bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health promotion at Swedish Child Health Centres
Authors: Bremberg S 
Published: August 2010

Effective health promotion intervention is understood to modify appropriate risk and protective factors. The relevance of such interventions for the Child Health Service (CHS) was examined in three steps. In the first step, the six most important public health problems in the target group that might be affected by CHS interventions were identified. The health problems include sudden infant death syndrome (SIDS), mental health problems, injuries, infections, asthma and allergic and nutritional disorders. In the second step, three groups of modifiable determinants were identified: risk and protective factors for (i) SIDS, asthma and allergic disorders and airway tract infections (determinants: breastfeeding, environmental tobacco smoke, sleeping non‐prone and lacking indoor ventilation), (ii) injuries and (iii) mental health problems. In the third step, evidence for the preventive measure's ability to alleviate the effects of these risk factors was scrutinized. Evidence was found for effectiveness of CHS interventions aiming at decrease of environmental tobacco smoke. Evidence was also found for injury prevention provided that the intervention is a part of a wider community effort, and possibly also if it is very focused. Requirements for mental health promotion are also at hand.Thus, effective health promotion via CHS interventions is feasible.
Pediatric journals on the Internet
Authors: Gdalevich M , Mimouni D , Mimouni M 
Published: August 2010

The objective of this study was to evaluate the structure and contents of the websites of the major journals in general pediatrics. A comprehensive search of the Internet was carried out to identify all pediatric journals in English that are listed in the Scientific Citation Index. Websites of 11 journals in general pediatrics were found, and their Web pages were systematically compared. Two of the appraised websites provided free on‐line access to the full journal text, seven had online abstracts, and all provided the table of contents. The contents and abstracts covered varying periods, mostly just a few years back. Most of the journals offered easy search and other navigational options, but only a few allowed electronic submission of manuscripts. Conclusion: We conclude that in the era of immense growth and dissemination of information. aimed either at medical professionals or their patients, general pediatrics journals are lagging behind. The pediatrician today remains dependent on hospital libraries and their limited and sometimes cumbersome capabilities. Only a few of the pediatric journal websites can serve as an efficient online source for updating the knowledge. Further developments in the future should allow for improved services.
Human milk mineral intake and serum concentrations of calcium and phosphorus in newborn term infants: influence of intrauterine growth restriction
Authors: Mataloun MMGB , Leone CR 
Published: August 2010

A prospective case–control study was performed to test the hypothesis that the milk Ca and P contents of term, small‐for‐gestational‐age (SGA) newborns’mothers differs from that of term, adequate‐for‐gestational‐age (AGA) newborns’mothers. We studied 71 pairs of mothers and newborns, divided into two groups: I (control): 41 pairs of mothers and term AGA newborns and I1 (study): 30 pairs of mothers and term SGA newborns. This latter group was subdivided according to type (symmetric: birthweight, length and head circumference < 10th percentile; asymmetric: birthweight < 10th percentile) and severity (<P3: birthweight <3rd percentile and >P3 – <P10: birthweight between 3rd and 10th percentiles) of intrauterine growth restriction (IUGR). Mothers’milk and blood samples were collected for Ca and P analysis using standard techniques (milk on days 3, 15 and 30 postpartum and blood from both the umbilical cord and the newborn on days 15 and 30 of life). There were no differences in blood and human milk Ca and P contents between the two groups. In the study group, milk (p= 0.001) and serum (p= 0.002) P levels and milk Ca (p= 0.002) levels increased during the first month of life. Regarding type and seventy of IUGR, milk P levels increased in the IUGR asymmetric and <P3 groups; serum Ca levels increased in the IUGR >P3 – <P10 group. Conclusion: These findings suggest a tendency towards differences in human milk between AGA and SGA newborns regarding longitudinal variations.
Postnatal cystic germinolysis and neonatal chronic lung disease: evaluation of risk factors and neurodevelopmental outcome
Authors: Smets K , Schwagten B 
Published: August 2010

Late neonatal onset of subependymal germinolysis in the caudothalamic groove has been associated with chronic lung disease. This clinical study had two objectives: (i) to clarify the link between chronic lung disease and germinolysis; and (ii) to evaluate the impact of germinolysis on neuromotor development of patients with chronic lung disease. Twenty‐four patients with chronic lung disease and germinolysis were compared to 24 patients, matched for gestational age, with chronic lung disease but without germinolysis. There was no difference in the occurrence of perinatal risk factors for impaired cerebral development (small for gestational age at birth, impaired postnatal growth, postnatal steroid treatment, duration of mechanical ventilation) or in the presence of clinical markers potentially related to cerebral ischaemia (need for treatment of hypotension or poor perfusion, seizures, oliguria, hypocapnia). Both groups showed a high incidence of clinically significant developmental delay (mean Bayley Development Index of 72 ± 23 [SD] in both groups), regardless of the presence or absence of germinolysis. Conclusions: We were unable to clarify the link between chronic lung disease and germinolysis, and it seems that germinolysis has no major impact on neurodevelopmental outcome of patients with chronic lung disease.
Neonatal withdrawal syndrome after in utero exposure to selective serotonin reuptake inhibitors
Authors: Nordeng H , Lindemann R , Perminov KV , Reikvam A 
Published: August 2010

Selective serotonin reuptake inhibitors (SSRIs) are a new group of antidepressants used in mild to moderate cases of depression. In studies evaluating the safety of SSRIs during pregnancy, no increase in major anomalies has been reported. This might have led to increasing off‐label prescription of SSRIs to pregnant women. Neonatal withdrawal syndrome commonly occurs in infants exposed during the third trimester to drugs known to cause addiction. We report five cases of neonatal withdrawal syndrome after third trimester in utero SSRI exposure. In three cases the mother used paroxetine in doses from 10 to 40 mg, one mother used citalopram 30 mg, and one mother fluoxetine 20 mg. Withdrawal symptoms occurred within few days after birth and lasted up to one month after birth. Four of the infants needed treatment with chlorpromazine. Symptoms were irritability, constant crying, shivering, increased tonus, eating and sleeping difficulties and convulsions. Conclusion: Neonatal withdrawal syndrome can occur after third trimester in utero SSRI exposure. Further research should focus on whether it is safe to use SSRIs during the last trimester. All neonates exposed to SSRIs during the last trimester should be followed‐up closely for withdrawal symptoms after birth.
Predicting serious bacterial infection in young children with fever without apparent source
Authors: Bleeker SE , Moons KGM , Derksen‐Lubsen G , Grobbee DE , Moll HA 
Published: August 2010

The aim of this study was to design a clinical rule to predict the presence of a serious bacterial infection in children with fever without apparent source. Information was collected from the records of children aged 1‐36 mo who attended the paediatric emergency department because of fever without source (temperature ≥38°C and no apparent source found after evaluation by a general practitioner or history by a paediatrician). Serious bacterial infection included bacterial meningitis, sepsis, bacteraemia, pneumonia, urinary tract infection, bacterial gastroenteritis, osteomyelitis and ethmoiditis. Using multivariate logistic regression and the area under the receiver operating characteristic curve (ROC area), the diagnostic value of predictors for serious bacterial infection was judged, resulting in a risk stratification. Twenty‐five percent of the 231 patients enrolled in the study (mean age 1.1 y) had a serious bacterial infection. Independent predictors from history and examination included duration of fever, poor micturition, vomiting, age, temperature <36.7°C or ≥40°C at examination, chest‐wall retractions and poor peripheral circulation (ROC area: 0.75). Independent predictors from laboratory tests were white blood cell count, serum C‐reactive protein and the presence of ≥70 white blood cells in urinalysis (ROC area: 0.83). The risk stratification for serious bacterial infection ranged from 6% to 92%. Conclusion: The probability of a serious bacterial infection in the individual patient with fever without source can be estimated more precisely by using a limited number of symptoms, signs and laboratory tests.
Perianal anatomy in non‐abused preschool children
Authors: Myhre AK , Berntzen K , Bratlid D 
Published: August 2010

The purpose of this study was to describe the normal variation in perianal anatomy in preschool children, selected for non‐abuse, and to compare the findings in two examination positions. A letter of invitation was sent to 3773 children, after which 305 children (103 boys and 202 girls) were recruited. Inclusion in the study was based on self‐selection, whereby parents who did not suspect any occurrence of sexual abuse of their child gave informed consent to participate. The mean age of the children was 5.63 y (range: 5.13–6.75). An anal examination was performed in the left lateral position (LLP) and the prone knee‐chest position (KCP), for approximately 30 s each. A colposcope and a camera were used. All data were systematically analysed for gender differences, and a paired sample test was used to compare findings in LLP and KCP. Venous congestion in LLP and external anal dilatation in both positions were significantly more common in girls, while midline depressions and smooth areas (both positions) were significantly more common in boys. External and total anal dilatation, midline smooth areas and depressions and the occurrence of a prominent anal verge were significantly more common in the KCP. The finding of total anal dilatation was rare. Conclusion: We observed several gender and position differences in perianal anatomy, and most of these findings seem to be related to structure and tone in the anal muscles.
Short‐term prospective study of sleep disturbances in 5–8‐year‐old children
Authors: Smedje H , Broman J‐E , Hetta J 
Published: August 2010

The course and psychological correlates of disturbed sleep during middle childhood were investigated using parents' responses to questionnaires. Five specified sleep disturbances were explored in 614 5–8‐y‐old children, at baseline and at follow‐up, 14 ± 3 mo later. Difficulties falling asleep, in 6.2% of the children at baseline, persisted in 47.4% of the cases at follow‐up; night‐waking, in 18.6% at baseline, persisted in 45.5%; snoring, in 9.4% at baseline, persisted in 60%; nightmares, in 4.4% at baseline, persisted in 29.6%, and bedwetting, in 6% at baseline, persisted in 46%. Moreover, children with difficulties falling asleep at baseline frequently displayed bedtime resistance and shorter sleep at follow‐up, while night‐waking at baseline was related to co‐sleeping at follow‐up. Snoring at baseline was associated with a trend towards restless sleep at follow‐up. Nightmares at baseline were related to several other sleep complaints as well as to behavioural difficulties during daytime at follow‐up. Bedwetting at baseline was associated with tendencies towards hyperactivity at follow‐up. Separate analyses of cases of persisting sleep disturbances showed that persisting difficulties falling asleep were associated with a need to remedy sleep problems, while persisting nightmares were strongly related to reports suggesting behavioural and emotional problems. Conclusion: During middle childhood, difficulties falling asleep, night‐waking, snoring, nightmares or bedwetting commonly persist over the course of a year. Persistent nightmares frequently indicate significant psychological problems in affected children.
Changes in body weight and body mass index (BMI) in teenage girls prior to the onset and diagnosis of an eating disorder
Authors: Swenne I 
Published: August 2010

Growth charts from the school health services were used to study weight changes prior to the onset and diagnosis of eating disorders (ED) with weight loss in 122 teenage girls. In these girls menarche started at 12.6 ± 1.0 y (mean SD), which is the same for the general population. At their maximal premorbid weight, the girls were 14.6 ± 1.2 y of age and had a higher weight and body mass index (BMI) than the general population, as evidenced by standard deviation scores (SDS) above zero for weight (0.65 ± 0.95, p < 0.001) and BMI (0.61 ± 0.94, p < 0.001). Weight gain prior to the onset of weight loss followed two different patterns. Eighty‐three (68%) girls tracked upwards through the weight curves to reach their maximal weight, thus putting on weight at a higher rate than expected. Thirty‐nine (32%) girls tracked downwards through the weight curves to reach their maximal weight, but did so starting from a weight and BMI at well above average. Conclusions: Weight gain in teenage girls prior to the onset of an ED deviates from that of the general population. Being or becoming heavier and less lean than their peers could influence body image and decisions on dieting, which, in turn, may be the start of the development of an ED in the otherwise predisposed. The deviation from normal tracking patterns prior to the onset of disease also causes problems in diagnostic procedures and in setting treatment targets for weight gain, since “normal” or expected weight becomes more difficult to establish.
Causes of childhood deaths in Bangladesh: an update
Authors: Baqui AH , Sabir AA , Begum N , Arifeen SE , Mitra SN , Black RE 
Published: August 2010

Knowledge of the causes of child death is important for health‐sector planning since they relate to available interventions. Little is known about causes of child death in Bangladesh from the conventional sources since there is no vital registration system and very few deaths are attended by a qualified physician. To determine the cause structure of child deaths, verbal autopsy interviews were conducted in the Bangladesh Demographic and Health Survey (BDHS) 1993/94 national sample. Verbal autopsy is a method of finding out the causes of death based on an interview with the next of kin or other caregivers. Between BDHS 1993/94 and BDHS 1996/97, 1–4‐y‐old child mortality in Bangladesh declined by about 27.0%. This impressive decline prompted a verbal autopsy study using the BDHS 1996/97 national sample to determine whether the cause structure had changed. The same verbal autopsy instrument and methods to collect the data and the same computer algorithm to assign causes of death were used in both surveys. Comparison of BDHS 1993/94 and 1996/97 cause‐specific mortality rates revealed that deaths due to almost all causes had declined, although significantly so only for acute respiratory infections (ARI), persistent diarrhoea and drowning. Deaths due to neonatal tetanus, acute watery diarrhoea and undernutrition had not decreased at all. Conclusion: Despite an impressive decline in deaths due to ARI, this condition remains the most important known cause of death in Bangladeshi children. Neonatal tetanus and measles together account for about 10% of deaths in children under 5 y. Further improvements in child survival are possible by improving access to and quality of available child survival interventions.
Childhood and adolescent tuberculosis in northern Taiwan: an institutional experience during 1994–1999
Authors: Wong KS , Chiu CH , Huang YC , Lin TY 
Published: August 2010

This study evaluated the clinical characteristics of childhood and adolescent tuberculosis (TB) at the end of the twentieth century in a referral children's hospital in northern Taiwan. The hospital charts were reviewed retrospectively of children/adolescents aged less than 18 y who were seen in a children's hospital in northern Taiwan between 1994 and 1999 and diagnosed with TB. A total of 62 individuals was diagnosed during this period. The patients' demographic data, presenting symptoms, clinical features, bacteriological results, drug susceptibility and tuberculin skin‐test results were analysed. Most diagnosed cases lay in one of two main age ranges, younger than 5 y and adolescents. The presenting symptoms of study subjects were typically non‐specific. Bone involvement occurred for 21 patients (33.9%) and was the most common extrapulmonary manifestation. Mycobacterium tuberculosis was isolated from 47 patients (75.8%). Five isolates were resistant to pyrazinamide, three to streptomycin and one to isoniazid, but no multidrug resistant isolates of TB were detected from culture‐proven cases. Seventeen of 47 (36.2%) culture‐proven patients revealed negative acid‐fast staining initially but, subsequently, M. tuberculosis was isolated from various clinical specimens using a standard method at a later date. The tuberculin skin test was positive for 24 of 32 patients (75%) who received such an examination.Conclusion: Extrathoracic TB was more common in children below 5y of age than their adolescent counterparts, and chiefly involved the peripheral long bones. The potential drug resistance of M. tuberculosis in childhood and adolescent TB did not appear to have been a major problem in northern Taiwan before the year 2000.
Organization of the neuronal circuits in the central nervous system during development
Authors: Lagercrantz H , Ringstedt T 
Published: August 2010

The human brain is a product of genetic instructions, cellular interactions and influences of innate activity and external stimulation. The formation of the neural tube and the patterning of the brain are determined by homeotic genes. After a prosencephalic phase with the formation of the hemispheres, the neurons prolipherate to number about 100 billion halfway through gestation. They also migrate to their final positions in an inside‐outside fashion with the newly formed neurons at the outer layer of the cortex, followed by synaptogenesis, programmed cell death and organization of the neuronal circuits. This phase is probably determined not only by genes but also by innate activity, which for example has been detected in the foetal retina: “Cells that fire together wire together while those which don't won't”.Conclusion: Development of the neuronal circuits in the CNS can be viewed as epigenetic, i.e. many different components must come together at the right time and place.
Molybdenum in infancy: balance studies in patients with intestinal stomata
Authors: Sievers E , Schleyerbach U , Oldigs H‐D , Arpe T , Schaub J 
Published: August 2010

This study investigated the supply of the essential trace element molybdenum (Mo) in infants with preternatural anus. It was divided into two separate investigations: (A) the complete fecal excretion of nine patients was collected in fractions over 24 h; and (B) 72 h balance studies and parallel plasma analysis were conducted in five infants and complemented by the longitudinal comparison of one of these patients with his (otherwise healthy) premature sister. Atomic absorption spectroscopy (balance studies) and high‐resolution inductively coupled plasma mass spectrometry (HR‐ICP‐MS, plasma) were used for analysis. The following results were obtained. (A) The fecal Mo concentration ranged from 1.98 to 42.02 nmol Mo g−1 dry fecal weight. (B) The daily intake in the balance studies was 43.2 (11.33–100.5) nmol Mo kg−1 and the median retention was –2.91 (–32.45 to 48.6) nmol Mo kg−1. In the premature twins the boy with an intestinal stoma had a negative balance and lost –3.32 μmol within 32 d, while his sister retained +0.45 μmol Mo in the same period. Plasma Mo ranged between 9.4 and 46.7 nmol 1−1. Conclusion: The negative Mo balance results may indicate an increased risk of Mo deficiency in infants requiring a long‐term preternatural anus.
Remission of thrombotic thrombocytopenic purpura in a patient with compound heterozygous deficiency of von Willebrand factor‐cleaving protease by infusion of solvent/detergent plasma
Authors: Kentouche K , Budde U , Furlan M , Scharfe V , Schneppenheim R , Zintl F 
Published: August 2010

Plasma exchange or plasma infusion is considered to be the therapy of choice in patients with thrombotic thrombocytopenic purpura (TTP) who are deficient in von Willebrand factor‐cleaving protease (VWF‐CP). Recently, mutations in the ADAMTS13 gene were identified as being responsible for VWF‐CP deficiency in patients with familial TTP (VWF‐CP deficiency in the absence of an inhibitor). Here we report on a girl who presented with recurrent thrombocytopenia and anaemia since birth, developing the full pentad of characteristic TTP at the age of 16y. Congenital TTP was confirmed on the basis of severe VWF‐CP deficiency in the absence of an acquired inhibitor. The patient was found to be compound heterozygous for two hitherto undescribed mutations in the ADAMTS13 gene: a truncating frame shift mutation, 4143insA in exon 29, and the nonsense mutation 3100A > T in exon 24 (R1034X). After infusion of solvent/detergent plasma, the patient went into remission and remained asymptomatic under regular plasma therapy at 2‐wk intervals for over two years. Conclusion: TTP in childhood may be mild and oligosymptomatic. Determination of VWF‐CP activity is helpful in the differential diagnosis of thrombocytopenia.
Are substitutions in the first hypervariable region of the mitochondrial DNA displacement‐loop in sudden infant death syndrome due to maternal inheritance?
Authors: Arnestad M , Opdal SH , Musse MA , Vege Å , Rognum TO 
Published: August 2010

Aim: To investigate whether all substitutions in the first hypervariable region (HVR1) in sudden infant death syndrome (SIDS) can be recovered along the maternal line of the family (inherited), or whether SIDS victims have new substitutions compared to maternal relatives (somatic mutations) that may be related to environmental factors. Methods: Seventy‐one SIDS/mother pairs, including 11 families with SIDS, mother and mother's relatives and/or SIDS siblings, were studied. The HVR1 sequence was recorded in the base‐pair range 16056‐16400. The recorded HVR1 sequence was compared with the Cambridge sequence, and differences were recorded as substitutions. The substitution pattern in the SIDS victims was compared with the pattern found in family members along the maternal line. Results: All the substitutions found in SIDS victims could be traced in the maternal line of the family; in 5 cases this was observed through three generations, and in 3 cases through four generations. Discussion: In patients with known mitochondrial (mt) DNA disease, a large number of sequence variants have been found in the D‐loop region. Substitutions in the D‐loop may be part of a haplotype with mutations elsewhere in the mtDNA. Conclusion: HVR1 substitutions in SIDS victims are hereditary and not due to somatic mutations.