bluuebunny/crossref_metadata_2025 huggingface dataset:
Specific Antibodies to Poliovirus Type I in Breastmilk of Unvaccinated Mothers before and Seven Years after Start of Community‐Wide Vaccination of Their Infants with Live, Oral Poliovirus Vaccine
Authors: ZAMAN S. , CARLSSON B. , JALIL F. , JEANSSON S. , MELLANDER L. , HANSON L. Å.
Published: January 2008

ABSTRACT. Secretory IgA (SIgA) antibodies against poliovirus type 1 were determined using the ELISA method in breastmilk samples obtained each month from 100 young, healthy, unvaccinated mothers living in urban slum areas of Lahore, Pakistan. The study covered two different groups, one in 1980–1981 and the other in 1987, before and seven years after a nation‐wide expanded programme of childhood immunization (EPI) had started. The SIgA titres did not change neither with duration of lactation nor with time after vaccination in the infants of the mothers studied. The seasonal breastmilk IgA antibody titres to poliovirus type 1 corresponded to the epidemiological conditions existing both before (1980–81) and after general vaccination coverage with live, oral poliovirus vaccine (OPV) had reached 80% of the infant population (1987). Neutralization titres did not seem to correlate well with ELISA titres although colostrum samples had high levels of neutralizing antibodies. The wide variation between high (> 10 000) and low (<500) individual breastmilk IgA antibody titres observed during various seasons could be of consequence for the breast‐fed baby. Colostrum, which was also found to have significant neutralization capacity, might interfere with the OPV now often given on the day of birth.
Immunological Follow‐up in Children Born to HIV‐1 Infected Mothers
Authors: RODRIGUEZ M. C. GARCIA , OMEÑACA F. , FERREIRA A. , MADERO R. , ZAPICO R. , MURO M. , JOSÉ I. DE , FONTAN G.
Published: January 2008

ABSTRACT. From November 1985 to January 1990 we examined 156 children born to 154 HIV‐1 seropositive mothers every 3 months. Eighty‐seven infants were over 18 months by January 1990. Six of them met the CDC criteria of HIV‐1 infection or died from AIDS; a transmission rate of 7%. Six of the children aged less than 18 months also met the CDC criteria of HIV‐1 infection. These 12 infected children were compared with the 81 presumably unifected children. The perinatal findings were similar in both groups. Most of the HIV‐1 infected babies showed early abnormalities in humoral and cellular immunity, hypergammaglobulinemia, low percentage of CD4 circulating lymphocytes and increased spontaneous in vitro immunoglobulin production. These changes were persistent in the HIV‐1 infected children, but sporadic in those uninfected. Immunological abnormalities were frequently found before clinical symptoms appeared. We conclude that repeated immunological abnormalities in babies born to HIV‐1 seropositive mothers are suggestive of HIV‐1 infection.
Antibodies to Gliadin in Children with Coeliac Disease
Authors: RAUTONEN JUKKA , RAUTONEN NINA , SAVILAHTI ERKKI
Published: January 2008

ABSTRACT. We have measured antibodies to gliadin (AGA), bovine β‐lactoglobulin, and chicken egg ovalbumin with a four‐layer solid phase radioimmunoassay (RIA) in 62 children and adolescents with coeliac disease and in 36 healthy controls. The geometric mean titre of IgG AGA in patients at initial diagnosis was more than 100‐fold that of controls (p<0.0001). Even patients on gluten‐free diet had significantly higher IgG AGA titres than the controls (p= 0.0001), the difference being more than 5‐fold. All the 42 patients with active disease (30 at initial diagnosis and 12 after gluten challenge) had their IgG AGA titre above 1000, as compared with 2 (5.7%) of the 35 controls (p<0.0001). Both IgG and IgA AGA were quite sensitive and specific in identifying children with coeliac disease; the sensitivities for IgG and IgA AGA were 100% and 95.2%, the specificities 94.3% and 97.2%, respectively. We conclude that determination of IgG and IgA AGA with RIA is suitable for monitoring dietary compliance in children with coeliac disease, and the method is sensitive and specific for screening for coeliac disease in children.
Idiopathic Dilatation of the Aorta with Dissection in a Family without Marfan Syndrome
Authors: TEIEN D. , FINLEY J. P. , MURPHY D. A. , LACSON A. , LONGHI J. , GILLIS D. A.
Published: January 2008

ABSTRACT. Dissection of the aorta is very rare in children, but classically occurs in the presence of Marfan syndrome or other connective tissue disorder. We present a case of spontaneous dissection in a 12‐year‐old boy whose half brother has an idiopathic dilated aorta and whose mother has also required surgery for dissection of a dilated aorta. No features of connective tissue disorder were present in any family member.
Persistent Diarrhoea in the Community: Characteristics and Risk Factors
Authors: ARAYA M. , BAIOCCHI N. , ESPINOZA J. , BRUNSER O.
Published: January 2008

ABSTRACT. In 58 previously well‐nounshed patients who were fed cow's milk and who later developed persistent diarrhoea (≥ 15 days), data obtained during the first 8 days of acute diarrhoea were compared with those of patients whose episodes lasted ≤8 days. Children with persistent diarrhoea weighed less at birth, passed ≥6 stools/day during the first 48 hours, received early treatment with antibiotics. Their milk feedings were stopped during the first 48 hours, they had past history of digestive diseases and hospitalizations, they were brought in for consultation after 5 days of symptoms and their nutritional status deteriorated more (p≤0.003, p≤0.03, p≤0.0001, p≤0.0001, p≤0.0001, p≤0.002, p≤0.0001, and p≤0.03, respectively). Their mothers were significantly younger (p<0.0013), had better schooling (p<0.037), and fewer children (p<0.044), and were separated from the index child during the day more often (p<0.056). After persistent diarrhoea was diagnosed, enteropathogens in stools or lactose intolerance or both were demonstrated in 75.9%. Treatment induced remission in all cases. Using logistic regression predictive model was established which enables us to identify, among patients with acute diarrhoea, those at risk of prolonging their illness.
Antibiotic Susceptibility of 629 Bacterial Blood and CSF Isolates from Swedish Infants and the Therapeutic Implications
Authors: TULLUS K. , OLSSON‐LILJEQUIST B. , LUNDSTRÖM G. , BURMAN L. G.
Published: January 2008

Tullus, K., Olsson‐Liljequist, B., Lundström, G. and Burman, L. G. (Department of Paediatrics, St. Göran's Children's Hospital and Department of Bacteriology, the National Bacteriological Laboratory, Stockholm, Sweden). Antibiotic susceptibility of 629 bacterial blood and CSF isolates from Swedish infants and the therapeutic implications. Acta Paediatr Scand 80: 205, 1991.

Blood and CSF isolates (n=629) from Swedish infants up to one year of age were tested in vitro against 13 antimicrobial agents in order to update the guidelines for empiric therapy of septicaemia and meningitis. Ampicillin plus gentamicin provided inadequate empiric therapy for meningitis, due to the poor CSF penetration of the aminoglycoside and the frequent occurrence of bacterial resistance to ampicillin. Ceftazidime and cefuroxime were moderately active, particularly against isolates from small infants. Cefotaxime today seemed to provide the best empiric therapy of septicaemia and meningitis in infants. Because of the occurrence of Listeria and enterococcal infections, ampicillin should initially be added and other combinations are also advisable for the occasional cases of Enterobacter, Citrobacter, Serratia, and Pseudomonas infections. For coagulase‐negative staphylococci only vancomycin offered a broad activity (100% at achievable serum levels).
Pre‐ and Perinatal Factors in Febrile Convulsions
Authors: FORSGREN L. , SIDENVALL R. , BLOMQUIST H. K:SON , HEIJBEL J. , NYSTRÖM L.
Published: January 2008

Forsgren, L., Sidenvall, R., Blomquist, H. K:son, Heijbel, J. and Nyström, L. (Departments of Neurology, Paediatrics and Epidemiology and Health Care Research, University Hospital, Umeå, Sweden). Acta Paediatr Scand 80: 218, 1991.

In a community based study, 110 children with febrile convulsions (FC) were identified prospectively. Pre‐ and perinatal risk factors were compared with 213 age and sex matched controls sampled from the community. During pregnancy, proteinuria and preeclampsia/eclampsia Occurred more often in mothers of cases. Premature birth and bilirubinemia ≥ 200 μmol/l were also more common in cases. There were no differences between cases and controls in Occurrence of chronic illnesses in mothers, parents age at birth, birth order, and factors occurring during delivery such as type of anesthesia, Occurrence of acute or elective cesarean section, use of vacuum extraction, mode of presentation, signs of fetal distress in amnion fluid, umbilical problems, abnormalities of fetal heart rate or duration of delivery. Perinatal asphyxia was uncommon and there was no difference between cases and referents. Occurrence of complications during the first neonatal week did not differ between groups.
Isolated ACTH Deficiency with Absent Response to Corticotrophin‐Releasing Factor—41: Evidence for a Primary Pituitary Defect
Authors: MURCH S. H. , CARTER E. P. , TSAGARAKIS S. , GROSSMAN A. , SAVAGE M. O.
Published: January 2008

ABSTRACT. An 8‐year‐old girl presenting in hypoglycaemic coma was shown to have isolated deficiency of adrenocorticotrophic hormone (ACTH) secretion. Failure to secrete ACTH in response to intravenous administration of synthetic ovine corticotrophin‐releasing factor (CRF‐41) suggests that this disorder was due to a primary pituitary defect, rather than of hypothalamic origin.
Plasma Cyclic AMP Response to Intravenous Parathyroid Hormone in Pseudohypoparathyroidism
Authors: STIRLING H. F. , DARLING J. A. B. , BARR D. G. D.
Published: January 2008

ABSTRACT. Highly purified bovine parathyroid hormone (PTH) was given by intravenous bolus injection to patients being investigated for disorders of mineral metabolism, and to adult volunteer controls. Plasma cyclic AMP measured basally and at 10 min gave reliable discrimination between the normal response and cases of pseudohypoparathyroidism. Infants under 3 months of age tended to have higher basal levels of CAMP and a flatter pattern of response to the dose of PTH used. This simplified test procedure in children offers considerable advantages over previous tests of PTH responsiveness which involve urine collections and multiple blood sampling. It is suitable for selective screening of individuals suspected of pseudohypoparathyroidism on the basis of their family history or physical abnormalities.
Aetiological and Precipitating Factors for Childhood Enuresis
Authors: JÄRVELIN M. R. , MOILANEN I. , KANGAS P. , MORING K. , VIKEVÄINEN‐TERVONEN L. , HUTTUNEN N.‐P. , SEPPÄNEN J.
Published: January 2008

ABSTRACT.Aetiological factors for enuresis in 68 nightwetting (NW) and 73 day and mixed day and nightwetting (DW/MW) children were examined against a random sample of 142 control children drawn from a population of 3375 seven‐year‐old children. Twenty‐six variables concerning age, sex, social background, life changes, familial and perinatal history, development, growth, neurological damage, psychic structure and urinary tract disorders were included in the logistic regression analysis. The familial influence on enuresis was clearly seen in both nightwetters and daywetters. The NW children were further discriminated from the controls by items connected with delayed development, such as slower growth and poorer visuomotor and spatial perception. Marital separation or birth of a sibling were also found to be precipitating factors especially for nightwetters. The DW/MW children were discriminated from the controls by perinatal risk factors, signs of neurological dysfunction and smaller voided volume, and especially secondary daywetters by urinary tract infections. These models showed that there are similarities between nocturnal and diurnal enuresis, although there are still many differences and every individual case requires consideration of all these disposing factors.
Acute Otitis Media in Early Infancy:Recurrence and Prophylaxis
Authors: FAUSKIN G.
Published: January 2008

ABSTRACT. During a four‐year period, two groups of patients were observed for recurrences of bouts of acute otitis media (AOM) after initial episodes of AOM in early infancy. Of 19 infants with a first bout of AOM before 3 months of age, all had at least one recurrence within eight months, of them 15 (79%) within four months. All members of a second group of 37 infants with two bouts of AOM before 12 months of age had a third bout within 14 months, and 28 of them (76%) had a recurrence within four months. During the ensuing two years (phase two), a group of 6 infants with one bout of AOM before 3 months of age (group one) and a group of 25 infants with two bouts of AOM before 12 months of age (group two) were treated for four months with 25 mg/kg/day aminopenicillin as a single oral daily dose. There were no episodes of AOM in these infants during the prophylactic period. During a third phase lasting two years, patients were assigned to treatment or no treatment regimens for four‐month periods. Patients in treatment regimens received aminopenicillin or erythromycin ethylsuccinate‐sulfamethoxazole (EES‐SMZ) once daily. In infants with one bout of AOM before 3 months (Group 1) there were seven bouts of AOM in 9 untreated vs. one bout in 13 treated patients. In the group of infants with two bouts of AOM before 12 months (Group 2), 13 untreated infants had six bouts of AOM vs. no bouts in 19 treated patients.
Absenteeism because of Illness at Daycare Centers and in Three‐Family Systems
Authors: DAHL I. L. , GRUFMAN M. , HELLBERG C. , KRABBE M.
Published: January 2008

ABSTRACT. Absenteeism because of illness was recorded for 346 children and 98 staff members at eight daycare centers in Gothenburg during a nine‐month period between October 1987 and June 1988. A comparison was made with a similar, nationwide study, carried out in 1977 by the Swedish Central Bureau of Statistics. This comparison demonstrated that the absence of children and employees from daycare centers for health reasons was of the same proportion in the present study as that reported a decade earlier. Absenteeism because of illness among the 346 children at the daycare centers was also compared with absenteeism among 49 children in 14 groups run according to the three‐family system (three to six children/group). It was found that absenteeism was at least twice as frequent among children at daycare centers than among those in the three‐family system.
Autistic Symptoms in Children with Infantile Hydrocephalus
Authors: FERNELL E. , GILLBERG C. , WENDT L. VON
Published: January 2008

ABSTRACT. From a population‐based series of children with Infantile Hydrocephalus (IH) 69 patients (mean age 11.7 years) were examined with respect to the occurrence of autistic symptoms. Autistic symptomatology was evaluated according to a modified short Swedish version of the so‐called Autism Behavior Checklist. Sixteen of the 69 IH children (23%) reached a score which was considered indicative of autistic symp toms (AS) in the child. This group was compared with the remaining 53 IH children without autistic symptoms (non AS). Significant differences were found between these two groups with respect to aetiological and clinical data. In the AS group 44% were born preterm as compared to 9% in the non AS group. CT scan showed major abnormalities in 64% of the AS children while this was present in 28% in the non AS group. The occurrence of major neuroimpairments—epilepsy, mental retardation and cerebral palsy—was 50%, 88% and 50% in the AS group as compared to 9%, 23% and 1996 respectively in the non AS group. It was concluded that the more severe the brain damage in children with IH the more likely that autistic symptomatology would ensue. This implies that specific neuropsychiatric services to these families are required.
Mono‐ or Polypharmacotherapy in Institutionalized Epileptic Children with Severe Mental Retardation?
Authors: FERNGREN H. , ÅKERSTRÖM I. , RANE A.
Published: January 2008

ABSTRACT. Nine severely mentally retarded patients with severe epilepsy who were living in an institution were studied during a three‐year period by a multi‐disciplinary team. A seizure rate serum level chart was made for each patient. It served as the basis for monthly discussions in the team about medication changes. Drug plasma concentrations were monitored monthly. Statistical comparisons between seizure frequency on different drug regimens were made by χ2 test. Withdrawal of all medication was possible in one case and reduction to monotherapy in two cases. In the remainder of the patients a combination of two or three anticonvulsants gave the best clinical effect. We thus found polypharmacotherapy necessary for some severely retarded patients with epilepsy. Our multidisciplinary approach and chart monitoring system has many advantages and is valuable for the medical care and drug treatment of this patient category.
Tumoral Calcinosis
Authors: LAKHKAR B. B. , LAKHKAR B. N.
Published: January 2008

ABSTRACT. Tumoral calcinosis is a rare entity of unknown etiology. In this condition nodular calcareous masses are deposited in the soil tissues around juxtaarticular areas. It occurs in young healthy subjects with normocalcemia. Hyperphosphatemia is only rarely present.
Pulmonary Alveolar Lipoproteinosis in a Seven‐Year‐Old Girl:A Follow‐up over Six Years
Authors: PAUL K. , MÜLLER K. M. , OPPERMANN H. C. , NÜTZENADEL W.
Published: January 2008

ABSTRACT. Alveolar lipoproteinosis is a rare disease in childhood, and its outcome is considered unfavourable compared to adults. We report on the spontaneous improvement of the disease over a six‐year period in a child now 13 years of age. At the time of diagnosis the vital capacity was reduced to 65% of the mean predicted for her height, but deteriorated to 40% during the following year. A bronchoalveolar lavage was performed with small amounts of fluid but it did not immediately reverse the pulmonary alterations. Contrary to expectation, in the following years there was a continuous and gradual increase of the vital capacity to 70% of the mean predicted without specific therapy. This observation underlines the importance of an individual approach to prognosis in this disease and contributes to discussion of therapeutic procedures in the paediatric age group.
Urinary C‐peptide Excretion in Obese and Anorectic Children
Authors: WALLENSTEEN M. , GINSBURG B.‐E. , PERSSON B. , DAHLQUIST G.
Published: January 2008

ABSTRACT. To assess the total insulin secretion in children in different nutritional states we have analysed the 24 h urinary C‐peptide excretion in 32 obese children (16 boys and 16 girls) 8–15 years of age as well as in 7 girls with anorexia nervosa 11–16 years of age. Obese children had a median urinary C‐peptide excretion rate of 0.27 nmol/kg/24 h, which was not different from that of a group of normal‐weight children. In the group of anorectic girls, on the other hand, the median value 0.47 nmol/kg/24 h was significantly (p<0.05) higher than for normal‐weight girls of the same age (median = 0.26 nmol/kg/24 h). These results indicate that in obese children insulin secretion, measured as the 24 h urinary C‐peptide excretion per kg body weight, is the same as in normal‐weight children. Total insulin secretion is consequently increased. In anorexia nervosa, on the other hand, the higher C‐peptide excretion per kg body weight compared with normal‐weight children, indicates that insulin secretion is increased in relation to body weight.
Feeding Problems, Height and Weight in Different Groups of Disabled Children
Authors: THOMMESSEN M. , HEIBERG A. , KASE B. F. , LARSEN S. , RIIS G.
Published: January 2008

ABSTRACT. Two hundred and twenty‐one disabled children from seven diagnostic groups have been examined with respect to height, weight and prevalence of four different feeding problems. Retarded growth and feeding problems were common in children with cerebral palsy, mental retardation, congenital heart disease and deaf‐blindness, but rare in children with esophagus atresia, cystic fibrosis and epilepsy. Mean relative height and weight were significantly lower (p≪.01) in children with mechanical feeding problems, such as impairment of self‐feeding skills and oral‐motor dysfunction, than in children without these problems, regardless of diagnostic group. Mean relative weight was also significantly lower in children with poor appetite than in children with good appetite. Feeding problems contribute to short stature and underweight in severely disabled children.
Utilization of Primary Care versus Specialized Care in Children with and without Chronic Illness: A Population‐Based Study
Authors: WESTBOM L. , KORNFÄLT R.
Published: January 2008

ABSTRACT. Children's utilization of curative care was studied to analyse the division of responsibilities between undifferentiated primary care and specialized care. All chronically ill (n= 510), a control group (n= 287) and the total population 0–15 years of age (n= 6080) in a primary care district were studied using register data. Chronically ill children comprised 8.4% of the total child population and were registered for 1/10 of the primary health care visits, 1/3 of the specialized visits, 1/3 of the hospitalizations and 112 of the in‐patient days of all children. The yearly ambulatory visits were 3.7/child in the chronically ill and 1.5/child in the control group, of which 1/3 and 2/3, respectively, were to primary care. Utilization of specialized care increased with disability. Chronically ill children visited primary care mainly for acute respiratory infections but seldom for allergic or other chronic conditions.
Neonatal Sepsis in Pakistan: Presentation and Pathogens
Authors: BHUTTA ZULFIQAR A. , NAQVI SHEHLA H. , MUZAFFAR TAHSEEN , FAROOQUI BADR J.
Published: January 2008

ABSTRACT. The case records of all neonates admitted to the neonatal unit at Aga Khan University Hospital (Karachi) in a 30 month period (Nov. 86April 89) were analysed. Of 60 neonates with confirmed sepsis, 33 (55%) had non‐nosocomial infection (NNC) whereas 27 (45 %) had nosocomial sepsis (NC). The most common organisms causing early‐onset NNC sepsis were Klebsiella species (53%) and Escherichia coli (10%), whereas the organisms causing late‐onset NNC sepsis included Salmonella parathypi (21%), Group A Streptococcus (21%), Escherichia coli (14%) and Pseudomonas species (14%). Klebsiella was the most common organism causing NC sepsis, others being Staphylococcus aureus(15%) and Serratia species (15%). The mortality in NC sepsis, early‐onset and late onset NNC sepsis was 44%, 26% and 43%, respectively. Risk factors associated with NNC sepsis included low birthweight, prematurity and prolonged and complicated deliveries. There was a high incidence of drug resistance to ampicillin and gentamicin among gram‐negative organisms causing sepsis (mean 67 %).
Effects of Indomethacin on Cerebral Hemodynamics at Rest and during Endotracheal Suctioning in Preterm Neonates
Authors: SALIBA E. , CHANTEPIE A. , AUTRET E. , GOLD F. , POURCELOT L. , LAUGIER J.
Published: January 2008

ABSTRACT. The effect of therapeutic doses of indomethacin versus placebo (saline) on cerebral hemodynamics was studied in nine mechanically ventilated preterm infants. Recordings were made at rest and during endotracheal suctioning. Indomethacin at a dose of 0.2 mg/kg body weight was infused over 5 min. Compared to placebo, there was a significant decrease in Doppler mean frequency in the anterior cerebral artery within minutes of starting the indomethacin infusion during the resting period after the first (p<0.01), second (p< 0.001) and third (p<0.025) doses. This effect has persisted during endotracheal suctioning. Thus, indomethacin alters cerebral hemodynamics by decreasing Doppler mean frequency. In view of these findings, and particularly because of the alteration in the resting cerebral hemodynamics, the recommendation of prophylactic treatment with indomethacin remains questionable.
Vitamin D Metabolism in Pre‐Operative Extrahepatic Biliary Atresia
Authors: TOKITA A. , NITTONO H. , MORI T. , MARUYAMA T. , HAYASHI M. , OBINATA K. , WATANABE T. , YABUTA K. , MIYANO T.
Published: January 2008

ABSTRACT. In order to clarify the pathogenesis of rickets in preoperative patients with extrahepatic biliary atresia, we evaluated baseline serum 25‐OHD and 1,25(OH)2D levels and correlated serum 25‐OHD levels with increase in age and season of birth in 16 preoperative patients. Further, parenteral vitamin D2 tolerance tests were performed in 5 cases. Serum 25‐OHD and 1,25(OH)2D levels were significantly lower than those in 15 normal controls. There was a negative correlation between the serum 25‐OHD levels and increase in age. The patients born during the winter had lower serum 25‐OHD concentrations than those born in summer. The mean value of increased 25‐OHD levels after the parenteral vitamin D2 tolerance tests did not differ from that of 6 controls. Since there was no impairment of vitamin D 25‐hydroxylation, the reduction in serum 25‐OHD may therefore be mainly due to disturbed intestinal vitamin D absorption. It was also concluded that season of birth and increase in age are pathogenic factors in the etiology of rickets in preoperative patients with extrahepatic biliary atresia.
Single Dose Treatment of Cystitis in Children
Authors: LIDEFELT K.‐J. , BOLLGREN I. , WIMAN A.
Published: January 2008

ABSTRACT. The efficacy of single dose treatment with trimethoprim compared to a 5‐day course with the same drug was investigated in 100 children, 3–12 years, with isolated episodes of symptomatic non‐febrile urinary tract infection. Cure, defined as sterile urine during the first week after treatment, was achieved in 74 % (37150) in the single dose group compared to 8696 (43/50) in the 5day treatment group. The difference was not statistically significant (χ2= 2.25, p=0.134 two‐tailed). The cure rates in relation to P‐fimbriation of the infecting E. coli strains were similar in the two groups. During the 6 month follow‐up, six children in each treatment group had one or more reinfections. Extended studies are needed to conclude if single dose and conventional treatment courses are equally effective.
Immunological Markers in the Cerebrospinal Fluid of HIV‐1‐Infected Children
Authors: GALLO P. , LAVERDA A. M. , ROSSI A. DE , PAGNI S. , MISTRO A. DEL , COGO P. , PICCINNO M. G. , PLEBANI A. , TAVOLATO B. , CHIECO‐BIANCHI L.
Published: January 2008

ABSTRACT. Several immunological abnormalities were detected in the cerebrospinal fluid (CSF) of human immunodeficiency virus type 1 (HIV‐1)‐infected children. Intrathecal synthesis of immunoglobulins, free light chains (FLC), IL‐1β, IL‐6, and M‐CSF were demonstrated both in asymptomatic children and children with subacute encephalopathy. Our findings further support the hypothesis that an immunopathological subclinical process within the central nervous system (CNS) may be an early manifestation of acquired immunodeficiency syndrome (AIDS). Cytokine detection in the CSF may represent a useful diagnostic tool in evaluating the outcome of HIV‐1‐infected patients.
Blood Lipids and Diet in Swedish Adolescents Living in Norsjö, an Area with High Incidence of Cardiovascular Diseases and Diabetes
Authors: LARSSON B. , JOHANSSON I. , HELLSTEN G. , HALLMANS G. , ERICSON T. , BRUCE Å.
Published: January 2008

ABSTRACT. In Norsjö in Northern Sweden a cardiovascular intervention programme, for adults is presently tested. The aim of the present study was to investigate the presence of factors related to cardiovascular disease in all 15‐year‐old adolescents living in Norsjö in 1987 and 1988. The total cholesterol concentration in serum, as an average for the test period, was 4.2 mmol/l and 4.7 mmol/l for boys and girls, respectively. Fourteen per cent of the boys and 32% of the girls had a total cholesterol concentration exceeding 5 mmol/l. Twenty‐seven per cent of the adolescents had high values for two or more variables related to risk of developing cardiovascular disease. The evaluation of the dietary registrations showed unsatisfactory values for fibre, P/S ratio and total fat. The dietary habits were better in the 15‐year‐olds in 1988 than in 1987 as judged by significantly higher average daily intake of fibre as well as a higher content of fibre per megajoule in the food.
Asthma as the First Presenting Symptom of Complex Glycerol Kinase Deficiency
Authors: SAKURA N. , NISHIMURA S. , KAWAHARA N. , KOMAZAWA Y. , YAMAGUCHI S.
Published: January 2008

ABSTRACT. Two patients presenting with asthma as the first clinical symptom of a mild form of Addison crisis were found to have complex glycerol kinase deficiency (CGKD). They had been treated with bronchodilators prior to the exact diagnosis. Asthma may appear in a mild form of Addison crisis in a patient with CGKD. Pediatricians should be aware of this unusual presentation of CGKD.
Sleep State, Hypoxia and Periodic Breathing in the Neonate
Authors: MANNING D. J. , STOTHERS J. K.
Published: January 2008

ABSTRACT. The influence of sleep state on hypoxia‐induced periodic breathing was evaluated in full‐term babies studied during the first week of life. Following exposure to 15% O2, periodic breathing occurred in 7 of 42 babies during quiet sleep, and 5 of 20 during active sleep (p < 0.05). The median levels of transcutaneous pO2 at which periodic breathing occurred during hypoxia, and was abolished on reoxygenation were similar in each sleep state. The median duration of periodic apnoea was significantly greater in quiet than active sleep. In 7 babies the occurrence of periodic breathing during hypoxia was accompanied by a change in sleep state. This was probably coincidental in 3 cases, but in the other 4 babies hypoxia may have induced both the change in state and breathing pattern.
Low‐Dose Doxapram Therapy in Premature Infants and Its CSF and Serum Concentrations
Authors: KUMITA H. , MIZUNO S. , SHINOHARA M. , ICHIKAWA T. , YAMAZAKI T.
Published: January 2008

ABSTRACT. The efficacy of low‐dose doxapram therapy (0.2 mg/kg/h) in combination with methylxanthines was evaluated in 20 premature infants with idiopathic apnea unresponsive to methylxanthines alone, and in 13 premature infants with secondary apnea. The serum concentrations of doxapram and, in some infants, the simultaneous cerebrospinal fluid and serum concentrations were measured, and the correlation between cerebrospinal fluid and serum concentrations in the postnatal period was determined. The following results were obtained: 1) In idiopathic apnea of prematurity, low‐dose doxapram therapy was as effective as a dose of 1.0‐2.5 mg/kg/h and the side effects were few, mild, and reversible. 2) In premature infants over seven days of age, serum concentrations of doxapram were almost stable but were significantly lower than in infants within the first six days of life. 3) The ratio of the cerebrospinal fluid to serum doxapram concentration was 0.48 ± 0.13 (mean ± SD). There was a good correlation between cerebrospinal fluid and serum concentrations (r= 0.933, p < 0.001). The initial doxapram dose can be set as low as 0.2 mg/kg/h in very young premature infants with idiopathic apnea of prematurity unresponsive to methylxanthines.
Magnetic Resonance Imaging in Athetotic Cerebral Palsied Children
Authors: YOKOCHI K. , AIBA K. , KODAMA M. , FUJIMOTO S.
Published: January 2008

ABSTRACT. The magnetic resonance findings in 22 children with athetotic cerebral palsy were studied. Sixteen had perinatal asphyxia, two had neonatal jaundice, and four had no association with predisposing conditions. In six of the children, symmetrical high intensity areas were found in both the thalamus and putamen in T2‐weighted images. In five children they were seen only in the thalamus, and in another one only in the putamen. In six children, symmetrical periventricular high intensity areas were seen. In seven of the subjects, no abnormal magnetic resonance findings were seen. Magnetic resonance lesions, possibly caused by asphyxia, were found in the basal ganglia, thalamus and/or cerebral white matter in 14 of 16 children. Three children with lesions only in the cerebral white matter had mild motor abnormality, and six children with lesions in both the thalamus and putamen did not have mild abnormality.
Appropriate Diets for the Rehabilitation of Malnourished Children in the Community Setting
Authors: BROWN KENNETH H.
Published: January 2008

The treatment of severe PEM includes–as appropriate in individual patients–fluid and electrolyte therapy, antimicrobial drugs, dietary management, and social and behavioral counseling. Except in the case of severe anorexia or life‐threatening infections or dehydration, nutritional rehabilitation can be completed in the community setting, using centrally‐processed or locally‐prepared food mixtures and, when necessary, supplemental vitamins, minerals, and trace elements. Energy intakes should be maximized to promote rapid recovery, and protein: energy ratios must be increased according to the expected rate of weight gain. Nutrient: energy densities should meet or exceed the RDAs. Cultural and economic factors must be considered in the formulation of mixed diets, and organoleptic characteristics of the enhanced recipe(s) must be appropriate for young children. Selected issues concerning implementation of a community‐based rehabilitation program are discussed.
Genetic and Epidemiological Aspects of the Carbohydrate‐deficient Glycoprotein Syndrome
Authors: EEG‐OLOFSSON KARIN EDEBOL , WAHLSTROM JAN
Published: January 2008

A new systemic disease with abnormal metabolism of the carbohydrate moieties of glycoproteins has recently been described (CDG syndrome). Available data suggest that the disease is inherited via an autosomal recessive gene. In the future, chromosome analysis and saving of DNA from all patients with the disease are recommended to facilitate linkage analysis.
Growth Hormone Treatment in Short Children with Chronic Renal Failure and after Renal Transplantation: Combined Data from European Clinical Trials
Authors: VAN ES A. , Berg U. , Broycr M. , Callis L. , Del Valle C.J. , Garcia L. , Govantes J.J. , Holmberg C. , Janssens F. , Jodal U. , Loris C. , Navarro M. , Preece M.A. , Proesmans W. , Rappaport R. , Rees L. , Rigden S.P.A. , Crespo F. Rivas , Simon J. , Sipila J. , Vanderschueren‐Lodeweyckx M. , Vicens‐Calvet E. , Villa A.
Published: January 2008

Growth retardation is common in children with chronic renal failure (CRF). To investigate the efficacy and safety of recombinant human growth hormone treatment in such children and in children after renal transplantation, 43 prepubertal children with CRF, and 30 prepubertal and 25 pubertal patients with a renal transplant were studied. Data are reported for 31, 26 and 17 of these patients, respectively. Median height velocity increased from 4.2 to 9.8 cm/year during the first year of treatment, and to 6.8 cm/year during the second year of treatment in the patients with CRF. In the prepubertal transplant group, median height velocity changed from 3.5 to 8.4 cm/year during the first year and to 5.4 cm/year during the second year. In the pubertal transplant group, median height velocity increased from 3.2 to 6.6 cm/year during the first year and was 4.5 cm/year during the second year. The gain in height SDS for the prepubertal children in both the CRF and transplant groups was approximately 1 SD over 2 years. Treatment was well tolerated, and renal function did not change significantly in any group.
Expression and Physiological Significance of Growth Hormone Receptors and Growth Hormone Binding Proteins in Rat and Man
Authors: CARLSSON B. , EDEN S. , NILSSON A. , OHLSSON C. , TORNELL J. , VIKMAN K. , ISAKSSON O.G.P.
Published: January 2008

The molecular structure of the GH receptor has recently been characterized and the receptor identified as a member of a new receptor superfamily that includes the prolactin receptor and

several cytokine receptors. No obvious signal transducing domain has been identified on any of these related receptors. One possible signalling mechanism involves receptor interaction with other membrane‐associated proteins that function as mediators of signal transduction. Whether such a mechanism is involved in signal transduction of the GH receptor is not known. Another common feature of these receptors is the presence of soluble forms such as the GHBP. The functions of these proteins in the circulation and at the level of the target cell remain to be resolved.
An Overview of the Diagnoses in the Kabi Pharmacia International Growth Study
Authors: WILTON P. , WALLSTRÖM A.
Published: January 2008

This paper provides an overview of the diagnoses of patients entered in the Kabi Pharmacia International Growth Study (KIGS). By May 1991, data from a total of 5377 children treated with growth hormone (GH) were included in the main database. Of these children, 2691 were classified as having idiopathic GH deficiency (GHD), 866 as having GHD of known origin, and 1820 as having other causes of short stature. The majority of patients with idiopathic GHD have no history of perinatal trauma. In the patients with GHD of known origin, 137 were congenital cases and 729 acquired GHD. The largest number of congenital cases (114) belonged to the group of central malformations (e.g. septo‐optic dysplasia and empty sella syndrome). Of the cases with acquired GHD, 73% were associated with tumours or leukaemia. Other causes of short stature include 12 groups of diagnoses, with more than 150 cases in four of them (idiopathic short stature, 635; defined syndromes with chromosomal aberrations, 337, of which 304 were Turner's syndrome; defined syndromes without chromosomal aberrations, 157; intrauterine growth retardation without stigmata, 366). Analysis of the KIGS data allows modern GH therapy for GHD to be compared with older treatment modalities. The study offers the advantage of larger numbers of cases than can be achieved in individual trials and allows assessment of the use of GH therapy for GHD of comparatively uncommon causes.
Giardiasis: haematological status and the absorption of vitamin B12 and folic acid
Authors: Hjelt Karsten , Pærregaard Anders , Krasilnikoff Peter A
Published: January 2008

The haematological status, as well as the fractional absorptions of folic acid (FAFol) and vitamin B12 (FAB12) were studied in 29 children aged 0.7–13.5 years (mean 3.3 years) with chronic diarrhoea due to giardiasis. Small intestinal biopsies revealed mucosal damage in 20 children; the biopsies of the remaining nine children were normal. At the initial investigation the FAFol and FAB12 values were below normal in approximately one‐sixth and one‐third of patients, respectively. Bacterial overgrowth of the small intestinal tract did not seem to play a role in FAB12 malabsorption. About one‐fifth of patients had mild anaemia. None of the patients showed FAB12 insufficiency and only one patient suffered from folate depletion. At follow‐up, FAFol, FAB12, haemoglobin and Erc‐folate concentrations increased significantly while P‐B12 and P‐folate remained unchanged. Iron status, as well as dietary intake of iron, appeared insufficient prior to, as well as after treatment. Serum iron, transferrin saturation and haemoglobin concentrations were lower in patients who had acquired the disease abroad or suffered from persistent diarrhoea.
Glucose polymers in diarrhoea–risk of hypernatraemia
Authors: Lindfors A , Lundberg B , Stenhammar L
Published: January 2008

An infant girl with congenital heart disease was fed glucose polymers as dietary supplements. During an attack of gastroenteritis with severe diarrhoea she developed hypernatraemic dehydration, probably due to the high osmotic load of the glucose polymers. This case illustrates the importance of giving adequate amounts of free water to a child on glucose polymers, especially during excessive fluid loss.
Mild course of cystic fibrosis associated with heterozygosity for infrequent mutations in the first nucleotide‐binding fold of CFTR
Authors: Dörk Thilo , Wulbrand Ulrich , Steinkamp Gratiana , Tümmler Burkhard
Published: January 2008

The mild clinical course of a patient with cystic fibrosis is presented who inherited the two mutations Gly551→Asp and Arg553→Stop in the cystic fibrosis transmembrane conductance regulator gene. The missense mutation Arg 553→Stop discovered in American Blacks is also present on cystic fibrosis chromosomes of Caucasian ancestry.
Lipoproteins in preterm and small‐for‐gestational‐age infants during the first week of life
Authors: Morillas JM , Moltó L , Robles R , Gil A , Sánchez‐Pozo A
Published: January 2008

Plasma lipoprotein levels and composition have been determined in preterm and small‐for‐gestational‐age (SGA) infants, and compared to full‐term infants, during the first week of life. Significantly lower levels of HDL and higher levels of VLDL were found in both preterm and SGA infants in comparison to full‐term healthy infants. These results suggest a low capacity to metabolize VLDL. Preterm infants showed a behaviour similar to full‐term infants with regard to the changes in lipoprotein composition. Small‐for‐gestational‐age infants showed a higher lipoprotein lipid content than preterm infants. A low ratio of cholesteryl ester to free cholesterol (CE/FC) was found in both preterm and SGA infants suggesting a reduced lecithin: cholesterol acyl transferase (LCAT) activity. In preterm infants we observed no changes in the CE/FC ratio during the first week of life, whereas in SGA infants this ratio increased after birth.
Oxygen saturation and breathing patterns in preterm infants with cyanotic episodes
Authors: Samuels MP , Poets CF , Stebbens VA , Alexander JA , Southall DP
Published: January 2008

The pathophysiology of cyanotic/apnoeic episodes in preterm infants was investigated using overnight tape recordings of beat‐to‐beat arterial oxygen saturation (SaO2), plethysmographic waveforms from the oximeter, breathing movements and nasal airflow. Recordings were made in 16 preterm infants with recurrent cyanotic episodes of unknown cause that had received stimulation or resuscitation, and 15 preterm controls, matched for birth weight, post‐conceptional and postnatal age. The recordings were analysed for baseline SaO2, the number of hypoxaemic episodes (SaO2≤80% for ≥ 4 s) and the breathing patterns associated with each episode. There was a significant difference in the total number of hypoxaemic episodes between patients and controls (520 versus 100;P < 0.01), but no difference was found for mean baseline SaO2 (98.6 versus 99.0%; p > 0.05). The mean duration of each hypoxaemic episode in the patients was 9.5 s compared with 5.8 s in the controls (P < 0.01). Although most hypoxaemic episodes (62 and 76%) were associated with pauses in breathing movements, a proportion (8 and 18%, respectively) occurred despite continuous airflow and breathing movements in both patients (6 of 16) and preterm controls (2 of 15). The rate of decrease in SaO2 was significantly more rapid during these latter hypoxaemic episodes than during episodes associated with isolated apnoeic pauses (8.5 versus 3.2% per second, p= 0.02). Preterm infants with cyanotic episodes have increased numbers of clinically unapparent hypoxaemic episodes, some of which have continued ventilation and rapid desaturation. The pathogenesis of these episodes warrants further investigation.
Glucocorticoid treatment or food deprivation counteract the stimulating effect of growth hormone on rat cortical bone strength
Authors: Ørtoft Gitte , Oxlund Hans , Jørgensen Peter Holmberg , Andreassen Troels T
Published: January 2008

Growth hormone (GH) has been found to increase the length, thickness and bending strength of rat femora. The present study was designed to investigate if glucocorticoid treatment or food restriction would interfere with the effect of exogenous GH on bone growth. Male rats treated with GH for 30 days experienced a weight gain of 30–35% and longitudinal and periosteal femoral growth. A dose‐related increase in the bending strength of the femora was found and was explained by an increased thickness of the femora. In spite of a reduced real density, biomechanical competence was preserved after GH treatment. GH treatment combined with a relatively small dose of glucocorticoid, which in itself had no significant effect on bone growth and strength, reduced the stimulating effect of GH on body weight gain, femoral growth and strength. GH‐treated rats that were food restricted, so as to limit their body weight gain to that of the saline group, experienced significant longitudinal and periosteal femoral growth. Bone strength, however, was not increased, which conforms to a reduced mineralization and increased porosity of the femora. Young's modulus (normalized bone stiffness) was significantly decreased in this group, probably as a result of decreased mineralization. Furthermore, the combination of GH treatment and food restriction resulted in a reduced apparent density indicating increased bone resorption.
Chloramphenicol‐resistant Haemophilus influenzae meningitis in young urban Nigerian children
Authors: Johnson Abdul‐Wahab BR , Mokuolu Olugbenga A , Onile Boas A
Published: January 2008

In a developing country like Nigeria, the unusual emergence of Haemophilus influenzae type b, resistant to cost‐effective antimicrobials, is of serious concern. We report three cases of H. influenzae type b meningitis in young Nigerian children in whom clinical and bacteriological features of resistance to chloramphenicol were identified. One of the cases had concomitant resistance to ampicillin (multiple‐drug resistance). Significant anaemia was an associated feature in two cases, one of whom had a recent measles infection. All three cases were malnourished. The possible mechanisms of antimicrobial resistance in H. influenzae infections are highlighted while the need for periodic surveillance of antibiotic resistance profiles in resource‐poor countries is emphasized. The potential value of prophylactic measures like H. influenzae type b conjugate immunization is discussed.
Lumbar bone mineral content measured by dual energy X‐ray absorptiometry in newborns and infants
Authors: Salle Bernard L , Braillon Pierre , Glorieux Francis H , Brunet Jacques , Cavero Eduardo , Meunier Pierre J
Published: January 2008

Dual energy X‐ray absorptiometry (DXA), a non‐invasive method for measuring small amounts of mineral, was used to assess the bone mineral content (BMC) and bone mineral density (BMD) of the lumbar spine (5 vertebrae) in 57 newborns (on day 1‐2) and 22 infants (1‐24 months of age). A modified high‐resolution program (Hologic) allowed us to assess BMC and BMD with a precision higher than 2.4% and 1.5%, respectively. In newborns, BMC and BMD correlated positively with birth weight, body area, length and gestational age:r= 0.73, 0.71, 0.63 and 0.60, respectively, for BMC; and r=0.59, 0.58, 0.54 and 0.53, respectively, for BMD. In infants, both BMC and BMD were highly correlated with weight, age, length and body area over two years (r= 0.94 or better in each instance). The data provide normal values for lumbar spine BMC and BMD in newborns (gestational age 31‐40) and infants up to two years of age; DXA appears to be an excellent and safe tool for pediatric bone mineral measurements.