bluuebunny/crossref_metadata_2025 huggingface dataset:
The pressure pain threshold (PPT) of certain muscles in children suffering from recurrent abdominal pain of non‐organic origin. An algometric study
Authors: Alfvén Gösta
Published: January 2008

The origin of recurrent abdominal pain of “non‐organic origin” is believed to be psychogenic in most cases. But the pathogenesis of the pain itself is unknown. To test the hypothesis that recurrent abdominal pain of non‐organic origin is related to increased pain sensitivity in the myofascial elements of the abdominal wall itself, an investigation of pain pressure threshold of the abdominal wall, close to the umbilicus, was carried out. Altogether 140 children in the fourth school grade, approximately 11 years old, were tested for pressure pain threshold. Two groups were constituted: one without pain symptoms (no recurrent abdominal pain, chest pains or headache (n= 50)) and one with recurrent abdominal pain (n= 49). The pressure pain threshold differed significantly (p<0.0001). To support the hypothesis that recurrent abdominal pain is a part phenomenon of a specific pattern of muscular tension and tenderness, the pressure pain threshold was tested in five other muscles, with significant results.
Decreased serum levels of nutritional biochemical indices in healthy children with marginally delayed physical growth
Authors: Mokni R , Chakar A , Bleiberg‐Daniel F , Mahu JL , Walravens PA , Chappuis P , Navarro J , Lemonnier D
Published: January 2008

Biochemical markers of nutritional status (albumin, transthyretin, insulin‐like growth factor‐I and zinc) were measured in slowly growing two‐ to five‐year‐old, low‐income Parisian children whose weight‐for‐height or height‐for‐age z scores (WHZ or HAZ) were between — 1 and — 2 SD of the NCHS median. The results were compared to controls who were matched for age, sex, and ethnic origin with WHZ and HAZ between — 1 and + 2 SD. Mean serum levels of transthyretin, albumin and insulin‐like growth factor‐I and mean plasma zinc concentrations were significantly lower in the growth‐impaired children than in the controls (p= 0.002, p= 0.006, p= 0.015, and p= 0.035, respectively). While the height‐retarded children had low mean serum insulin‐like growth factor‐I values, the weight‐retarded subjects had decreased levels of albumin, transthyretin and zinc when compared to controls. Lower mean levels of nutritional markers in healthy, slowly growing children suggest that inadequate dietary intakes of zinc, protein and/or energy may result in marginal delays in weight and height gains.
Avidity and titers of the antibody response to two inactivated poliovirus vaccines with different antigen content
Authors: Mellander L , Böttiger M , Hanson LÅ , Taranger J , Carlsson B
Published: January 2008

The inactivated poliovirus vaccine is heat stabile, gives high serum IgG concentrations but less pronounced mucosal immunity and must be given as repeated injections. A new enhanced‐potency Dutch inactivated vaccine could circumvent these difficulties. We compared antibody concentrations measured as neutralization or ELISA titers, and avidity of serum and salivary antibodies in children vaccinated with three doses of the earlier Swedish vaccine given over nine months or the new antigen‐rich vaccine. After three doses, but not after two, serum neutralization titers for type 1 and type 3 poliovirus were higher using the new vaccine but secretory IgA levels in saliva were similar. The avidity of the serum IgC antibodies was significantly higher after two doses of the new vaccine than after three doses of the old. Thus the new vaccine gives excellent antibody responses of high titers and avidities, but should preferably be given in three doses.
Changes in coeliac disease behaviour over the years
Authors: Bottaro G , Failla P , Rotolo N , Sanfilippo G , Azzaro F , Spina M , Patane R
Published: January 2008

We performed a retrospective study of 325 coeliac children (179 females and 146 males, F/M ratio 1:2), diagnosed from 1984 to 1989. The children were divided into two groups; group A were diagnosed between 1984 and 1986 and group B were diagnosed between 1987 and 1989, when the antigliadin antibody test had been introduced in our routine. The data showed a difference between the number of diagnoses in the two groups, 117 in group A versus 208 in group B, with a yearly increment of new cases. In both groups, the onset of the disease occurred within the 2nd year of life, in most cases (group A, 88.9%); group B 89.4%) showing a mode at approximately the 9th month. Diagnosis was made within the 2nd year of life in the majority of cases (group A, 80.3%; group B, 87.4%), showing a mode of approximately the 12th month. In both groups, chronic diarrhoea was the most frequent symptom (75.2% in group A and 70.2% in group B), while minor symptoms, such as isolated short stature, pallor, delayed puberty and others, did not show any important change. We conclude that in Sicily, in recent years, the incidence of coeliac disease has been increasing. The most representative clinical form is the classic one, with onset within the 2nd year of life, and chronic diarrhoea, growth failure and abdominal distention as key symptoms.
Early clinical symptoms and incidence of aspartylglucosaminuria in Finland
Authors: Arvio M , Autio S , Louhiala P
Published: January 2008

Early clinical symptoms were analyzed from all known 43 children with aspartylglucosaminuria, born during 1974–1989 in Finland. Pre‐ and perinatal histories appeared normal for all children, except for muscular hypotonia and weak sucking in some babies. Three infants had abduction stiffness in the hips, needing follow‐up. Other abnormalities found in infancy were umbilical or inguinal hernias and unusual susceptibility to respiratory and ear infections. This susceptibility diminished clearly in most patients after six years of age. Episodic diarrhea, described earlier, appeared to be a rather infrequent symptom and a less valuable diagnostic clue. New clinical phenomena were talipes planovalgus or clubfoot, needing surgical treatment, and aggressive behavior, needing, occasionally, child psychiatric consultation or treatment. In addition, angiokeratoma of the skin, not an infrequent phenomenon among adult patients, was found in one child. The main indications for further studies were delayed speech, attention deficit and clumsy or delayed motor functions. The disease is easily misdiagnosed and, universally, probably underdiagnosed. Its incidence in Finland was recalculated and appeared to be at least 1 in 18 500 live‐born babies in this country.
Mucha—Habermann disease: a diagnostic possibility for prolonged fever associated with systemic and skin symptoms
Authors: Korppi M , Tenhola S , Hollmen A
Published: January 2008

The severe form of Mucha‐Habermann disease with systemic symptoms is a rarely diagnosed disease which should be considered for children with prolonged fever, impaired general condition, skin manifestations and elevated C‐reactive protein concentration and/or erythrocyte sedimentation rate. Eleven cases have been described previously in children. We describe two acute episodes of this syndrome in a three‐year‐old child; the diagnosis was based on clinical, dermatological and histological findings. During both episodes, the fever lasted for more than one week, C‐reactive protein concentration increased to more than 150 mg/l, and there was extensive lymph node enlargement. Skin eruption was initially maculopapulous, then vesiculous and finally pustulous. On skin biopsy, vasculitic changes were observed. We treated the second attack of our patient with high‐dose gamma globulin; the first attack appeared to resolve itself spontaneously.
SIDS outdoors and seasonality in Sweden 1975–1987
Authors: Milerad J , Norvenius G , Wennergren G
Published: January 2008

In order to link the reported increasing incidence of SIDS in Sweden to environmental or other risk factors, we compared birth records and circumstances of deaths in infants who died in 1975–1977 with those who died a decade later, 1985–1987. The number of live births differed by only 6850 in these two periods. Data were acquired from autopsy records of the deceased infants and matched with their respective birth certificates which were obtained from the National Board of Health and Welfare. The reported postperinatal incidence of SIDS increased from 0.51 per 1000 in 1975–1977 to 0.93 per 1000 in 1985–1987. No significant differences in boy/girl ratio, birth weight, gestational age or age at death were found in the two periods. While the number of infants who died at night indoors in their own bed remained almost unchanged, the number of infants who died outdoors in baby carriages during the cold season increased almost four‐fold. The observed increase in incidence could, to a large extent, be related to the increase in outdoor deaths. We speculate that increased incidence of smoking among young women as well as other changes in lifestyle may have been contributing factors.
Sodium‐lithium countertransport and family history of hypertension in childhood
Authors: Houtman PN , Shah V , Dillon MJ
Published: January 2008

We have studied the relationship between sodium‐lithium countertransport, determined in childhood, and family history of hypertension. Countertransport was measured in healthy children and those with secondary hypertension. There was no significant difference in countertransport between these two groups. In the normal children (n= 52, median age 6.8 years), there was a positive relationship between body mass index and countertransport (rs= 0.34, p<0.02). A positive relationship between family history of hypertension using a ranked scoring system, and countertransport, not related to age, body mass or blood pressure (n = 34, rs= 0.63, p<0.001) was also found. There was no significant relationship between intraccllular sodium concentration and countertransport. These data confirm that countertransport in normal children is related to body mass index and indicate that a genetic predisposition to primary hypertension marked by sodium‐lithium countertransport is identifiable in childhood.
Treatment of severe pertussis by administration of specific gamma globulin with high titers anti‐toxin antibody
Authors: Ichimaru T , Ohara Y , Hojo M , Miyazaki S , Harano K , Totoki T
Published: January 2008

Our patient presented with severe respiratory distress and marked pleocytosis. She was mechanically ventilated and received gamma globulin with high titers of anti‐pertussis toxin and anti‐filamentous hemagglutinin. Her clinical signs improved and a notable decrease in white blood cell count was observed. Ten months after treatment, the patient showed normal physical and mental development and anti‐pertussis toxin and anti‐filamentous hemagglutinin titers were significantly increased. Recently, the effectiveness of gamma globulin therapy has been emphasized again. Our experience supports the use of iv gamma globulin infusion. Also, gamma globulin did not influence the patient's own immunologic response to pertussis. Gamma globulin therapy with high anti‐pertussis toxin titers could be considered for treatment of severe pertussis.
Early child health in Lahore, Pakistan: I. Study Design
Authors: Jalil F , Lindblad BS , Hanson LA , Khan SR , Ashraf RN , Carlsson B , Zaman S , Karlberg J
Published: January 2008

In this paper, details are given of a community based follow up study of four areas: a village, a periurban slum, an urban slum and an upper middle class control group living in and around Lahore, Pakistan. The aim was to characterize the determinants of child health in a rapidly urbanizing community. The study was undertaken in two steps. An initial cross‐sectional survey collecting socio‐economic and demographic background information was carried out between March to August 1984. This was followed by a longitudinal study of 1476 infants representing the outcome of the pregnancies registered continuously between September 1984 to March 1987 among the 3242 families in the study. These infants were followed monthly from birth to 3 years of age and thereafter less frequently. In this communication we describe the study design, the study population, the organization and the research methodology used, including the reasons for drop outs from birth to 24 months of age. The internal consistency of the data is also presented. After the initial examination of the newborns within between 0–7 days of birth, the infants were visited monthly for 24 months making a total of 20911 examinations. At 24 months of age 70% of the infants were still in the study, 11% had died before reaching this age, 13% had moved from the area and 6% had refused to participate in the study. The economic, conditions, social structure, and the quality of life were found, not surprisingly, to vary significantly among the four areas. This community‐based project provides new, critical and reliable information for local health planners. The study highlights the importance of the development of a useful model for research collaboration between institutions in developed and developing countries.
Early child health in Lahore, Pakistan: VI. Morbidity
Authors: Zaman S , Jalil F , Karlberg J , Hanson LÅ
Published: January 2008

Morbidity patterns were studied according to the age, area of living, sex and season among 1476 monthly followed infants born during 1984–1987 in four socio‐economically different areas in Lahore, Pakistan. Infections were responsible for 87.0% of the morbidity during the first two years of life. The overall monthly based morbidity was 77.0% between birth and 24 months of age; diarrhoeal diseases 30.3%, upper and lower acute respiratory tract infections (ARI) 22.4%, skin and eye infections 6.7% and skin rash 6.2%. The vaccine‐preventable diseases were only 0.5% of the total. Anaemia and rickets were rare (2.0%), but commonly seen among the nutritional deficiencies. Diarrhoea, tetanus, septicaemia, AN and infections of the skin and eyes were reported more during earlier ages and from the three poorer areas of living. Diarrhoeal diseases, respiratory tract, skin and eye infections, in particular, followed clear seasonal patterns, while scabies prevailed throughout the year. The presence of these many preventable infections and illnesses implies that proper planning of interventions must be forthcoming.
Demography, auxology and response to recombinant human growth hormone treatment in girls with Turner's syndrome in the Kabi Pharmacia International Growth Study
Authors: Price DA , Albertsson‐Wikland K ,   Kabi Pharmacia International Growth Study
Published: January 2008

Demographic and auxological data were analysed from 818 girls with Turner's syndrome treated with recombinant human growth hormone (GH) and entered into the Kabi Pharmacia International Growth Study. Size at birth was low and correlated with the heights of both parents. The median age at start of GH treatment was 11.4 years and the parents had a median height SDS of ‐2.9. Height SDS at the start of treatment correlated with parental heights. Height velocities conformed to Turner‐specific standards. The weight‐for‐height index increased sharply above 9 years of age. The frequency of spontaneous appearance of Tanner breast stage 2 was high (34.1% of girls > 10 years of age). Bone age (Greulich and Pyle) data were described by the equation: bone age = 1.61 (chronological age) ‐0.04(chronological age)2 ‐ 3.61. This equation was used to correct adult height predictions. The median initial dose of GH was 0.8 IUkglweek and was maintained during the first 3 years of treatment. The median frequency of injections was six/week. Height velocity increased from 4.1 to 6.8 cm/year in the first year, and height velocity SDS for chronological age remained positive for 4 years. The height prediction corrected for bone age increased over the first 2 years only. Differences in demography and auxology were described according to karyotype and country of origin. A greater height velocity SDS was observed at higher GH doses and when oxandrolone was used concomitantly.
Erythropoiesis of very low‐birth‐weight infants dependent on prenatal growth rate and protein status
Authors: Kivivuori SM , Järvenpää AL , Salmenperä L , Viinikka L , Siimes MA
Published: January 2008

Kivivuori SM, Järvenpää AL, Salmenperä L, Viinikka L, Siimes MA. Erythropoiesis of very low‐birth‐weight infants dependent on prenatal growth rate and protein status. Acta Paediatr 1994; 83:13–18. Stockholm. ISSN 0803–5253

This study investigated erythropoiesis in very low‐birth‐weight infants with special reference to the role of protein status in the regulation of erythropoiesis in 22 appropriate‐ and 11 small‐for‐gestational‐age infants. Blood sampies were drawn at three and six weeks of age. The serum concentrations of erythropoietin, estimated by a solid‐phase enzyme immunoassay, were similar in the two groups at both study ages. The total circulating erythrocyte volume and the serum concentration of prealbumin were higher in the appropriate‐ than in the small‐for‐gestational‐age infants at three and six weeks of age. The former group had a better protein status, although their protein intake was similar or lower. We conclude that erythropoiesis in very low‐birth‐weight infants is influenced more by protein status and prenatal growth than by serum concentration of erythropoietin.
An epidemiological study of Hirschsprung's disease and additional anomalies
Authors: Russell Michael Bjørn , Russell Charlotte Astrid , Niebuhr Erik
Published: January 2008

Russell MB, Russell CA, Niebuhr E. An epidemiological study of Hirschsprung's disease and additional anomalies. Acta Pædiatr 1994;83:68–71. Stockholm. ISSN 0803–5253.

The incidence of Hirschsprung's disease was studied in approximately 1.5 million consecutive live births in Denmark by hospital records. A diagnosis of Hirschsprung's disease required a histologic verified absence of ganglion cells in either biopsy or surgical colonic specimens. The incidence of Hirschsprung's disease was found to be 0.140 per 1000 live births (1:7,165) with a male: female ratio of 4.1:1 in short segment, and 2.4:1 in long segment Hirschsprung's disease (p = 0.36). Maternal age and birth order were unimportant factors. The association of Hirschsprung's disease and Down's syndrome was seen in 9 of the 207 patients and may represent a real association, whereas the association with congenital heart defects seen in 2% (not including patients with Down's syndrome) is more doubtful. A mortality of 16% among the patients with Hirschsprung's disease emphasizes the extreme importance of early diagnosis.
Diabetes mellitus in Danish cystic fibrosis patients: prevalence and late diabetic complications
Authors: Lanng S , Thorsteinsson B , Lund‐Andersen C , Nerup J , Schiøtz PO , Koch C
Published: January 2008

Lanng S, Thorsteinsson B, Lund‐Andersen C, Nerup J, Schiatz PO, Koch C. Diabetes mellitus in Danish cystic fibrosis patients: prevalence and late diabetic complications. Acta Pzdiatr 1994;83: 72–7. Stockholm. ISSN 0803–5253.

The prevalences of impaired glucose tolerance (IGT), diabetes mellitus and late diabetic complications were studied in all Danish cystic fibrosis (CF) patients. A total of 311 CF patients were identified with an estimated ascertainment rate above 98%. Glucose tolerdnce was classified in 278 (89%) patients: the prevalences of IGT and diabetes mellitus were 13.7% (38 patients) and 14.7% (41 patients), respectively, with no sex differences. The prevalence of diabetes mellitus increased with age but not with the severity of CF as compared with age‐ and sex‐matched non‐diabetic CF patients. Diabetes was diagnosed at a median age of 20 years (range 3–40 years) and the duration of diabetes was 1.7 years (0.1–17 years). Twenty‐eight of the diabetic patients (70%) were trcated with insulin, on average 20 (4–90) IU per day. Late diabetic complications were identified in 4 patients (10%) with a duration of diabetes mellitus of 1–17 years: background retinopathy (2 patients), diabetic nephropathy (1 patient), microalbuminuria (1 patient) and neuropathy (2 patients). Thus diabetic CF patients are probably not less prone to develop late diabetic complications than patients with other types of diabetes of equally long duration and comparable glycemic control.
Inhibitor to factor V after exposure to fibrin sealant during cardiac surgery in a two‐year‐old child
Authors: Muntean W , Zenz W , Finding K , Zobel G , Beitzke A
Published: January 2008

Muntean W, Zenz W, Finding K, Zobel G, Beitzke A. Inhibitor to factor V after exposure to fibrin sealant during cardiac surgery in a two‐year‐old child. Acta Prediatr 1994;83:84–7. Stockholm. ISSN 0803–5253

A two‐year‐old infant developed an inhibitor to factor V after cardiac surgery, with application of fibrin sealant containing bovine thrombin. Investigation of this inhibitor by means of inhibition experiments and immunoblot analysis revealed that the inhibitor reacted strongly with bovine, but only weakly with human factor V. Plasmapheresis proved effective in increasing factor V levels. This patient provides further evidence that exposure to topical thrombin preparations may lead to the development of inhibitors in the postoperative period that may cause bleeding complications.
Incidence and clinical features of incomplete Kawasaki disease
Authors: Fukushige J , Takahashi N , Ueda Y , Ueda K
Published: January 2008

During the nine‐year period from 1983 to 1991, a total of 242 patients (142 males and 100 females) presenting with Kawasaki disease were seen at one hospital. Among them, 25 (10%) patients demonstrated incomplete Kawasaki disease and 17 of these 25 (68%) lacked two of the six principal symptoms of Kawasaki disease, with the most frequently missing symptoms being cervical lymphadenopathy and polymorphous exanthema. The typical laboratory features of Kawasaki disease, such as elevated erythrocyte sedimentation rate, leukocytosis, anemia, positive C‐reactive protein and thrombocytosis were also seen in the incomplete cases. None of the 25 patients underwent iv gamma‐globulin therapy while in 1 (4%), transient dilatation of the coronary artery was recognized. Incomplete Kawasaki disease may therefore be characterized by a less frequent association of rash, cervical lymphadenopathy and coronary involvement.
Low neonatal cerebral oxygen delivery is associated with brain injury in preterm infants
Authors: Pryds O
Published: January 2008

Neonatal cerebral oxygen delivery was estimated in 93 preterm infants (gestational age < 34 weeks) who survived the neonatal period. Of these, 26 had developed neurological handicap at follow‐up 1.7–4.6 years later. Neonatal cerebral oxygen delivery was dependent on gestational age, and was also related to the degree of intra‐uterine growth retardation, carbon dioxide tension, and blood glucose concentration. Lower oxygen delivery was observed in infants who developed germinal layer haemorrhage or periventricular leucomalacia compared with infants with normal brains. However, as no information on cerebral metabolic demand or oxygen extraction is available, it is unclear whether decreased oxygen delivery is a contributing factor to brain damage or whether it is a marker of existing injury.
Outcome of extremely low‐birth‐weight infants: 1980–1990
Authors: Blaymore‐Bier J , Pezzullo J , Kim E , Oh W , Garcia‐Coll C , Vohr BR
Published: January 2008

Neonatal and follow‐up data of infants from the special care nursery whose birth weights were < 750 g, born between 1980 and 1990, were reviewed. There was a 20% relative improvement in the odds of surviving the neonatal period, a 16% improvement in the odds of being discharged and a 19% improvement in the odds of surviving until 2 years of age with each consecutive year. Home oxygen use increased significantly over the study period. The neurodevelopmental outcomes of infants were similar over the 11‐year period, with 53% being classified as neurologically normal, with a mean developmental index of 83 at 1 to 2 years of age. We conclude that there has been an improved survival of infants with birth weights < 750 g in our institution, and that the overall incidence of serious neurodevelopmental deficits among survivors has remained stable.
Peak expiratory flow rate in healthy children aged 6–17 years
Authors: Høst A , Høst AH , Ibsen T
Published: January 2008

Peak expiratory flow rate (PEFR) was measured in a cross‐sectional study in 861 healthy Danish schoolchildren aged 6–17 years using a Mini Wright peak flowmeter. We found a strong correlation between PEFR and height, age and sex. The results were comparable with those from previous studies using a Wright peak flowmeter. The equation for prediction of PEFR in boys was calculated as (3.8 × height) + (10.6 × age) ‐ 313.2 (p < 0.0001, r= 0.8), and for girls, PEFR = (2.2 × height) + (14.2 × age) ‐ 143.9 (p < 0.0001, r= 0.64). Our results appear to be reliable, as evidenced by the high correlation coefficient in this large sample. Among healthy children without previous asthma, earlier episodes of recurrent wheezing were reported in 8.8% and a significantly lower PEFR was found in this group.
Assessment of tubular reabsorption of sodium, glucose, phosphate and amino acids based on spot urine samples
Authors: Rossi R , Danzebrink S , Linnenburger K , Hillebrand D , Grüneberg M , Sablitzky V , Deufel Th , Ullrich K , Harms E
Published: January 2008

Reference values for tubular transport of sodium, phosphate, glucose and amino acids are generally based on inulin or creatinine short‐term clearances, which are difficult to obtain in children. Hence, quantitative assessment of tubular transport capacities is rarely performed. For a simplified procedure, reference values for fractional sodium excretion, phosphate reabsorption related to glomerular filtration rate, percent glucose and percent amino acid reabsorption were established in 62 children from spot urine and simultaneously obtained blood samples. Sodium excretion, and glucose and amino acid reabsorption were significantly lower in infants than children, whereas phosphate reabsorption decreased during the first year of life. Results using the proposed protocol and those obtained from timed urine specimens correlated well; the phenomenon of renal adaptation during childhood could equally well be demonstrated. Renal tubular dysfunction can be diagnosed without timed urine specimens.
Parent and teacher perceptions of child behaviour following cardiac surgery
Authors: Oates RK , Turnbull JAB , Simpson JM , Cartmill TB
Published: January 2008

To determine if parents whose children had undergone successful cardiac surgery perceived their children any differently from parents of children who had not undergone surgery, we used the Achenbach Child Behaviour Checklist (CBCL) to compare parent and teacher perceptions in these two groups. Subjects included 168 children who had undergone cardiac surgery 4 to 8 years previously and 51 controls. On the behaviour scale of the CBCL, the teachers' mean t scores showed no significant difference bctween the cardiac and control groups, in contrast to the parents' scores where parents perceived a higher degree of behavioural problems in children who had undergone cardiac surgery. On the Social competence scale of the CBCL, the parents scored their children who had undergone cardiac surgery as less Socially competent than did the parents of the controls. Teachers' scores showed no difference between groups.
Endovascular treatment of a spinal arteriovenous malformation in a 21‐month‐old boy
Authors: Bjork A , Eeg‐Olofsson O , Svendsen P , Moström U , Pellettieri L
Published: January 2008

Reports of spinal arteriovenous malformations in children are rare. This case report describes a 21‐month‐old boy whose first symptom was attacks of abdominal pain, followed gradually by neurological symptoms. The diagnosis was made using magnetic resonance imaging and spinal angiography, and the patient was successfully treated with embolization.
Physiological changes, plasma β‐endorphin and cortisol responses to tracheal intubation in neonates
Authors: Pokela Marja‐Leena , Koivisto Maila
Published: January 2008

Physiological, plasma β‐endorphin and cortisol responses to nasotracheal intubation were studied in 20 distressed infants of median age 0.3 days (range 0.1–23 days) randomized into groups given pethidine 1 mg/kg (n=10) or alfentanil 20 μg/kg plus suxamethonium 1.5 mg/kg (n=10) before intubation. All of the infants were given glycopyrrolate 3–5 μg/kg. Hypoxaemia during intubation was found in all 10 infants in the pethidine group and in 7 of 10 infants in the alfentanil‐suxamethonium group, its duration being significantly longer in thc pethidine group and being associated with the duration of the intubation procedure. Blood pressure increased, but not statistically significantly, in all except 2 patients in the alfentanil‐suxamethonium group and bradycardia appeared in 1 patient in each group. Plasma β‐endorphin and cortisol values did not show any statistically significant intra‐group or inter‐group differences. Newborn infants suffer from hypoxaemia during intubation when awake more and therefore need adequate premedication before elective intubation. One alternative is the combination of glycopyrrolate, alfentanil and suxamethonium described here, although the ideal medication and dosage still remain to be defined.
Ten years after acquiring an HIV‐1 infection: a study in a cohort of eleven neonates infected by aliquots from a single plasma donation
Authors: van den Berg H , Gerritsen EJA , van Tol MJD , Dooren LJ , Vossen JM
Published: January 2008

We present data from a 10‐year follow‐up study of 11 children who had been infected in the neonatal period by small aliquots of plasma from a single donation. Three of the children died within the first 2.5 years of life, 5 other children died between 6.2 and 11 years after infection and 3 are alive at present. The latter children are classified as P1B (asymptomatic), P2A (non‐specific findings) and P2B (neurological changes). All infected children showed progressive decline of cellular immunity. Immunoglobulin levels in serum were increased in the majority of children for prolonged periods and homogeneous immunoglobulin components were present. The severity of the disease was related neither to the clinical condition of the infants in the neonatal period nor to the volume of transfused plasma, the interval between freezing and thawing of the plasma, gestational age at birth and age at transfusion. Coinciding infections with other viruses had no impact on disease progression during the follow‐up period of 10 years.
Impaired growth in children with asthma during treatment with conventional doses of inhaled corticosteroids
Authors: Thomas BC , Stanhope R , Grant DB
Published: January 2008

We describe 6 (4F, 2M) prepubertal children with moderate asthma diagnosed at a mean age of 2.8 years. All patients were treated with inhaled corticosteroids in a dose of between 300 and 800 mcg of beclomethasone diproprionate (becotide) daily, given either as an aerosol or rotahaler. Mean height velocity SDS decreased from −0.8(range +0.5 to −2.0)to −3.2(range −1.3 to −4.8) when the dose was increased. Alternatively, when the dose was reduced or stopped, mean height velocity SDS increased from −3.2 (range −2.0 to −4.8) to +0.8 (range −1.2 to +2.7). Careful assessment of height velocity is indicated in all children receiving treatment with inhaled corticosteroids.
Renal excretion of endothelin in children is influenced by age and diuresis
Authors: Mattyus Istvan , Zimmerhackl LB , Schwarz A , Hentschel M , Brandis M , Miltenyi M , Tulassay T
Published: January 2008

Mattyus I, Zimmerhackl LB, Schwarz A, Hentschel M, Brandis M, Miltenyi M, Tulassay T. Renal excretion of endothelin in children is influenced by age and diuresis. Acta Pædiatr 1994;83:468–72. Stockholm. ISSN 0803–5253

Endothelin is a peptide with vasoactive and diuretic potential. Its release has been demonstrated from endothelial and renal epithelial cells. Urinary excretion of endothelin, as shown by others, is thought to reflect intrarenal production. We measured endothelin by RIA in a population of healthy children from Germany and Hungary (group 1), neonates (group 3) and children before and during forced diuresis (groups 2a and 2b). Group 1 consisted of 24 children living in Germany and 13 children resident in Hungary. The age range in this group was 2.9–17 years. Daily excretion correlated significantly with age (r= 0.48, p < 0.001), but endothelin excretion corrected for body surface area remained constant with regard to the age group studied. This indicates that body or kidney size may influence endothelin excretion, respectively. There was no difference in endothelin excretion between the two countries. In premature infants and neonates (group 3), daily excretion of endothelin was highest in infants with very low gestational ages and decreased in full‐term neonates to values not significantly different to the group of older children. The high values in premature infants may have been influenced by mechanical ventilation of physical stress, which cannot be differentiated in this study, however. In contrast to reported results in adults, renal excretion of endothelin was correlated positively to urine flow in all groups. Furthermore, the influence of forced diuresis was evaluated in 10 children with oncological disease before (group 2a) and during (group 2b) forced diuresis with fluid load (3 l/m2; n= 4) and fluid load with furosemide injection (0.3–1.0 mg/kg body weight; n= 6). During this diuretic state, endothelin excretion was enhanced significantly.
Spectral analysis of heart rate variability in spontaneously breathing very preterm infants
Authors: van Ravenswaaij‐Arts C , Hopman J , Kollée L , Stoelinga G , van Geijn H
Published: January 2008

Van Ravenswaaij‐Arts C, Hopman J, Kollée L, Sloelinga G, Van Geijn H. Spectral analysis of heart rate variability in spontaneously breathing very preterm infants. Acta Pædiatr 1994;83:473–80. Stockholm. ISSN 0803–5253

The influence of maturation, sleep state and respiration on heart rate variability was studied in 16 spontaneously breathing preterm infants (<33 weeks). ECG, respiratory impedance curve and movements were recorded four times a day, during the first three days of life. The power content of selected frequency bands of the R‐R interval power spectrum, as well as respiratory frequency and breath amplitude oscillation frequency, were calculated for 3–min periods. An increase in low‐frequency heart rate variability with gestational age was found. High‐frequency variability increased during early postnatal life. Sleep state influenced very low‐frequency heart rate variability. The amount of respiratory sinus arrhythmia and breath amplitude sinus arrhythmia was determined mainly by respiratory rate and breath amplitude oscillation frequency, respectively. The influences of gestational and postnatal age on heart rate variability might be due to an increase in sympathetic tone before birth and a change in parasympathetic‐sympathetic balance after birth. Respiration has an important influence on heart rate variability, even in very preterm infants.
Retinopathy of prematurity: review of a seven‐year period in a Danish neonatal intensive care unit
Authors: Arrøe Mette , Peitersen Birgit
Published: January 2008

Arrae M, Peitersen B. Retinopathy of prematurity: review of a seven‐year period in a Danish neonatal intensive care unit. Acta Pædiatr 1994;83:501–5. Stockholm. ISSN 0803–5253

In the period 1985–1991, 21675 infants were born at the University Hospital of Copenhagen, Hvidovre Hospital, Denmark. Two hundred and twenty‐four infants (10.3%) with birth weights 1500 g and gestational ages 32 completed weeks were transferred to the neonatal intensive care unit of the hospital. One hundred and eighty survived to at least 8 weeks of age and 170 had eye examinations. Forty‐five of the 170 infants examined (26.5%) had retinopathy of prematurity (ROP) and 18 (40%) of these developed blindness or severely impaired vision, a higher incidence than reported in other studies. Significant differences were found between infants with and without ROP for: birth weight, gestational age, Apgar score at 1 min, resuscitation, ventilator treatment, duration of supplementary oxygen, severe complications in the neonatal period and sequels from the central nervous system. Statistical analyses, corrected for correlations, showed that the occurrence of ROP was related significantly to early intubation, hypotension, persistent ductus arteriosus and necrotizing enterocolitis.
Spermaturia in two normal boys without other signs of puberty
Authors: Nysom Karsten , Pedersen Juri L , Jørgensen Merete , Nielsen Claus T , Müller Jørn , Keiding Niels , Skakkebæk Niels E
Published: January 2008

Nysom K, Pedersen JL, Jørgensen M, Nielsen CT, Müller J, Keiding N, Skakkebæk NE. Spermaturia in two normal boys without other signs of puberty. Acta Paediatr 1994:83:520–1. Stockholm. TSSN 0803–5253

We report spermaturia in two normal boys with testicular volumes of 3 ml and no other signs of puberty. This supports the hypothesis that spermatogenesis can begin before any other signs of puberty and indicates that the definition of start of puberty as testicular volumes of 4 ml or more may be too rigorous.
Bronchial asthma after early childhood wheezing: a follow‐up until 4.5–6 years of age
Authors: Kuikka L , Reijonen T , Remes K , Korppi M
Published: January 2008

Over a period of 12 months from 1981 to 1982, 83 patients aged less than 2 years were treated in hospital for acute bronchiolitis. The children were followed‐up prospectively; 68 (83%) completed the study until 4.5–6.0 years of age. At this age, 17 (25%) of the 68 children with bronchiolitis still suffered from wheezing attacks. These 17 asthmatics suffered from both atopic dermatitis (29 versus 6%) and allergic rhinitis (29 versus 8%) more frequently than non‐asthmatic children. In contrast, positive results in the skin prick tests were almost equally common (29 and 20%) in asthmatic and non‐asthmatic children. In these tests, allergies to birch pollen, timothy grass pollen and house dust mite were most common; asthma was particularly associated with house dust mite allergy. The presence of atopic dermatitis, elevated immunoglobulin E values and repeated wheezing episodes between I and 2 years of age were significant risk factors for later asthma. In conclusion, the risk for later asthma is increased after early childhood bronchiolitis; the frequency of asthma was 25% in the present study. Our results confirm that atopics are at a greater risk of developing asthma later in childhood than non‐atopics; the risk was significant from 1 year of age onwards.
Hyper‐IgM immunodeficiency with disseminated cryptococcosis
Authors: Iseki M , Anzo M , Yamashita N , Matsuo N
Published: January 2008

We describe two siblings with X‐linked hyper‐IgM immunodeficiency. One patient developed disseminated cryptococcosis. Co‐culture of this patient's T cells with normal B cells suppressed IgC and IgA production. The CD40 ligand gene of one patient was examined and contained a nonsense mutation at nucleotide 475. CD40 ligand is a membrane protein which is expressed on activated T cells and induces B‐cell proliferation. These results suggest that there is a defect in T‐ and B‐cell interactions in this immunodeficiency syndrome. It is also possible that patients with this syndrome are predisposed to cryptococcal infections.
Eosinophilia in newborn infants
Authors: Patel L , Garvey B , Arnon S , Roberts IAG
Published: January 2008

To evaluate the clinical significance of eosinophilia in newborn infants, 261 admissions to the neonatal unit over a 12‐month period were studied retrospectively; 33 babies with eosinophilia (<1.0 × 109/1) were studied, Clinical and laboratory data for the first month of life were compared, where available, between gestational age‐matched pairs with and without eosinophilia. Of the 33 babies with eosinophilia, 23 were < 26 weeks' gestation and all had age‐matched controls; 10 were ≤26 weeks' gestation but had no appropriate gestational age‐matched controls. Babies <26 weeks' gestation with eosinophilia had a significantly higher number of septic episodes than controls: 20 of 23 versus 4 of 23. All 10 babies ≤ 26 weeks' gestation with eosinophilia developed sepsis. Infections with gram‐negative organisms and necrotizing enterocolitis occurred only in babies who developed eosinophilia. In 5 babies no cause for the eosinophilia was found. In conclusion, eosinophilia in the newborn is usually explainable and is most often associated with infection.
Reactive hyperemia of skin microcirculation in septic neonates
Authors: Pöschl JMB , Weiss T , Fallahi F , Linderkamp O
Published: January 2008

Reactive hyperemia after 1 min of arterial occlusion was studied in back, thigh and heel skin of 40 preterm and full‐term neonates using laser Doppler flowmetry. Twelve infants had clinical signs of septicemia, but normal laboratory tests at the time of fluxmetry. However, CRP, leukocyte count and the ratio of immature to total neutrophils increased during the following days and septicemia was confirmed by positive blood cultures (septic group). Seven neonates with clinical signs of septicemia had developed neither positive blood cultures nor laboratory signs (non‐septic group). Fifteen were healthy neonates. In the septic neonates, time to reach maximal hyperemia, maximum post‐occlusive hyperemia and recovery time of skin perfusion were increased significantly in back and thigh skin and the heal skin temperature was decreased when compared to healthy neonates. Healthy and non‐septic neonates showed no significant difference in any of the parameters. We conclude that altered reactive hyperemia in the skin may be an earlier sign of neonatal septicemia than laboratory tests.
A persisting secular trend for body measurements in Dutch children. The Oosterwolde 11 study
Authors: Gerver WJM , Bruin R De , Drayer NM
Published: January 2008

To investigate whether the secular trend for growth in Dutch children still exists, the Oosterwolde I study of 1980 was repeated in 1989. A persisting secular trend was visible for height while the z scores of body proportions show no change during the past 10 years, which suggests that there is no change in the timing of puberty.
Cerebral blood flow and plasma hypoxanthine in relation to surfactant treatment
Authors: Bell AH , Skov L , Lundstrøm KE , Saugstad OD , Greisen G
Published: January 2008

We have previously reported reduction in EEG activity in preterm babies after tracheal instillation of Curosurf. To elucidate the cause of EEG depression, we have examined cerebral blood flow (CFB), amplitude‐integrated EEG (aEEG), mean arterial blood pressure (MABP) and plasma hypoxanthine (Hx) concentration in a group of preterm babies before and immediately after administration of surfactant. No change occurred in CBF immediately after surfactant treatment despite a significant decrease in MABP. At 60 min after surfactant administration, a significant reduction in CBF occurred (p < 0.05). However, when CBF values were corrected for changes in PaCO2, no reduction in CBF was observed. Mean plasma Hx concentration was 11.6 (SD 7.3) μmol/l before surfactant therapy, which decreased significantly to 8.1 (5.8) μmol/l (p < 0.05) 15–30 min after treatment. No correlations were found between plasma Hx concentration and FiO2, a/A pO2, PaCO2, SaO2, arterial blood pressure, CBF or the degree of EEG depression. This study indicates that EEG depression observed after surfactant instillation is not caused by cerebral ischemia.
Prevention of neonatal infections by vaginal chlorhexidine disinfection during labour
Authors: Henrichsen T , Lindemann R , Svenningsen L , Hjelle K
Published: January 2008

Comparison of two different methods of vaginal disinfection was made with regard to prevention Of neonatal infections. In method I, an antepartum vaginal douche with a chlorhexidine solution was used; method II involved the use of chlorhexidine gluconate obstetrical gel during vaginal exploration. We studied 2853 normal deliveries from a total number of 3236 deliveries: 1467 deliveries were allocated randomly to receive a vaginal douche whereas 1386 underwent vaginal exploration using chlorhexidine gel. A total of 203 neonates were transferred to the neonatal unit (120 males and 83 females): 101 belonged to the group where the mothers were subjected to method I, whereas in 102 method II had been used. Within 48 h postpartum 30 neonates from the method I group and 34 neonates from the method II group received systemic antibiotics. There was a tendency towards a higher proportion of full‐term neonates with verified septicaemia in the method II group (6 versus 2), whereas the numbers of probable infections were 8 versus 12. The corresponding total numbers in preterm infants were 3 and 2, respectively. These differences were not statistically significant. We conclude that the use of chlorhexidine douche compared with vaginal exploration with chlorhexidine gel provides no additional advantages.
The psychological development of children of epileptic parents. II. The differential impact of intrauterine exposure to anticonvulsant drugs and further influential factors
Authors: Lösche G , Steinhausen H‐C , Koch S , Helge H
Published: January 2008

After obtaining evidence that tetratogenic effects were operant in a sample of children born to epileptic mothers, we analyzed the effects of type of medication and further influential factors. Children with prenatal exposure to polytherapy had significantly lower scores than controls for a large number of psychological tests. In addition to polytherapy, there were even stronger effects of socioeconomic status and sex was found to be less influential than polytherapy. Among further epilepsy variables, only seizure frequency of the mother during pregnancy had a modest impact on the child's developmental outcome, whereas a score of obstetric abnormality was less effective in predicting developmental outcome, as measured and defined by various standardized psychological tests.
Environment and epidemiology of congenital malformations
Authors: Eriksson M , Zetterström R
Published: January 2008

This paper is dedicated to the late Dr. Spyros Doxiadis who was not only an outstanding scientist but also a great educator who had a deep concern for underpriviliged children all over the world. In Sweden, we are very pleased that Dr. Doxiadis was one of the world famous scientists who received an honorary doctor's degree on the occasion of the 5th Centenary of Uppsala University in 1977.
Severe neonatal jaundice associated with glucose‐6‐phosphate dehydrogenase deficiency: pathogenesis and global epidemiology
Authors: Valaes T
Published: January 2008

The association of glucose‐6‐phosphate dehydrogenase deficiency (G6PD def) with severe neonatal jaundice (NJ) and Kernicterus was described just over 30 years ago in reports from Sardinia (1–4) Singapore (5,6) and Greece (7,8). In this review we will examine the progress made since that time in our understanding of the pathophysiology of severe NJ associated with G6PD def, its global epidemiology, and its role in the balanced polymorphism of the G6PD def gene (Gd). Including this review in the Festschrift to Spyros Doxiadis should highlight his contribution to the field. In Greece the search for a new cause of severe NJ and Kernicterus was triggered by his realization that the recognized at the time, causes of severe NJ were absent in a large proportion of the neonates treated at the “Alexandra” Maternity Hospital in Athens (9).
Immunopathogenesis of chronic inflammatory bowel disease
Authors: Braegger Christian P
Published: January 2008

The aetiology and pathogenesis of chronic inflammatory bowel disease are unknown. However, there is circumstantial evidence that immune mechanisms may play a significant role in mediating the gut lesion and various systemic manifestations. The role of the cellular immune system, soluble mediators, including proinflammatory and immunoregulatory cytokines, humoral immunity and mucosal complement activation will be discussed.