bluuebunny/crossref_metadata_2025 huggingface dataset:
Perinatal Mortality in a Saudi Maternity Hospital
Authors: SWAILEM A. R. , SERENIUS F. , EDRESSEE A. W. , OHLSSON A.
Published: January 2008

ABSTRACT. Perinatal mortality was analyzed in infants to mothers who delivered at the main Maternity hospital in Riyadh and who represented a large proportion of the obstetric population in the city. The crude perinatal mortality rate was 39.8 per 1000 births. The hirth weight‐specific mortality rates were compared with the corresponding Swedish rates. The ratio between the birth weight‐specific mortality rates in Riyad and Sweden increased from the lightest to the heaviest hirth weight category. Thus the perinatal mortality rate was 2.3 times higher in infants less than 1500 g, and 8.8 times higher in infants with birth weights of 3500 g and more. Similarly, the ratio between the gestational age‐specific mortality rates in Riyadh and Sweden increased with advancing gestational age. The perinatal mortality rate of infants less than 28 weeks was 1.6 times higher, and that of term infants 4.8 times higher than in Sweden. The findings indicated shortcomings in the obstetric services. The perinatal mortality rate of teenage mothers, who comprised 17 percent of the material, was 9.1 times the Swedish rate. Other risk groups were para 0 mothers and mothers with a previous infant loss.
Causes of Perinatal Death at a Saudi Maternity Hospital
Authors: SERENIUS F. , SWAILEM A. R. , EDRESSEE A. W. , OHLSSON A.
Published: January 2008

ABSTRACT. The time, cause and avoidahility of perinatal deaths were analyzed in infants who were delivered in the main Maternity hospital in Riyadh and who represented a large proportion of all births in the city. The crude perinatal mortality rate was 39.8 per 1000 births. Of all deaths 53 percent occurred either intrapartum or within 24 hours of birth. The mortality rate in this time period was 9 times higher, and the intrapartum mortality rate 16 times higher than the corresponding Swedish rates. The causes of death were classified according to Wigglesworth. Of all deaths, 37 percent were due to asphyxial conditions in labor, 32 percent to conditions associated with preterm birth, and 17 percent to malformations. The perinatal mortality rates caused by asphyxia, preterm birth and malformations were 14.7, 12.6 and 6.7 per 1000 births, respectively. 75 percent of infants who died from asphyxia were born at term, and nearly half of the preterm deaths were associated with severe asphyxia at birth. Avoidable factors were found in 74 percent of the deaths. The high rate of asphyxia indicated deficiences in the obstetric management and a high priority should be given to the strengthening of the obstetric service.
Maturity‐Onset Diabetes of the Young
Authors: HEIERVANG E. , FØLLING I. , SØVIK O. , SANDNES T. , MYRM/EL T. , MOEN T. , MYKING O.
Published: January 2008

ABSTRACT. A Norwegian family showed 20 cases of verified or suspected diabetes in 5 generations, 13 being females and 7 males. In 12 patients the diagnosis was established at 26 years of age or earlier. Fourteen patients were definitely non‐insulin‐dependent. A high frequency of severe diabetic ophthalmopathy was noted, five patients were blind, two had proliferative retinopathy, and one simplex retinopathy and cataract. Five patients from the last 3 generations were islet cell antibody negative and C‐peptide positive. In selected patients the serum insulin response to oral glucose was markedly reduced. HLA determinations in these patients showed absence of DR3 and DR4, and presence of DR2. The inheritance of diabetes in this family is compatible with an autosomal, dominant trait, and the majority of cases fulfilled the criteria of maturity‐onset diabetes of the young. The high frequency of severe ophthalmopathy underscores that this disease may have an unfavourable evolution.
First Description of “Indian Childhood Cirrhosis” in a Non‐Indian Infant in Europe
Authors: WEISS M. , MULLER‐HOCKER J. , WIEBECKE B. , BELOHRADSKY B. H.
Published: January 2008

ABSTRACT. The first female child of healthy German parents, breast‐fed for 5 weeks, developed progressive abdominal distension due to hepatosplenomegaly at the age of 7 months and died from acute liver failure 3 months later. Histology showed destruction of liver architecture with extreme hepatocellular copper storage, characteristic of “Indian childhood cirrhosis” (ICC). The family received drinking water from a well via copper pipes. The copper level of the water was extremely elevated (430 and 5 510 μg/1) so that exogenous copper intake during the first months of life may have induced the fatal liver disease, probably in association with an unproven genetic disposition. This is the first description of a case of ICC in a member of a non‐Indian family in Europe.
Prediction of the Development of Neonatal Jaundice by Increased Umbilical Cord Blood Bilirubin
Authors: KNUDSEN AAGE
Published: January 2008

ABSTRACT. Umbilical cord serum bilirubin concentration as a predictor of subsequent jaundice was studied in 291 newborns. It was possible to define subgroups of infants with significantly higher or lower risks of developing jaundice. If cord bilirubin was below 20 |imol/l, 2.9% became jaundiced as opposed to 85% if cord bilirubin was above 40 μmol/l. Furthermore, 57% of jaundiced infants with cord bilirubin above 40 nmol/1 required phototherapy, but only 9% if cord bilirubin was 40 μmol/1 or lower (p<0.003). Knowledge of infants at risk of developing jaundice allows simple bilirubin reducing methods to be implemented before jaundice is present and could influence a decision regarding early discharge from hospital. Since the ability of plasma to bind bilirubin in cord blood from jaundiced and non‐jaundiced infants showed no significant differences, the increased cord bilirubin among infants who later became jaundiced is presumably caused by increased fetal bilirubin production or decreased removal of bilirubin from the fetal circulation.
Epidemiologic Study of Neonatal Subcutaneous Gangrene Caused by Multi‐Resistant Staphylococcus aureus
Authors: WU SHI‐XIAO , TANG JUN
Published: January 2008

ABSTRACT. Forty‐five cases of neonatal subcutaneous gangrene were admitted between Nov. 1985 and Feb. 1987, with a mortality of 6.6%. This paper presents the first epidemiologic study of 20 cases of this disease caused by multi‐resistant Staphylococcus aureus. Eight of 20 cases were caused by an epidemic strain belonging to phage 29 (group I) and carrying 2.8, 3.3, 4.2 and 28.5–34.0 kb plasmid DNA. The restriction endonudease analysis confirmed that the plas‐mid DNA of approximately similar size in different isolates were identical or highly homologous. According to the results of an epidemiologic study the source of infection of one patient who died was her grandmother and the other one was her mother, so the family members can also be the source of neonatal infection caused by multi‐resistant S. aureus.
The Natural History of IgE Sensitisation and Atopic Disease in Early Childhood
Authors: VAN ASPEREN P. P. , KEMP A. S.
Published: January 2008

ABSTRACT. We have prospectively followed 57 children of atopic parents up to 5 years of age, documenting clinical atopic disease and allergen skin test reactions. The cumulative prevalences of the clinical features of atopic disease over the 5 years were: atopic dermatitis (58%), wheeze (49%), recurrent wheeze (33%), rhinitis (68%) and immediate food reactions (18%). Atopic dermatitis and immediate food reactions predominated in infancy (birth to 20 months) while wheezing was more prominent in later childhood (20 months to 5 years). Rhinitis was common in both infancy and childhood. IgE sensitisation to ingested allergens was prominent in early infancy and was usually transient. Inhaled allergen sensitisation occurred later in infancy and was generally permanent with wheal sizes tending to increase with age. There was a significant association between IgE sensitisation to ingested but not inhaled allergens and all atopic manifestations in infancy, with the exception of rhinitis. In contrast IgE sensitisation to inhaled allergens was associated with rhinitis and wheeze in later childhood. We found two clinical groups. One group, with only ingested allergen sensitisation had a high incidence of atopic dermatitis but low incidence of respiratory symptoms at 5 years of age. The other group, who developed evidence of IgE sensitisation to inhaled allergens, had a high incidence of rhinitis and wheeze but low incidence of atopic dermatitis at 5 years of age.
Allergic Diseases in Swedish School Children
Authors: ÅBERG N. , ENGSTRÖM I. , LINDBERG U.
Published: January 2008

ABSTRACT. The occurrence of allergic diseases in children was studied on the basis of a questionnaire sent to the parents of 20000 school children, 7, 10 and 14 years of age, in 3 parts of Sweden with different climatic conditions. The prevalence of asthma was 2.4%, allergic rhinocon‐junctivitis 7.4%, eczema 7.8% and total allergic diseases 16.9%. The prevalence of all diseases was significantly higher in the northern part of the country than in the southern parts. This geographic variation was not related to heredity, infant feeding pattern or known exposure variables other than the cold and dry climate. Parental history of allergic diseases increased the incidence in the offspring 2–9 times, with a pattern of symptom specificity and a cumulative effect of double parental history. Breast‐feeding postponed the onset of allergic disease only in children with double parental history.
Epilepsy and Mental Retardation Following Febrile Seizures In Childhood
Authors: WOLF SHELDON M. , FORSYTHE ALAN
Published: January 2008

ABSTRACT. In an unselected group of children who were seen following an initial febrile convulsion, the frequency of subsequent afebrile seizures was 3.5% and of mental retardation 1%. The most common afebrile seizure type was generalized major (86%). About 3/4 of the children who developed afebrile seizures did so by three years and all by five years following the initial febrile seizure. The children with afebrile seizures differed from those without afebrile seizures in the frequency of neonatal abnormality, family history of mental retardation, focal initial febrile convulsions, and delay in psychomotor milestones before the initial febrile seizure. Only about 1/3 of the children who developed afebrile seizures ever had a recurrent febrile convulsion and none had complex recurrent febrile seizures. Half the children with mental retardation had histories of delay in psychomotor milestones prior to the initial febrile seizure, and no child with mental retardation had any seizure longer than five minutes. The administration of daily phenobarbital did not reduce the frequency of epilepsy, in spite of a significant reduction in the incidence of recurrent febrile seizures. There remains no evidence that the prevention of recurrent febrile convulsions significantly decreases the frequency of afebrile seizures or mental retardation.
Population Surveillance of Congenital Malformations Possibilities and Limitations
Authors: KÄLLÉN BENGT
Published: January 2008

ABSTRACT. The paper discusses the possibility of detecting newly introduced teratogenic agents by a population surveillance of congenital malformations. In practice, only outbreaks of previously rare malformations or combinations of malformations can be detected by such systems. The most important aspect of malformation surveillance is therefore a detailed reporting of malformations whereas statistical techniques play a minor role. For ongoing surveillance, a high ascertainment level is less important than speed and amount of detail. For studies of longtime changes in malformation rates, ascertainment must be as complete as possible. Such changes have been identified repeatedly, but are usually explained by changes in diagnosis, ascertainment or population characteristics.
Selected Trace Elements and Proteins in Serum of Apparently Healthy Newborn Infants of Mothers Who Smoked during Pregnancy
Authors: AHLSTEN GUNNAR , TUVEMO TORSTEN , GEBRE‐MEDHIN MEHARI
Published: January 2008

ABSTRACT. The serum concentrations of selected trace elements and proteins in cord blood from 17 new‐bom infants whose mothers were habitual smokers were compared with values from 22 infants of non‐smoking mothers. All the mothers were healthy with normal pregnancies and deliveries. Cigarette smoke exposure was verified by determinations of nicotine, cotinine and thiocyanate concentrations in cord blood. Infants of smoking mothers had a slightly lower mean birth weight (3490±430 g) than control infants (3780±460 g). Infants of smokers had lower serum iron (p=0.05) and prealbumin (p≤0.05), but higher serum copper (p≤0.05) and ceruloplasmin (p≤0.01) levels than the controls. Infants of smoking mothers tended to have higher levels of the acute‐phase reactants alpha‐2‐macroglobulin and orosomucoid, but lower levels of albumin, transferrin and retinol‐binding‐protein, although differences were not statistically significant.
Metabolic Differences between AGA‐ and SGA‐lnfants of Very Low Birthweight.
Authors: BOEHM G. , SENGER H. , MÜLLER D. , BEYREISS K. , RÄIHÄ N. C. R.
Published: January 2008

ABSTRACT. Seven very low birthweight (VLBW) infants, small for gestational age (SGA), with moderate intrauterine growth retardation and 7 VLBW‐infants, appropriate for gestational age (AGA), fed breast milk fortified with 6 g freeze‐dried human milk per 100 ml were studied on the 8th, 21st and 42nd days of life. The protein intake on the study days varied between 2.68 and 3.61 g/kg/day in the SGA‐ and 2.69 and 3.75 g/kg/day in the AGA‐infants. Serum concentrations of total bile acids (BA) and the renal excretion of total nitrogen (TN) as well as alpha‐amino‐nitrogen (AAN) were measured in all infants on each study day. On the 8th day of life a mean protein intake of 3.2 g/kg/day resulted in higher serum concentrations of BA as well as in a higher renal excretion of TN and AAN in the SGA‐infants when compared to the AGA‐infants. On the 21st day of life these differences were smaller and only the serum concentration of BA and the renal excretion of AAN were still significantly higher in the SGA‐infants. On the 42nd day of life only the serum concentrations of total BA were elevated in the SGA‐infants when compared to that in the AGA‐infants. The observed metabolic differences between moderately SGA‐ and AGA‐infants related to protein and bile acid metabolism diminished during the first weeks of life. The present data suggest that when nutritional management of VLBW‐infants is planned, differences in metabolic capacities must be considered and protein intake should be increased with caution and in accordance to the individual metabolic situation of the infants during the first weeks of life.
Disability in Children with Myelomeningocele A Nordic Study
Authors: HAGELSTEEN J. H. , LAGERGREN J. , LIE H. R. , RASMUSSEN F. , BØRJESON M. C. , LAGERKVIST B. , MUTTILAINEN M. , TAUDORF K. , KÖHLER L.
Published: January 2008

ABSTRACT. This study was carried out to evaluate the medical impairments and disability among 527 children with myelomeningocele living in four Nordic countries. The information was extracted from questionnaires and data based on case records. The level of intellectual functioning was fairly high with 76% within normal range (IQ>90). Shunt operations were performed in 68% of the children and 1/3 had had four or more shunt revisions. Twenty‐three per cent walked without support. Bladder incontinence was found in 60% of the children whereas 4% were entirely continent. Intermittent catheterisation was used in 36% with higher frequency among girls (48%) than boys (24%). We found a higher incidence of bacteriuria among those who used catheterisation than among those who used manual compression. Bowel control was experienced by 112 (21%) of the children. The overall disability is classified according to Lorber's 5‐graded handicap scale and Lagergren's 3‐graded scale. According to Lagergren's scale, 70% suffered from severe overall disability.
Long‐term Quality of Life and Psychosocial Coping after Treatment of Solid Tumours in Childhood A Population‐Based Study of 94 Patients 11–28 Years after Their Diagnosis
Authors: MÄKIPERNAA ANNE
Published: January 2008

ABSTRACT. In order to assess the long‐term quality of life after childhood cancer, we examined and interviewed 94 survivors of childhood solid tumours (excluding brain tumours) diagnosed in our hospital between 1960 and 1976. Their follow‐up times ranged from 10.7 to 27.7 years, and their ages at the time of this study from 11.3 to 41.5 years. The subjects had a higher educational level than the Finnish general population. Fewer of the females and as many of the males were married as in the general population. Eight healthy men had been rejected for military service because of the history of cancer. An unsatisfied desire to know more about their own medical history was evident. According to our findings, some subjects after childhood solid tumour are at risk of developing emotional and social problems. However, the great majority of the survivors were well balanced psychologically, living a normal social life and showing adequate capacity to cope.
Valvuloplasty with Large Trefoil Balloons for the Treatment of Congenital Pulmonary Stenosis
Authors: THANOPOULOS B. D. , MARGETAKIS A. , PAPADOPOULOS G. , KEFALAKIS E. , ROKAS S.
Published: January 2008

ABSTRACT. Percutaneous balloon valvuloplasty was performed in 16 children, 1 1/2 to 14 years old, with congenital pulmonary stenosis with the use or trefoil balloons. These balloons, which consist of 3 identical angioplasty balloons, do not interrupt completely the blood flow during inflation. The size of the trefoil balloons used was 30 to 50 % larger than the valve anulus. A dual balloon technique employing a large trefoil and a smaller single balloon was used to obtain an effective pulmonary valvuloplasty in two patients with large valve anulus. The mean prevalvuloplasty systolic gradient of 78.2 28.9 mmHg (range 40 to 140 mmHg) was reduced to 20.3±5.7 (range 10 to 30 mmHg) after valvuloplasty. No patient developed significant hypotension or bradycardia or other complications as a result of the procedure. The findings demonstrate that percutaneous balloon valvuloplasty with oversized trefoil balloons effectively treated congenital pulmonary stenosis without complications in the cases studied. The use of large trefoil instead of single balloons of a similar diameter is advantageous since they cause no significant compromise of the cardiac output during valvuloplasty.
Congenital Chylothorax and Persistent Pulmonary Hypertension of the Neonate
Authors: CARMANT LIONEL , GUENNEC JEAN‐CLAUDE LE
Published: January 2008

ABSTRACT. In this case of congenital chylothorax, an associated persistent pulmonary hypertension was a severe complication which has not hitherto been described. Recurrence of the chylothorax with the introduction of regular formula is also reported.
Decreased Adherence of Polymorphonuclear Neutrophils in Children with Viral Infection
Authors: TOLONE C. , TORALDO R. , CATALANOTTI P. , IANNIELLO R. , D'AVANZO M. , GALDIERO F. , IAFUSCO F.
Published: January 2008

ABSTRACT. The adherence of polymorphonuclear neutrophils was examined in 16 children affected by enteritis, pneumonia, hepatitis and infectious mononucleosis. The results were compared with those obtained in 30 healthy adult volunteers and in 15 healthy children of the same age. Adhesiveness was significantly higher in adults than in healthy children, and significantly higher in healthy children than in children with viral infection. In 7 patients tested one month after regression of the disorder, PMN adhesiveness had returned to normal.
On the Construction of Cross‐Sectional Statistical Standards for Growth
Authors: CLEVELAND S. , FRYER J. G. , KARLBERG J.
Published: January 2008

ABSTRACT.Cross‐sectional growth studies generally produce standardizing groups which are too small to permit the direct construction of standards. This problem can he circumvented by the introduction of appropriate structural assumptions. The two key papers in the literature which focus on this issue, Healy (1962) and Goldstein (1972), give methodologies which involve somewhat different premises. Healy takes the ages of individuals to he uniformly distributed over a well‐defined interval (hut their precise levels unknown). Goldstein by comparison supposes age levels to he known exactly. Both authors postulate that the characteristic of interest follows a Gaussian density whose mean and variance are each linear functions of time,a+btandc+dt, say. In this paper we begin to explore the robustness of the two methods. Our results show that Healy's original moment solution to the estimation of (a, b, candd) may be quite insensitive to departures from a uniform distribution for ages provided that this distribution remains symmetric about the interval mid‐point. Moreover, the distribution of the characteristic of interest may deviate from the Gaussian without too much effect, provided that symmetry about the meana+btis retained. However, there is much more doubt about asymmetric departures in both cases especially with regard to the estimation ofbandd. Opting for simple‘interpolated’estimates of these two parameters (when possible) rather than Healy's original formula‐based versions will strongly aid robustness in general. Using some Icelandic cross‐sectional growth data referring to schoolchildren of age 7–10 years, we show that Goldstein's normality assumption can also have adverse effects if the actual distribution is somewhat skew. Transformation of the data to normality using the Box‐Cox power family is the route adopted here. A concomitant point well worth noting is that transformation to the Gaussian can he achieved using a constant variance target over surprisingly long time intervals.
Relating Growth Rate to Environmental Factors—Methodological Problems in the Study of Growth‐Infection interaction
Authors: COLE T. J.
Published: January 2008

ABSTRACT. The effect of infection on the growth of children under 2 was studied in a rural (Keneba, n= 176) and an urban (Bakau, n= 122) community in The Gambia, and in a Papua New Guinean village (PNG, n= 24). Weights taken every 4 to 6 weeks (n= 3929) were converted to weight velocities, and these were related to the intensity of infection (coded in ten categories) during each growth period using within‐subject multiple regression analysis. Diarrhoea (in Keneba), lower respiratory tract illness (Bakau) and measles (PNG) all had highly significant effects on growth, reducing weight gain by between 17 and 69 g/day. Two statistical problems, i.e. the varying lengths of time between weight measurements, and the negative correlation between successive weight velocities, were discussed. However redoing the analysis taking them into account made no practical difference to the conclusions.
Growth Hormone Treatment in Adults with Growth Hormone Deficiency: Effect on Muscle Fibre Size and Proportions
Authors: WHITEHEAD H.M. , GILLILAND J.S. , ALLEN I.V. , HADDEN D.R.
Published: January 2008

Whitehead, H.M., Gilliland, J.S., Allen, I.V. and Hadden D.R. (Sir George E. Clark Metabolic Unit and the Department of Neuropathology, Royal Victoria Hospital, Belfast, Northern Ireland, UK). Growth hormone treatment in adults with growth hormone deficiency: effect on muscle fibre size and proportions. Acta Paediatr Scand [Suppl] 356: 65, 1989.

The effect of a 6‐month period of substitution therapy with recombinant human growth hormone (rhGH) on muscle fibre size and muscle fibre type proportions has been investigated in a group of 13 adults with growth hormone deficiency. All had a peak growth hormone (GH) response to insulin‐induced hypoglycaemia of less than 7 mU/I. There was no statistically significant change in the lesser fibre diameter or fibre proportions of either type 1 or type 2 muscle fibres in the rhGH group, as compared with placebo.
Growth Hormone Deficiency in Adults
Authors: SALOMON F. , CUNEO R.C. , HESP R. , SONKSEN P.H.
Published: January 2008

Salomon, F., Cuneo, R.C., Hesp, R. and Sönksen, P.H. (Department of Medicine, St. Thomas's Hospital, London, UK and the Radioisotopes Division, MRC Clinical Research Centre, Harrow, Middlesex, UK). Growth hormone deficiency in adults. Acta Paediatr Scand [Suppl] 356: 69, 1989.

There is a lack of information on the long‐term effects of growth hormone (GH) treatment on body composition in adults with GH deficiency (GHD). In a randomized, double‐blind, placebo‐controlled study, the changes in body composition in 24 adults with severe GHD were investigated. The majority of patients had developed GHD in adulthood as a consequence of pituitary tumours and/or pituitary surgery. They were all receiving appropriate conventional pituitary replacement therapy (i.e. no GH) and had suffered from GHD for at least 12 months; the mean known duration of GHD was 8 years. Severe GHD was defined as peak GH levels of less than 3.0 mU/I in response to the insulin tolerance test. Treatment with recombinant human GH (rhGH, Genotropin' 0.07 IU/kg) or placebo was given for 6 months as a daily subcutaneous injection at bedtime. At entry into the study, lean body mass was reduced in the patients with GHD compared to normal controls, and total body fat was increased. Overall, there was no change in body weight in either group. However, lean body mass, as measured by total body potassium in a K40 counter, increased from 53.5 ± 0.6 (mean ± SEM) to 59.7 ± 0.6 kg over the Cmonth period in the GH‐treated group (p < 0.0001). The biggest increase occurred during the first month. No significant change was observed in the placebo group. In addition, an overall decrease in fat mass of 5.7 ± 0.9 kg was observed in the GH‐treated, but not the placebo‐treated, patients after 6 months, particularly on the abdominal site. Again the largest decrease occurred during the first month of treatment. The reduction in fat mass was also paralleled by a decrease in the total plasma cholesterol. GHD in adults has therefore been shown to be associated with an abnormal body composition. Replacement therapy with hGH for 6 months normalizes lean body mass (compared to predicted value) and reduces fat mass.
Epidemiologic Study of Neonatal Jaundice A Survey of Contributing Factors
Authors: BRACCI R. , BUONOCORE G. , GAROSI G. , BRUCHI S. , BERNI S.
Published: January 2008

Bracci, R., Buonocore, G., Garosi, G., Bruchi, S. and Berni, S. (Division of Neonatology, University of Siena, Siena, Italy). Epidemiologic study of neonatal jaundice. A survey of contributing factors. Acta Paediatr Scand Suppl 360: 87, 1989.

In the attempt to detect factors influencing bilirubinemia in healthy full‐term or near‐term newborn infants, a statistical analysis was carried out on a population of 1126 neonates to study the variables possibly associated with maximum bilirubin values reached in the first days of life. The following variables were studied: maximum bilirubin level (maxBIL), sex, mode of delivery, gestational age, birthweight, ratio of birthweight/weight on 5th day, Apgar score, Rh and ABO incompatibility. Blood glucose and calcium levels, haematocrit, intake of breast milk, formula and glucose solution were also evaluated during the first 5 days of life. Higher maxBIL was found in males compared to females, after spontaneous delivery vs. emergency caesarean section, after caesarean section without fetal distress vs. emergency caesarean section, and in ABO incompatibility vs. no ABO incompatibility. Statistically significant inverse correlations were observed between maxBIL and gestational age, birth weight, blood glucose, and SE‐calcium. Significant positive correlations were found between maxBIL and haematocrit and breast milk intake. A multiple regression analysis between maxBIL and the significantly correlated parameters showed that only gestational age and birth weight remained significantly correlated with maxBIL. The results of the present investigation confirm that the factors most commonly reported as being responsible for neonatal hyperbilirubinemia do in fact play a role, although it can be considered almost negligible with the exception of gender, mode of delivery, ABO incompatibility, birthweight and gestational age.
Biochemical and Morphological Effects of Human Hepatic Alkaline Phosphatase in a Neonate with Hypophosphatasia
Authors: WENINGER M. , STINSON R. A. , Jr H. PLENK , BÖCK P. , POLLAK A.
Published: January 2008

Weninger, M., Stinson, R. A., Plenk, H. Jr, Böck, P. and Pollak, A. (Division of Neonatology, Department of Paediatrics, the Bone and Biomaterials Research Laboratory, Institution of Histology and Embryology and Institute of Micromorphology and Electron Microscopy, University of Vienna, Vienna, Austria and Division of Clinical Pathology, Department of Pathology, University of Alberta, Edmonton, Canada). Acta Paediatr Scand Suppl 360: 154, 1989.

Enzyme replacement‐therapy for a severely affected premature boy (birthweight: 2 380 g, GA: 36 weeks) with hypophosphatasia was attempted by infusions of purified human hepatic alkaline phosphatase. Treatment (1.2 IU/kg/min) started at age three weeks and was repeated in weekly intervals until age 10 weeks, when the child died. Samples of alkaline phosphatase were diluted with 10 ml of physiological saline and infused over 30 min via an umbilical arterial catheter. No toxic or allergic side effects were observed. Serum alkaline phosphatase activity increased from 3 IU/L before treatment to a maximum level of 195 IU/L with a half‐life time between 37 and 62 hours. Urinary excretion of phosphoethanolamine decreased during therapy from a maximal level of 9.5 to 5.5 μmol/mg creatinine (normal: <0.4 μmol/mg creatinine). Calcium, phosphorus, parathormone and 1,25‐diOH vitamin D levels were within normal range. Sequential radiographic studies showed no improvement of bone mineralization. Bone morphology was studied by light and electron microscopy before treatment and post mortem. The borderline between mineralized and unmineralized matrix was more distinct after treatment and on the electron microscopical level initial spots of mineralization were more frequent between the collagen fibrils compared to the biopsy specimen before treatment. In contrast to previous studies however, only woven and bundle bone structures were studied from the tibial crest, where the lack of osteoblast‐like cells upon the newly formed osteoid matrix was prominent.
Methods for Assessing the Linkage Between Pulsatile Hormone Profiles
Authors: MERRIAM G.R. , MA N. , LIU L. , WACHTER K.W. , LIBRE E.
Published: January 2008

Merriam, G.R., Ma, N., Liu, L., Wachter, K.W. and Libre, E. (Reproductive Endocrine Unit, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA). Acta Paediatr Scand [Suppl] 349: 167, 1989.

Although the different anterior pituitary hormones are generally considered to be regulated independently, examination of their patterns in blood suggests that pulsatile secretion of several of these hormones may be synchronized. Traditional methods of cross‐correlation analysis may not be adequate for quantifying this linkage. Since some simultaneity may arise by chance, expected rates of random coincidences must also be estimated to determine if apparent concordance rates significantly exceed those due to chance. A method of estimating linkage by counting simultaneous and near‐simultaneous events within temporal‘windows’of varying width is proposed and tested against 11 series of luteinizing hormone (LH) and prolactin measurements from normal men. Rates of concordance in series drawn from different subjects rather than the same subject, or series scrambled in time, do not contain meaningful simultaneous events and so can be used to estimate the rate of random synchrony. By these standards, a clear excess of concordant prolactin and luteinizing hormone (LH) peaks was observed in normal men, suggesting significant physiological synchrony between these pulses of secretion. This method can be applied to a variety of hormonal systems.
Exercise Therapy and Hypocaloric Diet in the Treatment of Obese Children and Adolescents
Authors: REYBROUCK T. , VINCKX J. , VAN DEN BERGHE G. , VANDERSCHUEREN‐LODEWEYCKX M.
Published: January 2008

ABSTRACT. Fourteen obese children and adolescents were treated with a combined therapy of low calorie diet and exercise and their progress compared to that of 11 obese children treated with diet only. Children treated with combination therapy were encouraged to perform aerobic exercises daily, for a period of time which was calculated to consume approximately 250 kcal per exercise session. After 4 months of therapy, a significantly (P<0.05) larger decrease of % overweight was observed in the group of children treated with diet and exercise (‐25±13.5%) than in those treated with diet only (‐15.8±10.5%). Treatment compliance was better in the group treated with diet and exercise than in the group which followed a low calorie diet only. We think that unsupervised exercise therapy can be successfully combined with a low calorie diet in the treatment of childhood obesity.
Cardiac Myxoma as the Cause of Death in an Infant
Authors: HALS J. , EK J. , SANDNES K.
Published: January 2008

ABSTRACT. Cardiac myxoma is a rare disease most frequently encountered in adults, usually localized in the left atrium. It rarely occurs in infants. We report a 3 1/2 month old girl whose sudden death was caused by a huge atrial myxoma, completely occluding the tricuspidal orifice. The importance of possible prodromal symptoms suggesting a cardiac disease is stated, and the role of echocardiography as an excellent examination technique is discussed.
Socio‐Economic Variables and Pregnancy Outcome
Authors: ERICSON A. , ERIKSSON M. , KÄLLÉN B. , ZETTERSTRÖM R.
Published: January 2008

ABSTRACT. The effects of various social indicators on infant and child mortality were studied in Sweden with the use of a medical birth register to which census information was linked. Two years were studied: 1976 births linked to the 1975 census, and 1981 births linked to the 1980 census. Survival was followed to the age of 5 by linkage of the birth register with the death certificate register. The only statistically significant effect of a single socio‐economic variable was that of housing conditions on perinatal death rate and postperinatal death rate up to the age of one. The family situation (e. g., cohabitation or not) had some effect, although it was not statistically significant. On the basis of cohabitation status and other social indicators, including housing conditions, we selected two groups: one privileged and the other underprivileged. Using crude mortality rates, we found no definite difference. There was evidence that the mortality rate had decreased more between 1976 and 1981 in the privileged than in the underprivileged group, but the difference may have been coincidental. After standardization for maternal age and parity, however, a difference appeared with a ratio of 1.14 between the underprivileged and the privileged groups, which was valid for deaths up to the age of one. After that age, no difference was seen. Following standardization for birthweight, the opposite was found: a higher weight‐specific mortality rate in the privileged group than in the underprivileged group. The interpretation of these findings is discussed.
The Relationship between Rooming‐in/not Rooming‐in and Breast‐Feeding Variables
Authors: YAMAUCHI YOSHITADA , YAMANOUCHI ITSURO
Published: January 2008

ABSTRACT. We studied the relationship between rooming‐in/not rooming‐in and breast‐feeding variables such as breast feeding frequency, breast milk intake, supplements of other human milk or 5% glucose solution, cumulative weight loss, weight recovery and hyperbilirubinemia. We found that the breast feeding frequency was significantly higher in infants rooming‐in than in those not rooming‐in. Intake of breast milk on days 3 and 5 was significantly lower and maximum weight loss was significantly higher in infants rooming‐in than in those not rooming‐in. Infants rooming‐in also had less supplement of other human milk compared with non‐rooming‐in infants (p <0.01). However, the weight increase per day from minimum to weight on day seven was higher in infants rooming‐in than in non‐rooming‐in infants (39.3 ± 21.4 g/day vs. 31.4 ± 15.3 g/day, p<0.01). The frequent suckling by rooming‐in infants may explain, in part, the better weight gain, since frequent suckling may decrease energy consumption by reducing movement and crying during the early days of life, thus contributing to better weight gain. Our study suggests that some of the neonatal feeding problems related to breast feeding could be eliminated by education of mothers and nurses and by changes in hospital policies and practices in breast feeding.
Infantile Hydrocephalus–the Impact of Enhanced Preterm Survival
Authors: FERNELL E. , HAGBERG G. , HAGBERG B.
Published: January 2008

ABSTRACT. The epidemiology of infantile hydrocephalus (IH) in the birth years 1983‐86 was investigated in the south‐western health care region of Sweden. The study was made as a continuation of a previous one which had shown a significant increase in the prevalence of IH in 1967‐82. That rise was entirely referable to the relatively larger number of preterm IH infants born in 1979‐82 and was considered to be due to the enhanced survival, especially of very preterm infants. The present series comprised 57 liveborn IH infants‐27 preterms and 30 born at term. The livebirth prevalence of IH was 0.64 per 1000, 0.30 for preterm and 0.34 for fullterm infants. The high prevalence of preterm IH infants in 1979‐82 had persisted, but had not increased further. This might indicate an improved outcome in preterm survivors in the period 1983‐86, as the survival rate had continued to increase. The striking predominance of a perinatal aetiology of IH in very preterm infants could be confirmed: 90 % had had intraventricular haemorrhages verified by ultrasound in the postpartum period. The outcome in very preterm surviving infants with IH was still alarmingly poor: 78% had cerebral palsy, 72 % mental deficiency, and 56 % epilepsy.
Standards for Growth and Final Height in Turner's Syndrome
Authors: NAERAA R. W. , NIELSEN J.
Published: January 2008

ABSTRACT. Data on birth, growth and final height were collected retrospectively for 78 women with Turner's syndrome born 1955‐66. Seventy‐one had received estrogen treatment from a mean age of 17.7 years (SD=2.0 years), while 7 were spontaneously menstruating. At birth Turner girls were 440 g lighter (p<0.001) and 1.4 cm shorter (p<0.001) than 46, XX girls. Standards for untreated growth were established for the age period 6.5‐17.5 years, while growth after 17.5 years was described in both untreated and estrogen treated women. Analysis of growth pattern showed that though no pubertal growth sport was present, the steady decrease of height velocity (HV) was interrupted at the age of 9 years. HV was then constant until 12 years of age, whereafter it slowly decreased. Mean final height (FH) was 146.8 cm (SD=5.8 cm, n=76) compared to 166.8 cm in the general female population. No difference was found between 45, X women and women with other karyotypes (p>0.7). Correlations between FH and parental heights, birthweight and birthlength were similar to those reported for normal women (19). FH varied with age at diagnosis. Those diagnosed after 17 years of age had a mean FH=151.3 cm, while those diagnosed before had a mean FH=145.8 cm (p<0.001).
Natural History of Allergic Diseases in Children
Authors: ÅBERG NILS , ENGSTRÖM INGA
Published: January 2008

Abstract. Questionnaire data from 1335 14‐year‐old children with a history of past or present asthma, allergic rhinitis or eczema were analysed regarding age at onset and cessation of symptoms. Incidence of asthma and eczema was highest during the first years of life. Early incidence of asthma was higher in boys than in girls but the sex ratio equalized gradually during childhood. Early incidence of eczema was equal between the sexes but the proportion of girls increased gradually with later age at onset. In 24 % of the children more than one symptom was found. Cessation of symptoms was common in asthma (55 %), in particular in those with early onset (74 %), but less common in eczema (34 %). Cessation of symptoms was less common in both diseases when associated with other allergic symptoms. Incidence of allergic rhinitis was fairly constant during childhood and cessation of symptoms was uncommon. A high risk of allergic airways disease was found after early eczema.
Epilepsy in Hydrocephalic Children
Authors: SAUKKONEN ANNA‐LIISA , SERLO WILLY , WENDT LENNART von
Published: January 2008

ABSTRACT. Epilepsy and epileptogenic activity in EEGs were studied in 168 shunt treated hydrocephalic (HC) children, the mean age at first operation 1.62 years (SD 1.87). 80 patients (47.6%) suffered from epileptic seizures during the follow‐up period (mean 8.9 years). The epileptic seizures appeared before the initial shunting, and after the first shunt inplantation in 43 (25.6%). There was no correlation between epilepsy and the aetiology of HC, number of shunt revisions, or shunt infections. Sixteen patients suffered from seizures during the neonatal period. Generalized spike and wave activity (SWA) was seen in EEG in eight out of these, and only one was seizure‐free at the end of the follow‐up period. All eight patients with epileptic seizures during the neonatal period without generalized SWA in EEG were seizure‐free, however. SWA was seen in the first EEG prior to shunting in 75/168 patients (44.6%). All those patients who did not receive prophylactic medication, developed epileptic seizures, whereas 68.1% of those who received prophylactic anticonvulsive medication remained free of seizures. Partial epilepsy after shunting manifested itself in 15 patients, but this did not correlate with the side of the sunt or with the side of the SWA in the EEG. Slit ventricles (SLV) developed in 75 patients during the follow‐up period, while the ventricles remained normal or dilated in 66 cases (27 patients had no CT follow‐up). Epilepsy manifested itself in 8 out of these 141 patients (2 SLV, 6 non‐SLV) during the first postoperative year, and in 29 patients in the SLV group and one in the non‐SLV group at some time after the first postoperative year.
Spontaneous Pneumopericardium in an Otherwise Healthy Full‐term Newborn
Authors: BJÖRKLUND L. , LINDROTH M. , MALMGREN N. , WARNER A.
Published: January 2008

ABSTRACT. Neonatal pneumopericardium is usually a complication of mechanical ventilation in premature infants with respiratory distress syndrome. We report a full‐term neonate who developed pneumopericardium after forceps delivery and mild asphyxia. The child was never ventilated and had no signs of parenchymal lung disease. The pneumopericardium resolved spontaneously. Although drainage of pneumopericardium is usually recommended, this may not always be necessary when there are no signs of cardiac tamponade.
Transient Abnormal Myelopoiesis and Diffuse Hepatic Necrosis in Down's Syndrome with Prominent Bleeding Diathesis
Authors: TSUDA T. , KOMIYAMA A. , AONUMA K. , AKABANE T. , NAKAYAMA M.
Published: January 2008

ABSTRACT. The first case known to us with Down's syndrome with transient abnormal myelopoiesis and diffuse hepatic necrosis is reported. The infant had prominent bleeding diathesis and hepatosplenomegaly. She died on the 7th day because of intractable bleeding. The autopsy disclosed extramedullary hematopoiesis and extensive hepatic cell necrosis. Characteristic in our case was the outstanding bleeding diathesis due to coagulopathy.
IgE Antibodies to Pityrosporum orbiculare in Children with Atopic Diseases
Authors: NORDVALL S. L. , JOHANSSON SIV
Published: January 2008

Abstract. IgE antibodies to Pityrosporum orbiculare and 16 other species of fungi were measured with the radioallergosorbent test (RAST) in sera of 131 children. The children were 7‐18 years old, suffered from atopic diseases and showed a varied allergic profile on a skin prick test (SPT). IgE antibodies to P. orbiculare were found in the sera of 26 of the 131 children. A higher proportion of the P. orbiculare RAST positive children than of the negative ones had current eczema (p<0.0001). In a stepwise logistic regression analysis of SPT and RAST data, the occurrence of serum IgE antibodies to P. orbiculare had the highest explanatory value for current eczema. Ten of 15 children with current atopic eczema and total serum IgE of >500 kU/1 had serum IgE antibodies to P. orbiculare. Twenty‐four of the 26 P. orbiculare RAST positive children harboured serum IgE antibodies to other fungi. The strong relationship between atopic eczema and the occurrence of IgE antibodies to P. orbiculare indicates that these antibodies may be pathogenetically important in at least some patients with atopic eczema and this gives another dimension to this common skin disease.
Subglottic Stenosis in Neonates and Children
Authors: PUHAKKA H. J. , KERO P. , VALLI P. , IISALO E. , ERKINJUNTTI M.
Published: January 2008

ABSTRACT. From 1978 through 1987, acquired subglottic stenosis was confirmed endoscopically in 31 children. The mean gestational age of the children was 32 weeks and mean birthweight 2180 g. Of the children 84 % were below 12 months of age at the time of diagnosis. Respiratory distress syndrome was confirmed in 17 children. Before diagnosis, 97 % of the children had been treated by endotracheal intubation for ventilatory support, the mean duration of intubation being 37 days. In 10 children, subglottic stenosis was mild and mature and these children were followed up only. Endolaryngeal prosthesis was employed in 2 children and laryngotomy with autogenous bone graft in 5 children. Mean follow‐up time was 5 years 4 months. At follow‐up, 18 of the children showed good or excellent results.
Acute Respiratory Tract Infections in Children
Authors: HARSTEN G. , PRELLNER K. , HELDRUP J. , KALM O. , KORNFÄLT R.
Published: January 2008

ABSTRACT. Respiratory tract infections (RTIs) in small children account for a considerable proportion of health care expenditure. In 113 children, followed for the first three years of life, we studied the frequency of acute RTI and its relationship to the factors: type of day‐care, age, sex, family size, living conditions, allergic predisposition, family smoking habits, and season. To elucidate the influence of age, the frequency of acute RTI and its relationship to type of day‐care was longitudinally studied on a quarterly basis. The frequency of acute RTI diagnosis increased gradually from birth culminating in a peak at the beginning of the second year. Besides age and season, type of day‐care was the only factor studied to show any relationship with the frequency of acute RTI diagnosis. Up to the age of almost 2 1/2 years, children attending day‐care centres accounted for more RTI diagnoses than did those in home care or family day‐care, categories with comparable frequncies.
Variation of Growth in Length and Weight of Children I. Years 1 and 2
Authors: SORVA R. , TOLPPANEN E.‐M. , PERHEENTUPA J.
Published: January 2008

ABSTRACT. As part of our work aiming at facilitation of growth screening, we analyzed the growth of 741 healthy infants from birth to 2 years of age. We 1) show that weight depends on length rather than age, 2) present new growth standards in a format which allows direct reading of relative length and relative weight, and 3) define the normal variation of changes over different periods in terms of relative length (SD score, SDS) and relative weight (deviation of weight from the median weight for length and sex, % DW). The group mean values for changes in length SDS and % DW were zero, but there were wide individual variations, which decreased with age and length. We present curves defining these variations for use in growth screening.