bluuebunny/crossref_metadata_2025 huggingface dataset:
Congestive heart failure caused by vitamin D deficiency?
Authors: Brunvand L , Haga P , Tangsrud SE , Haug E
Published: January 2008

We describe a child, 3.5 months old, with severe vitamin D deficiency, profound hypocalcaemia, hyperphosphataemia, dilated left ventricle, severely reduced myocardial contractility and congestive heart failure. She also had depressed thyroid function with subnormal thyroxine and non‐detectable serum thyrotropin (TSH) levels. The child promptly responded to calcium infusions, conventional anticongestive therapy and calcitriol. She is now 3 years old and received no medication. Myocardial function is normal but she has motor delay. We believe that her transitory congestive heart failure was caused by severe vitamin D deficiency with profound hypocalcaemia.
Active epilepsy in mentally retarded children. I. Prevalence and additional neuroimpairments
Authors: Steffenburg U , Hagberg G , Viggedal G , Kyllerman M
Published: January 2008

A population‐based study of active epilepsy was conducted in 6‐13‐year‐old mentally retarded children born between 1975 and 1986. The population at risk comprised 48 873 children. Ninety‐eight children were identified, 35 mildly and 63 severely retarded. The prevalence was 2.0 per 1000; 0.7 per 1000 for mildly and 1.3 per 1000 for severely retarded children. Sixty‐nine children had at least one additional neuroimpairment. Cerebral palsy was found in 42 children with a majority of spastic/ dystonic tetraplegias; visual impairment was present in 24 and autism in 24. Thirty‐three children had only a mild or no gross motor disability and mild mental retardation, while 23 had IQs <20 and a very severe gross motor disability. This study underlines the fact that active epilepsy in mentally retarded children is often associated with additional neuroimpairments, especially a combination of severe cerebral palsy and severe visual impairment.Children, epilepsy, mental retardation, neuroimpairments, prevalence
Active epilepsy in mentally retarded children. II. Etiology and reduced pre– and perinatal optimality
Authors: Steffenburg U , Hagberg G , Kyllerman M
Published: January 2008

A population–based study of active epilepsy in mentally retarded children identified 98 children, 6–13 years old. A biopathological origin was established in 66% of mildly and 92% of severely retarded children: a prenatal etiology was considered in 51 % and 57%, a perinatal in 9% and 19%, a postnatal in 6% andl6% and an untraceable etiology in 34% and 8%, respectively. Severe mental retardation was more frequent in the peri– and postnatal groups (80% and 83%) than in the prenatal and untraceable groups (67% and 29%). Thirty–four pre– and perinatal optimal items were defined. Children with a prenatal etiology did not differ from controls in any of the periods. Children with a perinatal etiology had, compared with controls, higher proportions of non–optimal items successively increasing through the pre– and perinatal periods showing the accumulation of negative events.Children, epilepsy, etiology, mental retardation, reduced optimality
The impact of lactation centres on breastfeeding patterns, morbidity and growth: a birth cohort study
Authors: Barros FC , Semer TC , Filho S Tonioli , Tomasi E , Victora CG
Published: January 2008

The influence of lactation centres on breastfeeding patterns, morbidity and nutritional status was assessed through a longitudinal study from birth up to the age of 6 months among 605 mothers and newborns in Guaruja, Sao Paulo, Brazil. Children recruited in the perinatal period who subsequently attended the lactation centres (54%) were exclusively breastfed significantly more at 4 months (43 versus 18%) and at 6 months of age (15 versus 6%), than non‐attenders, even after adjusting for confounders. Also, attenders presented less diarrhoea in the last fortnight than non‐attenders (10 versus 17%), and their weight for age was significantly better (mean z‐scores of 0.26 and 0.02, respectively). Lactation centres are effective in promoting breastfeeding, and their use in areas with short breastfeeding duration should be considered. This is the first report of a significant impact of a breastfeeding promotion programme on children's morbidity and growth.
High‐dose methotrexate causes short‐term suppression of growth in rabbits
Authors: Moëll C , Garwicz S
Published: January 2008

Bone growth in rabbits was measured using roentgen stereophotogrammetric analysis (RSA), a method for accurate measurement of the distance between metallic markers inserted into long bones. Injections of methotrexate (Mtx) were given to five rabbits and tibial growth was measured daily for 5 days. Im injections of Mtx lOOmg/kg body weight, followed by folinic acid “rescue” 48 h later, had no influence on growth. Intraperitoneal injection of Mtx 1000 mg/kg body weight resulted in a clear reduction in daily growth during the study period. The rabbits were given folinic acid “rescue” 24, 36 and 48 h after Mtx injection and showed no symptoms or signs of Mtx toxicity. Serum levels of Mtx, 3 days after the high‐dose injection, declined successively but were still measurable after 72 h. Using RSA, the short‐term influence of cytostatic drugs can be evaluated in an experimental setting. The effect of Mtx on growth in rabbits was discernible only at very high doses. Suppression of growth was moderate, appeared soon after injection of Mtx and was of moderate duration.
Fruit juice malabsorption: not only fructose
Authors: Hoekstra JH , Van Den Aker JHL , Hartemink R , Kneepkens CMF
Published: January 2008

Malabsorption of free fructose, when ingested in excess over glucose, is considered a significant factor in apple juice induced diarrhoea. Absorption of the carbohydrates in fruit juices was investigated by means of the hydrogen breath test in 15 healthy children aged 2.2‐6.4 years, consuming 15 ml kg’of each juice with a maximum of 375 ml. Incomplete absorption was found following the ingestion of apple juice (5/5), grape juice (10/10) and bilberry juice (8/10), although the last two contain equivalent concentrations of fructose and glucose. When the same tests were repeated after yeast treatment of the juices, which leads to major reductions in fructose and glucose contents, malabsorption was found to persist. No symptoms were observed following any of the tests. Our results suggest a significant role for other carbohydrates than fructose, possibly those originating from the fruit skin, with respect to fruit juice‐induced breath hydrogen excretion.
Electrophysiological assessment of brain function in severe malnutrition
Authors: Robinson S , Young RE , Golden MHN
Published: January 2008

Brain function in 10 severely malnourished children and matched controls was assessed using spectral analysis of electroencephalographic responses to photic driving during slow‐wave sleep. The percentage power in the classical EEG broad‐band domains was derived from temporo‐occipital records. The malnourished group (5‐23 months old; z‐score height‐for‐age –3.2 ± 0.3, weight‐for‐height –2.5 ± 0.3) were tested on admission and on discharge from hospital. No significant differences were found between admission and discharge. Significant differences were found between malnourished and control groups, in the α1 band in the undriven EEG, and in the α/β1 power ratio while driving at 8 Hz. These electrophysiological abnormalities, persisting despite somatic rehabilitation, must be associated with the chronic rather than the acute aspects of malnutrition, and can index the deviation of brain function from normality.
Chronic active Epstein‐Barr virus infection in children in Japan
Authors: Ishihara S , Okada S , Wakiguchi H , Kurashige T , Morishima T , Kawa‐Ha K
Published: January 2008

The patients with chronic active Epstein‐Barr virus infection (CAEBV) in childhood in Japan are described. Among 39 registered cases, 20 patients were males and 19 were females. Unlike the X‐linked lymphoproliferative syndrome, there was no hereditary background. The incidence of hypersensitivity to mosquito bites was high (31.3%) as a past history. Most patients exhibited hepatomegaly (92.3%), splenomegaly (87.2%) and fever (84.6%). The incidence of absent anti‐EB virus nuclear antigen titres was unexpectedly low (17.1%). Lymphoreticular disorders and cardiovascular diseases were major complications. Twenty‐four (61.5%) patients died 6 months to 8 years after the onset, mainly of hepatic failure (eight cases), cardiac failure (five cases), virus‐associated haemophagocytic syndrome (three cases) and haematological malignancies (two cases). This study reveals that CAEBV in Japan has several clinical features and should be informative for the pathogenesis of EB virus.
Postnatal development of the cerebral blood flow velocity response to changes in CO2 and mean arterial blood pressure in the piglet
Authors: Haaland K , Karlsson B , Skovlund E , Lagercrantz H , Thoresen M
Published: January 2008

Cerebral blood flow velocity was studied during changes (haemorrhage) in mean arterial blood pressure or PaCO2 in 56 (aged 0–26 days) anaesthetized and ventilated piglets. The CO2 reactivity increased with age from 6.5% kPa−’(< 1 day) to adult levels of 25% kPa−1 for piglets over 4 days old. The mean arterial blood pressure reactivity was reduced from 1.3% mmHg−1 (< 1 day old) to 0.0%/ mmHg (> 4 days old). The reactivities were similar with two different anesthetics: chloralose/urethane or pentobarbital. To validate the cerebral blood flow velocity data, both electromagnetic flow and precerebral Doppler ultrasound velocity were recorded from the same common carotid artery with extracranial branches tied off. There were no differences between the results with these two methods nor between these results and those obtained when the cerebral blood flow velocities were recorded from an intracerebral artery and the electromagnetic flowmeter recorded from the carotid artery. The vessel diameter appears stable during these interventions. In conclusion, the autoregulatory response and the reaction to PaCO2 appear poorly developed in the newborn piglet, but rapidly mature during the first 4 days of life.
Iatrogenic radiant heat burns in severely asphyxic newborns
Authors: Simonsen K , Græm N , Rothman LP , Degn H
Published: January 2008

We report two cases of newborns who developed second‐degree burns following resuscitation under infra‐red heating lamps. Both infants were asphyxic and suffered from insufficient peripheral circulation which, combined with the long duration of the exposure to the light, contributed to the development of the lesions. Both infants died shortly after birth for reasons other than the burns.
Feasibility and accuracy of a fiberoptic catheter for measurement of venous oxygen saturation in newborn infants
Authors: van der Hoeven MAHBM , Maertzdorf WJ , Blanco CE
Published: January 2008

The current parameters of oxygenation, arterial oxygen saturation and arterial oxygen pressure represent the availability of oxygen to the tissues. Venous oxygen saturation reflects oxygen extraction and could be a more useful indicator of tissue oxygenation. Therefore, we tested the feasibility and accuracy of a fiberoptic catheter, inserted into the right atrium via the umbilical vein, to measure venous oxygen saturation continuously. In 24 of 36 (67%) infants the catheter could be placed into the right atrium. Blood samples were withdrawn through the catheter, analyzed with a hemoximeter and compared with simultaneously recorded oximeter values. The fiberoptic catheter readings correlated significantly with hemoximeter values and the mean difference of the 116 paired samples was −0.37%. We conclude that the success rate and complications of the fiberoptic catheter were similar to previously published results. The oxygen saturation readings accurately represented oxygen saturation in the right atrium in newborn infants.
Serum interleukin‐2 receptor in infants and young children
Authors: Chan KN , Phillips AD , Walker‐Smith JA , MacDonald TT
Published: January 2008

Soluble interleukin‐2 receptor (IL‐2R) concentrations were measured in 110 serum samples from 102 children undergoing routine small bowel biopsy for a wide range of gastrointestinal symptoms. Young children in the control group who had no gastrointestinal disease and a normal intestinal mucosa were found to have high concentrations of IL‐2R. There was a significant inverse relationship between IL‐2R concentration and age in the control group. Children with a gastrointestinal diagnosis appeared to have increased IL‐2R concentrations, although some of the diagnostic groups were too small in size for statistical analysis. Children with cow's milk sensitive enteropathy had IL‐2R concentrations equivalent to those of age‐matched controls. High concentrations of IL‐2R in young healthy children implies that serum IL‐2R is of no clinical use as an index of inflammation in this age group.
Risk factors for development of dehydration in young children with acute watery diarrhoea: a case‐control study
Authors: Bhattacharya SK , Bhattacharya MK , Manna B , Dutta D , Deb A , Dutta P , Goswami AG , Dutta A , Sarkar S , Mukhopadhaya A , Krishnan T , Naik TN , Nair GB
Published: January 2008

In a case‐control study to understand the risk factors for development of life‐threatening dehydration, a total of 379 children comprising 243 cases (moderate or severe dehydration) and 136 controls (non or mild dehydration) up to 2 years of age suffering from acute watery diarrhoea were studied. By univariate analysis, the presence of vibrios in stool, withdrawal of breast feeding during diarrhoea, not giving fluids, including oral rehydration solution (ORS), during diarrhoea, frequent purging (> 8/ day), vomiting (> 2/day) and undernutrition were identified as risk factors. However, by multivariate analysis after controlling for confounders, withdrawal of breast feeding during diarrhoea (odds ratio (OR) = 6.8, p < 0.00001) and not giving ORS during diarrhoea (OR = 2.1, p < 0.006) were identified as significant risk factors. The confounding variables which also contributed significantly to increasing the risk were age (≤ 12 months; OR = 2.7, p = 0.001), frequent purging (> 8/day; OR = 4.1, p < 0.00001), vomiting (> 2/day; OR = 2.4, p = 0.001) and severe undernutrition (%median <60 weight‐for‐age of Indian Academy of Paediatrics classification; OR = 3.1, p= 0.001). We feel that these findings will be useful for Global and National Diarrhoeal Diseases Control Programmes for formulating intervention strategies for preventing death due to diarrhoeal dehydration.
S cases have increased levels of interleukin‐6 in cerebrospinal fluid
Authors: Vege Å , Rognum TO , Scott H , Aasen AO , Saugstad OD
Published: January 2008

Cerebrospinal fluid (CSF) from 20 infants who died of sudden infant death syndrome (SIDS), 7 cases of infectious death and 5 cases of violent death were examined with respect to concentrations of interleukin‐6 (IL‐6). The measurements were performed by ELISA. IL‐6 levels in SIDS were significantly lower than in infectious death (p < 0.02), but significantly higher than in violent death (p < 0.02). Since IL‐6 plays an important role in immune responses and may induce fever, the findings may suggest that immune activation plays a role in SIDS. The presence of cytokines in the central nervous system (CNS) may cause respiratory depression, especially in vulnerable infants.
Total body irradiation: a neuropsychological risk factor in pediatric bone marrow transplant recipients
Authors: Smedler A‐C , Nilsson C , Bolme P
Published: January 2008

Bone marrow transplantation (BMT) involves conditioning with cyclophosphamide and, for leukemic patients, total body irradiation (TBI). Based on the concern that this may lead to later neuropsychological impairment in children, a longitudinal study was conducted. Thirty pediatric bone marrow transplant recipients, treated for leukemia or severe aplastic anemia (SAA), and their sibling donors, were given a neuropsychological examination in 1986 and 1988. A third follow‐up study of patients treated before 12 years of age was undertaken in 1990‐91. We present longitudinal data on patients treated with BMT when 3‐11 (n= 15) and 12‐17 (n= 11) years old. No neuropsychological deficits were found in the older group, or among non‐irradiated SAA patients. In the first follow‐up, children treated with BMT, including TBI at 3‐11 years of age, performed less well than donors on tasks involving perceptual and fine‐motor speed. In the second follow‐up, this group of patients also demonstrated a slight deficit in non‐verbal problem solving. An additional relative decline in verbal reasoning was noted in the third follow‐up, 5.5‐10 years after treatment. Alertness to signs of developmental difficulties in children treated with BMT, including TBI, is recommended.
The child group used as a reference system when analysing frequency of morbidity in day–care centres
Authors: Sennerstam R
Published: January 2008

Morbidity frequency was analysed among children attending six day–care centres in a suburb of Stockholm, Sweden. Absence due to illness was calculated annually for each child and correlated with each child's own group. Thus a child was classified as “often sick” or “mainly healthy” in relation to the other children in the child's own group, constituting a reference system. In almost every group a “sick third” was found, whose absence due to illness was twice that of the rest of the group. Children from families of lower social standing, those with a relatively large number of siblings and those living in poor social conditions were found to be among those most often reported as sick. In such families, smoking was more commonplace. These parents more often lived in a rented apartment than in a single detached owner house. Multiple linear regression analysis revealed that young mothers and children with several siblings had the strongest correlation with absence due to illness of the proband child. Increasing maternal age revealed improvement vis–a–vis all socioeconomic parameters investigated, reflecting an improvement in standing correlated to less sick children.
Brain lactate in preterm and growth–retarded neonates
Authors: Leth H , Toft PB , Pryds O , Peitersen B , Lou HC , Henriksen O
Published: January 2008

Glucose is the predominant cerebral energy source under physiological conditions, although other substrates may support cerebral metabolism. The present study was undertaken to determine if lactate is present in the immature human brain, and if so, whether or not concentrations of lactate differ between small–for–gestational–age and appropriate–for–gestational–age infants. Thirty stable, healthy infants with normal brains were investigated. As the only nutrient, all received milk enterally prior to the investigation, which was carried out without sedation. Mean gestational age was 35 completed weeks (range 28–41 weeks) and mean birth weight was 2170g (range 855–4100 g). Proton nuclear magnetic resonance spectra from the striatal region were obtained while the infants were sleeping quietly. Lactate was present in all 10 preterm small–for–gestational–age and 10 of 13 preterm appropriate–for–gestational–age infants, and the concentration was inversely related to postmenstrual age (p < 0.002). In addition, lactate increased with the degree of growth retardation (p < 0.01). At present the significance of lactate is unclear. Lactate may be produced locally or in peripheral tissues, and may support brain metabolism.
Polyunsaturated fatty acids in erythrocyte and plasma lipids of children with severe protein–energy malnutrition
Authors: Leichsenring M , Siitterlin N , Less S , Bäumann K , Anninos A , Becker K
Published: January 2008

The fatty acid composition of plasma cholesterol esters, plasma phospholipids, erythrocyte phosphatidylcholine and erythrocyte phosphatidylethanolamine was investigated in severely malnourished Nigerian children with kwashiorkor (n = 12) and marasmus (n = 32). Normally nourished children from the same area (n = 23) served as controls. The malnourished children showed a significant reduction of highly polyunsaturated fatty acids in cholesterol esters, phospholipids and phosphatidylcholine. No differences between the groups were found in erythrocyte phosphatidylethanolamine. Children with kwashiorkor had lower levels of linoleic acid metabolites and docosahexaenoic acid than marasmic children. The results suggest that the kwashiorkor syndrome is associated with impaired desaturation and elongation of PUFA and/or increased lipid peroxidation.
Pelvic ultrasound measurements in normal girls
Authors: Griffin IJ , Cole TJ , Duncan KA , Hollman AS , Donaldson MDC
Published: January 2008

Pelvic ultrasound scans were carried out in 153 normal girls aged between 3 days and 14.9 years, in order to obtain reference data for ovarian volume, uterine length and uterine configuration. The right ovary was significantly larger than the left (by about 17%). Ovarian volume increased exponentially with age, over this age range. No relationship with pubertal stage (independent of age) could be demonstrated. Uterine length decreased from birth to 4 years, before steadily increasing. The fundalcervical ratio (FCR) decreased initially then increased to lie above 1.0 by 15 years of age. A midline endometrial echo was seen in half of the subjects aged less than 6 months, but otherwise it was not seen before 11.8 years of age or at Tanner stage B2. Smoothed reference centile curves for uterine length, right and left ovarian volume were produced, allowing z scores (or SD scores) to be calculated for each measurement.
Final height of girls with Turner's syndrome: correlation with karyotype and parental height
Authors: Cohen A , Kauli R , Pertzelan A , Lavagetto A , Roitman Y , Romano C , Laron Z
Published: January 2008

Final height of 75 adults with Turner's syndrome (45 Israeli, 30 Italian), never treated with GH, was examined to see if a relationship with karyotype patterns and parental height existed. Patients were divided into five groups according to their chromosome pattern, as follows: group A = 45,X karyotype (34 patients); group B = mosaicism (11 with karyotype 45,X/46,XX and 7 with karyotype 45,X/ 46,XY); group C = deletion of all or part of Xp (19 patients); subgroup CI = 6 with complete deletion of Xp; subgroup C2 = 9 with mosaicism 45,X/46,X,i(Xq); subgroup C3 = 4 with 45,X/46,X,ring(X); group D = deletion of Xq (4 patients); pure gonadal dysgenesis (PGD) group = 9 patients with pure 46,XX gonadal dysgenesis. No statistical difference was noted between the mean height of the two national populations studied (Italian 142.2 ±5.7 and Israeli 143.0 ±7.2 cm). The mean heights of group D (148.9 cm; range 147–166.2) and the PGD group (156.0 cm; 141–171.5) were found to be significantly higher than those observed in groups A, B and C (p <0.03, p < 0.02 and p <0.02, respectively), even though gonadal distinction existed in all five groups. Subgroup CI, where a deletion of the entire Xp segment [46,X,i(Xq)] was present, was found to be the shortest group (median height 134.5; range 131.9–138 cm). No fixed pattern of correlation between final height and parental height was found within any of the groups studied but if we consider the mean final height of all Turner patients studied, without division into groups, it correlates well, but only with mothers’height and not with fathers’height. These data provide further confirmation that short stature in Turner's syndrome is multifactorial and depends on the deletion of the distal portion of the short arm of chromosome X, on the lack of sex hormone secretion and, in part, on parental height.
Ascorbic acid during cerebral ischemia in newborn piglets
Authors: Oriot D , Beharry K , Gordon JB , Aranda JV
Published: January 2008

We measured ascorbic acid (reduced and oxidized) in brain, CSF and blood, before, during and after cerebral ischemia in newborn piglets. Bilateral carotid ligation induced a 54% decrease in cerebral blood flow (p < 0.01) and a 43% decrease in the cerebral metabolic rate of oxygen (p < 0.01). After ischemia and reperfusion, we obtained a 60% decrease (p < 0.01) in total brain ascorbic acid content. CSF ascorbic acid increased during reperfusion:+60% at 30min (p < 0.001) and +160% at 120min (p < 0.05). Blood ascorbic acid content did not change. These changes and the absence of massive oxidation of ascorbic acid in brain tissue suggest release of ascorbic acid by the brain during ischemia.
High prevalence of undiagnosed coeliae disease in 5280 Italian students screened by antigliadin antibodies
Authors: Catassi C , Rätsch IM , Fabiani E , Ricci S , Bordicchia F , Pierdomenico R , Giorgi PL
Published: January 2008

Many cases of coeliae disease are currently undiagnosed. We carried out a pilot study on screening for coeliae disease in a school population. The screening protocol consisted of three parts: (1) IgG and IgA antigliadin antibody (AGA) assay; (2) antiendomysium antibody and total serum IgA determinations; (3) jejunal biopsy. A total of 5280 students aged 11‐15 years (71.7% of the eligible population) underwent the first evaluation; 113 subjects performed the second tests and 35 of these needed the third investigation. Coeliae disease was diagnosed in 23 cases, most of which were atypical or silent forms. The prevalence of undiagnosed coeliae disease was 4.36 per 1000 screened subjects (95% CI 2.58‐6.14) and 5.03 per 1000 (95% CI 3.41‐6.65) in the general population. The ratio of known to undiagnosed cases was 1 to 6.4. This high prevalence of undiagnosed coeliae disease raises a number of problems that require further evaluation.
Positioning improves the oral and pharyngeal swallowing function in children with cerebral palsy
Authors: Larnert G , Ekberg O
Published: January 2008

Many children with cerebral palsy have feeding difficulties. The aim of this study was to investigate if trunk and neck positioning influenced oral and pharyngeal swallow. Five children with feeding problem aged 3‐10 years with cerebral palsy were examined using videofluoroscopy. All children had tetraplegia with dystonia, i.e. poor head control and poor trunk stability. All children had gross aspiration and posterior oral leak. The pharyngeal phase was delayed in relation to the oral phase. Two children had pharyngeal retention. The children were positioned with both an extended and flexed neck. The flexed neck position was combined with a 30o reclined sitting position. In both positions they were given puree with barium and liquid barium during video recording. In the reclined position with the neck flexed, aspiration decreased in all five children, oral leak diminished in two children and retention improved in one child.
Muscular dystrophy misdiagnosed as hepatic disease in a child with coeliac disease
Authors: Stenhammar L , Klintberg B , Tevebring J , Henriksson KG
Published: January 2008

A 13‐month‐old boy presented with elevated serum aminotransferases and a flat small bowel mucosa indicating coeliac disease. He improved clinically on a gluten‐free diet but serum aminotransferases continued to increase. This was found to be caused by an occult Duchenne muscular dystrophy. The case illustrates the fact that the finding of elevated serum aminotransferases in a coeliac child on a gluten‐free diet should indicate that further investigations are needed to exclude coexisting disease.
Growth, fatty acid composition of plasma lipid classes, and plasma retinol and a‐tocopherol concentrations in full‐term infants fed formula enriched with Zω‐6 and u‐3 long‐chain polyunsaturated fatty acids
Authors: Decsi T , Koletzko B
Published: January 2008

Full‐term infants fed formula without dietary long‐chain polyunsaturated fatty acids (LCF) exhibit significantly lower plasma LCP values than breast‐fed infants. We studied prospectively two groups of healthy full‐term infants fed conventional infant formula without LCP (F, n = 10) or the same formula enriched with both ω‐6 and ω‐3 LCP (LCP‐F, n = 12). Anthropometric data were obtained and fatty acid (FA) compositions of plasma phospholipids, triglycerides and sterol esters as well as plasma retinol and α‐tocopherol concentrations were determined at 5 days and 1, 2, 3 and 4 months of age. Gains in weight, length and head circumference did not differ between the two groups throughout the study period. Plasma FA values did not differ at 5 days of age. Between 1 and 4 months of age, plasma phospholipids of infants fed LCP‐F consistently had significantly (p < 0.05) higher percentages of arachidonic acid (1 month: 9.7 (0.8) versus 7.0 (1.3) %wt/wt, 4 months: 8.7 (0.5) versus 6.6 (1.0) %wt/ wt, median (interquartile range), LCP‐F versus F) and docosahexaenoic acid (1 month: 2.9 (0.5) versus 1.6 (0.3) %wt/wt; 4 months: 2.9 (0.4) versus 0.9 (0.3) % wt/wt). Plasma retinol and a‐tocopherol concentrations did not differ between the two groups throughout the study. We conclude that this form of LCP enrichment of formula for full‐term infants effectively enhances plasma LCP contents without detectable adverse effects. The potential effects on functional outcome need to be studied carefully in prospective clinical trials. Growth, infant formula, infant nutrition, long‐chain polyunsaturated fatty acids, retinol, α‐tocopherol
Healthy eating for infants–mothers’actions
Authors: Stordy BJ , Redfern AM , Morgan Jane B
Published: January 2008

Stordy BJ, Redfern AM, Morgan JB, Healthy eating for infants–mothers’actions. Acta Paediatr 1995;84:733‐41. Stockholm. ISSN 0803‐5253

The aim of this study was to analyse the nutrient composition, with respect to energy density, protein, fat, carbohydrate, non‐starch polysaccharides and certain micronutrients, of home‐prepared infant foods and to compare the nutrient composition with the draft European Commission directive for baby foods, the published nutrient content of manufactured baby foods, and with breast milk. Two hundred and sixty‐five samples of home‐prepared weaning foods for infants aged 3‐12 months were collected and chemically analysed. Many of the food samples were low in energy, protein, fat, iron, calcium and zinc and high in non‐starch polysaccharides and sodium. Home‐prepared weaning foods have some shortcomings in terms of nutrient composition. Advice from health care professionals needs to focus on these areas at the same time as presenting the nutritional merits of manufactured baby foods. Baby food, infant feeding, infant food composition
Alanine‐ and glucose‐based hypo‐osmolar oral rehydration solution in infants with persistent diarrhoea: a controlled trial
Authors: Sarker SA , Majid N , Mahalanabis D
Published: January 2008

To evaluate the efficacy of a hypo‐osmolar and a standard (World Health Organization) oral rehydration salt (ORS) solution in persistent diarrhoea, a randomized controlled clinical trial was conducted in 55 children. After a 1‐day observation period the children were assigned to one of three solutions: standard ORS (WHO‐ORS) (osmolality 311 mosmol/1), hypo‐osmolar ORS containing L‐alanine and glucose (osmolality 255 mosmol/1) and iv polyelectrolyte solutions (osmolality 293 mosmol/1) for ongoing replacement of stool loss for the next 4 days. Excellent acceptability of ORS (101‐160 ml/kg body weight/day) by the children was observed. There were no significant differences in the total intake of solutions and food, and frequency of stools among the groups Stool outputs were significantly less in infants receiving hypo‐osmolar ORS than in those receiving WHO‐ORS for 0‐24h (p= 0.04), 0‐48h (p= 0.01), 0‐72h (p= 0.04) and 0‐96h (p= 0.03). The results indicate a sufficient scope of ORS practice in persistent diarrhoea. Furthermore, we found that a hypo‐osmolar ORS containing L‐alanine and glucose is as efficacious as an iv solution and more effective than WHO‐ORS for replacement of ongoing stool loss in persistent diarrhoea. Alanine‐glucose ORS, hypo‐osmolar solution, oral rehydration solution, persistent diarrhoea
Gangliosides in children with autism
Authors: Lekman A , Skjeldal O , Sponheim E , Svennerholm L
Published: January 2008

Concentrations of the four major brain gangliosides, GM1, GDla, GDlb and GTlb, biochemical markers of neuronal membranes, were determined in the cerebrospinal fluid (CSF) of 20 children with autism and in 25 controls. In addition, the gangliosides were determined in children with different forms of non‐progressive neurological disorders lacking clinical features of autism. GM1, GDla, GDlb and GTlb were significantly increased in patients with autism compared with age‐matched controls and children with non‐progressive neurological disorders. The gangliosides have previously been shown to have a function in synaptic transmission and increased synaptic activity leads to added release of gangliosides. Our finding of increased CSF levels of gangliosides in autism suggests increased synaptic activity in this disorder. Autism, gangliosides, mental retardation, neurological disorders, synaptic activity
Enhancement of erythropoiesis by erythropoietin, bovine protein and energy fortified mother's milk during anaemia of prematurity
Authors: Røemnestad A , Moe PJ , Breivik N
Published: January 2008

Twenty‐four premature infants, < 32 weeks gestational age, were randomly assigned in a double‐blind, placebo‐controlled trial to 6 weeks of treatment with either recombinant human erythropoietin (rHuEpo) 150 U/kg three times per week given sc (n= 12) or placebo (n = 12). The infants were fed a diet rich in protein (3.2 g/kg/ day) and energy (130 kcal/kg/day) based on their own mother's milk fortified with bovine protein together with moderate iron supplementation (4 mg/kg/day). During the treatment (rHuEpo versus placebo) significant differences in mean (±SD) reticulocyte count (4.8 ±1.2 versus 2.7±1.4%; P<0.01), mean packed red cell volume (PCV) (0.38 ± 0.03 versus 0.34 ± 0.04, p < 0.05) and mean haemoglobin concentration (12.6 ± 1.1 versus 11.5± 1.2 g/100 ml; p< 0.05) were found. Within the rHuEpo group, PCV and haemoglobin concentration remained unaltered from entry to 1 week after cessation of treatment whereas a significant decline was observed in the placebo group. No indications of iron deficiency were seen. We conclude that moderate doses of rHuEpo given to infants fed a diet rich in protein and energy are effective in ameliorating anaemia of prematurity. High iron supplementation does not seem to be essential for a significant erythropoietic response. No adverse effect attributable to rHuEpo was observed. Anaemia, erythropoietin, iron, prematurity, protein
Failure of cefotaxime treatment in two children with meningitis caused by highly penicillin‐resistant Streptococcus pneumoniae
Authors: Guibert M , Chahime H , Petit J , Odievre M , Labrune Ph
Published: January 2008

Two infants, aged 8.5 and 11 months, were admitted for meningitis caused by Streptococcus pneumoniae. Failure of cefotaxime led to the identification of highly penicillin‐G‐resistant strains. Minimum inhibitory concentrations (MICs) for penicillin were2 μg/ml, and cefotaxime MICs were 2 μg/ml. Both patients rapidly responded to a combination of iv imipenem and rifampicin. It is now mandatory to test in‐vitro susceptibilities of Streptococcus pneumoniae to penicillin G and other beta‐lactam agents when meningitis is diagnosed in infants. Antibiotics, meningitis, Streptococcus pneumoniae
Effect of the method of breast feeding on breast engorgement, mastitis and infantile colic
Authors: Evans K , Evans R , Simmer K
Published: January 2008

This exploratory study compared the effect of two methods of breast feeding on breast engorgement, mastitis, infantile colic and duration of breast feeding. An opportunity sample of subjects was assigned either to the experimental group (prolonged emptying of one breast at each feed) (n = 150) or to the control group (both breasts equally drained at each feed) in= 152) and both groups were followed prospectively to 6 months after delivery. The experimental group had a lower incidence of breast engorgement in the first week (61.4% versus 74.3%; p < 0.02) and colic over the first 6 months (12% versus 23.4%; p < 0.02). There was no significant difference between the two groups in the incidence of mastitis over 6 months and the length of breast feeding (16.510.3 weeks versus 17.510 weeks experimental versus control group). The majority of mothers in the experimental group (63%) felt it necessary to offer the second breast at the end of a feed to satisfy their infant's hunger. The “perceived insufficient milk supply syndrome” was the main reason given for cessation of breast feeding in both groups. This study provides data to advise nursing mothers about these two methods of breast feeding.Breast engorgement, breast feeding methods, foremilk, hindmilk, infantile colic, mastitis

K Evans, Department of Nursing (ward 4C), Flinders Medical Centre, Bedford Park, South Australia 5042, Australia
Bulging fontanelle after supplementation with 25 000 IU of vitamin A in infancy using immunization contacts
Authors: Baqui AH , Francisco A de , Arifeen SE , Siddique AK , Sack RB
Published: January 2008

To evaluate the safety of vitamin A supplementation in early infancy using DPT/OPV immunization contracts, a double‐blind, randomized, placebo‐controlled trial was conducted in Bangladesh. One hundred and sixty‐seven infants received three doses of either 25 000 IU of vitamin A or a placebo at about 6.5, 11.8 and 17.0 weeks of age. Trained physicians examined each of the infants on days 1, 2, 3 and 8 after supplementation. Nine infants (10.5%) supplemented with vitamin A had episodes of bulging of the fontanelle compared with two infants (2.5%) in the placebo group (p < 0.05). Twelve of the 14 episodes occurred in infants supplemented with vitamin A. Of these 12 episodes, none occurred with the first dose, 3 occurred with the second and 9 with the third dose. The higher incidence of bulging of the fontanelle in the vitamin A group relative to the placebo group and its temporal association with the vitamin A doses are suggestive of a causal association. The finding that increased numbers of vitamin A doses were associated with a higher probability of bulging of the fontanelle suggests a cumulative effect.Bulging fontanelle, clinical trial, safety, toxicity, vitamin A

AH Baqui, Urban MCH‐FP Extension Project, ICDDR.B, GPO Box 128, Dhaka 1000, Bangladesh
Role of amylase‐treated, energy‐dense liquid diet in the nutritional management of acute shigellosis in children: a controlled clinical trial
Authors: Rahman MM , Mazumder RN , AH M , Mahalanabis D
Published: January 2008

To evaluate if an energy‐dense porridge liquefied by amylase‐rich flour (ARF) from germinated wheat increased the calorie intake in children with acute shigellosis, we studied 66 children, aged 6‐35 months, in a randomized, controlled clinical trial. Children were randomized to receive either an energy‐dense porridge liquefied with ARF (group 1), a thick unaltered porridge (group 2) or a porridge diluted with water (group 3) to a similar viscosity as that in group 1. MeanSD calorie intakes (kJ/kg/ day) from the porridges were 280 113, 167100 and 15180 in groups 1, 2 and 3, respectively (p = 0.006, ANOVA). Total energy intakes (meanSD) from the study diet and other food sources were 469151, 377121 and 351look J/kg/day, respectively (p= 0.006, ANOVA). Intake of breast milk was similar in all groups. Using multiple regression analysis the effect of ARF‐treated energy‐dense porridge in increasing the calorie intake persisted after adjusting for a number of confounders, such as age of the child, isolation of Shigella dysenteriae type 1 and fever. The results of this study suggest that ARF‐treated porridge increases energy intake in infants and young children during acute shigellosis. This feeding approach may be useful in preventing malnutrition following dysentery due to shigellosis.Amylase, energy‐dense, energy intake, liquefied, shigellosis

D Mahalanabis, Clinical Sciences Division, International Centre for Diarrhoeal Disease Research, GPO Box 128, Dhaka 1000, Bangladesh
Adult height in women with early‐treated congenital adrenal hyperplasia (21‐hydroxylase type): relation to body mass index in earlier childhood
Authors: Yu ACM , Grant DB
Published: January 2008

To investigate if obesity, as judged by increased body mass index (BMI), during childhood is associated with impaired adult stature in patients with 21‐hydroxylase‐type congenital adrenal hyperplasia (CAH), a retrospective analysis was carried out on outpatient records of 30 girls with CAH who had reached adult height. Height SD score for age (HtSDS(ca)), HtSDS for bone age (HtSDS(ba)), BMI and steroid dosage in early childhood (3.2‐4.6 years) and later childhood (7.2‐9.1 years), were compared with adult HtSDS (HtSDS(adlt)), adult HtSDS less mid‐parental HtSDS (HtSDS(adlt) ‐ HtSDS(mp)), predicted adult height SDS (HtSDS(pdct)), adult height SDS less predicted adult HtSDS (HtSDS(adlt) ‐ HtSDS(pdct)) and age at menarche. Mean (SD) for HtSDS(adlt) was ‐1.13 (1.05), mean HtSDS(pdct) ‐0.12 (0.9) and mean age at menarche 13.5 (1.9) years. BMI in childhood was not correlated with HtSDS(adlt) but showed negative correlations with HtSDS(adlt) ‐ HtSDS(mp) (r = ‐0.43; p < 0.02) and HtSDS(adlt) ‐ HtSDS(pdct) (r ‐ 0.45; p < 0.02). BMI in later childhood showed negative correlations with HtSDS(adlt) ‐ HtSDS(pdct) (r = ‐0.61; p < 0.001) and age at menarche (r= ‐0.63; p < 0.001). We conclude that in girls with early‐treated CAH, a high BMI during early childhood is associated with loss of genetic height potential, and in later childhood with over‐prediction of adult height and early menarche.Adult stature, body mass index, congenital adrenal hyperplasia (21‐hydroxylase type), predicted adult height

DB Grant, Medical Unit, Institute of Child Health, Guilford Street, London WC1N 1EH, UK
Plasma growth hormone response to growth hormone‐releasing hexapeptide (GH‐RP‐6) in children with short stature
Authors: Pombo M , Barreiro J , Penalva A , Mallo F , Casanueva FF , Dieguez C
Published: January 2008

Eighteen children with short stature were evaluated for growth hormone (GH) reserve after pharmacological tests and a single iv injection of GH‐RP‐6. These children were divided into two groups: 10 were diagnosed as having idiopathic GH deficiency by classical stimulation tests (group A) and the remaining 8 (group B) were considered growth‐retarded children with normal GH secretion, following conventional stimulation, but reduced endogenous GH secretion. The results were compared with a group of 12 normal children. As a group, patients in group A showed a lower GH response to GH‐RP‐6, while patients in group B had a similar response as normal controls. However, on an individual basis, a considerable degree of overlapping in responses among the three groups was evident. These data indicate that, on an individual basis, GH‐RP‐6 testing is not of diagnostic value in children suspected of having idiopathic GH deficiency.GH deficiency, GH‐RP‐6, short stature

C Dieguez, PO Box 563, 15705 Santiago de Compostela, Spain
Isolated congenital tuberculosis otitis in a preterm infant
Authors: Ng PC , Hiu J , Fok TF , Nelson EAS , Cheung KL , Wong W
Published: January 2008

We report an unusual case of localized congenital tuberculosis otitis in a preterm infant. Unlike disseminated congenital cases, the manifestations of localized otitis are associated with a triad of signs: (i) regional lymphadenopathy in the absence of typical systemic features of tuberculosis; (ii) delayed onset of presentation; and (iii) refractory otitis unresponsive to conventional antimicrobial agents. The need for greater diligence in looking for neonatal tuberculosis is emphasized, especially in an ethnic or socioeconomic environment where the disease is prevalent.Congenital tuberculosis, otitis, preterm

PC Ng, Department of Paediatrics, Level 6, Clinical Sciences Building, Prince of Wales Hospital, Shatin, NT, Hong Kong
Hyperimmune cow colostrum reduces diarrhoea due to rotavirus: a double‐blind, controlled clinical trial
Authors: Mitra AK , Mahalanabis D , Ashraf H , Unicomb L , Eeckels R , Tzipori S
Published: January 2008

The therapeutic efficacy of hyperimmune bovine colostrum (HBC) from cows immunized with four serotypes of human rotavirus was evaluated in a double‐blind, randomized trial in 75 boys, aged 6‐24 months, infected with rotavirus diarrhoea. The treatment group received 100 ml of HBC three times a day for 3 consecutive days, while the controls received the same amount of bovine colostrum from unimmunized cows. The two groups were comparable at entry. Patients who received HBC had a significantly shorter duration of diarrhoea than the controls (median 56 versus 72 h (p < 0.001); confidence interval of median difference (CI) 8‐32 h). Total stool output (g/kg) between admission and cessation of diarrhoea was reduced by 29% in the HBC‐treated group compared with controls (median 205 versus 290g (p= 0.04); CI= 1‐154g). In 50% of the children in the study group, diarrhoea stopped by 48 h, whereas nearly 100% of the controls were still suffering from diarrhoea. No untoward effects were noted in either group. Colostrum from cows immunized with rotavirus antigen is clinically effective in reducing the duration and severity of childhood diarrhoea due to rotavirus.

Children, hyperimmune cow colostrum, rotavirus diarrhoea
Young child feeding in a rural area in the Red River delta, Vietnam
Authors: Hoa DP , Thanh HT , Höjer B , Persson Lå
Published: January 2008

Infant and young child feeding practices were investigated in a sample survey (1132 mothers) in a rural area in northern Vietnam. Pre‐lacteal feeding was almost universal. Mean duration of breast feeding was 17 months, but foods other than breast milk were introduced early. Only 50% of infants between 3 and 5 months of age were predominantly breast fed. The educational level of the mother was strongly associated with breast feeding duration, with illiterate mothers breast feeding the longest. Christian mothers breast fed for longer than non‐Christians. Very few were using feeding bottles at the time of the study, although formulas and bottles have recently been appearing on the local market. The breast feeding pattern described together with the rapidly changing social and economic situation in Vietnam could mean a risk of rapid decline in breast feeding.Breast feeding, complementaryfeeding; education, pre‐lacteal feeding, Vietnam
Bronchopleural fistula: successful selective bronchial occlusion with a Fogarty's catheter in a preterm infant
Authors: Mosca F , Lattanzio M , Colnaghi MR , Pugliese S
Published: January 2008

A preterm infant (26 weeks’gestation) mechanically ventilated for respiratory distress syndrome developed severe interstitial emphysema of the right lung with a bronchopleural fistula, pneumothorax and mediastinal shift. Selective occlusion of the right main bronchus with a Fogarty's catheter produced rapid improvement in the clinical condition and radiological features. Occlusion of the main bronchus in a newborn with a bronchopleural fistula and pulmonary interstitial emphysema is an easily performed manoeuvre that can be life‐saving.Bronchopleural fistula, neonatal respiratory distress syndrome, pulmonary interstitial emphysema, selective bronchial occlusion
Recurrent chest pain as the presenting manifestation of spinal meningioma
Authors: Marseglia GL , Savasta S , Ravelli A , Gaino TM , Burgio GR
Published: January 2008

We report the case of a 9‐year‐old boy with a spinal cord meningioma whose only manifestations were recurrent episodes of chest pain lasting for 2 years. This case shows that spinal cord meningioma should be considered among the possible causative factors of chronic chest pain in childhood.Chest pain, meningioma, spinal tumors