bluuebunny/crossref_metadata_2025 huggingface dataset:
Epstein‐Barr virus infection and its role in the expanding spectrum of human diseases
Authors: Okano M
Published: August 2010

Recent advances of the various laboratory tests to detect Epstein‐Barr virus (EBV) infection have clarified the causative role for a spectrum of EBV‐associated diseases. They include lymphoproliferative disorders (LPD), which occur in immunologically compromised individuals, Hodgkin's disease (HD), chronic active EBV infection (CAEBV), virus‐associated hemophagocytic syndrome (VAHS), certain forms of T cell lymphoma, and some gastric carcinomas, in addition to the classical EBV‐associated diseases such as EBV genome‐positive Burkitt's lymphoma (BL), undifferentiated nasopharyngeal carcinoma (NPC) and infectious mononucleosis (IM). This review intends to introduce the recent progress of studies on EBV infection mainly from the clinical points of view.
Parental stress, psychosocial problems and responsiveness in help‐seeking parents with small (2–45 months old) children
Authors: östberg M
Published: August 2010

Experienced parental stress in 75 mothers and 65 fathers seeking help for their young child (M = 14.5 months; SD = 9.4 months) in a Specialist Child Health Centre was examined and related to child problem load, psychosocial problems and parental problems in responding to the child's signals and demands. Maternal stress level was compared with a population‐based sample of 1500 mothers with children of similar ages. The measure of parental stress was a revised Swedish version of the American Parenting Stress Index (Parent Domain). Mothers in the clinical sample indicated higher levels of parental stress compared to fathers in the same families and to mothers in the comparison sample. A clear association was found between higher stress and a global clinical assessment of parental unresponsiveness to the child. Child problem load was associated with mothers' overall stress level. A clinical estimate of the parents' psychosocial situation was also associated with mothers' and fathers' stress level, and gave a large unique contribution to the variability in mothers' stress scores. It was concluded that focus in intervention programs should be on the whole family, and that the father should be seen as a resource that might well be more involved in the caretaking of the child. The study also clearly demonstrated the discriminant and construct validity of the parental stress instrument.
A case of severe neonatal lupus erythematosus without cardiac or cutaneous involvement
Authors: Selander B , Cedergren S , Domanski H
Published: August 2010

Neonatal lupus erythematosus is a disease primarily characterized by cardiac and/or cutaneous involvement. Liver and haematological involvement occur in a few cases and these are normally considered to be mild and transient complications. The disease is suspected to be caused by transplacental passage of maternal autoantibodies, primarily anti‐Ro/SSA and anti‐La/SSB, from mothers with systemic lupus erythematosus. Here we report a child with neonatal lupus erythematosus who died from severe liver and haematological disease when 2 d old. The baby had no cardiac or cutaneous involvement. The mother has had two subsequent pregnancies. In the first she had a boy without certain signs of neonatal lupus erythematosus. In the next pregnancy the child developed congenital complete heart block and cutaneous lesions.
Sleeping position, breastfeeding, bedsharing and passive smoking in 3‐month‐old Swedish infants
Authors: Lindgren C , Thompson JMD , Häggblom L , Milerad J
Published: August 2010

Parents of 1028 infants who attended community‐based infant health clinics were interviewed concerning infant sleeping position, feeding habits, bedsharing and passive smoking at 3 months of postnatal age. In addition, they were asked to state which source of information had mainly influenced them in the choice of the sleeping position. Fifteen per cent of the infants were regularly laid to sleep in the prone position, compared with 72% (1991) before official guidelines concerning infant sleeping position were issued. The overall prevalence of exclusive breastfeeding was 70.4%. Prevalence of maternal smoking was 17.9% and 22.8% of the infants were regularly bedsharing with the parents. Those mothers who did not comply with official recommendations regarding infant sleeping position were also less likely to follow other recommendations concerning infant care practices. Prone sleeping infants were more likely to be formula fed and exposed to passive smoking, and hence associated with additional risk factors for sudden infant death syndrome.
Septicaemia in an Austrian neonatal intensive care unit: a 7‐year analysis
Authors: Berger A , Salzer HR , Weninger M , Sageder B , Aspöck C
Published: August 2010

The results of blood cultures and clinical data of 101 neonates with 110 episodes of septicaemia during a 7‐y study period were reviewed. The overall incidence of culture‐proven sepsis within the study period was 6.0 per 100 neonatal intensive care unit admissions and the mortality rate was 14%. Three groups of pathogens accounted for 70% of all isolates: coagulase‐negative staphylococci (27%), aerobic Gram‐negative rods (24%) and Enterococcusfaecalis (19%). Group B streptococcus was the major pathogen of very early‐onset septicaemia (within 24 h of birth), whereas late‐onset infections were most commonly caused by coagulase‐negative staphylococci. Birthweight <1500g, gestational age <30 weeks of gestation and early onset of symptoms within the first week of life were associated with poor prognosis. In addition, the case fatality rate of episodes caused by Gram‐negative organisms was significantly higher than that of Gram‐positive bacteraemia.
Sequelae associated with cerebral candidiasis in two premature infants
Authors: Scott PA , Ohlsson A
Published: August 2010

This study reports on two premature infants who developed cerebral candidiasis and survived. Both were found to have significant handicaps on follow‐up.
Risk factors for impaired length growth in early life viewed in terms of the infancy‐childhood‐puberty (ICP) growth model
Authors: Liu YX , Jalil F , Karlberg J
Published: August 2010

A difference in length or height growth is observed between populations in developing and developed countries and, within a country, between well‐off and poor subpopulations. The aim of this community‐based study was to identify possible risk factors for growth stunting in early life using the infancy‐childhood‐puberty (ICP) growth model. A periurban slum, a village and an urban slum, plus a local control group in Lahore, Pakistan, were investigated. In total, there were 425 infants born from September 1984 to March 1987 in the study. Children were followed from birth to 24 months and anthropometric data were recorded at each examination. A well‐designed questionnaire was used to collect background information to identify risk factors for growth faltering over this period. The age at onset of the childhood component was determined individually using the ICP growth model. A late onset was defined as onset after 12 months. Univariate odds ratio analysis identified 20 significant risk factors for a delayed childhood onset in the total sample. Backward logistical analysis showed that only six variables were significant, i.e. small number of rooms in a household, episode(s) of diarrhoeal diseases, poor house structure, low body mass index, early end of breastfeeding and birth in warm season. Stratified analysis showed that episode(s) of diarrhoeal diseases and birth in warm season were the only significant risk factors in the two poor areas. This study also found that the impact of diarrhoeal diseases on length growth persisted after allowing for birth season. Seasonal variation in length growth was seen in the age at onset of the childhood component. General socioeconomic status was found to be a risk factor for growth faltering in early life. Diarrhoeal diseases and being born in a warm season are particular risk factors for growth faltering in early life.
Early childhood feeding practices in southern Italy: is the Mediterranean diet becoming obsolete? Study of 450 children aged 6‐32 months in Campania, Italy
Authors: Greco L , Musmarra F , Franzese C , Auricchio S ,   The regional members of the Cultural Paediatric Association
Published: August 2010

With increasing affluence, the traditional food choices of Mediterranean populations are changing. The changes appear to begin in early infancy, with increased consumption of processed foods. To determine current consumption patterns of the diets of 450 toddlers, 6–32 months old, enrolled from 17 paediatric practices in the Campania region of Italy, quantitative data were collected for 7 d, using calibrated feeding bottles, cups and dishes. Automated food analysis was employed and quality control was performed on a sub‐sample. The average daily intake was 373 kJ/kg. Forty‐three percent of energy was provided by carbohydrates, while fats supplied 39%, 45% of fats were saturated and 46.7% were monosaturated (primarily olive oil). Proteins provided 18% of daily energy; most (81.4%) were of animal origin. Fibre was virtually absent from the study children's diet. Total daily cholesterol reached an average value of 191 mg/d, corresponding to 201 mg/4.2 mJ. The intake per kg of cholesterol increased with age in the first year, while proteins and fats decreased. Dairy products were the main source of energy, fats and cholesterol. Vegetables and legumes were a minor source of energy at all ages: the consumption of fruit decreased with age. Although the overall pattern of feeding of this cohort remains favourable compared with other children groups in developed countries, consumption of whole milk and full fat dairy products may be reduced to equilibrate the diet.
Growth hormone treatment of short children born small‐for‐gestational‐age: the Nordic Multicentre Trial
Authors: Boguszewski M , Albertsson‐Wikland K , Aronsson S , Gustafsson J , Hagenas L , Westgren U , Westphal O , Lipsanen‐Nyman M , Sipilä I , Gellert P , Müller J , Madsen B
Published: August 2010

The aims of this study were to evaluate the efficacy and safety of different doses of growth hormone (GH) treatment in prepubertal short children born small‐for‐gestational‐age (SGA). Forty‐eight children born SGA from Sweden, Finland, Denmark and Norway were randomly allocated to three groups: a control group of 12 children received no treatment for 2 y, one group was treated with GH at 0.1 IU/kg/d (n= 16), and one group was treated with GH at 0.2 IU/kg/d (n= 20). In total 42 children completed 2 y of follow‐up, and 24 children from the treated groups completed 3 y of treatment. Their mean (SD) age at the start of the study was 4.69 (1.61) y and their mean (SD) height was ‐3.16 (0.70) standard deviation scores (SDS). The children remained prepubertal during the course of the study. No catch‐up growth was observed in the untreated group, but a clear dose‐dependent growth response was found in the treated children. After the third year of treatment, the group receiving the higher dose of GH, achieved their target height. The major determinants of the growth response were the dose of GH used, the age at the start of treatment (the younger the child, the better the growth response) and the family‐corrected individual height deficit (the higher the deficit, the better the growth response). Concentration of insulin‐like growth factor‐I (IGF‐I) and IGF‐binding protein‐3 increased during treatment. An increase in insulin levels was found without negative effects on fasting glucose levels or glycosylated haemoglobin levels. GH treatment was well tolerated. In conclusion, short prepubertal children born SGA show a dose‐dependent growth response to GH therapy, and their target height SDS can be achieved within 3 y of treatment given GH at 0.2 IU/kg/d. However, the long‐term benefit of different regimens of GH treatment in children born SGA remains to be established.
Precipitants and aetiology of cyclic vomiting syndrome
Authors: Withers GD , Silburn SR , Forbes DA
Published: August 2010

Thirty‐two patients aged 2–22 y with cyclic vomiting syndrome (CVS), and 64 age‐ and gender‐matched controls were assessed to determine the nature, severity, precipitants and associated features of attacks and the incidence of potential aetiological factors. The mean age of onset was 3.5 y. Patients experienced a mean of nine attacks per year, of average duration 2.4 d, and two‐thirds missed more than 10 d of school per year. Patients were more likely to have migraine and co‐ordination difficulties, a past history of forceps delivery and gastroesophageal reflux than controls. Compared with controls, subjects had a higher incidence of psychological symptoms (38% compared with 19%) and migraine (37% compared with 9%). CVS is a chronic, disabling condition and is a migraine variant, with attacks usually precipitated by stress and intercurrent infections.
Acute effects on systemic circulation after intratracheal instillation of Curosurf or Survanta in surfactant‐depleted newborn piglets
Authors: Moen A , Yu X‐Q , Almaas R , Curstedt T , Saugstad OD
Published: August 2010

Systemic vasodilatation in surfactant‐depleted newborn piglets is induced by 200 mg/kg of modified porcine lung surfactant (Curosurf™). The aim of this investigation was to study whether this effect is dependent on dose and could further be induced by instillation of a bovine surfactant preparation (Survanta™). Twenty‐two 3–5‐d old piglets were subjected to repeated saline lung lavage and then randomized to one of three groups. Instillation of either Curosurf 100 mg/kg (n= 8), Survanta 100 mg/kg (n= 7) or Curosurf 200 mg/kg (n= 7) was performed through the endotracheal tube. Systemic vascular resistance decreased 7 (± 4)%, 15 (± 12)% and 18 (± 6)% in the three groups, respectively (p < 0:05 in all three groups). A significant difference between the high and low dose Curosurf groups was found (p < 0:05), whereas no significant difference was seen between the Curosurf 100 mg group and the Survanta group. The decrease in vascular resistance was compensated by an increase in cardiac output, resulting in a stable mean arterial blood pressure. In conclusion, both Curosurf and Survanta induce a significant decrease in systemic vascular resistance in surfactant‐depleted newborn piglets. A more pronounced effect was observed after 200 mg/kg than after 100 mg/kg of Curosurf.
Risk factors for low birthweight in Japanese infants
Authors: Maruoka K , Yagi M , Akazawa K , Kinukawa N , Ueda K , Nose Y
Published: August 2010

The purpose of our study was to identify risk factors for low birthweight (LBW; birthweight < 2500 g) in Japanese infants. The data was collected from questionnaires completed by the parents of 23 132 infants who underwent a standardized well baby check‐up for 1‐month‐old infants, conducted by the Fukuoka City Medical Association from 1987 to 1995. The following eight factors and their second‐order interaction terms were examined as potential risk factors for LBW: maternal age at delivery, history of live‐born LBW infant, history of abortion in previous pregnancies, maternal smoking, coffee and alcohol consumption during pregnancy, prenatal training and live birth order. The results of multiple logistic regression analysis showed that the following three factors and one interaction term significantly contributed to LBW: history of live born LBW infant, maternal smoking, live birth order and the interaction between maternal smoking and live birth order. The smoker‐related risk for LBW was quite different in each of the three groups stratified by live birth order. Efforts should be made, for example, to increase the accessibility of early, high‐quality prenatal care for the high‐risk groups with previous LBW babies and to implement smoking intervention, ranging from specific medical procedures to broad‐scale public health and health‐related educational programs in schools.
Infant Flow Driver or single prong nasal continuous positive airway pressure: short‐term physiological effects
Authors: Ahluwalia JS , White DK , Morley CJ
Published: August 2010

The effectiveness of single prong nasal continuous positive airway pressure (CPAP) was compared with the Infant Flow Driver (IFD) in a crossover study in 20 neonates treated with ≤ 30% oxygen by nasal CPAP. They were randomized to the device used at the start of the study. Each infant was studied for four consecutive 2‐h periods alternating between single prong nasal CPAP and the IFD. The FiO2 from the IFD read 0.02 higher than the same setting on the ventilators used for single prong nasal CPAP. The IFD improved the mean (95% CI) of theFiO2by 0.05 (0.02–0.08),p= 0:008. Taking into account the systematic error in the FiO2 between the devices the real mean improvement in FiO2 produced by the IFD was 0.03 (‐0.005 to 0.06), p= 0:09. There were no significant differences in respiratory rate, heart rate, blood pressure or comfort score of infants during periods of single nasal prong CPAP compared with periods on the IFD.
Body fatness and serum lipids of 11‐year‐old Chinese children
Authors: Leung SSF , Chan YL , Lam CWK , Peng XH , Woo KS , Metreweli C
Published: August 2010

It has been suggested that distribution of body fat has a stronger bearing on health risk than total body fat. Magnetic resonance imaging (MRI) was used to examine the distribution of fat and correlated with body fat assessed by the usual clinical methods–weight, weight‐for‐height, body mass index (BMI), triceps and subscapular skinfold thickness in 11‐y‐old Chinese children. Lipid profiles were used as indicators for coronary risk. Eighty‐eight subjects had body fat distribution estimated by MRI, while 49 had serum lipids measured. Anthropometric parameters correlated significantly with total fat at the umbilical level measured by MRI (weight: r= 0:90 in boys, 0.75 in girls; BMI: r= 0:94 in boys, 0.87 in girls; percent median weight‐for‐height: r= 0:90 in boys, 0.79 in girls, triceps skinfold thickness: r= 0:89 in boys, 0.90 in girls; subscapular skinfold thickness: r= 0:93 in boys, 0.88 in girls). Obese subjects had proportionally less visceral fat than subcutaneous fat at umbilical level. Using stepwise multiple regression, predictive factors for high‐density lipoprotein cholesterol were BMI in boys and breast‐staging in girls. For triglycerides, it was genital staging in boys and for total cholesterol, it was breast‐staging in girls. Visceral fat was not a significant determinant of serum lipids.
Body mass index development during the first 6 months of life in infants born to human immunodeficiency virus‐seropositive mothers
Authors: Agostoni C , Zuccotti GV , Giannì ML , D'Auria E , Giovannini M , Riva E
Published: August 2010

The development of body mass index (BMI) was measured during the first 6 months of life in three groups of infants [human immunodeficiency virus (HIV) ‐uninfected, n= 92; later symptomatic HIV‐infected, n= 18; early symptomatic HIV‐infected, n = 9] born to HIV‐positive mothers and compared with a reference group (n= 65) born to healthy mothers. A trend towards lower values in the two groups of HIV‐infected infants was already evident at birth. Among the four groups, HIV‐uninfected infants showed the highest BMI values while the early‐infected infants showed the lowest BMI values at all measurements. The later‐infected group had a value close to the reference at 1 month, and then increased at slower rates than the uninfected and the reference groups. Infants born to HIV‐positive mothers may have higher energy and nutrient requirements after birth, either to sustain an increased BMI development (when uninfected) or to meet catabolic mechanisms (when infected).
Infantile hydrocephalus: declining prevalence in preterm infants
Authors: Fernell E , Hagberg G
Published: August 2010

The prevalence and aetiological panorama of infantile hydrocephalus in western Sweden have been followed since the late 1960s. A significant increase in the live birth prevalence of very preterm infants with infantile hydrocephalus was found, from 6.99 per 1000 in the birth year period 1973‐78 to 25.37 in 1983‐86, and owing to an increased survival of very preterm infants with a high risk of hydrocephalus, secondary to an intraventricular haemorrhage occurring in the perinatal period. In the present study covering the birth years 1991–94, a declining prevalence to 13.69 per 1000 very preterm infants was found. In moderately preterm and term groups, mostly with prenatal aetiologies, the prevalence was unchanged. Outcome in surviving children with infantile hydrocephalus remained essentially the same as in previous studies, indicating that the underlying aetiology is the most decisive factor with respect to ensuing neuroimpairments.
Long‐term psychological outcome of children after surgery for transposition of the great arteries
Authors: Aldén B , Gilljam T , Gillberg C
Published: August 2010

To assess the psychological consequences of a single congenital heart defect, we tested intellectual function, self‐perception,‘'body image”, child psychiatric symptoms and the family climate in 21 boys and 10 girls, at a mean age of 13.2y, on average 11.5 y after surgery for transposition of the great arteries. Where applicable, test norms were used for comparison. WISC‐R IQ tended to be slightly lower than that of the general population. Self‐perception, as reflected on the“I think I am”test, was normal.“Body image”as measured by the“Draw‐a‐man”test was poor in the boys, but did not show a relationship with any other test tapping mental health. Six children (19%) had clinically significant child psychiatric symptoms, which is slightly more than expected, and were overrepresented in patients with poorer cardiac function. Five of these represented“internalizing”disorders. The patients’families scored higher than expected on the family climate“chaos”subscale, which has been demonstrated to be associated with the development of psychiatric symptoms. Overall, however, the children and their families were regarded as socially and psychologically well‐functioning.
Changes in skin blood flow over the foot with warming of the contralateral heel
Authors: Dollberg S , Atherton H , Hoath S
Published: August 2010

Vasospasm in one leg is a common complication of umbilical artery catheterization in preterm infants. It is a common practice to wrap the contralateral leg in a warm washcloth. The rationale for this intervention is to induce reflex vasodilatation of the affected extremity, thereby avoiding the necessity to remove or replace the catheter. This study tested the hypothesis that heating the contralateral extremity in preterm infants would increase peripheral blood flow to the contralateral foot. Ten stable preterm infants who had had no umbilical catheter inserted for at least 2 weeks were studied. Skin perfusion was measured using the laser Doppler method in the distal leg after heating of the opposite foot to 40.5°C. Blood flow to the skin of the contralateral foot was measured before and after warming the ipsilateral one. The skin blood flow measured with and without heat application to the contralateral foot was not significantly different. Direct heat does not induce contralateral reflex vasodilatation in the foot of preterm infants.
Local application of honey for treatment of neonatal postoperative wound infection
Authors: Vardi A , Barzilay Z , Linder N , Cohen HA , Paret G , Barzilai A
Published: August 2010

Honey has been described in ancient and modern medicine as being effective in the healing of various infected wounds. In this report we present our experience in nine infants with large, open, infected wounds that failed to heal with conventional treatment. Conventional treatment was defined as having failed if after ≥14 d of intravenous antibiotic and cleaning the wound with chlorhexidine 0.05% W/V in aqueous solution and fusidic acid ointment the wound was still open, oozing pus, and swab cultures were positive. All infants showed marked clinical improvement after 5d of treatment with topical application of 5–10 ml of fresh unprocessed honey twice daily. The wounds were closed, clean and sterile in all infants after 21 d of honey application. There were no adverse reactions to the treatment. We conclude that honey is useful in the treatment of post‐surgical wounds that are infected and do not respond to conventional systemic and local antibiotic treatment.
Recurrent Pseudomonas bronchopneumonia and other symptoms as in cystic fibrosis in a child with type I pseudohypoaldosteronism
Authors: Marthinsen L , Kornfält R , Aili M , Andersson D , Westgren U , Schaedel C
Published: August 2010

We report a child with multiple target organ pseudohypoaldosteronism type 1 with frequent recurrent pulmonary infections caused by Pseudomonas aeruginosa and Pasteurella multocida and high levels of chloride in sweat, urine and nasal secretion. Repetitive faecal chymotrypsin samples have all shown pathological values in spite of no other sign of exocrine pancreas dysfunction. The similarities with cystic fibrosis and the importance of the salt content in bronchial fluid are discussed.
Serum digoxin‐like immunoreactive factor in children and its relation to sodium metabolism
Authors: Garbagnati E
Published: August 2010

Serum digoxin‐like immunoreactive factor (DLIF), an endogenous substance that cross‐reacts with anti‐digoxin antibodies, was assessed (fluorescence polarization immunoassay) in children (n= 134) aged 5‐16 y, who had never been treated with cardiac glycosides. DLIF was found in 50% of serum samples at a mean concentration of 0.16 ± 0.06 ng/ml (range 0.03–0.35 ng/ml). Although the study population as a whole was apparently homogeneous with regard to serum sodium content, and none had clinical signs of sodium imbalance, children with DLIF showed significantly lower natraemia (p= 0:0002), higher urinary concentration (p= 0:001) and fractional excretion (p= 0:001) of sodium, and increased systolic blood pressure (p= 0:009) compared with children without DLIF. Inverse correlations were found between DLIF concentration and serum sodium (p < 0:01), urine sodium content (p < 0:001), 24‐h sodium excretion (p < 0:001), systolic (p < 0:001) and diastolic (p < 0:01) blood pressure. These findings suggest that sodium handling is different in children with and without DLIF, since this material seems to be released preferably in subjects who show a trend towards negative sodium balance. Such an association suggests that DLIF may be a physiologically relevant material involved in sodium homeostasis.
Serum inflammatory markers and effects of age and tobacco smoke exposure in young non‐asthmatic children
Authors: Carlsen KC Lødrup , Halvorsen R , Carlsen K‐H
Published: August 2010

Serum eosinophil cationic protein (ECP), but not serum myeloperoxidase (MPO), has been found to reflect disease activity of asthma and eczema, but no reference values exist for young children. Thus, we aimed to provide values of serum‐ECP and serum‐MPO in young children without obstructive airways disease (OAD), and determine possible influencing factors. Parental interview was performed and serum was collected from a total of 245 children (207 children aged 24‐41 months and 76 children aged 0‐23 months) with no history of lower respiratory disease. Repeated serum samples were obtained in 38 subjects. Ten percent of the children had active eczema at examination. All children were controls in the“Environment and Childhood Asthma”study in Oslo. Geometric means (GM ± 1.96 SD) for serum ECP were 11.8 μg/l (2.5‐56.0) and 7.9 μg/l (2.0‐30.4), respectively, in the 0‐23 and 24‐41‐month‐old children, with the corresponding values for serum MPO 453 μg/l (153‐1349) and 347 μg/l (142–859), respectively. Age was inversely associated with serum‐ECP and serum‐MPO, most pronounced in the youngest children. Active eczema and maternal daily smoking adversely affected serum‐ECP, but not serum‐MPO. Gender and parental atopy did not influence the results. We conclude that serum‐ECP in very young children is influenced by age and active eczema and is related to maternal smoking in a dose‐dependent fashion. These factors should be considered when assessing inflammatory markers in very young children.
Foetal supraventricular tachycardia treated with sotalol
Authors: Sonesson S‐E , Fouron J‐C , Wesslen‐Eriksson E , Jaeggi E , Winberg P
Published: August 2010

Sonesson S‐E, Fouron J‐C, Wesslen‐Eriksson E, Jaeggi E, Winberg P. Foetal supraventricular tachycardia treated with sotalol. Acta Pædiatr 1998; 87: 584‐7. Stockholm. ISSN 0803‐5253

This retrospective study (1991‐95) presents our experience with sotalol in the treatment of 14 foetuses with supraventricular tachycardia (SVT). SVT was diagnosed in a structurally normal heart at a gestational age of 24‐35 (median 28) weeks. In eight foetuses, hydrops was evident at presentation. In all patients pharmacological conversion with digoxin was tried before sotalol treatment was started. Sotalol was given orally to the mothers in a dose of 80–160 mg x2. Cardioversion was obtained in 10 foetuses. In seven of these patients re‐entry tachycardia and in five pre‐excitation could be documented after birth. In two foetuses not responding to sotalol a long RP tachycardia was demonstrated; even when using digoxin, sotalol, flecainide and/or propafenone in different combinations after birth complete suppression of the arrhythmia was not obtained. Two severely hydropic foetuses died 1 and 10 d, respectively, after starting with sotalol. The 12 surviving infants were doing well except for one infant, with a cerebral lesion probably related to the arrhythmia. These findings demonstrate that sotalol can be useful in the treatment of foetal SVT.
Arachidonic acid metabolites in CSF in hypoxic‐ischaemic encephalopathy of newborn infants
Authors: Vilanova JM , Figueras‐Aloy J , Roselló J , Gómez G , Gelpí E , Jiménez R
Published: August 2010

The aim of this study was to evaluate the cerebral synthesis of eicosanoids in the asphyctic newborn and to investigate the relation between the prostanoid profiles in cerebrospinal fluid (CSF) and the appearance and severity of hypoxic‐ischaemic encephalopathy (HIE). Levels of 6‐keto‐PGF 1‐α, TXB2, PGE2 and PGF2‐α in CSF were measured in 40 full term newborns during the first day of life. Thirty of these newborns had birth asphyxia and were divided into three groups: 10 without HIE, 12 with mild HIE and 8 with moderate‐severe HIE. They were compared to a control group of 10 non‐hypoxic newborns. Determinations of the metabolites in CSF were performed by RIA and expressed as pg/ml (mean ± SD). The CSF TXB2 (thromboxane A2 metabolite) in asphyxiated newborns was always higher than in the control group (28.12 ± 10.6), and related to the severity of HIE (p= 0:005): without HIE (50.84 ± 16.4; p= 0:02), mild HIE (80.65 ± 12.64; p± 0:01) and moderate‐severe HIE (178.14 ± 20.5; p < 0:01). The CSF 6‐keto‐PGF 1‐α (prostacyclin metabolite) in asphyxiated newborns was always higher than in the control group (80.55 ± 12.56), but indirectly related to the severity of HIE: without HIE (240.95 ± 28.12; p < 0:01), mild HIE (183.65 ± 30.1; p < 0:01) and moderate‐severe HIE (140.55 ± 25.12; p < 0:01). In the moderate‐severe HIE group, the increase in TXB2 was higher than the rise in 6‐keto‐PGF 1‐α.
Bacterial genotype and neurological complications of Escherichia coli O157:H7‐associated haemolytic uraemic syndrome
Authors: Cimolai N , Carter JE
Published: August 2010

We examined the possibility of an association between the bacterial genotype ofEscherichia coli O157:H7 and the likelihood of progression to neurological complications in childhood gastroenteritis‐associated haemolytic uraemic syndrome (D+HUS). Bacterial stool isolates were available from 51 patients with HUS; 11 of these patients suffered a neurological complication. Bacteria were assessed for plasmid content, verotoxin (Shiga‐like toxin) profile, verotoxin 2 subtype, and presence of the eaeA (effacement and attachment) marker. No association of bacterial genotype with central nervous system (CNS) manifestations was observed. Whilst the cause of CNS manifestions may be multifactorial, there is no evidence at present to implicate specific bacterial traits.
Prevention of hypoglycaemia in a patient with type Ib glycogen storage disease by an amylase (α‐glucosidase) inhibitor
Authors: Ihara K , Kuromaru R , Ryu A , Fukushige J , Hara T
Published: August 2010

Patients with type Ib glycogen storage disease (GSD Ib) are susceptible to hypoglycaemic episodes. To determine whether an amylase (α‐glucosidase) inhibitor, voglibose, can be useful in the control of hypoglycaemia, we tried it in a 14‐y‐old male with GSD Ib. Oral administration of voglibose prolonged the duration of normoglycaemia and reduced the incidence of hypoglycaemia attacks. These findings indicate that voglibose may be useful for preventing hypoglycaemia in GSD Ib patients.
Clinical features and outcome of eight infants with intrahepatic porto‐venous shunts detected in neonatal screening for galactosaemia
Authors: Ono H , Mawatari H , Mizoguchi N , Eguchi T , Sakura N
Published: August 2010

Of 18 newborn infants found to have persistent galactosaemia and without enzyme deficiencies, intrahepatic porto‐venous (P‐V) shunts were the cause in 8 cases. We retrospectively analysed the clinical and biochemical features of the eight infants. Four patients received prednisolone, one of whom with heart failure owing to arteriovenous shunts also underwent hepatic arterial embolization. The other four patients were merely observed without receiving drug therapy. Regardless of treatment, the P‐V shunts disappeared in five infants before the age of 1 y and persisted in three others. All infants showed mild or moderate abnormalities in liver function tests. None exhibited hyperammonemia or neuropsychiatric symptoms related to the shunts. The data indicated that the prognosis of infants with intrahepatic P‐V shunts is generally good. In the absence of complications related to the P‐V shunts, no treatment other than galactose elimination diet is indicated.
Sensitivity of peak expiratory flow rate for diagnosing bronchial obstruction on methacholine inhalation challenge in school‐aged asthmatic children
Authors: Linna O
Published: August 2010

To study whether forced expiratory volume in 1 s (FEV1) for the diagnosis of bronchial reactivity by means of the methacholine inhalation challenge test could be appropriately replaced by simple measurements of peak expiratory flow rate (PEFR), 75 consecutively referred asthmatic children aged 6–15 y were examined during a symptom‐free period. Their baseline FEV1 and PEFR values ranged from 70 to 130% (mean 99.1) and from 77 to 122% (mean 101.4) of those predicted, respectively. The methacholine inhalation challenge was performed with stepwise doubled cumulative doses and both FEV1 and PEFR were measured at each step. Of the 67 children who had a 20% reduction in either test, the fall in FEV1 was achieved after a lower dose of methacholine than the 20% fall in PEFR in 49 cases, after a higher dose in 15 and after the same dose in 3. There was a significant correlation (r= 0:56, p < 0:001) between the changes in FEV1 and PEFR, although considerable scatter was found in the results. The 64 children who had a reduction of 20% in FEV1 showed a corresponding drop in PEFR that varied from 1.8 to 28.8% (mean 15.3), including 9 children for whom this drop was less than 10%. The results indicate that if the challenge test were based on PEFR measurements, the reference values for the test would have to be different.
Determinants of bone mineral density in prematurely born children aged 6–7 years
Authors: Kurl S , Heinonen K , Länsimies E , Launiala K
Published: August 2010

The aim of this study was to assess the long‐term effects of prematurity and growth during the first year on bone mineralization in prematurely born children. The study group consisted of 38 prematurely born Finnish children (17M, 21F) examined at the age of 6‐7 y. After birth, all children were fed with banked human milk until discharge from hospital. Thereafter, 27 children were partially breastfed until the age of 5–7 months. Infants with gestational age (GA) <33 weeks (n = 25) received calcium 45‐50 mg/100 kcal, phosphorus 40‐45 mg/100 kcal, vitamin A 1000 IU/d, vitamin C 2 mg/d and vitamin D 400 IU/d until 2.5 kg. Infants born > 33 weeks received only vitamin D 400 IU/d. Bone mineral density (BMD) and bone mineral content (BMC) were measured by dual energy X‐ray absorptiometry (DXA) of the lumbar spine (L2‐L4) at 6‐7 y of age. At examination, all children had normal height and weight. BMD values were within the confidence interval of the Finnish reference values. In regression analysis bone area, present weight, GA and weight at 1 y were the most significant factors explaining 77.1% of the variance of BMC. After adjusting for other independent variables the prematurely born children who were thinner at 1 y of age subsequently had higher BMC values when examined at the age of 6‐7 y. This study shows that growth patterns during the first year of life have long‐term effects on bone mineralization.
Changes in Doppler ultrasonography in asphyxiated term infants with hypoxic‐ischaemic encephalopathy
Authors: Ilves P , Talvik R , Talvik T
Published: August 2010

Cerebral blood flow velocity was assessed by pulsed‐Doppler ultrasonography in 39 asphyxiated and 35 healthy term newborn infants during the first days of life. Asphyxiated infants, investigated at the age of 12 ± 2h, with moderate stage hypoxic‐ischaemic encephalopathy (HIE) (n= 7) had decreased (15.6 ± 3.9cm/s) and infants with severe stage of HIE (n= 8) increased (26.5 ± 9.6 cm/s) mean cerebral blood flow velocity in medial cerebral artery compared to the control group (20.9 ± 3.7 cm/s). Four out of six infants with severe stage of HIE and mean cerebral blood flow velocity of 3 SD above the mean for normal infants at the age of 12 h died and two developed multicystic encephalopathy during the neonatal period. We conclude that severe post‐hypoxic increase of mean cerebral blood flow velocity at the age of 12 ± 2 h is connected with development of severe stage HIE and poor prognosis.
A Chinese adolescent girl with Fechtner‐like syndrome
Authors: Leung TF , Tsoi WC , Li CK , Chik KW , Shing MMK , Yuen PMP
Published: August 2010

We describe a 15‐y‐old girl with Fechtner‐like syndrome, who is the first Chinese reported to have this rare syndrome. She presented with left homonymous hemianopia and neuroimaging revealed haemorrhage in both parietal and occipital lobes. Peripheral blood smear showed macrothrombocytopenia and intracytoplasmic inclusion bodies inside leucocytes. Thrombocytopenia and proteinuria responded to intravenous immunoglobulin and pulsed methylprednisolone. This case illustrates that life‐threatening haemorrhage can occur in patients with Fechtner syndrome. Although there was no effective treatment reported in the literature, high dose steroid and immunoglobulin seemed to be useful in our patient. Our patient also had nephritic‐nephrotic syndrome with renal insufficiency, which is unusual in adolescent female patients.
Plasma levels of carboxy terminal propeptide of type I procollagen and pyridinoline cross‐linked telopeptide of type I collagen in healthy school children
Authors: Kikuchi T , Hashimoto N , Kawasaki T , Kataoka S , Takahashi H , Uchiyama M
Published: August 2010

The aim of this study was to reveal the relationship of the plasma levels of the carboxy terminal propeptide of type I procollagen (PICP) and the pyridinoline cross‐linked carboxyterminal telopeptide domains of type I collagen (ICTP) to age and height velocity (HV), and to compare PICP and ICTP levels in those who have not reached their final height with those who have. PICP and ICTP levels were measured by RIA in 271 healthy children (161M, 110F) aged from 10 to 15 y. The HV was calculated from their health check‐up cards. The subjects were divided into two groups in this study: the final height (FH) group whose HV was < 1.0 cm/y, and the non‐final height (NFH) group whose HV in the last year was ≥ 1.0 cm/y. PICP and ICTP levels almost paralleled the values of age‐related changes of HV. Furthermore PICP and ICTP levels significantly correlated with HV. PICP and ICTP levels of the FH group were higher than those of adults previously reported. The values will be useful as reference for healthy children and growth disorder. Before reaching final height, PICP and ICTP can be useful makers of not only bone turnover but also of linear growth. Bone turnover rate is still increasingly active just after linear growth has been completed, and then it become similar to the levels of adults.
The intestinal ecosystem in chronic functional constipation
Authors: Zoppi G , Cinquetti M , Luciano A , Benini A , Muner A , Minelli E Bertazzoni
Published: August 2010

Chronic functional constipation is common in infants, and the bacterial composition of stools in this condition is not known. The study aims were to: (i) investigate the composition of the intestinal ecosystem in chronic functional constipation; (ii) establish whether the addition of the water‐holding agent calcium polycarbophil to the diet induces an improvement in constipation; and (iii) determine the composition of the intestinal ecosystem after the use of this agent. In total, 42 children (20F, 22M; mean age: 8.6 ± 2.9 y) were studied. Twenty‐eight children with functional chronic constipation without anatomical disorders were treated double‐blind in random sequence for 1 month with an oral preparation of calcium polycarbophil (0.62 g /twice daily) or placebo. Intestinal flora composition was evaluated by standard microbiological methods and biochemical assays on faecal samples collected before and after treatment. Fourteen healthy children were studied as controls. The results show that (i) the constipated children presented a significant increase in clostridia and bifidobacteria in faeces compared to healthy subjects–different species of clostridia and enterobacteriaceae were frequently isolated; no generalized overgrowth was observed; Clostridia outnumbered bacteroides and E. coli mean counts by 2–3log, while bacteroides and E. coli counts were similar (5‐6 log 10/g fresh faeces); these intestinal disturbances could be defined as a dysbiosis, i.e. a quantitative alteration in the relative proportions of certain intestinal bacterial species. (ii) Clinical resolution of constipation was achieved only in 43% of treated children and an improvement in 21% (one bowel movement every 2 d). (iii) Calcium polycarbophil treatment induced no significant changes in the composition of the intestinal ecosystem, nor in blood chemistry parameters.
Erythrocyte superoxide dismutase activity and plasma malondialdehyde levels in children with Henoch Schönlein purpura
Authors: Demircin G , öuner A , Ünver Y , Bülbül M , Erdoĝan ö
Published: August 2010

Reactive oxygen molecules (ROM) have been suggested to contribute to many pathological conditions including vasculitides and renal diseases. In the present study we measured the activity of superoxide dismutase (SOD) as an antioxidant enzyme in red blood cells and the level of malondialdehyde (MDA), which is a product and an indicator of lipid peroxidation, in the plasma of 16 children (7M, 9F) with Henoch Schönlein purpura (HSP) at the onset of the disease (SOD 1 and MDA 1) and at the remission period (SOD 2 and MDA 2). The results were compared with the results of 17 healthy children studied as a control group. There was no significant difference for SOD activities between the patients in each period and the control group (p > 0:05). There was a statistically significant difference between MDA 1 and MDA 2 levels (p < 0:01), each of which were also significantly different from the MDA levels of control group (p < 0:001 and p < 0:01, respectively). The effect of ROMs on different clinical conditions of HSP was also examined and lipid peroxidation was found to be increased more in patients with renal involvement. It is concluded that oxidant stress especially lipid peroxidation plays an important role in the pathogenesis of HSP and in development of renal injury.
Quality of life of young adults with idiopathic short stature: effect of growth hormone treatment
Authors: Rekers‐Mombarg LTM , Busschbach JJV , Massa GG , Dicke J , Wit JM ,   the Dutch Growth Hormone Working Group
Published: August 2010

The aim of the study was to evaluate whether treatment with recombinant human growth hormone (rhGH) affects the quality of life of young adults who were diagnosed as idiopathic short stature (ISS) during childhood, and whether their quality of life and aspects of the personality are different from normal. Experiences and expectations concerning rhGH treatment of the subjects and their parents were also investigated. Eighty‐nine subjects were included into the study: 24 subjects (16M, 8F) were treated with rhGH from childhood, whereas 65 subjects (40M, 25F) were never treated. At the time of the interview all subjects had attained final height [mean (SD) ‐2.3 (0.9) SDS for Dutch references], and the age of the treated subjects was 20.5 (1.0)y, and 25.7 (3.5)y of the control subjects (p < 0:001). The level of education was similar, but the treated subjects had less often a partner compared to the control subjects (adjusted for age and gender, p < 0:001). The Nottingham Health Profile and Short Form 36 Health Survey showed no difference in general health state between treated and control subjects, and the healthy Dutch age‐specific references (norm group). Although 74% of the subjects reported one or more negative events related to their height, and 61% would like to be taller, only 22% and 11% were willing to trade‐off at Time Trade‐Off and Standard Gamble, respectively. The personality of the subjects, which was measured by the Minnesota Multiphasic Personality Inventory, was not different from the norm group. The satisfaction with the rhGH treatment was high, as it had caused 12 (8) cm and 13 (7) cm gain in final height according to the subjects and parents, respectively. Based on initial predicted adult height (Bayley & Pinneau), this gain was only 3.3(5.6) cm. We concluded that although the treated subjects had a partner less often when compared to the control subjects, the quality of life of subjects with ISS at adult age is normal and appears not to be affected by rhGH therapy, The treated subjects were very satisfied with the treatment, probably by overestimation of the final height gain.
Failure of short‐term mannose therapy of patients with carbohydrate‐deficient glycoprotein syndrome type 1A
Authors: Kjaergaard S , Kristiansson B , Stibler H , Freeze HH , Schwartz M , Martinsson T , Skovby F
Published: August 2010

Carbohydrate‐deficient glycoprotein syndrome type 1A (CDGS1A) is an inherited disorder with multi‐systemic abnormalities resulting from failure to generate sufficient lipid‐linked oligosaccharide precursor or to transfer the sugar chain to many glycoproteins. Cultured fibroblasts from these patients have reduced incorporation of mannose into glycoproteins which can be corrected by adding D‐mannose to the culture medium. Providing dietary mannose to elevate mannose concentrations in vivo therefore might remedy some of the underglycosylation in the patients. Five children with CDGS1A aged 15 months to 14 y completed a protocol of enteral supplementation with D‐mannose 100 mg/kg every 3 h for 9 d. The mean S‐mannose level increased from 32 μM (range 22‐42 μM) to a trough value of 72 μM (range 39–103 μM). No serious side effects were observed. Surprisingly, the mean serum concentration of four glycoproteins (transferrin, α1‐antitrypsin, antithrombin, and thyroxine‐binding globulin) tended to decrease, and the mean serum concentration of carbohydrate‐deficient transferrin (CDT) increased. Furthermore, the initially present abnormal isoforms of these glycoproteins and of protein C became more prominent and/or additional abnormal isoforms appeared. This short‐term trial does not support a benefit of mannose to the deficient glycosylation of CDGS1A patients.