bluuebunny/crossref_metadata_2025 huggingface dataset:
A case of Guillain‐Barré syndrome accompanied by sympathetic overactivity and hypertensive encephalopathy
Authors: Okada T , Hiyoshi K , Noto N , Fujita Y , Fuchigami T , Okubo O , Harada K
Published: January 2008

Hypertension has often been observed in patients with Guillain‐Barré syndrome, and various underlying mechanisms have been implicated. We report the case of a child with the Guillain‐Barré syndrome whose hypertension was associated with increases in both renin activity and circulating catecholamines. This case also appeared to be complicated by hypertensive encephalopathy. Following administration of intravenous regitine, a blood pressure change was observed and cardiac performance was assessed by two‐dimensional echocardiography. Results indicated that increased total peripheral resistance may have been responsible for the symptoms and the hypertension. The hypertension was effectively managed by nifedipine, captopril and prazosin without the need for β‐blockade.
Type of nappy and nursing habits in acquiring acute urinary tract infection
Authors: Nuutinen M , Huttunen N‐P , Uhari M
Published: January 2008

The role of the nappy and nursing habits as possible risk factors of urinary tract infection (UTI) were analysed in a prospective case‐control study. Cases entered hospital due to their first UTI attack. Children hospitalized for some other reason, mainly upper respiratory infections or elective surgery, served as controls matched for age and sex. Cases and their controls (208 girls and 184 boys) used nappies day and night. The odds ratios for risk of contracting UTI according to different nappy types used prior to the first UTI diagnosis were 0.95 for all‐in‐one (superabsorbent) nappies (95% CI 0.62‐1.46), 1.04 (0.69‐1.57) for standard disposable nappies and 1.00 (0.46‐2.16) for washable cotton nappies. The type and number of nappies used daily as well as the number of defecations per day were similar in UTI patients and the controls. There were no significant differences in the frequency of buttock washes nor in the daily time spent without nappy. The use of cotton nappies practically finished during the study. The type of nappy used or other nursing habits with the baby appeared to be insignificant risk factors for UTI during nappy age. The use of modern nappies has become so thoroughly commonplace that the true impact of nappy type on any condition during infancy is difficult or even impossible to evaluate in a case‐control setting.
Metabolic function and liver histopathology in Reye‐like illnesses
Authors: Hou J‐W , Chou S‐P , Wang T‐R
Published: January 2008

Forty children with Reye syndrome (RS) or Reye‐like illnesses were investigated to elucidate the underlying aetiologies. Extensive biochemical studies including patterns of organic acids and amino acids, liver histopathology, and, if available, a DNA approach were performed. In addition to classical RS (n= 10), the causes of Reye‐like conditions included hereditary organic acidaemias (n= 13), urea cycle defects (n= 4), mitochondrial disorders (n= 3), fulminant hepatitis (n= 2), tyrosinaemia (n= 1), valproate‐associated hepatotoxicity (n= 1), and other non‐specific generalized organic acid disorders (n= 6). It is important to collect specimens when encephalopathy with liver dysfunction of unknown causes is noted. When the underlying inherited metabolic disorders are confirmed, the prevention of the recurrence by adequate diet control and medications, and genetic counselling become possible.
Elevated urinary excretion of endothelin in insulin‐dependent diabetes mellitus: no influence of physical exercise
Authors: Mattyus I , Zimmerhackl LB , Schwarz A , Brandis M , Miltenyi M , Tulassay T
Published: January 2008

The urinary excretion of endothelin was measured by radioimmunoassay in children with diabetes mellitus in metabolically stable condition before and after ergometric exercise. Apparently healthy children served as normal controls. The excretion of endothelin, calculated for 24 h and the ratio of endothelin/creatinine in urine were also significantly higher in diabetic children compared to normal controls. Physical exercise had no influence on renal endothelin excretion. In diabetic children the volume of diuresis was higher compared to controls. Physical exercise had no influence on diuresis. In a previous study we found a positive correlation between diureses and endothelin excretion. Therefore, the increased endothelin excretion in the diabetic patients may be at least partially the consequence of the higher diuresis values. It cannot be excluded, however, that it may be a sign of altered renal function as well. Furthermore, the present study suggests that in patients with diabetes mellitus elevated sympathetic nerve activity as a result of physical activity does not influence renal endothelin production.
Risk factors for deaths in under‐age‐five children attending a diarrhoea treatment centre
Authors: Teka T , Faruque ASG , Fuchs GJ
Published: January 2008

Few case‐control studies have examined possible risk factors for diarrhoeal deaths in under‐age‐five children in the developing countries. We analysed data from the surveillance system of our diarrhoea treatment centre/hospital for the period 1990‐94 on 928 children less than 5 years of age. In univariate analysis, 11 factors were significantly associated with death: lack of breastfeeding, severe malnutrition, complicated diarrhoea, pneumonia, xerophthalmia, duration of diarrhoea 7‐14 days, moderate or severe dehydration, recent history of measles, Shigella flexneri infection, maternal illiteracy, and very low household income. Rotavirus diarrhoea was negatively associated with fatal outcome. In the assessment of severe malnutrition, weight‐for‐height measurement discriminated mortality risk better than weight‐for‐age or height‐for‐age indices. Only two factors retained their significance, severe malnutrition and non‐breastfeeding in the multivariate analysis with adjusted odds ratio (95% confidence interval) of 84.2 (9.1, 775.9) and 4.2 (1.3, 13.2) respectively.
A randomized controlled trial of early physiotherapy for high‐risk infants
Authors: Weindling AM , Hallam P , Gregg J , Klenka H , Rosenbloom L , Hutton JL
Published: January 2008

The aim of this study was to investigate the hypothesis that infants at high risk of cerebral palsy would benefit from early physiotherapy. In total, 105 infants with abnormal cranial ultrasound scans were randomized at around term to early physiotherapy or standard treatment (delaying physiotherapy until abnormal physical signs became apparent). At 12 and 30 months there were clinical and objective assessments. Nine infants died and nine were lost to follow‐up by 12 months when 87 infants were assessed. One other child had died and three others were lost to follow‐up by 30 months when 83 children were assessed. Cerebral palsy was only accurately predicted in 45 (54%) infants. There was no difference in outcome. The difficulty of predicting cerebral palsy reliably and the heterogeneity of the condition should be borne in mind when planning treatment and assessing its efficacy.
Gastric emptying in pre‐term infants: the effect of breast milk fortifier
Authors: Ewer AK , Yu VYH
Published: January 2008

Failure of adequate gastric emptying frequently prevents successful, early enteral nutrition in the preterm infant. The effect on gastric emptying of adding breast milk fortifier is unknown, but clinical experience suggests that it is less well tolerated by some infants. We therefore compared gastric‐emptying rates of breast milk and fortified breast milk within pre‐term infants, using a previously described ultrasonic technique. Eleven infants were studied on 22 occasions. Median (range) gestation of the group was 28 weeks (25‐31) with birth weight 1090 g (714‐1360). The human milk fortifier FM‐85 (Nestlé, Vevey, Switzerland) was used in all infants. Half‐emptying time for unfortified breast milk was less than half that for fortified breast milk. Mean (±SEM) half emptying times were 21 min (±3.6) and 48 min (±4.0), respectively. Breast milk emptied faster than fortified breast milk in 10 out of 11 patients. These data demonstrate that the addition of human milk fortifier can significantly slow gastric emptying. This has important implications for the management of infants who have feed intolerance.
Oral IgA‐IgG treatment of chronic non‐specific diarrhoea in infants and children
Authors: Casswall TH , Hammarström L , Veress B , Nord CE , Bogstedt A , Brockstedt U , Dahlström KA
Published: January 2008

The effect of orally administered immunoglobulin (IgAbulinR) on chronic non‐specific diarrhoea of infancy was studied in seven children, median age 26 (21‐36) months and duration of diarrhoea 32 (18‐84) weeks. Routine laboratory tests for malabsorption and small bowel biopsies were taken in all children before and after 3 weeks of IgAbulinR treatment. The biopsy specimens were analysed with regard to histopathology, electronmicroscopy, immunohistochemistry and microbiology. The number of stools decreased from a median of 4.0 (3.0‐5.0) to 1.5 (1.0‐3.5) (p < 0.05) stools per day over the study period.
The captopril test in children with renovascular and renal hypertension
Authors: Fossali E , Intermite R , Minoja M , Tirelli S , Sereni F
Published: January 2008

We used the captopril test (CT) in 32 children, 8 with renovascular hypertension (RVH), 17 with renal hypertension (RH) and 7 with normal blood pressure, in order to study the renin‐angiotensin system activation (RASA). All children affected by RVH presented a positive CT: a post‐captopril plasma renin activity (PRA) of 12 ng ml‐1 h ‐1 or more, an absolute PRA increase of 10 ng ml ‐1 h ‐1 or more and a 150% increase or more, or 400% or more if the baseline PRA was less than 3 ng ml‐1 h‐1. The CT may be useful for demonstrating the RASA in RVH.
The changing panorama of cerebral palsy—bilateral spastic forms in particular
Authors: Hagberg B , Hagberg G
Published: January 2008

Our Swedish population‐based cerebral palsy (CP) project started 25 years ago and today covers the birth years 1954–1990, with over 1400 CP cases. This large series (1, 2, 3) has opened new perspectives on time trends and aetiological background factors, where two areas of successively increasing knowledge stand out as particularly helpful. One is the growing amount of biological and clinical data from the continuously increasing cohorts of surviving very preterm infants, the other is the rapidly expanding and refined information from neuroimaging. Bilateral spastic CP (BSCP), including spastic and ataxic diplegia, tetraplegia and spastic‐dyskinetic CP, is the most prevalent clinical group of CP syndromes, present in around 75% of preterm and 45% of term CP, and has shown the most significant prevalence changes over time. In this presentation we, therefore, focus on BSCP, also analysed in a collaborative study between southwest Germany and western Sweden and recently presented in a series of four papers (4, 5, 6, 7).
Cognitive explanations of autism
Authors: Frith U
Published: January 2008

A brief review of the theory of mind account of autism is presented. A lack of theory of mind in autism is well supported by empirical studies and can explain quite specifically the nature of the social communication impairments. Other characteristic behavioural features of autism, in particular perseveration and rigidity, are tackled by the hypothesis of executive function deficits. The theory of weak central coherence attempts to explain the uneven pattern of intellectual abilities seen in autistic individuals, proposing that they adopt a distinctive cognitive style. It is likely that a number of separate cognitive deficits will be identified and that these will provide clues to the underlying brain abnormalities in autism.
Growth hormone treatment of short children born small for gestational age: metanalysis of four independent, randomized, controlled, multicentre studies
Authors: Zegher F de , Albertsson‐Wikland K , Wilton P , Chatelain P , Jonsson B , Löfström A , Butenandt O , Chaussain J‐L
Published: January 2008

A minority of children born small for gestational age (SGA) fail to achieve sufficient catch‐up growth during infancy and remain short throughout childhood, apparently without being growth hormone (GH) deficient. The effect of GH administration was evaluated over 2 years in short prepubertal children born SGA. The children (n= 244), who were taking part in four independent multicentre studies, had been randomly allocated to groups receiving either no treatment or GH treatment at a daily dose of 0.1, 0.2 or 0.3 IU/kg (0.033, 0.067 or 0.1 mg/kg) s.c. At birth, their mean length SD score (SDS) was ‐3.6 and their mean weight SDS ‐2.6; at the start of the study, mean age was 5.2 years, bone age 3.8 years, height SDS ‐3.3, height SDS adjusted for parental height ‐2.4, weight SDS ‐4.7 and body mass index (BMI) SDS ‐1.4. The untreated children had a low‐normal growth velocity and poor weight gain. Although bone maturation progressed more slowly than chronological age, final height prognosis tended to decrease, according to height SDS for bone age. GH treatment induced a dose‐dependent effect on growth, up to a near doubling of height velocity and weight gain; BMI SDS was not altered. Bone maturation was also accelerated differentially; however, final height prognosis increased in all GH treatment groups. The more pronounced growth responses were observed in younger children with a lower height and weight SDS. In conclusion, GH administration is a promising therapy for normalizing short stature and low weight after insufficient catch‐up growth in children born SGA. Long‐term strategies incorporating GH therapy now remain to be established.
Prediction of adult height in healthy Japanese children
Authors: Tanaka T , Komatsu K , Takada G , Miyashita M , Ohno T
Published: January 2008

Longitudinal records from 13,707 children (6749 boys and 6958 girls), aged 6–17 years, were fitted by a smoothing cubic spline function, and the factors influencing changes in height SD score (SDS) during puberty were analysed. Height SDS at 6 years correlated closely with final height SDS. However, short children at 6 years of age tended to increase their height SDS at final height, whereas tall children at the same age tended to decrease their final height SDS. For children with the same prepubertal height, the later that pubertal maturation occurred, the greater was the final height achieved. As short children entered puberty relatively late and tall children entered puberty relatively early, height SDS tended to approach 0 SD during puberty. A prediction function obtained by multiple regression analysis using height SDS at 6 years, the percentage by which the child is overweight at 6 years, age at onset of the pubertal growth spurt (PGS) and height at onset of the PGS provides a reasonable model for the prediction of final height SDS without the need to estimate bone age.
Platelet serotonin transporter in coeliac disease
Authors: Chiaravalloti G , Marazziti D , Batistini A , Favilli T , Ughi C , Ceccarelli M , Cassano GB
Published: January 2008

Abstract We investigated a peripheral serotonergic marker, i.e. platelet tritiated imipramine (3H‐IMI) binding sites, which are part of the 5‐HT transporter complex similar to that present in the brain, in 20 patients affected by coeliac disease (CD), as compared with 20 healthy controls. Platelet membranes and 3H‐IMI binding were carried out according to a standardized protocol. The results showed that coeliac patients had significantly lower H‐IMI binding sites than controls. This finding would suggest the presence of a dysfunction at the level of the 5‐HT transporter that might underline the psychic disturbances frequently observed in coeliac patients.
Improved triglyceride control with low glycaemic index‐high carbohydrate modified‐lipid diet in a hypertriglyceridaemic child
Authors: Morales LM , Semprún‐Fereira M , Ryder E , Valbuena H , Rincón E , Fernández V , Flórez H , Campos G , Gómez ME , Raleigh X
Published: January 2008

Abstract This study reports a 7‐y‐old boy with severe hypertriglyceridaemia who was successfully treated for 6 y with a low glycaemic index‐high carbohydrate modified‐lipid diet that produced beneficial changes in triglyceride and total cholesterol levels. It is suggested that a selection of a complex digestible carbohydrate and an adequate ratio between polyunsaturated and monounsaturated fat may, in the long term, favourably improve the lipid profile.
Deep Candida infection in children with leukaemia: clinical presentations, diagnosis and outcome
Authors: Klingspor L , Stintzing G , Tollemar J
Published: January 2008

Objectives: To analyse the clinical features associated with deep Candida infection (DCI) and the outcome in children with leukaemia, and to evaluate various diagnostic methods. Materials and methods: Serum samples were analysed to determine Candida IgA, IgM and IgG antibodies and detect free C. albicans glucoprotein antigen and C. enolase antigen in eight children who had nine episodes of DCI and six with suspected DCI. Results: DCI occurred shortly after the leukaemia diagnosis (median 40 days) or after the leukaemia relapse (median 30 days). Children with DCI had fever (100%), skin lesions/exanthema (45%), oral thrush (45%), oesophagitis (22%) and laryngo‐tracheitis (22%). Candida endocarditis, arthritis and hepatic candidosis were diagnosed in one patient each. Two children with disseminated candidosis died in leukaemia relapse. In patients with C. albicans infections serology had a sensitivity of 83%. However, in patients with C. parapsilosis infection antibody detection was negative. As the patients were cured of their Candida infection, the IgG antibodies disappeared and the IgM and IgA antibodies fell within the normal range for age. Conclusion: DCI in children occurs shortly after the leukaemia diagnosis or shortly after relapse of leukaemia. The clinical features are many. Candida serology may help to diagnose or confirm DCI. The dynamics of antibody titres may help to establish the efficacy of antifungal treatment.
γ T cells are decreased in the blood of children with Bordetella pertussis infection
Authors: Bertotto A , Benedictis FM De , Vagliasindi C , Radicioni M , Spinozzi F , Fabietti GM , Castellucci G , Ferraro L , Cozzali R , Niccoli A , Vaccaro R
Published: January 2008

The biological role of T cell receptor (TCR) γ bearing cells is not yet fully understood. We studied 12 children with Bordetella pertussis infection and 12 age‐ and sex‐matched healthy controls. Patients with whooping‐cough yielded significantly lower relative and absolute numbers of blood TCR‐γ+ cells than normal controls (both p < 0.001). It is suggested that the depletion of circulating γ T cells in patients with Bordetella pertussis infection might be the result of the dispatch of these cells to the site of inflammation, i.e. the bronchial mucosa. Interestingly, other human lung diseases, such as allergic bronchial asthma and sarcoidosis display similar pulmonary phenotypical features.
A new view on the CSF‐circulation with the potential for pharmacological treatment of childhood hydrocephalus
Authors: Greitz D , Greitz T , Hindmarsh T
Published: January 2008

A new model of the cerebrospinal fluid (CSF) circulation is proposed, implying that the main absorption of CSF occurs through the brain capillaries. This model is based on recent observations of CSF dynamics using radionuclide cisternography and cardiac gated magnetic resonance imaging. Magnetic resonance imaging of communicating hydrocephalus has demonstrated a highly significant decrease of CSF flow through the foramen magnum, which is explained by decreased expansion of the intracranial arteries. This invariable finding in combination with the new view of the CSF‐circulation makes a hemodynamic pathogenesis of hydrocephalus very probable. Communicating hydrocephalus may be caused by any process that restricts the arterial pulsations and is therefore termed restricted arterial pulsation hydrocephalus. In obstructive hydrocephalus, the ventricular dilatation leads to a compression of the cortical veins and consequently is termed venous congestion hydrocephalus. Based on these considerations, a new concept of pharmacological treatment of hydrocephalus is proposed by using a selective venous constrictor.
Interferon‐α2b treatment in hepatitis B carriers. Effect on hepatitis B virus DNA levels in children infected with different genotypes
Authors: Sangfelt P , Norder H , Magnius LO , Alaeus A , Carlsson T , Reichard O
Published: January 2008

Eleven hepatitis B virus (HBV) carrier children, infected with genotypes A‐D, were treated with interferon‐α. Two children had a sustained loss of hepatitis B e‐antigen and HBV DNA. They were infected with the non‐Asian genotypes A and D, and had low HBV DNA and high ALT levels in serum before treatment. However, HBV DNA titres decreased during treatment also in children infected with the East‐Asian genotypes B and C.
Growth of asthmatic children is slower during than before treatment with inhaled glucocorticoids
Authors: Saha M‐T , Laippala P , Lenko HL
Published: January 2008

Reports on the influence of inhaled glucocorticoids on growth have been controversial. We studied the growth of prepubertal asthmatic children prior to and during glucocorticoid therapy. We collected retrospectively the notes of 201 asthmatic children aged 1–11 years receiving inhaled beclomethasone dipropionate or budesonide. We calculated their height and height velocity standard deviation scores (HSDS and HVSDS, respectively) before the treatment and up to 5 years during the treatment and compared those with the growth of healthy peers. The dose of the medication was calculated and the severity of asthma was assessed. The asthmatic children grew similarly to their healthy peers before treatment with inhaled glucocorticoids: the mean HSDS was +0.02 and the mean HVSDS +0.01 for boys and ‐0.16 and +0.13 for girls, respectively. Growth retardation took place soon after the start of the treatment, the most profound decrease in the growth velocity (the change in the mean HVSDS from +0.05 to ‐0.88) occurring during the first year of treatment. The growth‐retarding effect of inhaled glucocorticoids was not dose dependent. In the covariance analysis the increasing severity of asthma had a significant interaction with repeated measurements, showing more growth retardation along with more severe asthma, especially during long‐term treatment. Asthma per se does not impair growth, but inhaled glucocorticoids may do so. Careful monitoring of the growth of all asthmatic children receiving inhaled glucocorticoids is necessary because the growth‐retarding effect of the medication is not dose dependent. Individual sensitivity might explain the differences seen in the growth patterns of children receiving inhaled glucocorticoids.
Serum procollagen I carboxyterminal propeptide (PICP) levels through puberty: relation to height velocity and serum hormone levels
Authors: Rotteveel J , Schoute E , van de Waal HA Delemarre
Published: January 2008

The synthesis of type I collagen, the major component of the organic bone matrix, is reflected by procollagen I carboxyterminal propeptide (PICP) levels. Conflicting reports have been made about the relationship between PICP levels and puberty. We have studied PICP levels in serum in relation to pubertal stage, height velocity, oestradiol, testosterone, androstenedione, dehydroepiandrosterone sulphate, insulin‐like growth factor I and growth hormone levels in 32 healthy boys aged 7.2–15.8 years and 32 healthy girls aged 7.2–14.8 years. The PICP levels in girls tended to be higher during midpuberty; in boys the levels were higher at the end of puberty. The PICP levels correlated strongly with height velocity in boys and girls. In conclusion, PICP correlates especially with height velocity. The variation of PICP between subjects during puberty is considerable. The PICP levels may predict growth at a certain moment, especially in cases where only one height measurement is available.
Bone marrow immunoglobulin‐secreting cells are not reduced in children with leukaemia as compared to children with solid tumours
Authors: Abrahamsson J , Mellander L
Published: January 2008

Children with leukaemia exhibit multiple immunological disturbances, including low circulating levels of immunoglobulins, caused by both the disease and chemotherapy. We investigated the number of isotype‐specific immunoglobulin‐secreting cells (ISCs) in the bone marrow at the time of diagnosis in 32 children and during therapy in 12 children with leukaemia. We compared these to the number of ISCs in 17 untreated children with solid tumours and related the ISCs to serum immunoglobulin levels, lymphocyte subsets, response to mitogenic stimulation and serum cytokine levels. Bone marrow specimens were analysed for isotype‐specific (immunoglobulins G, A and M) ISCs using the ELISPOT method. At the time of diagnosis, for all isotypes, the total number of ISCs per millilitre of bone marrow in children with leukaemia was no different from that in children with solid tumours. Chemotherapy significantly decreased the number of ISCs. The quantitative relationship between the different isotypes was unaffected by both tumour type and therapy. It can be concluded that in childhood leukaemia, tumour replacement of bone marrow cells does not cause a decreased number of ISCs and can therefore not account for the low serum immunoglobulin levels observed at time of diagnosis. Chemotherapy reduces the number of ISCs without changing the isotype distribution.
Coronary risk factors in Turkish school children—report of a pilot study
Authors: Coşkun Y , Bayraktaroǧlu Z
Published: January 2008

In 432 school children aged 7–15 years we investigated the following parameters: body mass index, blood pressure, total cholesterol, low‐density lipoprotein cholesterol and high‐density lipoprotein cholesterol. Only 2.8% of children were considered to be obese. Of the children, 3.5% had systolic, 4.9% had diastolic and 3.9% had both blood pressures higher than the acceptable age‐ and sex‐stratified values. The mean total cholesterol, low‐density lipoprotein cholesterol and high‐density lipoprotein cholesterol levels were 3.37, 1.93 and 1.33 mmol1‐1 respectively. In 31 (7.1%) of the children, total cholesterol levels were found to be above the risk cut‐off level of 4.4 mmol l‐1; in 39 (9%) of the children, low‐density lipoprotein cholesterol levels were elevated above an acceptable upper limit of 2.84 mmol1‐1. Significantly reduced high‐density lipoprotein cholesterol values were observed in 8.8%. Mean total cholesterol and low‐density lipoprotein cholesterol values were elevated significantly in hypertensive cases, while high‐density lipoprotein cholesterol levels showed no difference. Sensitivity and the positive predictive value for selected total cholesterol cut‐off points for determining elevated low‐density lipoprotein cholesterol were 67% and 54%, respectively. These levels of risk are considerably lower than those found in studies in Western countries.
Thoracic sequelae after surgical closure of the patent ductus arteriosus in premature infants
Authors: Seghaye M‐C , Grabitz RG , Alzen G , Trommer F , Hörnchen H , Messmer BJ , von Bernuth G
Published: January 2008

Thirty‐six children (median chronological age 6 years 1 month) who had undergone surgical closure of a patent ductus arteriosus through a left posterolateral thoracotomy in the neonatal period (median gestational age 32 weeks) were investigated prospectively with respect to anatomical and functional changes of the chest. At follow‐up examination, residual or recurrent patent ductus arteriosus was not observed. Three patients had chronic bronchial obstruction. Two patients showed pathological musculoskeletal thoracic sequelae that did not require any treatment at the time of follow‐up: persistence of immediate postoperative left phrenic palsy (n= 1) and thoracic scoliosis (n= 1). Twenty of the 27 patients in whom chest X‐ray was performed had minor radiological skeletal anomalies in the form of rib deformation or fusion related to die thoracotomy, lesions which have a potential to induce thoracic scoliosis. Left shoulder elevation at chest X‐ray and isolated left arm dysfunction at clinical examination were not observed. Despite the low incidence of scoliosis and the absence of left arm dysfunction observed at mid‐term follow‐up in our series, the incidence of minor rib deformations with a potential to induce severe anomalies such as scoliosis should motivate late follow‐up examination at adolescence to definitively assess the prevalence of thoracic sequelae after surgical closure of the patent ductus arteriosus in premature infants.
Analgesia in newborns given oral glucose
Authors: Skogsdal Y , Eriksson M , Schollin J
Published: January 2008

There is evidence that newborn babies feel pain even at the lowest gestational ages when they can survive. Because sweet solutions such as sucrose, given orally, may relieve pain in neonates, we decided to compare the effects of two concentrations of glucose (normally used for intravenous infusions) and of breast milk in a randomized controlled trial in 120 babies requiring heel‐prick tests. Glucose solutions and breast milk are readily available in the neonatal department. No other treatment was given. Our results strongly suggest that 1 ml of a 30% glucose solution given orally alleviates mild pain significantly and can be used for this purpose in newborns. Breast milk and 10% glucose did not have a similar effect.
Altered erythrocyte sodium‐lithium counter‐transport and Na+/K+‐ATPase activity in cystic fibrosis
Authors: Luczay A , Vásárhelyi B , Dobos M , Holics K , Ujhelyi R , Tulassay T
Published: January 2008

Patients with cystic fibrosis (CF) exhibit normal concentrations of sodium and chloride in spite of the disturbance of Cl‐ and Na+ transport in epithelial cells. To characterize compensatory mechanisms in the regulation of sodium homeostasis, erythrocytes of 13 CF patients were analysed for sodium‐lithium counter‐transport (SLC), Na+/K+ ‐ATPase activity and intracellular sodium content. Values were compared to those of healthy controls. Patients with CF had normal serum sodium and chloride concentrations and renal excretions of these ions were within the physiological range. Intracellular sodium concentration was similar in the CF and the control group (6.8 ± 2.2 vs 5.7 ± 1.0 mmol/l RBCs). Red blood cells' SLC and Na+/ K+ ‐ATPase activity were elevated in CF patients (381 ± 106 μmol/h/l RBCs vs 281 ± 64; p < 0.01) and (445 ± 129 μmol ATP mg prot/h vs 322 ± 84, p < 0.01). Our study demonstrates that transmembrane cation transport systems are highly activated in CF. The increased sodium transport may be part of a compensatory mechanism of sodium homeostasis in children with CF.
Aortic vessel wall characteristics and blood pressure in children with intrauterine growth retardation and abnormal foetal aortic blood flow
Authors: Ley D , Stale H , Marsal K
Published: January 2008

Blood pressure and pulsatile diameter changes of the abdominal aorta were measured in 68 children (mean age 9 years), with varying degrees of intrauterine growth retardation who were previously examined in their intrauterine life with Doppler velocimetry of the thoracic descending aorta. Diastolic blood pressure was lower (p < 0.05) and pulse pressure was increased (p < 0.01) in children with a birthweight small for gestational age as compared to those with a birthweight appropriate for gestational age. Systolic blood pressure was positively associated with relative increase in weight from birth up to the time of examination (p < 0.01), but not to early catch‐up growth. Aortic vessel wall diameters were smaller in children born small for gestational age, both before and after correction for current body surface area (p < 0.01). Blood pressure and aortic vessel wall characteristics exhibited no relationship to the foetal aortic Doppler wave‐form. Changes in foetal haemodynamics associated with intrauterine growth retardation do not appear to contribute to a later increase in blood pressure. Within a group of foetuses with suspected growth retardation, increasing foetal weight deviation and a birthweight small for gestational age is associated with lower diastolic blood pressure at 9 years of age.
Soluble CD30 serum antigen in Kawasaki disease
Authors: Vagliasindi C , Spinozzi F , Sensi L , Radicioni M , RosaMX O De , Solinas L , Vaccaro R , Bertotto A
Published: January 2008

4Very high levels of sCD30, a glycoprotein surface antigen expressed by T lymphocytes and other mononuclear cells of the immune system, were found in serum samples from 10 children with typical Kawasaki disease (KD), but not in blood specimens from a vast cohort of paediatric control subjects. These data strongly support an involvement of CD30+T cells in the immune processes which take place at the level of lymphoid organs during the acute phase of KD.
A trial in the Karelian Republic of oral rehydration and Lactobacillus GG for treatment of acute diarrhoea
Authors: Shornikova A‐V , Isolauri E , Burkanova L , Lukovnikova S , Vesikari T
Published: January 2008

In a controlled trial in Petrozavodsk, Karelia, the effects of oral rehydration and Lactobacillus strain GG (LGG) on recovery from acute diarrhoea (27% rotavirus, 21% bacterial aetiology) were studied in 123 children aged between 1 and 36 months of age. On admission to hospital, the patients were first randomized to receive either isotonic oral rehydration solution (ORS) with osmolality 311mosmol/l and sodium 90mmol/l (WHO‐ORS), or a hypotonic ORS with osmolality 224mosmol/l and sodium 60mmol/l (Light‐ORS), and thereafter randomized to receive either 5 × 109 colony forming units of LGG or a matching placebo. The two ORS performed equally for acute rehydration, and oral rehydration with either ORS was associated with a shorter duration of diarrhoea than intravenous rehydration (p= 0.036). Patients receiving LGG had a significantly shorter duration of watery diarrhoea [mean (SD) 2.7 (2.2) days] than those receiving the placebo [3.7 (2.8) days, p= 0.03]. LGG significantly shortened the duration of rotavirus diarrhoea but not diarrhoea with confirmed bacterial aetiology.
Newborn screening strategy for cystic fibrosis: a field study in an area with high allelic heterogeneity
Authors: Castellani C , Bonizzato A , Cabrini G , Mastella G
Published: January 2008

To verify to what extent mutation analysis on blood spot could improve cystic fibrosis neonatal screening in an area with high allelic heterogeneity, we designed a special protocol. Spot trypsin estimation at birth, trypsin re‐testing after 1 month, meconium lactase testing and mutation analysis of ΔF508, R1162X and N1303K, were retrospectively clustered according to different patterns (trypsin/lactase/mutation; trypsin/ lactase/re‐testing; trypsin/mutation) and compared. The programme, which lasted 2 years (1993‐94) and covered most of North‐eastern Italy, included 95 553 screened newborns. Thirty‐four affected babies were detected by screening and one by meconium ileus (incidence 1/2730). The combined use of trypsin, lactase and mutation analysis in cystic fibrosis neonatal screening permits a better sensitivity compared to the two other combinations (34 diagnoses vs 32 in both cases). Moreover, the higher specificity of the former method (false positives 42 vs 148) allows a reduction of recalls, which cause considerable anxiety. We confirm in trypsin‐positive newborns an increased frequency of cystic fibrosis heterozygotes (1/17).
The development of the complement system after 28 weeks' gestation
Authors: Wolach B , Dolfin T , Regev R , Gilboa S , Schlesinger M
Published: January 2008

Objective: To assess the levels and development of the various complement components in preterm infants, particularly among those born before 34 weeks' gestation. Subjects and methods: We measured the complement system's activities (CH50 and AP50) as well as its various components (Clq, r, s, C2‐C9, Factor B, and properdin) in 25 preterm infants [gestational age (GA) 28–33 weeks], 35 preterm infants (GA 34–36 weeks), 50 full‐term newborn infants (GA 37–42 weeks), and 49 healthy adults as control subjects. Results and conclusions: The results of these studies are: (i) complement levels and activity were significantly reduced in preterm and full‐term neonates when compared with adult levels, with the exception of C7 which was within the normal range in most infants. C8 and C9 were the most markedly reduced at all gestational ages, (ii) Complement levels correlated significantly with gestational age, but not with birth‐weight, type of delivery, or gender, (iii) Between 28 and 33 weeks' gestation, there appeared to be almost no development of the complement system.
Iron status of children with short stature during accelerated growth due to growth hormone treatment
Authors: Vihervuori E , Cook JD , Siimes MA
Published: January 2008

We determined the influence of human growth hormone (hGH) treatment on blood soluble transferrin receptor (sTfR) in 35 children with short stature. Whereas the serum concentration of ferritin decreased from 29.6 μg/1 to 19.7 μg/l, and that of transferrin increased from 2.9g/1 to 3.2g/1 during 6 months (p < 0.001), only a minimum rise in the sTfR concentration was observed (7.12 ± 0.20mg/1 vs 7.51 ± 0.19mg/l, p= 0.025). The prevalence of anaemia or microcytosis did not increase. Most of the changes in serum ferritin and transferrin concentrations occurred during the first week. The study demonstrates that rapid body growth per se does not affect the sTfR concentration, but it may affect the serum transferrin and ferritin concentrations. Alternatively, GH may have a specific effect on serum ferritin and transferrin concentrations.
Incidence of type I diabetes mellitus in Navarre, Spain (1975–91)
Authors: Chueca M , Oyarzabal M , Reparaz F , Garagorri JM , Sola A
Published: January 2008

The aim of this study was to ascertain the incidence of Type 1 diabetes mellitus in Navarre, an autonomous community in northern Spain. Subjects were patients who presented with diabetes between 1975 and 1991, age range 0–16 years, resident in Navarre at the onset of symptoms. Endocrinologists in outpatient centres and hospitals (both public and private) in Navarre were the primary source of data, while secondary sources were: independent general practitioners, health centre paediatricians and the Child‐Youth Diabetics Parents' Association of Navarre. The degree of ascertainment was 97.8%. Average annual incidence of diabetes detected was 9.54/100 000 (95% CI 8.2–11.1) in the 0–14 year‐old group. The least incidence was observed in 1976 and highest in 1990. The incidence in males (9.71/100 000) was higher than in females (7.83/100 000). The highest incidence was observed in the 10–14 year‐old group (13.70/100 000) when analysed by groups. No seasonal variation in the onset of diabetes was observed. These results suggest a significant increase in the incidence of type 1 diabetes between 1975 and 1991.
A case of Kawasaki disease with coronary artery aneurysms documenting Yersinia pseudotuberculosis infection
Authors: Konishi N , Baba K , Abe J , Maruko T , Waki K , Takeda N , Tanaka M
Published: January 2008

A case of a 5‐year‐old boy who fulfilled all the criteria for Kawasaki disease (KD) was described. He had associated bilateral coronary artery aneurysms. Our study revealed the isolation of Yersinia pseudotuberculosis in stool cultures, and the elevation and seroconversion of the agglutination antibody titres, and hence he was diagnosed as Y. pseudotuberculosis infection‐positive. We also demonstrated the positive mitogenic activity of the culture supernatant of the isolated bacterium from the patient and detected Y. pseudotuberculosis‐derived mitogen by PCR. This case therefore suggests that Y. pseudotuberculosis might be closely related to the cause of KD.
Germ cell tumours in a brother and sister
Authors: Akyüz C , Köseoǧ;lu V , GöǧüşL S , Balci S , Büyükpamukçu M
Published: January 2008

In familial germ cell tumour cases, a normal chromosomal karyotype pattern is rare. We report the findings of germ cell tumours in two siblings with a normal chromosomal karyotype. One of these patients had dysgerminoma in the right ovary and was treated successfully for this. At present, she is 23 years old and has two daughters. The other patient is a 15‐year‐old boy, who is the brother of the first patient and has mediastinal embryonal carcinoma. Although ultrasonography of the testes showed irregularity in the shape and non‐homogeneity of the parenchyma, histopathological examination was found to be normal at the time of diagnosis. At present, he is doing well and his chemotherapy is continuing. Both of them have a normal chromosomal karyotype, 46, XX and 46, XY, respectively. We suggest that children who have a sibling with germ cell tumour should be carefully assessed for development of another germ cell tumour.
High frequency oscillation and exogenous surfactant in the treatment of neonatal respiratory distress syndrome
Authors: Claris O , Salle BL
Published: January 2008

Surfactant therapy has become widely used in neonates suffering from respiratory distress syndrome. High frequency oscillation has been shown to be efficient and safe in animal models, but somewhat less convincing in human neonates. An overview is given of the experimental and clinical data assessing the combination of these two techniques. Personal preliminary data are briefly presented.
Serum levels of carboxyterminal propeptide of type I procollagen, aminoterminal propeptide of type III procollagen and laminin P1 in Duchenne muscular dystrophy
Authors: von Moers A , Danne T , Möller P , Scheffner D
Published: January 2008

The striking proliferation of connective tissue in Duchenne muscular dystrophy is attributed, besides other components of the extracellular matrix, to an increase of endomysial and perimysial type III and type I collagen. We investigated if muscle fibrosis correlates to an increased serum concentration of procollagen I or HI. Therefore, we measured the serum levels of carboxyterminal propeptide of type I procollagen, aminoterminal propeptide of type III procollagen and laminin P1 in 20 boys with progressive muscular dystrophy (16 definite Duchenne muscular dystrophy, 2 suspected of Duchenne muscular dystrophy, 2 Becker muscular dystrophy). In contrast to collagen I and III the expression of laminin in the basement membrane is known to be normal in Duchenne muscular dystrophy. There was no significant alteration of serum concentration of procollagen ni N‐peptide, procollagen I C‐peptide and laminin PI in boys with Duchenne muscular dystrophy. Measuring these parameters is not useful for investigating the extent of muscle fibrosis or for monitoring the effect of therapeutic trials such as steroid treatment.
Elevated sleep arousal thresholds in enuretic boys: clinical implications
Authors: Wolfish NM , Pivik RT , Busby KA
Published: January 2008

Enuretic children are described as difficult to arouse from sleep. We studied auditory sleep arousal thresholds in enuretic boys and report on die clinical implications of these findings. Fifteen enuretic and 18 control subjects (7–12‐year‐old males) were studied in a sleep laboratory for four consecutive nights using standard polysomnographic recording techniques. Sleep was undisturbed for the initial two nights and waking thresholds were measured on the following two nights. Enuretic children wet most frequently in the first two‐thirds of the night. Arousal attempts were successful 39.7% of the time in controls and only 9.3% of the time in enuretics. In conclusion, enuretic males were more difficult to arouse than age‐matched controls. The elevated arousal thresholds may be due to delayed maturation. Treatment programmes that rely on awakening should be aware of these features.
Diurnal plasma vasopressin and urinary output in adolescents with monosymptomatic nocturnal enuresis
Authors: Läckgren G , Nevéus T , Stenberg A
Published: January 2008

Plasma arginine vasopressin (AVP) levels, urinary flow and urine osmolality were investigated in a group of adolescents (20 boys and 5 girls), aged 11–21 y, with severe monosymptomatic nocturnal enuresis and a control group of healthy adolescents (16M and 4F) with similar age‐ and sex‐distribution. Half of the control group was investigated twice, with an interval of 6 months. AVP samples were taken every fourth hour in all adolescents and half of the control group were also investigated every second hour to achieve more samples during controlled sleep. After the study the enuretic group were put on long‐term oral desmopressin (DDAVP). The difference between day and night values of AVP was significant for both groups, but there was no difference in the day/night ratios of plasma‐AVP. All the adolescents produced less urine while asleep, but the controls produced significantly more urine than the enuretics during day. The controls also had a significantly larger nocturnal elevation of urine osmolality than the enuretics, thus a tendency towards polyuria was found. We could not find any significant difference between responders to DDAVP treatment and non‐responders in any of the parameters studied. AVP is secreted in a pulsatile fashion and with point hormone samples taken every fourth or second hour we were unable to find any difference in the diurnal AVP secretion between enuretics and normal controls.
Intrathecal methotrexate overdose
Authors: Lee ACW , Wong KW , Fong KW , So KT
Published: January 2008

We report two cases of intrathecal methotrexate overdose. A 3‐y‐old girl with acute lymphoblastic leukaemia and a 4‐y‐old boy with Burkitt's lymphoma were to receive an intrathecal injection of methotrexate after completion of intravenous methotrexate infusion. Instead of 12.5 mg, they both received a dose of 125 mg. Both children developed generalized convulsion 3 h after the overdose, but afterwards recovered completely. Intravenous folinic acid and dexamethasone rescue were employed, but no attempt was made to exchange the cerebrospinal fluid. In addition to the staffs failure to check the drug label carefully, the marked resemblance of the two dose preparations of methotrexate (50 mg/5 ml and 500 mg/5 ml) may have been contributory.
Rapid detection of neonatal sepsis using polymerase chain reaction
Authors: Laforgia N. , Coppola B. , Carbone R. , Grassi A. , Mautone A. , Iolascon A.
Published: January 2008

Clinical diagnosis of sepsis in newborn infants is not easy and there is no laboratory test with 100% specificity and sensitivity, with the exception of blood culture, the results of which are not available for at least 48–72 h. Polymerase chain reaction methodology has been used to diagnose different bacterial, viral and protozoal infections, and the possibility of amplifying the DNA region common to all bacteria could represent an optimal method for the diagnosis of sepsis. The authors have performed PCR in a group of 33 neonates at risk for early‐onset sepsis, correlating molecular data with blood culture results. The presence of bacterial DNA in blood samples was evaluated, amplifying the DNA region encoding the 16S rRNA. There were no false negative results (four positive blood cultures and four positive PCR), with competitive costs and time. This method also allows the diagnosis of sepsis due to uncommon species and also, using a second PCR with specific primers, an aetiological diagnosis.