Edler Lutz , Krammer Peter H. , Kuhn Annegret
Published: August 2010

Abstract:  Annexin 1 is an anti‐inflammatory molecule and has also been described to be a common target of autoantibodies. In this study, we determined whether antibodies against annexin 1 can be detected in sera of patients with cutaneous lupus erythematosus (CLE). Levels of anti‐annexin 1 antibodies were evaluated by a new established enzyme‐linked immunosorbent assay and found to be significantly higher in sera of patients with CLE when compared to normal healthy donors (NHD). Moreover, the percentage of sera positively tested for anti‐annexin 1 antibodies was elevated in patients with CLE when compared to NHD. In particular, the percentage of positive sera for anti‐annexin 1 antibodies was significantly higher in patients with discoid lupus erythematosus (DLE); however, disease activity did not correlate with the antibody levels. The results of this study indicate that anti‐annexin 1 antibodies in sera of patients with DLE might be a valuable aid in the diagnosis of this subtype.
Oral disease in the elderly in long‐term hospital care
Authors: Samaranayake LP , Wilkieson CA , Lamey P‐J , MacFarlane TW
Published: August 2010

OBJECTIVE: To obtain baseline information on the prevalence of oral problems and disease in institutionalized elderly in a Scottish hospital.

DESIGN: A cross‐sectional clinical investigation with complementary microbiological studies as appropriate. SUBJECTS AND METHODS: A cohort of 147 elderly in five long‐term care wards; collection of demographic data; clinical examination to determine: i) the dental, and denture status and associated lesions such as Candida‐associated denture stomatitis and angular cheilitis, ii) oral mucosal disease; swabs as appropriate for microbiology.

MAIN OUTCOME MEASURES: Dental status, root caries prevalence; denture status and hygiene, and associated disease; oral mucosal health.

RESULTS Median period of institutionalization of 147 patients was 15 months and 65% were aged 80 years or more; the majority were significantly mentally impaired; 52% wore complete dentures, 9% were partially dentate, 19% possessed partial or incomplete dentures; 20% were neither dentate nor had dentures. Of 80 patients who verbalired their complaints, 35% complained of dry mouth and 45% had denture‐related problems, principally discomfort. The commonest oral finding was a coated tongue (56%); angular cheilitis was present in 25%, and Candida‐associated denture stomatitis in 19%; none had oral ulcers.

CONCLUSIONS: There was considerable unmet dental need with significant oral disease and poor levels of oral and denture hygiene in this target group; both dental and medical professionals should act in concert to deliver curative as well as preventative dental care for the elderly living in institutions to improve their quality of life.
The histopathology of oral mucosal lesions associated with amalgam or porcelain‐fused‐to‐metal restorations
Authors: Larsson Å , Warfvinge G
Published: August 2010

OBJECTIVES: To analyse the interface stomatitis patterns of oral lichenoid lesions in contact with amalgam and to compare these with the histologic changes in oral lesions clinically associated with porcelain‐fused‐to‐metal (PFM) restorations. To relate these features to the presence of tissue‐bound mercury (Hg).

DESIGN: A retrospective analysis of tissue biopsies, with clinical data collected via a complementary questionnaire.

SUBJECTS AND METHODS: 479 biopsies diagnosed in 1987 as ‘lichenoid reactions’. From these, we retrieved all with amalgam contact and without candida or medication. From 1990–91, all mucosal lesions stated to be associated with PFM restorations were then retrieved for comparative analysis. The biopsies were examined with routine histologic and autometallographic methods. RESULTS: 77 amalgam‐associated lesions were found and could be subdivided into five pre‐defined interface stomatitis types. We found 22 lesions associated with PFM and 20 showed histopathologic features similar to those associated with amalgam. Hg accumulations were detected in the majority of amalgam‐associated but only in part of the PFM‐associated lesions.

CONCLUSIONS: Amalgam‐associated lichenoid lesions present a wide spectrum of histopathologic patterns, corresponding to similar patterns in dermatopathology but with no evidence of association with specific disease. PFM‐associated lesions tend to display similar lichenoid features, suggestive of common pathogenetic mechanisms. Hg accumulations may play a role to maintain the chronicity of such oral lichenoid lesions.
Cross‐infection compliance of UK dental staff and students
Authors: Porter SR , El‐Maaytah M , Afonso W , Scully C , Leung T
Published: August 2010

OBJECTIVES: The objectives of the study were to determine the compliance of a group of dental health care workers and students in aspects of cross‐infection control.

DESIGN: The dentists and dental students working in a dental clinic were observed by a ‘hidden’ ceiling‐mounted video camera. Procedures were recorded onto videotape and the actions of the observed clinicians and students assessed by two suitably qualified assessors.

SETTING: An emergency Oral Medicine clinic in a dental hospital.

SUBJECTS Seventy nine dentists and 35 dental undergraduates.

METHODS: The action of staff and students were recorded on videotape and assessed retrospectively.

MAIN OUTCOME MEASURES: Degree of compliance with recognised infection control policies.

RESULTS: Compliance with recommended guidelines for control of cross‐infection was poor. In only 56% of health care worker‐patient contacts were protective gloves changed between patients. Facemasks and protective eyewear were only worn in 38% and 29% of such contacts respectively.

CONCLUSIONS: Compliance with cross‐infection control measures are poor in dentistry ‐ even when clinicians are provided with appropriate facilities.
Declining prevalence of dental caries in school children in Singapore
Authors: Lo GL , Bagramian RA
Published: August 2010

OBJECTIVE: Dental health surveys of school children in Singapore from past decades were reviewed to document reductions in prevalence of dental caries.

MATERIALS AND METHODS: Surveys were carried out in schools by the Dental Division, Ministry of Health in 1970, 1979, 1984, 1989 and 1994.A sample size of approximately 5000 school children representing 1.2% of the school population aged 6 to 18 years old was examined in each survey.

RESULTS: Survey data showed an increase in the proportion of children free of caries in the permanent dentition from 30% in 1970 to 58.7% in 1994. The DMFT index for 6 to 18 year old children has dropped from 2.98 in 1970, 2.61 in 1979, 1.97 in 1984, 1.61 in 1989 to 1.05 in 1994.

CONCLUSION: Fluoridation of public water supplies together with the adoption of preventive dental health programmes by the State and professional bodies is credited as the major factor in caries reduction.
Dental practitioner risk, knowledge and practice with regard to the hepatitis B vaccination in South Africa
Authors: Naidoo S.
Published: August 2010

OBJECTIVES: To determine dental practitioner risk, knowledge and practice with regard to hepatitis B vaccination in South Africa.

DESIGN: Cross‐sectional, descriptive study. SUBJECTS: Dental students qualifying from the University of the Western Cape dental school between 1985 and 1995 (n= 173).

METHODS: A telephonic survey, using a structured questionnaire.

MAIN OUTCOME MEASURES: Knowledge and compliance with hepatitis B vaccination.

RESULTS: The present study shows that (i) individuals are not maintaining HBV protection and (ii) individuals are at risk.

CONCLUSIONS: Guidelines need to be developed to ensure that the entire dental team is not only vaccinated against HBV, but that post‐vaccination testing and follow‐up for booster vaccination is strictly adhered to.
Dental erosions and gastro‐oesophageal reflux disease in institutionalized intellectually disabled individuals
Authors: Böhmer CJM , Klinkenberg‐Knol EC , Boer MC Niezen‐de , Meuwissen PRM , Meuwissen SGM
Published: August 2010

OBJECTIVE: Both exogenous acids, from the diet, and endogenous acids, from stomach juice, can dissolve the enamel mineral, resulting in dental erosionS. Gastric acid may reach the mouth by gastro‐oesophageal reflux disease (GERD), recurrent vomiting, rumination and regurgitation. These conditions are frequently found in the intellectually disabled population. Therefore, we investigated the presence of dental erosions in combination with GERD among intellectually disabled inhabitants, with an IQ<50, taken from three Dutch institutes.

MATERIALS AND METHODS: At random 63 individuals underwent an oesophageal pH test and dental screening and possible predisposing and attributable factors were determined. An abnormal pH level was defined as a pH <4, >4.5% of the measured time. Subjects with dental erosions were compared to those without dental erosions.

RESULTS: In 29 out of 63 (46.0%) cases evidence of dental erosions was found. In 19 of these 29 subjects with erosions (65.5%) GERD was diagnosed, compared to nine (26.5%) out of 34 subjects without erosions (P= 0.04). In the subjects with erosions mean duration of pH <4 was 15.6% (range: 0.5–90.5) compared to 6.3% (range 0–40.4) in subjects without erosions (P= 0.02).An IQ <35 was found to be predisposing (P <0.001).

CONCLUSION: In this population of 63 institutionalised intellectually disabled persons dental erosions were diagnosed in 46%.Sixty‐five per cent of them had GERD. Individuals with longer duration of pH <4 than 6.3% of the measured time and with an IQ < 35 were at higher risk to develop dental erosions. This study shows that dental erosions in the intellectually disabled population might be an oral manifestation of GERD.
Increased expression of epidermal growth factor receptor in normal epithelium adjacent to head and neck carcinomas independent of tobacco and alcohol abuse
Authors: van Oijen MGCT , Rijksen G , Broek FW , Slootweg PJ
Published: August 2010

OBJECTIVE

In this study we examined if expression of the epidermal growth factor receptor (EGFR) in normal epithelium adjacent to head and neck squamous cell carcinomas (HNSCC) is increased and if this increase is due to the use of tobacco and alcohol.

MATERIALS AND METHODS: Cut sections of formalin‐fixed and paraffin‐embedded material of histologically normal epithelium adjacent to HNSCC from 25 patients who smoke excessively and abuse alcohol, and 17 HNSCC patients who do not abuse tobacco and alcohol were compared with cut sections of normal epithelium from 27 control individuals. The sections were immu‐nohistochemically stained for the EGFR.

RESULTS: We show an elevation of the expression of the EGFR in patients who smoke and drink excessively, that could also be ascertained, to a lesser extent, in patients that do not have a history of smoking or drinking (P = 0.08). We also find that the closer the epithelium lies to the HNSCC the higher the expression of the EGFR is.

CONCLUSIONS: Expression of the EGFR is increased in tumour‐adjacent epithelium and this is not only due to the use of tobacco and/or alcohol. We suggest that paracrine effects of the HNSCC and migration of tumour cells may also play a role in this increased expression.
HIV topic update: protease inhibitor therapy and oral health care
Authors: Porter SR , Scully C
Published: August 2010

Protease inhibitors have been a major advance in the management of HIV disease and have reduced the frequency and severity of many complications, including some oral lesions. They may also be of value in the management of occupational exposures to the virus. However, they may produce adverse effects including oral symptoms such as paraesthesia, taste disturbances and xerostomia, and may interact with a number of drugs used in oral health care. This article summarises the current situation.
Fine needle aspiration cytology as a diagnostic test for oral squamous cell carcinoma
Authors: Seetharam SS , Ramachandran CR
Published: August 2010

OBJECTIVE: The purpose of this study was to determine the possibility of using fine needle aspiration cytology (FNAC) as a primary diagnostic test in oral leukoplakia and squamous cell carcinoma.

MATERIALS AND METHODS: The sample consisted of 11 cases of oral leukoplakia and 60 cases of oral squamous cell carcinoma. FNAC and biopsy was done on all cases. A cytological and histopathological correlation was undertaken to determine the proportion of cancers that can be accurately diagnosed by FNAC and its ability to identify differentiation gradings of squamous cell carcinomas. A blind examination was undertaken.

RESULTS: In oral leukoplakias equal rates of true positive and false negative results were obtained. The overall positive correlation accounted for 33.33% with 33.33% inadequate FNACs. In oral squamous cell carcinomas 92.85% of true positive and 7.14% of false negative results were obtained. The differentiation gradings correlated in only 41.07%. The overall positive correlation was 86.66% with 6.66% inadequate FNACs.

CONCLUSIONS: The present study indicates that FNAC can be used as a reliable diagnostic test for oral squamous cell carcinoma but its use in oral leukoplakia is of limited value.
Living conditions of children at risk for noma: Nigerian experience
Authors: Idigbe EO , Enwonwu CO , Falkler WA , Ibrahim MM , Onwujekwe D. , Afolabi BM , Savage KO , Meeks VI
Published: August 2010

The study reported in this paper was carried out in the Northwestern and Southwestern regions of Nigeria, between October 1996 and April 1998. The study examined the possible contributory role of living conditions in the development of acute necrotizing gingivitis (ANG) or noma from oral lesionS. Questionnaire data obtained from 42 fresh noma cases seen in the Northwest and four fresh cases seen in the Southwest were examined. In addition 46 cases of advanced ANG from the Southwest were included. The main focus was to compare some of the environmental living conditions of cases with advanced ANG and those with noma in these regionS. All the noma and ANG cases were seen in children aged 2–12 years. The level of good oral hygiene practices and general environmental living conditions were significantly higher in the Southwest than in the Northwest. Data also showed that living in close proximity with livestock was significantly higher in the Northwest than in the Southwest (P < 0.05). The environmental living conditions of children in the Northwest were further compounded by poor sanitary faecal disposal practices as well as minimal access to potable water. The overall data indicated that living in substandard accommodations, exposure to debilitating childhood diseases, living in close proximity to livestock, poor oral hygiene, limited access to potable water and poor sanitary disposal of human and animal faecal waste could have put the children in the Northwest at higher risk for noma than the children in the Southwest. These could have been responsible for the higher prevalence of noma in the Northwest than in the Southwest.
Renal hemodialysis patients: oral, salivary, dental and periodontal findings in 105 adult cases
Authors: Gavaldá C. , Bagán JV , Scully C. , Silvestre FJ , Milián MA , Jiménez Y.
Published: August 2010

OBJECTIVES: A study of the dental, periodontal, oral mucosal and salivary condition of adult patients with chronic renal failure (CRF) receiving hemodialysis (HD).

MATERIAL AND METHODS: A total of 105 patients on HD were studied, together with 53 healthy age and sex‐matched controlS. Indices employed included carious, absent and obturated teeth index (CAO index), plaque index, calculus index and loss of periodontal attachment. Whole and parotid salivary secretions were also measured. RESULTS: The CAO index was not significantly higher among HD patients than controls (14.9± 8.7 vs 13.3± 7.9, respectively; t= 1.1; P= 0.3).However, plaque and calculus indices were significantly higher in HD patients (2.1± 0.8 and 2.3± 0.6, respectively) than controls (1.3± 0.8 and 1.6± 0.9) (P < 0.001). Loss of periodontal attachment was similar in both groups (4.9± 2.5 vs 4.2± 2.5 in the HD patients and controls, respectively) (t= 1.8; P= 0.07). There was no more oral mucosal pathology in HD patients than in controls (chi‐square = 5.8; P= 0.3).Stimulated salivary secretion was significantly higher in controls than HD patients for both whole (t= ‐5.2; P < 0.001) and parotid (t= ‐2.6; P= 0.01) salivas.

CONCLUSIONS: The results show significantly higher plaque and calculus indices and lower salivary secretion among the HD patients than in healthy controls.
HIV TOPIC UPDATE: Prevalence and incidence of oral lesions—the changing scene
Authors: Eyeson JD , Warnakulasuriya KAAS , Johnson NW
Published: August 2010

A range of oral mucosal and periodontal lesions is associated with HIV infection and HIV disease progression. These are often symptomatic and require treatment in themselves, and also have a diagnostic and prognostic role in the management of the underlying HIV disease. These lesions have been broadly divided into: (a) those strongly associated with HIV such as oral candidoses, oral hairy leukoplakia and Kaposi's sarcoma; (b) those less strongly associated such as swellings of the major salivary glands; and (c) those least commonly associated such as recurrent aphthous ulcers. Overall the prevalence and severity of these lesions inversely correlate with the level of immunosuppression. With the passage of time, there has been improved understanding of the disease pathogenesis resulting in the development of new drugs to combat this infection. Medication has changed from monotherapy to current triple combination therapy (Highly Active Anti‐Retroviral Therapy). This review looks at the impact of changing therapy on the prevalence of the various oral lesions associated with HIV. It finds a decrease in the prevalence of the oral lesions in the era of combination therapy as compared to earlier periods. It also shows a change in the types of lesions which predominate with those previously placed amongst the strongly associated lesions no longer being predominant in the era of combination therapy where such treatment is available.
Quantitative radiographic changes in the mandible and the tibia in systemically loaded rats fed a low‐calcium diet
Authors: Morimoto Y , Tanaka T , Kito S , Morimoto A , Haneji T , Kimura M , Ohba T
Published: August 2010

The combined effect of the duration of loaded physical exercise and the percentage of calcium intake on the mandible and tibia were studied in developing male rats. For the loaded exercise, rats ran on a treadmill at a rate of 12 m per min for either 1 or 2 h per day. A total of 54 4‐week‐old male Wistar rats were randomly assigned to one of six groups. After 4 weeks of the diet and loaded exercise, the rats were killed and their mandibles and tibia were removed. Each individual bone was assessed by radiography and the radiographs were then used for measurements of cortical thickness, bone length and bone width. All radiographic images were analyzed using a computer‐based scanner image analysis system. In addition, we measured the dry weight both of the tibia and mandible. The results demonstrated that significant differences in cortical thickness, bone length, bone width, and bone weight, both of the tibia and the mandible, were detectable between the normal diet group and the low‐calcium diet group. Among the normal diet groups, significant differences were found in cortical thickness, bone length, bone width, and bone weight of the tibia, whereas no significant differences in either cortical bone thickness, bone length or bone weight of the mandible were detected. In contrast, among the low‐calcium diet groups, no significant differences were detected in cortical thickness, bone length, bone width or bone weight for either the tibia or the mandible. Our results suggested that systemic exercise, such as running, promote the linear dimensions and the cortical thickness of the tibia in response to local stimuli. Furthermore, sufficient calcium intake appears to be necessary to allow the effect of systemic exercise on tibial bone growth to occur. In contrast, systemic loaded exercise does not promote either bone growth or development of the mandible even under conditions of sufficient calcium intake.
Ultrastructural study of direct bone formation induced by BMPs‐collagen complex implanted into an ectopic site
Authors: Nakagawa T , Tagawa T
Published: August 2010

OBJECTIVE: Some authors have reported that direct bone formation is ectopically induced by bone morpho‐genetic proteins (BMPs) independently of cartilage formation when type I collagen is used as a carrier. This study ultrastructurally investigated the mechanism of direct bone formation by BMPs‐collagen complex.

MATERIALS AND METHODS: Partially purified BMPs were combined with atelopeptide type I collagen (AC) and were implanted into the calf muscles of rats (n= 20). Tissue specimens were removed on days 7, 10, 14, and 21 after implantation.

RESULTS: Ultrastructurally, several regions near the pellet rim showed evidence of early calcification on day 10. In the uncalcified regions, mitochondrial calcification was seen in mesenchymal cells near AC fibers. The initially calcified regions contained numerous calcified granules deposited in the AC fibers. Some of these granules adhered to the cell membrane of osteogenic cells. In the highly calcified regions, some osteogenic cells secreted uncalcified matrix and deposited needle‐like crystals and calcified collagen microfibrils on the AC fibers.

CONCLUSION: This study suggests that the mesenchymal cells invading BMPs‐AC complex closely contacted the AC fibers, differentiated into osteogenic cells, and deposited calcified matrix on the AC fibers, resulting in direct osteoinduction without cartilage formation.
Evidence for plasticity genotypes in a gene–gene–environment interaction: the TRAILS study
Authors: Nederhof E. , Bouma E. M. C. , Riese H. , Laceulle O. M. , Ormel J. , Oldehinkel A. J.
Published: August 2010

The purpose was to study how functional polymorphisms in the brain derived neurotrophic factor gene (BDNF val66met) and the serotonin transporter gene linked promotor region (5‐HTTLPR) interact with childhood adversities in predicting Effortful Control. Effortful Control refers to the ability to regulate behavior in a goal‐directed manner and is an interesting endophenotype for psychopathology because of its heritability and the association of low Effortful Control with both internalizing and externalizing problems. In a longitudinal population‐based study Effortful Control was assessed with the parent version of the Early Adolescent Temperament Questionnaire at age 11. Pregnancy and delivery adversities and childhood events were assessed in a parent interview at age 11. Long‐term difficulties until age 11 were assessed with a parent questionnaire at age 13.5. Blood or buccal cells were collected at age 16 for genotyping the rs6265 and rs25531 SNPs and the 5‐HTTLPR length polymorphism. The study included 1032 complete data sets. Effortful Control was significantly predicted by the interaction between BDNF val66met, 5‐HTTLPR and childhood events. The BDNF val66met val/val–5‐HTTLPR l′/l′ genotype was unaffected by childhood events, while having either at least one BDNF val66met met or 5‐HTTLPR s′ allele (l′/l′‐met‐carrier; l′/s′‐val/val; s′/s′‐val/val) made children sensitive to childhood events. Predictions of Effortful Control by pregnancy and delivery adversities and long‐term difficulties were largely independent of genotype. We concluded that the l′/l′‐met‐carrier, l′/s′‐val/val and the s′/s′‐val/val genotypes showed greatest plasticity while the l′/l′‐val/val genotype was unaffected by childhood events.
Resistance to change and vulnerability to stress: autistic‐like features of GAP43‐deficient mice
Authors: Zaccaria K. J. , Lagace D. C. , Eisch A. J. , McCasland J. S.
Published: August 2010

There is an urgent need for animal models of autism spectrum disorder (ASD) to understand the underlying pathology and facilitate development and testing of new treatments. The synaptic growth‐associated protein‐43 (GAP43) has recently been identified as an autism candidate gene of interest. Our previous studies show many brain abnormalities in mice lacking one allele for GAP43 [GAP43 (+/−)] that are consistent with the disordered connectivity theory of ASD. Thus, we hypothesized that GAP43 (+/−) mice would show at least some autistic‐like behaviors. We found that GAP43 (+/−) mice, relative to wild‐type (+/+) littermates, displayed resistance to change, consistent with one of the diagnostic criteria for ASD. GAP43 (+/−) mice also displayed stress‐induced behavioral withdrawal and anxiety, as seen in many autistic individuals. In addition, both GAP43 (+/−) mice and (+/+) littermates showed low social approach and lack of preference for social novelty, consistent with another diagnostic criterion for ASD. This low sociability is likely because of the mixed C57BL/6J 129S3/SvImJ background. We conclude that GAP43 deficiency leads to the development of a subset of autistic‐like behaviors. As these behaviors occur in a mouse that displays disordered connectivity, we propose that future anatomical and functional studies in this mouse may help uncover underlying mechanisms for these specific behaviors. Strain‐specific low sociability may be advantageous in these studies, creating a more autistic‐like environment for study of the GAP43‐mediated deficits of resistance to change and vulnerability to stress.
Which plant for which skin disease? Part 1: Atopic dermatitis, psoriasis, acne, condyloma and herpes simplex
Authors: Reuter Juliane , Wölfle Ute , Weckesser Steffi , Schempp Christoph
Published: August 2010

Plant extracts and isolated compounds are increasingly used in cosmetics and food supplements to improve skin conditions. We first introduce the positive plant monographs with dermatological relevance of the former German Commission E. Subsequently clinical studies with botanicals for atopic dermatitis, psoriasis, acne, condylomata acuminata and herpes simplex are discussed. The best studies have been conducted with atopic dermatitis and psoriasis patients. Mahonia aquifolium, Hypericum perforatum, Glycyrrhiza glabra and certain traditional Chinese therapies have been shown to be effective in the treatment of atopic dermatitis. Mahonia aquifolium, Indigo naturalis and Capsicum frutescens are effective treatments for psoriasis. Green tea extract and tea tree oil have been investigated in the treatment of acne. Podophyllin and green tea extract are effective treatments for condylomata acuminata. Balm mint and a combination of sage and rhubarb have been shown to be effective in the treatment of herpes simplex in proof of concept studies.
Growth Hormone Treatment in Short Children ‐Short‐Term and Long‐Term Effects on Growth
Authors: ALBERTSSON‐WIKLAND K.
Published: August 2010

Short children with normal GH responses to arginine‐insulin provocation testing and various amounts of spontaneously secreted GH over 24 hours participated in an ongoing study with GH, 0.1 IU/kg/day. A total of 40 prepubertal children have been treated for 1 year. Their mean height velocity increased from 4.6 to 7.5 cm/year. The children with the slowest pretreatment height velocity showed the best increment. An inverse relationship was found between the endogenous GH secretion and the increment in growth; 80% of the children had an endogenous GH secretion of less than 300 milliunits/litre/24 hours, estimated as area under the curve above the calculated baseline. They all showed an increment in height above 2 cm. The remaining 20% all had an endogenous GH secretion of more than 300 milliunits/litre/24 hours, estimated as area under the curve above the calculated baseline, Twenty‐four of the children were prepubertal for the following 4 years, and their GH therapy continued. Their Deight velocity changed from 4.2 cm/year before therapy to 8.1,6.7,6.0 and 4.9 cm/year for the 1st, 2nd, 3rd and 4th years on treatment. Many of them have passed their expected final height, but have still not stopped growing. Those children who were in early puberty when GH treatment started went into a rapid growth spurt and have now stopped growing. They have all reached but not improved their expected final height. In 15 of the children GH treatment was stopped after 1‐3 years. Their mean height velocity for the first post‐treatment year was 5.1 cm/year; thus, for the group as a whole no‘catch down’was observed. Of the 15 children, only 4 decreased in height velocity despite increasing age. Further studies on the long‐term results of GH treatment in larger groups of short children are needed to verify the findings in this study.
Urinary Creatinine Excretion and Estimation of Muscle Mass in Infants of 25‐34 Weeks Gestation
Authors: MODI N. , HUTTON J. L.
Published: August 2010

ABSTRACT. The urinary excretion rate of creatinine was measured over 89 days in 31 infants of gestational ages 25‐34 weeks in the first week of life. Creatinine excretion was shown to have a significant positive correlation with weight and postconceptional age. Creatinine excretion factored by body weight was also positively correlated with weight and postconceptional age. Pooled analysis of published data together with our own, confirms that this correlation is important. Muscle mass was estimated from creatinine excretion rate. A regression equation was derived predicting muscle mass from birthweight and gestational age. Muscle mass increases from 12% of birthweight at 25 weeks gestation to 19% at 34 weeks and 24% at 40 weeks. This is in agreement with classic dissection studies which showed muscle mass to be 25% of body weight at term.
Amino Acid Levels in the Critically ill Preterm Infant Given Mother's Milk Fortified with Protein from Human or Cow's Milk
Authors: HAGELBERG S. , LINDBLAD B. S. , PERSSON B.
Published: August 2010

ABSTRACT. Twenty preterm infants undergoing neonatal intensive care were randomly allocated to one of two feeding regimens: human milk enriched with either human milk protein (HMP) or adapted cow's milk protein (CMP). The birthweights (1076 ± 301 g; 1031 ± 309 g) and the gestational ages (28.4 ± 1.6 weeks; 27.7 ± 2.1 weeks) were comparable. The amount of protein added to the milk was set at 0.7 g/100 ml in order to provide a total supply of 3.0‐3.5 g/kg/24 h. All infants received additional amounts of carbohydrate, calcium, phosphorous, and sodium chloride. Capillary whole blood amino acids were measured with high pressure liquid chromatography (HPLC). The amino acid levels did not differ significantly when the feeding groups were compared week by week, but the glycine/valine ratio was higher (p<0.05) in the HMP group after three weeks of fortification. Longitudinal changes after protein enrichment could be demonstrated in both groups. Alanine and threonine increased after one week (p<0.01) in both groups. Glycine in the HMP group peaked after two weeks (p<0.02), and valine in the CMP group increased (p<0.02) after one week on the feeding regimen. However, the amino acids never reached levels above those seen after a meal in normal term newborns. Other variables related to protein intake, such as protein and urea in serum, did not vary between the groups. Growth, expressed as gains in weight, length, and head circumference was poor but comparable. The quality of the protein, whether a human milk protein isolate or a cow's milk whey protein product, used for the fortification of human milk up to a protein load of 3.0‐3.5 g/kg/24 h, did not cause any alterations of significance in the amino acid profiles of peripheral blood.
Evaluation of Live Attenuated Varicella Vaccine (Oka‐RIT Strain) and Combined Varicella and MMR Vaccination in 13–17‐Month‐Old Children
Authors: VESIKARI T. , ÖHRLING A. , BAER M. , DELEM A. , BOGAERTS H. , ANDRE F. E.
Published: August 2010

ABSTRACT. The Oka‐RIT strain of live attenuated varicella vaccine at dose levels 5300 PFU (high titre) and 2000 PFU (low titre) was tested in 13–17‐month‐old children; 50% of the children received the varicella vaccine alone, and the other 50 % received it together with a measles‐mumps‐rubella (MMR) vaccine. The high titre and low titre varicella vaccines induced 96% and 92% seroconversion rates, respectively. Following combined vaccination with MMR, the corresponding seroconversion rates for varicella were significantly lower at 85% and 72% respectively. Seroconversion rates to measles, mumps and rubella were not affected by the combination of varicella vaccine plus MMR vaccination. Single varicella vaccine at both titre levels was found safe, although 10% of the children had minor skin reactions, possibly attributable to the vaccine. Reactions typically associated with MMR vaccination did not significantly increase after the combined varicella plus MMR vaccination. This study confirmed that the Oka‐RIT strain varicella vaccine is safe and immunogenic in healthy young children, but failed to find a totally satisfactory combination for a varicella‐MMR vaccine.
Clinical features and molecular genetic analysis of a boy with Prader‐Willi syndrome caused by an imprinting defect
Authors: Schulze A , Hansen C , Bækgaard P , Blichfeldt S , Petersen MB , Tommerup N , Brφndum‐Nielsen K
Published: August 2010

Abstract Prader‐Willi syndrome (PWS) is a neuroendocrine disorder caused by a non‐functioning paternally derived gene(s) within the chromosome region 15q11‐q13. Most cases result from microscopically visible deletions of paternal origin, or maternal uniparental disomy of chromosome 15. In both instances no recurrence has been reported. In rare cases, PWS is associated with lack of gene expression from the paternal allele due to an imprinting defect. We report the clinical features and the molecular genetic analysis of the first Danish child with PWS due to a defect of the putative imprinting centre (IC). When the imprinting mutation is inherited from a carrier father, the risk that future children will be affected is theoretically 50%. It is therefore important that these families are referred to a geneticist for counselling and further investigation. Prenatal diagnosis is currently only feasible when the mutation has been identified in the affected child.
Diffuse mesangial sclerosis: association with unreported congenital anomalies and placental enlargement
Authors: Mildenberger E , Lennert T , Kunze J , Jandeck C , Waldherr R , Versmold H
Published: August 2010

A case of diffuse mesangial sclerosis (DMS) associated with a number of undescribed congenital anomalies is reported. The occurrence of additional anomalies, especially ocular anomalies, is a common finding in DMS. However, neither megalocornea, Dandy‐Walker malformation, postaxial hexadactyly, rocker‐bottom feet, nor atrial septal defect, as observed in our patient, has been reported previously in association with DMS. This case might be considered an atypical manifestation of the Galloway‐Mowat syndrome. In contrast to most cases of DMS, the patient revealed intrauterine proteinuria as the placenta was enlarged to 31% of birth weight. This case demonstrates that the large placenta, > 25% of birth weight, is not only pathognomonic of the congenital nephrotic syndrome of the Finnish type but can also occur in DMS.
Childhood obesity and adulthood consequences
Authors: Rössner S
Published: August 2010

The prevalence of obesity is increasing worldwide both for adults and children. Although obesity has underlying genetic causes, possibly explaining about 50% of the body weight variation, the dramatic recent increase must be due to behavioural reasons. Lifestyle questions must be addressed if new preventive and treatment strategies are to be developed. Since many obese children grow into obese adults with high risks for complications and a low quality of life, more aggressive treatment methods for the obese child could be envisaged.
Randomized controlled trial of discontinuation of nasal‐CPAP in stable preterm infants breathing room air
Authors: Abdel‐Hady H , Mohareb S , Khashaba M , Abu‐Alkhair M , Greisen G
Published: August 2010

This trial assessed the consequences of discontinuation of nasal‐CPAP in stable preterm infants breathing room air. Eighty‐eight infants with a mean gestational age of 29 (24‐33) weeks and a mean birthweight of 1264 (665–2060) g, randomized to either discontinuation of CPAP or its continuation, were clinically observed and monitored for 6 h by cardiorespiratory monitor, pulse oximeter and transcutaneous blood gas monitor. The abdominal circumference and gastric air and aspirate volumes were measured prior to meals at trial entry and after 6 h. Discontinuation of CPAP led to a small but significant decrease in oxygenation at 1 and 6 h. During the trial, five infants in the experimental group required supplemental oxygen and one infant was put back on CPAP owing to excessive apnoeas. Discontinuation of CPAP did not influence the TcPCO2 or the number of apnoeas and bradycardias during the trial, but led to significantly increased respiratory rate, retractions, and flaring at 6 h. It also led to a significant decrease in the abdominal circumference and gastric air volume. Thirty‐nine percent of infants were put back on CPAP some time after the trial, mainly because of recurrent apnoeas and bradycardias. Taking the infant off CPAP during the trial reduced subsequent use of CPAP.
Immunogenicity of hepatitis B vaccine in term and preterm infants
Authors: Belloni C , Chirico G , Pistorio A , Orsolini P , Tinelli C , Rondini G
Published: August 2010

Some studies have suggested that decreased seroconversion rates might be found in premature infants with low birthweight (< 2000 g) following administration of hepatitis B vaccine at birth. The aim of the present investigation was to evaluate possible differences in seropositive rates between full‐term and preterm infants after primary vaccination, in particular when gestational age or birthweight is very low. Two‐thousand and nine neonates born to HBs Ag‐negative mothers were vaccinated with 10 μg of recombinant hepatitis B virus (HBV) vaccine, from May 1991 to October 1994. Children with infections, congenital malformations or serious illnesses were excluded. HBV vaccine was administered intramuscularly, on the fourth day of life and again at 1 and 6 months of age. A 1‐ml blood sample was drawn from each infant 1 month after the third vaccine dose for determination of the level of anti‐HBs antibody. The response to HBV vaccination was evaluated in 241 preterm (gestational age < 38 weeks) infants and 1727 term neonates. No statistical difference was observed in the distribution of anti‐HBs antibody level, either between preterm infants (< 38 weeks) and newborns of normal gestational age, or between low birthweight (< 2500 g) and normal weight infants. The results suggest that preterm and low birthweight infants (< 2500 g) respond to HBV vaccine in the same measure as normal‐term infants.
The effects of endurance training on selected coronary risk factors in children
Authors: Stergioulas A , Tripolitsioti A , Messinis D , Bouloukos A , Nounopoulos Ch
Published: August 2010

The effects of regular aerobic exercise on blood concentrations on high‐density lipoprotein cholesterol and prostacyclin were studied in 18 healthy sedentary boys who exercised on a bicycle ergometer for 1 h, four times per week, for 2 months at 75% of their physical working capacity. The results were compared with those of 10 control boys who did not participate in any specific program. The exercise group revealed a significantly higher mean high‐density lipoprotein cholesterol and 6‐keto‐PGF1a concentration at the end of the training program (p < 0:005 and p < 0:001, respectively). These results suggest that regular aerobic exercise has beneficial effects upon the high‐density lipoprotein cholesterol and 6‐keto‐PGF1a in healthy young boys and may be beneficial in the long term, by preventing atherosclerosis of coronary artery disease in adulthood.
Randomized trial examining cerebral haemodynamics following artificial or animal surfactant
Authors: Murdoch E , Kempley ST
Published: August 2010

To determine the effects of animal and artificial surfactants on cerebral haemodynamics, 20 premature babies receiving mechanical ventilation were randomized to receive Curosurf or Exosurf surfactant. Anterior cerebral artery blood flow velocity (CABFV) was measured using Doppler ultrasound before and up to 2 h after treatment. Following animal surfactant there was a rapid reduction in CABFV (median ‐36%, range ‐43% to +8%,p < 0:01), whereas artificial surfactant resulted in a slower rise which was less marked (median +20%, range ‐7% to +62%, p < 0:05). There were no significant changes in blood pressure. Two hours after administration, the oxygenation index (OI) improved significantly only in babies receiving animal surfactant. In this group there was a significant association between the change in CABFV at 1 min and the change in OI at 2 h (r = 0:66, p < 0:05). Animal surfactant produces rapid improvements in ventilation which are associated with marked alterations in cerebral haemodynamics.
Spinal cord compression–do we miss it?
Authors: Hesketh E , Eden OB , Gattamaneni HR , Campbell RHA , Jenney MEM , Lashford L
Published: August 2010

Four children with spinal cord compression due to malignant tumours are presented. The severity of the condition was not initially recognized by parents, or the nature of the likely cause by the initial physicians. Lower limb asymmetrical weakness, clear‐cut sensory levels, and marked pain indicate need for urgent imaging and exclusion of a space occupying lesion. In 1997 diagnosis of Guillain‐Barré syndrome should not be made without careful prior spinal imaging.
Dietary treatment for regurgitation–recommendations from a working party
Authors: Vandenplas Y , Belli D , Cadranel S , Cucchiara S , Dupont C , Heymans H , Polanco I
Published: August 2010

Regurgitation is a common manifestation in infants below the age of 1 y, and is a frequent reason for counselling of general practitioners and paediatricians. Current recommended therapeutic management starts with parental reassurance and dietary measures, followed by prokinetics. In this paper, the efficacy, safety and nutritional implications of the dietary treatment of regurgitation are evaluated. Industrially prepared thickened feeds may contain cereals of fibres; some have a low lipid content and are casein‐predominant. Milk‐thickened agents can also be added to regular infant feeding. Formulae claimed as“anti‐regurgitation formulae”, or positioned as such, should be considered as medical foods or therapeutic diets, and only be available on medical prescription. It is proposed to limit the“anti‐regurgitation”(AR) label to those diets which have been proven clinically effective on regurgitation and which are nutritionally safe.
Factors affecting cognitive, motor, behavioral and executive functioning in children with phenylketonuria
Authors: Arnold GL , Kramer BM , Kirby RS , Plumeau PB , Blakely EM , Cregan LS Sanger , Davidson PW
Published: August 2010

We administered measures of cognitive, frontal lobe (executive), behavioral and motor functioning to 18 children with classical phenylketonuria, aged 12–101 months, in order to determine the relationship of age, current and lifetime average phenylalanine levels, and individual variation (standard deviation of lifetime average levels) to these functions. On measures of cognitive function, in children ≥ 3 y of age lower current phenylalanine levels were associated with higher cognitive functioning. On a behavioral temperament scale designed for normal children, we found that higher current and average phenylalanine levels correlated with more difficult temperament. Motor function was also poorer in children with phenylketonuria, and was most impaired in children with current phenylalanine levels >360μmol/l. We also identified a previously unreported correlation between increased individual variation and poorer executive function performance, a finding that may raise new management concerns about level fluctuations. Maintenance of phenylalanine levels μ 360 μml/l may be necessary for optimal performance in children with phenylketonuria.
Metabolic control in children with insulin‐dependent diabetes mellitus 5y after diagnosis. Early detection of patients at risk for poor metabolic control
Authors: Forsander G , Persson B , Sundelin J , Berglund E , Snellman K , Hellstrom R
Published: August 2010

Children (n= 38) aged 3‐15 y were randomly chosen, at the time of diabetes diagnosis, for conventional management at a hospital ward, or for treatment partly in a training apartment where the family was offered problem‐based education and special therapeutic support. HbA1c, blood glucose stability, urinary C‐peptide excretions and incidence of hypoglycaemic attacks and diabetes ketoacidosis (DKA) were monitored and some standardized, self‐estimated psychological tests were performed during the first 2 y after diagnosis. During the 3 y thereafter, HbA1c, presence of DKA, microalbuminuria, retinopathy and hypertension were monitored. None of the patients demonstrated signs of diabetes microangiopathy or DKA. The overall mean HbA1c level was 7.2% 5 y after diagnosis and 30% of the children had HbA1c values < 6.3%. There were no differences in the HbA1c values for the patients treated by the different management regimens. Blood glucose variability (SD) was also similar, with 75% of the values in the range of 3–10 mmol/l. Patients with poor glycaemic control (mean HbA1c >8.3%) year 5 after diagnosis had already the second year after diagnosis significantly higher HbA1c values and blood glucose variability. The fathers of these patients demonstrated a higher degree of maladjustment. On the basis of increasing HbA1c values, high blood glucose variability and psychosocial risk factors such as their fathers’emotional responses, patients at risk for poor metabolic control in the future can be identified within 2 y after diagnosis. Efforts and resources can thus be focused at an early stage on this group.
Renal impairment in patients with long‐standing cyanotic congenital heart disease
Authors: Dittrich S , Haas NA , Bührer C , Müller C , Dähnert I , Lange PE
Published: August 2010

Nephropathy is known to occur in patients with long‐standing cyanotic congenital heart disease (CCHD). In order to assess the incidence, nature and degree of the problem among such patients, discriminating urine analyses were performed in 26 patients with CCHD, with a mean age of 22 (10–42) y. Ten patients showed reduced glomerular function, six of whom also had advanced glomerulopathy. Glomerular filtration rates were below normal in half of the patients and occurred with glomerular‐type proteinuria in five, with tubular‐type proteinuria in one and without pathological proteinuria in four. An elevated haematocrit and duration of cyanosis were identified as the main risks factors for the development of glomerulopathy. The risk of developing glomerular lesions rose sharply during the second decade of life. Nephropathy in CCHD is common and the dominant feature is glomerular damage, which is related to the duration of cyanosis and the extent to which the haematocrit is elevated.