bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of the ABC pain scale for healthy full‐term babies
Authors: Bellieni Carlo V , Bagnoli Franco , Sisto Renata , Neri Laura , Cordelli Duccio , Buonocore Giuseppe 
Published: August 2010

Abstract Aim: We developed and validated a pain scale (ABC scale) for term babies based on acoustic features of crying. Methods: The scale consisted of three different cry parameters: (a) pitch of the first cry; (b) rhythmicity of the crying bout; (c) constancy of crying intensity. These parameters were previously found to distinguish between medium and high levels of pain measured by spectral analysis of crying. We validated the scale using healthy term babies undergoing routine heel prick. Concurrent validity was assessed comparing pain values obtained with our scale with those obtained with another pain scale; this relationship was also used to assess the sensitivity of the scale. To assess specificity we compared the ABC scores during a painful event (heel prick) with two non‐painful events (preliminary phase of prick in the same group of babies, and heel prick with analgesia in another group). Results: Specificity: (a) analgesic/non‐analgesic comparison, p<0.0001; (b) pain/sham comparison, p<0.0001). Sensitivity: a high correlation between scores of the ABC scale and the Douleur Aigue du Nouveau‐Né scale indicates good sensitivity. Concurrent validity: Spearman ρ=0.91. Internal consistency: Cronbach's α=0.76. Inter‐rater reliability: Cohen's κ for multiple raters=0.83. Intra‐rater reliability: Cohen's κ=0.85. Practicality: All nurses who used it scored the scale as “good”. Conclusion: The ABC scale proved to be simple and reliable for assessing pain in healthy, non‐intubated term newborns.
Discitis in toddlers: A case series and review
Authors: Karabouta Zacharoula , Bisbinas Ilias , Davidson Anne , Goldsworthy Lisa L 
Published: August 2010

AbstractToddlers commonly present to medical services with non‐specific symptoms. The presence of refusal to walk and nocturnal waking with crying should alert clinicians to the possibility of discitis. Conclusion: Features that may alert clinicians to the diagnosis of discitis in young children are reviewed.
Effect of regular ingestion of Saccharomyces boulardii plus inulin or Lactobacillus acidophilus LB in children colonized by Helicobacter pylori
Authors: Gotteland Martin , Poliak Laura , Cruchet Sylvia , Brunser Oscar 
Published: August 2010

Abstract Aim: To evaluate the effect of a probiotic, Lactobacillus acidophilus LB (LB), or a synbiotic, Saccharomyces boulardii plus inulin (SbI), on Helicobacter pylori (Hp) colonization in children. Subjects and methods: A clinical trial was carried out in a school from a low socio‐economic area of Santiago. Two hundred and fifty‐four asymptomatic children (8.40±1.62 y) were screened for Hp by the 13C‐Urea Breath Test (13C‐UBT). Hp‐positive children were randomly distributed into three groups to receive either antibiotic treatment (lanzoprazole, clarythromycin and amoxicillin) for 8 d, or SbI or LB daily for 8 wk. A second 13C‐UBT was carried out at this time. Spontaneous clearance was evaluated in the same way in 81 infected, untreated children. The differences in the δ13CO2 over baseline values before and after treatments (ΔDOB) were evaluated. Results: 182 subjects (71.7%) were colonized by Hp, and 141 of them completed their treatment (22.5% dropout). Hp was eradicated in 66%, 12% and 6.5% of the children from the Ab, SbI and LB groups, respectively, while no spontaneous clearance was observed in the children without treatment. A moderate but significant difference in ΔDOB was detected in children receiving living SbI (−6.31; 95% CI: −11.84 to −0.79), but not in those receiving LB (+0.70; 95% CI: −5.84 to +7.24). Conclusion:
S. boulardii seems promising as an agent that interferes with Hp in colonized individuals. More studies are needed to confirm these results and to elucidate the mechanisms by which Sb inhibits Hp.
Prescribers' indications for drugs in childhood: A survey of five European countries (Spain, France, Bulgaria, Slovakia and Russia)
Authors: Sanz Emilio J , Hernández Miguel A , Ratchina Svetla , Stratchounsky Leonid , Asuncion Peiré Maria , Lapeyre Mestre Maryse , Horen Bernard , Kriska Milan , Krajnakova Halina , Momcheva Hristina , Encheva Daniela , Martínez‐mir Inocencia , Palop Vicente 
Published: August 2010

Abstract Background: Indication‐based, in comparison to diagnoses‐based, drug utilization studies in children are scarce in the literature. Aim: To determine the adequacy of the prescriber's indications for specific drug treatments compared to the current literature in five different European countries; and to show the possibilities of performing indication‐based drug utilization studies. Design: a descriptive, cross‐sectional, international study. Patients and methods: Randomly selected sample of 12 264 paediatric outpatients seen in consultation rooms attended by paediatricians or general practitioners. Data on patient demographics, diagnoses, and pharmacological treatment, with therapeutic indications for each drug, were collected in pre‐designed forms. Diagnoses and indications were coded using the ICD‐9 and drugs according to the ATC classifications. Results: Indications were registered for every drug prescribed in all locations. Antibiotic indications considered incorrect (common cold, upper respiratory tract infections, viral infections, general symptoms or “not specified”) accounted from 24.1% of the total antibiotics prescribed in Tenerife to 67.4% in Slovakia. Incorrect indication of first‐choice antibiotics prescribed in acute otitis media and tonsillitis ranged from 28.9% of total antibiotics use in Russia to 75.4% in Tenerife. Correct antibiotic indications ranged from 23.4% of total antibiotics used in Slovakia to 65.7% in Tenerife. Aspirin use in febrile viral conditions was detected mainly in Toulouse and Russia. Conclusion: The main areas for improvement detected were high use of mucolytics, prescription of aspirin in potential or established viral infections, overuse of antibiotics and identification of specific patterns of incorrect antibiotic prescription and clinical entities associated with each location.
Nils Rosén von Rosenstein and neonatal jaundice in the 18th century
Authors: Willy Ruud Hansen Thor 
Published: August 2010

Abstract Background: Nils Rosén von Rosenstein (1706–1773) was a Swedish nobleman and a professor at Uppsala University. His series of lectures on children's diseases and their treatment was published in 1764 under the title Underrättelser om Barn‐Sjukdomar och Deras Bote‐Medel. Materials and methods: Rosén von Rosenstein's book was translated into several languages. The present paper deals with the opinions and advice proffered on the jaundiced neonate in chapter 25 of the Danish edition from 1769. Results: The distinction between jaundice in the neonate and jaundice in older children is not clear everywhere in the chapter, and much of Rosén von Rosenstein's advice on therapy appears to be intended for all age groups. Rosén von Rosenstein believed that neonatal jaundice was less common in Sweden than elsewhere, and ascribed this to the common practice of purging newborns with a manna sugar laxative. The principal cause of jaundice, according to Rosén von Rosenstein, was bile stasis. When milk curdled in the stomach, the curds could plug the common bile duct, and bile would be forced into the lymphatics and from there into the blood. Thus, the bile was carried around the body and caused the skin and the sclera, as well as other organs, to become yellow. Cure was usually easy—a laxative in the form of puréed manna with powdered rhubarb was what Rosén von Rosenstein recommended. Conclusion: Rosén von Rosenstein's opinions and advice concerning neonatal jaundice were not original, and did not differ from those found in other medical texts from the 18th and 19th centuries. The bile stasis explanation for all kinds of jaundice, including neonatal jaundice, was widely held in the 18th century, and continued to predominate in paediatric texts until the end of the 19th century. Similarly, laxatives and enemas as the cure‐all for many ailments held sway until the late 1800s.
Congenital chylothorax associated with isolated congenital hypoplastic superior caval vein: A case report
Authors: Lee Chune‐Yi , Jan Sheng‐Ling , Wang Teh‐Ming , Chi Ching‐Shiang 
Published: August 2010

AbstractCongenital absence, or hypoplasia, of the superior vena cava (SVC) with situs solitus is quite uncommon. Most cases have been found incidentally and concomitant with left persistent SVC or other cardiac disorders. Congenital chylothorax may be associated with cardiac anomalies, various syndromes, thoracic ductal or venous thrombosis, birth trauma or local compression of the thoracic duct, but it is rarely caused directly by congenital SVC anomalies. Conclusion: We report a rare case of congenital chylothorax associated with isolated congenital hypoplastic SVC and underdeveloped collateral circulation.
Low soluble Fas (sFas) and sFas ligand (sFasL) content in breast milk after preterm as opposed to term delivery
Authors: Jochum F , Loui A , Weber A , Felderhoff‐Mueser U , Bührer C , Dudenhausen JW , Obladen M 
Published: August 2010

Abstract Aim: Various mechanisms of innate immunity and gastrointestinal integrity are potentially affected by soluble Fas (sFas) and sFas ligand (sFasL). Assuming that sFas and sFasL in milk reflect cellular events during lactogenesis, we aimed to assess the impact of premature parturition and duration of lactation on the concentrations of sFas and sFasL in human milk. Patients and methods: The content of the soluble form of the cell surface receptor Fas (sFas) and its natural ligand (sFasL) was measured in human breast milk of 44 healthy mothers after preterm (<35 wk, n=21) and term (>37 wk, n=23) delivery. Milk was furthermore classified as immature breast milk (days 4–7 of lactation) or mature breast milk (days 35–45 of lactation). Breast milk (2–3 ml) was sampled 5 min after the start of breastfeeding by manual expression or milk pump, and stored at −20°C until analysis by an ELISA. Results: sFas and sFasL concentrations were lower in immature milk after preterm compared to term delivery (sFas: 1.71; 1.38–2.47 ng/ml vs 3.03; 2.02–4.30 ng/ml, p<0.001; sFasL: 0.13; 0.07–0.21 ng/ml vs 0.29; 0.15–0.60 ng/ml, p<0.001 [median ± interquartile range]). Mature milk samples, taken 1 mo later from both gestational groups, did not differ in sFas/sFasL content. Soluble Fas was positively correlated with sFasL in the same sample of immature (p<0.001) and mature human milk (p<0.05). A positive correlation was found between sFas and sFasL in immature and mature milk samples of the same mother (p<0.01). The body mass index of the mothers and duration of pregnancy were positively correlated with the sFas and sFasL content in immature milk (p<0.05 and p<0.01, respectively) but not in mature milk.
Respiratory syncytial virus infection in children hospitalized for wheezing: Virus‐specific studies from infancy to preschool years
Authors: Kotaniemi‐Syrjänen Anne , Laatikainen Aino , Waris Matti , Reijonen Tiina M , Vainionpää Raija , Korppi Matti 
Published: August 2010

Abstract Aim: To evaluate whether the presence of immunoglobulin G (IgG) antibodies against respiratory syncytial virus (RSV) in early childhood is associated with later asthma, and to evaluate a new diagnostic test for RSV, reverse‐transcription polymerase chain reaction (RT‐PCR), comparing it to the antigen and antibody assays initially used in RSV diagnostics in the present cohort. Methods: At the start of the study in 1992–1993, RSV was studied by antigen detection (using time‐resolved fluoroimmunoassay) and complement‐fixing antibody assay. Advances in methodology allowed us to supplement RSV studies by RT‐PCR in frozen nasopharyngeal aspirates obtained on admission, and by specific IgG antibodies (using enzyme immunoassay) in frozen serum samples obtained during the follow‐up. Results: On admission, 29 of the 100 children hospitalized for wheezing at <2 y of age were RSV positive. When compared with conventional methods, the sensitivity of RT‐PCR was 83% (100% w.r.t. antigen detection) and its specificity was 92% in diagnosing RSV infection. RSV‐specific IgG antibody concentrations rose with age, but were not predictive of asthma at any age. In the present cohort, wheezing without RSV was particularly associated with increased risk for later childhood asthma. Conclusion: Hospitalization for wheezing in infancy is associated with increased risk for later childhood asthma, particularly in children without RSV infection on admission, although children with RSV have also slightly increased risk for later asthma. However, mere serological evidence of RSV infection is not associated with the development of asthma. In addition to RSV, more attention should be paid to less virulent agents in order to find those wheezing infants who are at particular risk of later childhood asthma.
Short‐term outcome in infants with a birthweight less than 501 grams
Authors: Rieger‐Fackeldey E , Schulze A , Pohlandt F , Schwarze R , Dinger J , Lindner W 
Published: August 2010

Abstract Aim: To report survival and morbidity until discharge in preterm infants < 501 g with life support started immediately after birth. Methods/study design: Cohort study of all preterm infants with birthweights < 501 g born in three tertiary perinatal centres between 1 January 1998 and 31 December 2001 (gestational age (GA) 25.2 [21.0–30.7] wk; birthweight 435 [290–500] g; median [range]). Results: A total of 107 infants with birthweights<501 g were born. Twenty‐nine were stillborn. A prenatal decision to initiate life support immediately after birth was reached in 9/37 (24%) infants<24.0 wk GA and in 39/42 (93%) infants 24.0 wk GA. Survival was 3/37 (8%) and 26/41 (63%) in infants<24 wk GA and 24.0 wk GA, respectively. Twenty‐nine of the 48 infants with immediate life support (60%) survived (95% CI: 46–75%). Forty‐two of these 48 (88%) infants were small for gestational age. No infant without immediate life support survived (0/30). Twenty‐three (79%) survivors developed chronic lung disease (CLD) and eight (28%) received photocoagulation for retinopathy of prematurity (ROP). Conclusion: In this population of extremely low birthweight infants, survival was higher than in previous studies when life support was provided immediately after birth. Short‐term morbidity was similar to other studies. The presented data on survival support our concept to offer immediate life support after birth in preterm infants with birthweights<501 g. The long‐term outcome of these infants needs to be assessed urgently.
Upper segment/lower segment ratio and armspan–height difference in healthy Turkish children
Authors: Turan Serap , Bereket Abdullah , Omar Anjum , Berber Mustafa , Ozen Ahmet , Bekiroglu Nural 
Published: August 2010

Abstract Aim: The determination of body proportions is an important part of the clinical evaluation of children with short stature. The upper segment/lower segment ratio (US/LS ratio) and armspan–height difference is commonly used for this purpose. However, reference data are scarce in this respect, and available standards do not include standard deviations for the measurements. We aimed to establish the normal values for upper segment/lower segment ratio and armspan–height difference in Turkish children. Methods: In the present study, height, upper and lower segment, and armspan were measured in 1302 healthy children (3–18 y). The age‐related mean and standard deviation curves of the US/LS ratio and armspan–height difference were constructed for each sex. Results: The mean values of the US/LS ratio in boys were decreased from 1.108 at 3 y to 0.984 at 10 y. The nadir of the US/LS ratio (0.922) was reached at age 15 y. In girls, the mean value of the US/LS ratio gradually decreased to less than 1 at 9 y of age (1 y earlier than in boys). The nadir of the US/LS ratio (0.946) was reached at age 13 y in girls (2 y earlier than in boys). Armspan was shorter than height as expected in younger ages, but became slightly longer at around age 12 in girls and boys. Unlike boys, the armspan–height difference did not change much after puberty in girls. Conclusion: US/LS ratio and armspan–height difference are practical parameters and easy to perform in any setting. We hope that these standards will aid clinicians in the evaluation of children with short stature.
Mortality among persons with a history of Kawasaki disease in Japan: Can paediatricians safely discontinue follow‐up of children with a history of the disease but without cardiac sequelae?
Authors: Nakamura Yosikazu , Aso Eiko , Yashiro Mayumi , Uehara Ritei , Watanabe Makoto , Tajimi Morihiro , Oki Izumi , Ojima Toshiyuki , Yanagawa Hiroshi , Kawasaki Tomisaku 
Published: August 2010

Abstract Aim: To clarify the question of whether patients with Kawasaki disease suffer a higher mortality rate after the incidence of the disease in comparison with age‐matched healthy individuals. Methods: Between July 1982 and December 1992, 52 collaborating hospitals collected data on all patients having a new, definite diagnosis of Kawasaki disease. Patients were followed up until 31 December 2001 or their death. The expected number of deaths was calculated from Japanese vital statistics data and compared with the observed number. Results: Of 6576 patients enrolled, 29 (20 males and 9 females) died. The standardized mortality ratio (SMR: the observed number of deaths divided by the expected number of deaths based on the vital statistics in Japan) was 1.15 (95% CI: 0.77–1.66). In spite of the high SMRs during the acute phase, the mortality rate was not high after the acute phase for the entire group of patients. Although the SMR after the acute phase was 0.75 for those without cardiac sequelae, six males (but none of the females) with cardiac sequelae died during this period; and the SMR for the male group with cardiac sequelae was 1.95 (95% CI: 0.71–4.25). The mortality from congenital anomalies of the circulatory system was elevated, but no increase in cancer deaths was observed. Conclusion: Although it was not statistically significant, the mortality rate among males with cardiac sequelae due to Kawasaki disease appeared to be higher than in the general population. On the other hand, the mortality rates for females with the sequelae and both males and females without sequelae were not elevated.
Interferon γ and tumour necrosis factor α in relation to anaemia and prognosis in childhood cancer
Authors: Ek Torben , Mellander Lotta , Abrahamsson Jonas 
Published: August 2010

AbstractThis study examined whether the initial plasma levels of tumour necrosis factor α (TNFα) and interferon γ (IFNγ) in 131 children with newly diagnosed cancer were associated with haematopoietic suppression, and whether plasma levels of TNFα or haemoglobin at diagnosis affects long‐term prognosis in childhood acute lymphoblastic leukaemia (ALL). Conclusions: IFNγ, and possibly also TNFα, were related to anaemia in children with solid tumours. Neither TNFα levels nor Hb levels were associated with increased risk of ALL relapse.
Biliary atresia research is crossing national and interdisciplinary borderlines by the European Biliary Atresia Registry (EBAR)
Authors: Petersen Claus , Melter Michael , Leonhardt Johannes , Becker Thomas , Harder Dörte 
Published: August 2010

AbstractThe European Biliary Atresia Registry (EBAR) was founded in 2001 in order to raise awareness of the rare disease biliary atresia and to reinforce international and interdisciplinary cooperation. The number of participating centres and registered patients increases continuously. EBAR activities can be found at the website http://www.biliary‐atresia.com. A first evaluation of the EBAR data is scheduled for 2006, when the registry will alter its infrastructure. This meeting will be organized together with the European Federation for Biliary Atresia Research (EFBAR), a scientific committee, which was founded in 2003. The objectives of this association are to create clinical and basic research studies, which are based on existing registries in Europe.
Severe food‐allergic reactions in children across the UK and Ireland, 1998–2000
Authors: Colver Allan F , Nevantaus Heidi , Macdougall Colin F , Cant Andrew J 
Published: August 2010

Abstract Aim: Medical and lay concerns about food allergy are increasing. Whilst food allergy may be becoming more common, fatal reactions to food in childhood are very rare and their rate is not changing. We sought to establish how common severe reactions are. Methods: Prospective survey, 1998 to 2000, of hospital admissions for food‐allergic reactions—conducted primarily through the British Paediatric Surveillance Unit, covering the 13 million children in the United Kingdom and Ireland. Results: 229 cases reported by 176 physicians in 133 departments, yielding a rate of 0.89 hospital admissions per 100 000 children per year. Sixty‐five per cent were male, 41% were under 4 y and 60% started at home. Main allergens were peanut (21%), tree nuts (16%), cow's milk (10%) and egg (7%). Main symptoms were facial swelling (76%), urticaria (69%), respiratory (66%), shock (13%), gastrointestinal (4%). Fifty‐eight cases were severe. Three were fatal, six near fatal, and 8 of these 9 had asthma with wheeze being the life‐threatening symptom. Three near‐fatal cases received excess intravenous epinephrine. None of the non‐fatal reactions resulted in mental or physical impairment. Seven of 171 non‐severe and 6/58 severe cases might have had a worse outcome if epinephrine auto‐injectors had been unavailable. Six of the severe cases might have benefited if auto‐injectors had been more widely prescribed. Conclusion: In the United Kingdom and Ireland, the incidence of severe reactions is low. The study highlights that: asthma is a strongly significant risk factor for a severe reaction and therefore warrants optimal management; severe wheeze is a prominent feature of severe reactions and warrants optimal management; intravenous epinephrine should be used with great care if needed. Epinephrine auto‐injectors do not always prevent death, but our study design and data do not allow a definite statement about whether overall they are beneficial.
Chlamydia pneumoniae infection predicts a reduced risk for subsequent atopic disease
Authors: Normann Erik , Gnarpe Judy , Gnarpe Håkan , Wettergren Björn 
Published: August 2010

Abstract Aim: To investigate long‐term effects on children previously infected with Chlamydia pneumoniae. Methods: A follow‐up questionnaire was sent to all participants from a former population‐based study in order to investigate health status during the 4 y that had elapsed between the two studies. In the original study, the prevalence of C. pneumoniae infection was 23% as determined by PCR analyses on throat swab specimens. These PCR results were found to have no detectable correlation for clinical disease. The main outcome measures in this follow‐up study were the reported prevalence of respiratory tract infections, asthma and allergy. Results: Approximately 83% completed the follow‐up questionnaire. No increase in respiratory tract infections was reported by children previously found to have C. pneumoniae infection. A diagnosis of allergy was more common in the former PCR‐negative population (13.4% vs 4.7%, p<0.03). The differences were most apparent in the population with atopic heredity. In a logistic regression model with different suggested risk factors for allergy, earlier infection with C. pneumoniae reduced the risk for allergy (OR=0.13; 95% CI: 0.02–0.99). This was not found for asthma. Conclusion: A positive PCR test for C. pneumoniae in young children was associated with a lower risk of developing allergic airway disease in this study population, and did not predict an increase in respiratory tract infections.