bluuebunny/crossref_metadata_2025 huggingface dataset:
The Occurrence of Genital Mycoplasmas in Babies with and without Respiratory Distress
Authors: TAYLOR‐ROBINSON D. , FURR P. M. , LIBERMAN M. M.
Published: January 2008

ABSTRACT. Vreaplasma urealyticum organisms (ureaplasmas) were isolated from throat swabs and/or gastric aspirates taken from 22.5 % of babies with respiratory distress in a special care unit. ‐The organisms were isolated most frequently (33%) from a small number of babies with severe distress. However, they were recovered only a little less often (26%) from babies without respiratory distress in the unit, and from 19 % of healthy babies, all of the aforementioned babies having been delivered vaginally. The numbers of organisms isolated from babies in the various groups were similar. There was, therefore, no clear evidence that ureaplasmas, nor M. hominis which was isolated from two babies only, were associated with respiratory distress. This finding was supported by the isolation of ureaplasmas from only one of 16 babies born by caesarian section, seven of whom developed respiratory distress but were ureaplasma‐negative.
Ganglioneuroma with an Uncommon Location in a Six‐year‐old Girl
Authors: LJUNG R. , HELIN I. , STROMBLAD L.‐G.
Published: January 2008

ABSTRACT. A 6‐year‐old girl with a neurogenic bladder disease is described. Additional gait disturbances and mild but progressive foot deformities led to the diagnosis and surgical treatment of a ganglioneuroma located exclusively intraspinally. It is suggested that the tumor originated from remnant neural crest cells, probably early in life or even prenatally
Relationships between physical growth, mental development and nutritional supplementation in stunted children: the Jamaican study
Authors: Powell CA , Walker SP , Himes JH , Fletcher PD , Grantham‐McGregor SM
Published: January 2008

The relationship between physical growth and change in mental development on the Griffiths mental development scales was investigated in 127 stunted Jamaican children over a 2‐year period. The role of nutritional supplementation in this relationship was examined. There were no consistent associations between changes in weight‐for‐height or head circumference and developmental change. Height gain over 2 years was significantly associated with change in mental age, and locomotor and hearing and speech subscale scores. Height gain in the first year predicted change in mental age, and hearing and speech in the second year. Some of the effect of supplementation on development was shared with linear growth. Therefore, nutrition probably explains part of the relationship between growth and development. However, supplementation also had effects on development independent of growth. The benefits of supplementation on development and the extent to which they were shared with growth varied among the subscales.
Short‐term and long‐term initial stay in hospital of children with insulin‐dependent diabetes: adjustment of families after two years
Authors: Simell T , Moren R , Keltikangas‐Järvinen L , Hakalax J , Simell O
Published: January 2008

A randomized prospective trial on the effect of the length of initial hospital stay (23 ± 4 days and 9 ± 3 days) in 61 consecutive children with newly diagnosed diabetes was carried out. Since the metabolic outcome was similar in the treatment groups for the first two years, we analyzed the adjustment and subjective well‐being of families to the diabetes after a two‐year follow‐up period. A semi‐structured interview by a psychologist who was blinded to the initial treatment length and medical history of the child showed that 74% of the families in the short‐term and 58% in the long‐term treatment groups had good overall psychosocial ability to function (ns); there were no unusual fears in 37% and 15% of the families (ns), respectively. After short‐term treatment, families needed slightly but not significantly less time to be confident about the management of diabetes in the family. These findings show that the short‐term initial hospital stay does not unfavorably affect the adjustment of the family to diabetes and should probably be preferred over the long‐term initial hospital stay.
Diagnostic imaging in children with urinary tract infection: the role of intravenous urography
Authors: Hansen A , Wagner AA , Lavard LD , Nielsen JT
Published: January 2008

Ninety children referred to hospital with urinary tract infection (UTI) were investigated by iv urography (IVU), ultrasonography (US) and 99mTc dimercaptosuccinic acid scan (DMSA). Fifty‐eight children also underwent micturating cystourethrography (MCUG). In 36 (40%) of the children, at least one result was abnormal. Abnormal findings were found in 29 children with IVU, in 10 with US and in 16 with DMSA. Six of the 58 children had vesicoureteric reflux (VUR) in 8 kidneys. In 16 children, IVU was the only examination with an abnormal result, and in 10 of these the findings were considered important for treatment or prognosis. IVU is an important supplement to US and DMSA in investigation programs for children with UTI. IVU should be performed in cases of renal scars, dilatations or in children with recurrent infections.
Treatment of respiratory failure in an infant with bronchopulmonary dysplasia infected with respiratory syncytial virus using inhaled nitric oxide and high frequency ventilation
Authors: Thompson MW , Bates JN , Klein JM
Published: January 2008

A 2‐month‐old, former 28‐week premature infant with brochopulmonary dysplasia infected with respiratory syncytial virus was treated with nitric oxide and high frequency oscillatory ventilation after conventional therapy failed. Nitric oxide and high frequency oscillatory ventilation rapidly improved oxygenation allowing recovery without the need for extracorporeal membrane oxygenation. This treatment regimen should be considered as an option in high‐risk infants with respiratory syncytial virus infection who meet extracorporeal membrane oxygenation criteria.
Metabolic alkalosis due to the use of an oligoantigenic diet in infancy
Authors: Vizia B De , Mansi A , Giangregorio A , Troncone R
Published: January 2008

A 7‐month‐old boy on an oligoantigenic diet because of multiple food intolerances presented with anorexia, failure to gain weight and severe hypochloremic metabolic alkalosis with hyperreninemia. Clinical symptoms and biochemical abnormalities disappeared after adequate dietary supplementation with potassium and sodium chloride. This case emphasizes that minimal daily mineral requirements must be provided in infant diets, and highlights the risk of nutritional deficiencies inherent in the prolonged use of oligoantigenic diets not adequately supplemented.
Bone mineral content of young female former gymnasts
Authors: Lindholm C , Hagenfeldt K , Ringertz H
Published: January 2008

Intense physical exercise and diet restriction could result in delayed puberty and have a negative influence on the acquisition of peak bone mass during puberty. Nineteen young women who had been in elite gymnastic training during their prepubertal and pubertal years were investigated with regard to their health, menstrual data and bone mineral areal mass (BMA). Twenty‐one women of comparable age served as controls. The age of menarche of the “former” gymnasts and the controls was 14.81.8 and 12.11.4years, respectively. Fourteen of the gymnasts had been or were using oral contraceptives (OCs) and most of the non‐users now had regular menstrual periods. During the years preceding the study, physical activity among the “former” gymnasts had gradually declined. Although the gymnasts had had a delayed puberty, no difference was found in total body or spinal BMA compared to the healthy controls. Their normal BMA in early adulthood could reflect a catch‐up due to a combination of decreasing athletic activity, normal menstrual cycles and intake of OCs. ? BMA, gymnasts, late menarche, oral contraceptives, prepubertal training
Creatine kinase isoenzyme BB concentrations in cerebrospinal fluid in asphyxiated preterm neonates
Authors: Talvik T , Haldre S , Sööt A , Hämarik M , Piirso A , Mikelsaar A‐V
Published: January 2008

Creatine kinase isoenzyme BB was determined in cerebrospinal fluid (CSF) in 79 preterm neonates using an original enzyme‐linked immunosorbent assay. The criterion for inclusion was an Apgar score of 7 or less at 5 min of life. Neurological examination was performed on day 2 and day 5 of life. CSF was obtained on the same days. Lumbar puncture was performed on 41 of these babies on day 2 and in 39 on day 5 of life (one baby underwent lumbar puncture twice). All babies had clinical features of hypoxic‐ischemic encephalopathy (HIF) which was classified according to Sarnat and Sarnat. The control group consisted of 90 asphyxiated term babies and 30 adults without CNS pathology. The concentration of CK‐BB in cerebrospinal fluid (meanSD) was significantly higher (p < 0.0005) in preterm (168.0 2) than in term babies (29.0 3.1) and healthy adults (5.3 1.2). Our results demonstrate the possibility of using the classification system of Sarnat and Sarnat for assessment of the severity of brain damage not only in term, but also in preterm babies. Neonates with HIE stages II and III showed markedly higher CK‐BB values than those with HIE I on day 2 (p < 0.025) and day 5 (p < 0.05) of life. CK‐BB values were markedly higher in preterm babies with none of some primitive responses (head turning, Babkin's reflex, palmar grasp). The mean concentration of CK‐BB was higher in neonates with retarded psychomotor development compared with those with normal development (p < 0.05) on day 3, and after 6 and 9 months. At 12 months of age no significant difference in median CK‐BB concentration was detected between neonates with normal and developmental disturbances.Asphyxia, cerebrospinal fluid, creatine kinase BB isoenzyme, hypoxic‐ischemic encephalopathy, neonates
Tongue necrosis due to vasculitis
Authors: Ekman‐Joelsson BM , Kjellman B , Hattevig G
Published: January 2008

We describe a 7‐year‐old boy with necrosis of the tongue due to a generalized vasculitis, with symptoms and signs consistent with periarteritis nodosa and appearing after an infection with streptococci. Approximately one‐third of the tongue had to be extirpated.
Influence of two infant formulas and human milk on the development of the faecal flora in newborn infants
Authors: Kleessen B , Bunke H , Tovar K , Noack J , Sawatzki G
Published: January 2008

The establishment of the faecal flora of 39 full‐term infants fed exclusively on breast milk (n = 20) or with two different modern adapted cow's milk formulas (n= 19) was studied during the first 3 months of life. One formula investigated was based on 100% bovine casein as the protein source whereas the other formula contained bovine milk proteins with a whey/casein ratio of 60:40. A faecal flora rich in bifidobacteria was found in all study groups; the growth of putrefactive bacteria (especially Bacteroides spp.), however, was limited. In formula‐fed infants, significantly higher bacterial counts of enterococci and Clostridia were detected compared to breast milk‐fed infants. Similarities and differences due to the feeding regimen were particularly reflected in the pattern of the anaerobic bacterial species. Bifidobacterium bifidum, B. infantis and B. breve constituted the majority of the bifidobacterial flora independent of the type of milk feeding. Other bifidobacterial species such as B. longum, B. adolescentis, B. parabifidum and B. pseudo‐catenulatum were detected in high numbers and at low frequencies in breastfed infants. The latter three were observed in infants fed the whey/casein formula as well. It seems that infants fed a casein formula develop a faecal flora more like that of breastfed infants concerning Lactobacillus spp. (especially L. fermentum and L. brevis).
Prevalence, genetics and clinical presentation of chronic granulomatous disease in Sweden
Authors: Åhlin A , De Boer M , Roos D , Leusen J , Smith CIE , Sundin U , Rabbani H , Palmblad J , Elinder G
Published: January 2008

To estimate the prevalence of chronic granulomatous disease (CGD) in Sweden, an inquiry asking for known and possible CGD cases was mailed to paediatric, internal medicine and infectious disease departments all over Sweden. The detected patients were characterized as to genetics and the clinical presentation. Twenty–one patients (belonging to 16 different families) were found, corresponding to a prevalence of ∼ 1/450 000 individuals. The patients with X–linked disease, lacking a functional gp91phox protein (n= 12), comprised 57% and 43% of the patients had an autosomal recessive (AR) disease lacking p47phox (n= 7) or p67phox (n=1), respectively. All unrelated patients with X–linked disease displayed different gene abnormalities such as point mutations predicting nonsense (n= 3), missense (n= 1) or splice site mutations (n = 2), but also a total deletion and a unique 40 base pair duplicature insertion. The patients with p47phox–deficiency showed a GT deletion at a GTGT tandem repeat, and the p67phox–deficient patient displayed a heterozygous in–frame deletion of AAG combined with a large deletion in the other allele. Three patients died during the study period, two from Pseudomonas cepacia infections. Patients with X–linked disease had more frequent infections (mean of 1.7 per year), than the patients with AR inheritance (0.5 infections per year). The most common infections were dermal abscesses (n=111), followed by lymphadenitis (n=82) and pneumonias (n=73). Inflammatory bowel disease–like symptoms, mimicking Crohn's disease of the colon, was seen in three CGD patients.
Psychological long‐term coping with experience of disease and treatment in childhood cancer survivors
Authors: Boman K , Bodegård G
Published: January 2008

Childhood cancer, although cured, may have long‐term psychological consequences for the adult survivor. The outcome of patients' coping with the illness and treatment experience was assessed in relation to a theoretical model describing optimal long‐term coping with a potential psychic trauma of this nature. Thirty young adult childhood cancer survivors were studied. The average age at diagnosis was 8 years, and at evaluation 22 years. The average time since diagnosis was 13 years. The evaluations of coping were carried out independently by two psychologists, who rated material from semistruc‐tured in‐depth interviews. By statistical cluster analysis three clusters were produced that could be interpreted as exhibiting “good”, “intermediate” and “poor” coping, containing 40, 33, and 27%, respectively, of the total group. Overall cluster differences were statistically significant. Profile analysis revealed statistical stability and internal homogeneity in the good coping cluster and the poor coping cluster.
Use of enalapril in neonatal hypertension
Authors: Schilder JLAM , Van den Anker JN
Published: January 2008

Treatment of hypertension with enalapril in a preterm infant is described. Enalapril is a new converting enzyme blocker with a longer plasma half‐life and less side effects than captopril. Oral administration of enalapril 0.1 mg/kg caused severe hypotension and renal failure in a preterm infant. We recommend an oral starting dose of 0.01 mg/kg in preterm infants and extremely close monitoring of infants receiving the first dose of enalapril.
Intranasal versus intravenous administration of midazolam to children undergoing small bowel biopsy
Authors: Högberg L , Nordvall M , Tjellström B , Stenhammar L
Published: January 2008

Sixty‐three children under the age of 9 years were randomized to receive intravenous (group A, n= 33) or intranasal (group B, n= 30) midazolam as sedation for small bowel biopsy. Mean doses of midazolam given to produce adequate sedation were 0.31 mg (kg body weight)−1 in group A and 0.34 mg (kg body weight)−1 in group B (NS). Four children in group A and 10 children in group B required additional doses to maintain adequate sedation throughout the biopsy procedure (p <0.05). There was no significant difference between the groups regarding the median procedure time (7 min in group A, 8.5 min in group B) or median fluoroscopy time (5 s in group A, 4 s in group B). All children in group B showed signs of discomfort from the nose when given midazolam intranasally. In conclusion, this study indicates that intravenous administration of midazolam is preferable to the intranasal route.
Congenital anomalies in two infants born after gestational γ‐globulin prophylaxis
Authors: Ross L
Published: January 2008

The offspring of two women given prophylactic γ‐globulin 50 and 54 days after their last menstrual periods had congenital duodenal stenosis and a paraoesophageal hiatus hernia, respectively. The possibility that γ‐globulin may have contributed to these malformations is discussed.
Coincidental cases of primary sclerosing cholangitis and biliary atresia in siblings?
Authors: Isoyama K , Yamada K , Ishikawa K , Sanada Y
Published: January 2008

Familial cases of primary sclerosing cholangitis or biliary atresia have been reported, although genetic influences and immunopathological abnormalities in these diseases are considered to be obscure. We report a case of primary sclerosing cholangitis and biliary atresia in siblings with the observation of HLA‐DR antigen expression in the abnormal bile duct epithelial cells.
Effects of maternal pethidine on infants' developing breast feeding behaviour
Authors: Nissen E , Lilja G , Matthiesen A‐S , Ransjo‐Arvidsson A‐B , Uvnas‐Moberg K , Widstrom A‐M
Published: January 2008

The aim of this quasi‐experimental study was to examine the effects of maternal pethidine during labour on the developing breast feeding behaviour in infants in the first 2 h after birth compared with infants not exposed to pethidine. Forty‐four healthy infants were observed immediately after birth. They were placed skin‐to‐skin on their mothers' chests. The development of mouth and sucking movements as well as rooting behaviour and state of sleep/wakefulness were noted. The observer was blind as to the pain relief the mother had received during labour. Of the 44 mothers 18 had received pethidine. The main findings were that infants exposed to pethidine had delayed and depressed sucking and rooting behaviour. In addition, a smaller proportion of infants exposed to pethidine started to suckle the breast. Rooting movements which are expected to be vigorous at 30 min after birth were affected both by administration of pethidine and a longer second stage of labour. It is suggested that the differences found in sucking behaviour may be a central effect of pethidine. Depression of rooting movements in the pethidine group may be caused by exhaustion due to a longer second stage of labour and administration of pethidine. It is recommended that pethidine‐exposed mother‐infant couples stay together after birth long enough to enable the infant to make the choice to attach or not to attach to the nipple without the forceful helping hand of the health staff.
Effects of differences in dietary fat on growth, energy and nutrient intake from infancy to eight years of age
Authors: Boulton TJC , Magarey AM
Published: January 2008

We report the results of food energy and nutrient intake, and somatic growth measured at intervals throughout infancy to 8 years of age in children from the Adelaide nutrition study cohort. At each age the sample was divided into three groups according to the percentage energy as fat: < 30%, 30–34.9% and > 34.9%. There were no clinically significant differences in height, weight or skinfold thickness according to the proportions of fat in the diet, although the high fat intake group had a higher food energy intake at 2,4 and 8 years of age. The low fat group had a greater proportion of energy as sugar at 4,6 and 8 years of age, and as starch at 4 and 6 years. At some ages there were differences in calcium, iron, thiamine and vitamin C intakes. There were minor differences in nutrient intake in children at 8 and 15 years of age according to their fat intake at 1 and 2 years. Boys in the lower fat intake group at 2 years of age were slightly shorter and lighter at 15 years of age than those who had been in higher fat intake groups. We conclude that the contemporary shift to a lower fat diet in early childhood is unlikely to have deleterious effects on growth and nutrient intake if eaten in the context of a family eating pattern, which meets current guidelines.
High‐calorie, rice‐derived, short‐chain, glucose polymer‐based oral rehydration solution in acute watery diarrhea
Authors: Lebenthal E , Khin‐Maung‐U  , Khin‐Myat‐Tun  , Tin‐Nu‐Swe  , Thein‐Thein‐Myint  , Jirapinyo P , Visitsuntorn N , Ismail R , Bakri A , Firmansyah A , Sunoto S , Shin K , Takita H
Published: January 2008

In this study, we have compared the effects of the World Health Organization oral rehydration solution (WHO ORS) and an ORS containing short polymers of glucose (Amylyte ORS) at a high caloric density (five times) and comparable osmolality, on stool output, duration of diarrhea, weight gain and fluid and electrolyte balance, in randomized, open‐labeled, controlled clinical trials in five centers. A total of 198 male children (4 months to 10 years) with acute diarrhea (<72 h after onset) were assigned by random allocation to either WHO ORS or Amylyte ORS at five centers in Asia. Children were stratified according to grade of dehydration (mild, moderate or severe) and the initial purging rates during the first 6h (low (<2ml/kg/h), moderate (2–5ml/kg/h) and high (>5ml/kg/h) purgers). The clinical characteristics of the children in the two treatment groups were comparable. Amylyte ORS reduced stool volumes significantly in children with severe dehydration (285.4 ± 74.2 versus 75.5 ±20.0 ml/kg; p < 0.05) and in children with a high initial purging rate (200.3 ±42.8 versus 130.5 ± 9.1 ml/kg; p < 0.05). This was accompanied by a significant (276.4 ±14.6 versus 227.6 ± 11.8 ml/kg; p < 0.01) reduction in ORS requirements in the Amylyte ORS treated group, the effect being greatest in children with severe dehydration (491.5 ± 108.5 versus 155.7 ± 27.3 ml/kg; p < 0.01) or high initial purging rates (394.2 ± 66.2 versus 316.8 ± 34.8 ml/kg; p < 0.05). In mild or moderate dehydration and low or moderate purgers, duration of diarrhea in children treated with Amylyte ORS was not reduced. A significant (p < 0.05) reduction in duration of diarrhea was found in children with severe dehydration (56.4 ± 1.8 versus 34.0 ± 5.6h) or high purging rates (51.5 ± 7.1 versus 38.2 ± 4.8 h). Significantly (p < 0.0001) greater weight gain (520.3 ± 48.5 g versus 228.5 ± 42.1 g) and percent gain in weight (4.8 ± 0.4% versus 2.3 ± 0.4%) were found in children given Amylyte ORS compared with those given WHO ORS. Amylyte ORS rehydrated children with acute diarrhea, reduced stool volume, duration of diarrhea and ORS requirements in children with severe dehydration or high initial purging rates, and improved weight gain. Amylyte ORS has the advantage of containing short polymers of glucose that provide over five times the calories per liter than the glucose‐based WHO ORS.
Is the higher postneonatal mortality in lower social status groups due to SIDS?
Authors: Arntzen A , Mourn T , Magnus P , Bakketeig LS
Published: January 2008

In order to study the influence of sociodemographic factors, postneonatal mortality of all live births surviving the neonatal period registered in the Norwegian Medical Birth Registry in 1978–1982 were examined (n= 209 030). Postneonatal deaths (n = 634) were divided into two categories; deaths due to the sudden infant death syndrom (SIDS) (n= 359) and deaths due to other causes (non‐SIDS) (n= 275). SIDS and non‐SIDS deaths showed different relationships to sociodemographic factors, and the associations appeared to be different for first‐born and later born children. SIDS mortality was highest for first‐born offspring when the mother was young (adjusted relative risks (RR) 2.3) and had a low educational level (adjusted RR 4.9). For later‐born offspring no association between maternal educational level and SIDS was found, while young maternal age (adjusted RR 4.4) and unmarried status (adjusted RR 2.3) were closely associated with SIDS. In the multivariate model, however, there were no statistically significant associations between non‐SIDS and sociodemographic factors for firstborn or later‐born children. Thus it appears that the increased postneonatal mortality in lower social groups can be explained by an association with SIDS.
EEG abnormalities, malnutrition, parasitism and goitre: a study of schoolchildren in Ecuador
Authors: Levav M , Cruz ME , Mirsky AF
Published: January 2008

We report on data collected in a sample of 194 schoolchildren (9–13 years of age) residing in a mountainous community in Ecuador. This study was part of an ongoing epidemiological inquiry into the prevalence of parasitism, malnutrition, neurocysticercosis, goitre, iodine levels and EEG abnormalities, and the relationships among these factors. Data were obtained by a local medical team supported by specialized personnel. The results showed that 34% of the EEG tracings were abnormal, with higher rates among girls. The best fitted log‐linear model to explain the results was the combination of EEG status, parasite infection, goitre and gender. The best predictor of EEG abnormalities was found to be a diagnosis of goitre.
Lumbosacral skin markers and identification of occult spinal dysraphism in neonates
Authors: Gibson PJ , Britton J , Hall DMB , Hill C Rowland
Published: January 2008

ABSTRACT. Some skin lesions over the spine are known to be associated with occult spinal dysraphism, but the significance of common skin lesions, such as sacral pits and dimples, is uncertain. In this prospective study, 95 neonates (1.9% of 4989 live births) were referred with possible markers of occult spinal dysraphism. Seven of 94 babies examined had abnormalities demonstrated by spinal ultrasound, compared with 5 of 105 controls. In 2 of 94 and 3 of 105 of these, the conus medullaris was located at L3 but no other abnormalities were found. Of the 75 babies with a sacral dimple or pit alone, none had an abnormality, suggesting that these skin lesions do not indicate a high risk of occult spinal dysraphism.
Dopamine suppresses thyroid‐stimulating hormone secretion in neonatal hypothyroidism
Authors: de Zegher F , Van den Berghe G , Dumoulin M , Gewillig M , Daenen W , Devlieger H
Published: January 2008

The infusion of dopamine, a hypophysiotropic catecholamine, which inhibits release of thyroid stimulating hormone (TSH), is the inotropic therapy of first choice in neonatal intensive care. Newborns with primary hypothyroidism are at increased risk of cardiocirculatory morbidity and are screened by measuring serum TSH concentrations. In an infant with both congenital heart disease and neonatal hypothyroidism, withdrawal of dopamine infusion was documented to evoke a doubling of serum TSH levels within 40 min, a finding suggestive of an inhibitory effect of dopamine administration on neonatal TSH hypersecretion. As a result, dopamine therapy may be a pitfall in TSH screening for neonatal hypothyroidism.
Fecal cholesterol excretion in preterm infants fed breast milk or formula with different cholesterol contents
Authors: Boehm G , Moro G , Muller DM , Miiller H , Raffler G , Minoli I
Published: January 2008

In 44 very low‐birth‐weight infants, fecal cholesterol excretion was measured and in 29 other infants serum total cholesterol concentrations in response to different cholesterol intakes were studied. The infants received fortified breast milk (mean cholesterol content 15.3mg/dl) or were fed either a standard preterm formula (cholesterol content 5.5mg/dl) or the same formula but with a modified lipid composition (long chain polyunsaturated fatty acid concentration closely related to breast milk fat) and 30 mg of cholesterol/dl. In the group fed the high cholesterol formula, fecal cholesterol excretion was significantly higher (35.5mmol/kg/day) than in the groups fed breast milk or the standard formula (20.1 and 18.2mmol/kg/day). Cholesterol balance in the group fed the high cholesterol formula (21.8mg/kg/day) was significantly higher than in the group fed breast milk (+8.6mg/kg/day). In the infants fed the low cholesterol formula the balance was negative (‐7.7 mg/ kg/day). Serum concentrations of total cholesterol were similar in the groups fed breast milk or the high cholesterol formula (3.47 and 3.51 mmol/1), but significantly higher than in the group fed the low cholesterol formula (3.15 mmol/1). The data suggest that preterm infants are able to regulate a higher cholesterol intake than during breast feeding by increasing fecal cholesterol excretion as well as decreasing endogenous synthesis.
Neonatal herpes simplex: clinical findings and outcome in relation to type of maternal infection
Authors: Malm G , Berg U , Forsgren M
Published: January 2008

In 39 mothers of children with neonatal herpes simplex virus infection, maternal infection was serologically characterized retrospectively and was related to maternal clinical symptoms and to the clinical findings and outcome in the child. Thirteen mothers had a primary infection (six type 1, seven type 2), mostly with clinical symptoms. The mean age of onset of the disease of the infants was 7 days and a disseminated disease was most commonly found. Most of the type 1‐infected children recovered completely, whereas all but one of the type 2‐infected children died. Twenty mothers had a recurrent (2 type 1, 18 type 2) and 4 an intermediate infection (primary type 2, prior infection with type 1), mostly asymptomatic. Their children had a localized disease (of the skin‐eye‐mouth or the central nervous system) with onset at a mean age of 14 or 13 days, respectively. The frequency of neurological sequelae was high. Two mothers had no serological signs of herpes infection.
Hypotonic oral rehydration solution in acute diarrhoea: a controlled clinical trial
Authors: Mahalanabis D , Faruque ASG , Hoque SS , Faruque SM
Published: January 2008

In a controlled trial, a hypotonic oral rehydration solution (ORS) (Na+67, K+20, CP66, citrate 7, glucose 89mmol/1 osmolality 249 mosmol/kg) was compared with a standard WHO‐ORS (Na+90, K+20, Cl‐80, citrate 10, glucose lllmmol/1, osmolality 311 mosmol/kg) in 60 children aged 5‐24 months with acute watery diarrhoea. In the hypotonic ORS group, stool frequency, proportion of children who vomited, ORS requirements and purging rate over 24‐48 h were reduced by 33% (p= 0.01), 30% (p= 0.02), 21% (p= 0.067) and 21% (p = 0.03), respectively. The proportion of children who vomited and the purging rate over 48 h were reduced by 23% (p= 0.03) and 10% (p= 0.097), respectively. Serum electrolytes after 48 h were comparable. The beneficial effect of hypotonic ORS was most marked in, and largely contributed by, the subgroup negative for rotavirus.
Acute asthma, salbutamol and hyperglycaemia
Authors: Dawson KP , Penna AC , Manglick P
Published: January 2008

The effects of frequent high‐dose nebulized salbutamol on plasma glucose concentrations were studied in 12 children (mean age 60 months) with acute severe asthma. There was a significant difference between mean initial glucose levels and peak levels. We conclude that hyperglycaemia can be produced in children as a result of nebulized salbutamol.
Sleeping position and sudden infant death syndrome (SIDS): effect of an intervention programme to avoid prone sleeping
Authors: Markestad T , Skadberg B , Hordvik E , Morild I , Irgens LM
Published: January 2008

The proportion of prone sleeping among sudden infant death syndrome (SIDS) victims and infants in general, and the rate of SIDS were prospectively studied in the county of Hordaland, Norway, three years before (1987–89) and three years after (1990–92) a campaign to discourage prone sleeping. Before the campaign, 64% of random reference infants were put prone versus 8% after (p < 0.0001). Concurrently, the rate of SIDS decreased from 3.5 to 1.6 per 1000 live births (63 infants before and 30 after the campaign,p= 0.0002). Prone sleeping was not considered a statistically significant risk factor for SIDS before (OR 2.0,95% CI 0.8–4.5), but was highly significant (OR 11.3,95% CI 3.6–36.5) after the campaign. Prone sleeping is an important risk factor for SIDS, but the association may be missed in epidemiological studies if prone is the predominant sleeping position. Behaviour with regard to sleeping position may be changed rapidly by means of a simple campaign.
Rate of radial bone mineral accretion in healthy children
Authors: Goslings WRO , Cole TJ , Prentice A , Bishop NJ
Published: January 2008

Radial bone width and mineral content were measured in 392 healthy Cambridge children aged 6–12 years from a cohort of 420 children studied 2 years previously. The typical rate of bone mineral accretion was 0.044 g/cm/year for boys across the whole age range and 0.042 g/cm/year for girls up to a mean age of 9 years, rising rapidly thereafter in association with changes in body size. The factors best predicting bone mineral accretion rate were mean bone mineral content, mean height, height velocity, weight velocity and bone width velocity. After adjusting for anthropometry, age did not contribute to the model. These are the first available longitudinal reference data for the rate of radial bone mineral accretion in healthy children.
The insulin–like growth factor axis and collagen turnover in asthmatic children treated with inhaled budesonide
Authors: Wolthers OD , Juul A , Hansen M , Muller J , Pedersen S
Published: January 2008

Serum concentrations of growth hormone–dependent insulin–like growth factor I (IGF–I) and insulinlike growth factor binding protein–3 (IGFBP–3), the carboxy terminal propeptide of type I procollagen (PICP), the carboxy terminal pyridinoline cross–linked telopeptide of type I collagen (ICTP) and the amino terminal propeptide of type III procollagen (PIIINP) were studied in 14 prepubertal children with asthma (mean age 9.7 years) during treatment with inhaled budesonide. The study design was a randomized, crossover trial with two double–blind treatment periods (200 and 800 μg) and one open, non–randomized treatment period (400 μg). All periods were 18 days’duration. Budesonide treatment was associated with a dose–related suppressive trend in serum concentrations of PIIINP when the 400 μg period was included (p < 0.01; z =–2.7) and when it was excluded from the calculations (p < 0.01; z =–2.6), indicating reduced synthesis of type III collagen. A similar trend was observed in ICTP levels when the 400 μg period was excluded from the calculations (p= 0.05; z =–1.9). No other statistically significant variations were seen.
Factors triggering the first febrile seizure
Authors: Rantala H , Uhari M , Hietala J
Published: January 2008

The symptomatology of infections as well as immunological and virological findings were analysed using a logistic model in a survey of 58 children experiencing their first febrile seizures. These were then compared with findings in 116 age– and sex–matched controls with infections but no seizures. There were no statistically significant differences in the aetiology of infections between patients and controls. High temperature was the only variable to explain the occurrence of febrile seizures in the logistic model after adjusting for duration of symptoms (partial correlation coefficient in logistic model, r = 0.31). The duration of symptoms before hospitalization was shorter in patients than in controls (mean 1.0 and 3.6 days). With a longer duration of symptoms, the likelihood of seizures diminished (r =–0.34). Patients in the seizure group had a significantly higher temperature at home than controls before hospitalization (39.4 versus 38.8°C). Our finding of higher temperatures in children with febrile seizures supports its importance as the most important triggering factor in febrile convulsions.
Neurological findings in early treated phenylketonuria
Authors: Weglage J , Pietsch M , Fünders B , Koch HG , Ullrich K
Published: January 2008

Twenty early treated, normal intelligent patients (IQ: mean 101.4, SD 10.0; age: mean 10.11, SD 1.3 years) with classical phenylketonuria and 20 age–, sex– and IQ–matched healthy controls were investigated for neurological outcome, especially with regard to fine motor ability using the motor performance task (“Motorische Leistungsserie”). No pathological findings were seen on clinical neurological examination. The patient group had significantly poorer results in a concentration task (Test–d–2) as well as in some subtests of the motor performance task. Patients had difficulties in tasks which needed speed and precision of arm–hand–finger movements. High serum phenylalanine concentrations were significantly correlated with these deficiencies in fine motor ability. Our data demonstrated mild neurological impairment even in early and relatively strictly treated patients with phenylketonuria.
Effect of body tilting on physiological functions in healthy term neonates
Authors: Chen C‐M , Tsai T‐C , Lan M‐C
Published: January 2008

The effect of body tilting on physiological functions was studied in 32 healthy, full–term neonates at 2 and 24 h of age. The neonates were placed in the supine position and the physiological functions were measured in the sequence of –30o (head–down), 0o and 30o (head–up) tilts. Arterial oxygen saturation and respiratory rate were comparable in the vaginal delivery and caesarean section groups. The baroreceptor responses were similar in the neonates delivered vaginally and by caesarean section. Mean heart rate increased on 30o up tilting and the responses tended to be larger at 24 h compared with those at 2 h of age, but these differences were not significant. At 2 h of age, mean systolic and diastolic blood pressures decreased on 30o up tilting. At 24 h of age, mean systolic and diastolic pressures decreased on up tilting (from –30o to o) and the values were sustained on further up tilting (from –0o to 30o). The present results indicate that baroreceptor reflexes are present from birth and the responses tend to be less developed at 2 h than those at 24 h of age.
Pelvic ultrasound findings in different forms of sexual precocity
Authors: Griffin IJ , Cole TJ , Duncan KA , Hollman AS , Donaldson MDC
Published: January 2008

Recently produced reference curves for various ultrasound dimensions were used to retrospectively assess 67 pelvic ultrasound scans carried out at the initial presentation in girls with sexual precocity. At presentation the group with precocious puberty had significantly increased uterine lengths and ovarian volumes compared with the normal population, and a significantly increased fundal–cervical ratio. Ovarian volume was also significantly increased in thelarche and thelarche variant. The fundal–cervical ratio was significantly increased in thelarche variant. There was considerable overlap between individuals with sexual precocity and normal subjects. The ultrasound findings that best discriminated early or precocious puberty from other forms of sexual precocity were the presence of a midline endometrial echo, and a uterine length above the 97th centile for age. An entirely normal pelvic ultrasound at presentation did not rule out the possibility of precocious puberty.
Playground accidents
Authors: Mayrx J , Russe O , Spitzer P , Mayr–Koci M , Hollwarth ME
Published: January 2008

To study the causes and sequelae of playground accidents we analysed, in a retrospective study, 374 playground accidents. Questionnaires were sent to the parents and 103 parents (28%) provided detailed information on the playground accidents of their children. Thirty–one percent of the children injured in playground accidents sustained fractures of the extremities or concussion of the brain. Swings, slides, climbing frames, metal bars and merry–go–round accidents accounted for 71% of the 338 playground equipment–related accidents, whereas 36 accidents (10%) occurred without the use of playground equipment. The majority of these accidents were caused by children fighting. Rope–plank–type swings were frequently involved in backward falling accidents and 86% of the slide accidents were fall accidents. Climbing frames should not be taller than 1.6 m. Further efforts are mandatory to create and maintain playgrounds which help children develop their skills with a minimal risk to injury.
Multiple brain abscesses in a premature infant: complication of Staphylococcus aureus sepsis
Authors: Regev RH , Dolfin TZ , Zamir C
Published: January 2008

eport a premature infant with Staphylococcus aureus sepsis, most probably originating from an infected peripheral iv site, and complicated by multiple brain abscesses. Diagnosis was made by cranial ultrasonography and computed tomography. Since systemic antibiotic treatment failed, surgical drainage was performed. The same organism that caused the initial sepsis grew from the pyogenic material obtained. The child is currently severely handicapped.
Neonatal nosocomial respiratory infection with coronavirus: a prospective study in a neonatal intensive care unit
Authors: Sizun J , Soupre D , Legrand MC , Giroux JD , Rubio S , Cauvin JM , Chastel C , Mix D , Parscau L de
Published: January 2008

The aim of this prospective study was to evaluate the incidence of viral respiratory infection in hospitalized premature newborn infants and to assess the role of coronaviruses. All hospitalized premature infants with a gestational age less than or equal to 32 weeks were included. Tracheal or nasopharyngal specimens were studied by immunofluorescence for coronaviruses, respiratory syncytial virus, adenoviruses, influenza and parainfluenza viruses. Forty premature infants were included; 13 samples were positive in 10 newborns (coronaviruses n = 10; influenza 1 n= 2; adenovirus n= 1). None was positive at admission. All premature infants infected with coronaviruses had symptoms of bradycardia, apnea, hypoxemia, fever or abdominal distension. Chest X‐ray revealed diffuse infiltrates in two cases. However, no significant difference was observed between infected and non‐infected premature infants for gestational age, birth weight, duration of ventilation, age at discharge, incidence of apnea or bradycardia. Nosocomial respiratory tract infection with coronaviruses appears to be frequent. The clinical consequences should be evaluated in a larger population.
Effects of long‐term growth hormone releasing hormone 1 ‐29 in significantly short children
Authors: Grunt JA , Schwartz ID , Buchanan C , Howard CP
Published: January 2008

Seven children with significant idiopathic short stature (SISS) whose heights were significantly below the third percentile (SD score for height —2.5 to —3.5) and who had normal levels of growth hormone (GH) were treated with growth hormone releasing hormone (GH‐RH) in a dose of 30 /μg/kg/day. Therapy was discontinued if patients failed to increase their rates of growth by more than 2.0 cm/year over their pre‐therapy growth rate. Treatment was discontinued in two of the patients after 12 months but was continued in the other five for 24 months. These data demonstrate that some patients with SISS grow well during the first 2 years of treatment with GH‐RH.
Physical and mental development in 4‐6‐year‐old triplets
Authors: Akerman B Alin , Hovmoller M , Radestad A , Thomassen PA
Published: January 2008

A total of 21 families with complete sets of triplets, born within 200 km of Stockholm, were invited to participate in a follow‐up study with the aim of assessing the physical and mental development of their triplets at 4‐6 years of age. Four families declined to participate in the study and thus the study group consisted of 17 sets of triplets who were born at 33‐36 gestational weeks from 1986 to 1989. Mean birth weight was 2104g (range 1310‐2670g) for the boys and 1882g (range 1290‐2590g) for the girls. At birth, none of the 51 triplets showed any malformations. No asphyxia or other major complications were noted to have occurred at delivery. The children were examined in their homes with a neurological examination and the Griffiths mental development scales (GMDS). No major physical disabilities were found. In a group of triplets born small for dates, the total GMDS score and most of the subscale scores were significantly lower than for their siblings. In contrast to what has been found in singletons and twins, the differences in mental development between triplet boys and girls were not significant. On the whole, physical and mental development did not differ from what has been found in twins and singletons of the same age and with the same birth weight.
Low humoral responses to hepatitis C virus among pediatric renal transplant recipients
Authors: Kudo T , Morishima T , Shibata M , Miwata H , Matsushima M , Tsuzuki K
Published: January 2008

Immunosuppressed patients infected with hepatitis C virus (HCV) are known to have a low prevalence of antibodies to the virus. We examined 12 HCV‐infected renal transplant recipients and 18 immunocompetent patients in terms of viral markers. The renal patients had a lower prevalence of anti‐C100‐3 antibodies and lower titers of anti‐p22 than the immunocompetents. Low titers of the antibodies seemed to be characteristic of HCV, because titers of anti‐mumps and anti‐cytomegalovirus antibodies were the same or even increased. Quantitation of HCV RNA showed approximately 200‐fold more copies of mean HCV RNA in the sera of the kidney patients than in the immunocompetents. This indicates that the low humoral responsiveness to HCV is not due to the lower concentration of the virus. Immunosuppressive conditions seemed to suppress anti‐HCV production with greater magnitude than other viral antibodies.
Percutaneous central iv access in the neonate: experience with 535 silastic catheters
Authors: Neubauer A‐P
Published: January 2008

We examined 535 central venous catheterizations performed in a neonatal intensive care unit. A total of 273 catheters were positioned using intra‐atrial ECG monitoring. With an average indwelling time of 23 days, we noted one complication for every 153 indwelling catheter days. A diagnosis of sepsis was confirmed on 22 occasions (4.1 %). Sepsis occurred more often in infants with a birth weight < 1000 g (6.9%) compared with infants 1000g (3.1%). The risk of phlebitis was highest when the saphenous vein was used as the puncture site. The lowest risk of phlebitis was when the basilic vein was chosen. Five cases of thrombosis, two of myocardial perforation and one intravascular catheter breakage were registered. Catheter placement under ECG monitoring proved to be a very suitable method for reducing the incidence of malpositioning. There were no side effects specific to the ECG method. The ECG method can be used safely and makes radiological control usually unnecessary. Central venous catheters, newborn infant, parenteral nutrition, silicone catheters
Localized proton magnetic resonance spectroscopy of cerebral abnormalities in children with carbohydrate‐deficient glycoprotein syndrome
Authors: Holzbach U , Hanefeld F , Helms G , Hanicke W , Frahm J
Published: January 2008

Morphologic and metabolic abnormalities in six children aged 2‐9 years with carbohydrate‐deficient glycoprotein (CDG) syndrome were assessed by magnetic resonance imaging (MRI) and localized proton magnetic resonance spectroscopy (MRS). In all patients, MRI revealed pronounced cerebellar atrophy. Follow‐up examinations in two patients suggested early onset and rapid progression in the first years of life. Further pathologies comprised Dandy‐Walker malformation, atrophy of the pons, brain stem and olives, supratentorial frontotemporal cortical atrophy, slightly dilated ventricles and a small corpus callosum. Two patients presented with small cysts in the white matter. The prominent metabolic abnormality detected by proton MRS in five patients was a reduction in N‐acetylaspartate in white matter by more than 20%, indicating loss of vital neuroaxonal tissue. Further findings in white matter were glutamine and 7‐aminobutyrate increases by a factor of 2. One patient with type III CDG syndrome showed the most severe alterations of metabolite concentrations. CDG syndrome, cerebellar atrophy, magnetic resonance imaging, proton magnetic resonance spectroscopy