bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gastrin, somatostatin and infantile hypertrophic pyloric stenosis
Authors: Dick AC , Ardill J , Potts SR , Dodge JA 
Published: August 2010

Despite multiple and often contradictory research, no firm conclusions regarding the role of hypergastrinaemia in infantile hypertrophic pyloric stenosis (IHPS) have been established. Evaluation of somatostatin, the main physiological antagonist of gastrin, has not been assessed in previous studies. Long‐term evaluation following pyloromyotomy suggests persistent abnormalities in gastrin and somatostatin in IHPS. The objective of this case‐controlled study was to compare fasting serum gastrin and somatostatin levels in IHPS. Serum sample were collected from 39 children with IHPS at the time of pyloromyotomy and 20 age‐matched controls with no evidence of gastrointestinal disease. Standard radioimmunoassay techniques were used to detect circulating levels of the hormones. A two‐tailed t‐test was used for statistical analysis. The levels of the two hormones (mean ± SEM) revealed that there was no evidence of hypergastrinaemia in IHPS compared with controls (75.6 ±16.1 and 68.1 ± 7.8 ng l−1, respectively), but that the level of somatostatin was significantly elevated (38.9 ±6.4 and 30.5 ± 5 8 ng l−1, p = 0.016). An inverse trend in the gastrin/somatostatin levels could not be identified in IHPS.Conclusion: Somatostatin but not gastrin is raised in IHPS. Somatostatin is known to inhibit the actions of inhibitory neurotransmitters in the pylorus and may explain the development of pylorospasm, which is believed to be important in the development of pyloric tumours. These results do not agree with a previous long‐term follow‐up study, but reflect the hormonal imbalance at the time of pyloric hypertrophy.
Iron‐fortified and unfortified cow's milk: Effects on iron intakes and iron status in young children
Authors: Virtanen MA , Svahn CJE , Viinikka LU , Raiha NCR , Siimes MA , Axelsson IEM 
Published: August 2010

Iron intakes and iron status were evaluated in 36 young Swedish children given either iron‐fortified or unfortified cow's milk. All children had good iron status and had received breast milk or ironfortified formulae during infancy. Twenty 1‐y‐old children were randomized to a diet with iron‐fortified milk (7.0 or 14.9 mg Fe T−1) and 16 to a diet with unfortified milk. The iron intakes in the unfortified group at 15 and 18 mo (mean ± SD 5.19 ± 2.29 and 5.84 ± 1.62 mg d−1) were low in relation to Nordic Nutrition Recommendations, while the intakes in the iron‐fortified group (10.20 ±2.60 and 10.87 ± 2.79 mg d−1) were normal in relation to recommendations. The gain (increase) from receiving fortified diet during the study period was at most [upper limit for 95% confidence interval (CI)] 2.6 g T−1 in blood haemoglobin, 1.9 fl in mean corpuscular volume, 2.7 Limol in serum iron and 4.5% in transferrin iron saturation, and the gain (decrease) was at most (lower limit for 95% CI) 0.29 g T−1 in serum transferrin and 0.9 mgr−1 in serum transferrin receptor (TfR). None of these differences was statistically significant. There was an almost significantly higher increase in serum ferritin (1.4 times higher relation of values at the end compared with the beginning, p= 0.06) and a significantly higher (1.2; p= 0.047) decrease in TfR/ log10 ferritin ratio in the fortified group. Conclusion: One‐year‐old children starting out with good iron status given either iron‐fortified or unfortified cow's milk from 12 to 18 mo maintain sufficient iron status during this period. However, children fed unfortified cow's milk have an iron intake which is low in relation to recommendations and the quantitative development of their reserve iron in iron stores seems to be weaker than that of the fortified group. The consequences of this require further study.
Precocious puberty in children with tumours of the suprasellar and pineal areas: Organic central precocious puberty
Authors: Rivarola MA , Belgorosky A , Mendilaharzu H , Vidal G 
Published: August 2010

During the past 11 y, 115 children younger than 8/9 y of age (female/male) with tumours of the suprasellar or pineal areas were followed in our clinic to study the incidence of precocious puberty. In addition, type of central lesion, clinical characteristics and gonadotropic secretion were studied in order to elucidate the different mechanisms of gonadal activation. A control group of 21 patients with idiopathic precocious puberty and a control group of 10 age‐matched patients with suprasellar tumours without precocious puberty were also studied. Precocious puberty associated with organic central lesions was found at diagnosis in 30 patients (26%), in 9 out of 48 patients with glial cell tumours (18.7%), 6 out of 9 patients with gem cell tumours (66.6%), 11 out of 11 patients with hypothalamic hamartomas (100%) and in 4 out of 4 patients with subarachnoid cysts or arachnoidocele (100%). Precocious puberty was not found in any of 36 patients with craniopharyngioma. With the exception of one patient with pineal germinoma, all lesions were localized to the suprasellar area. In all patients with hypothalamic hamartoma, precocious puberty was diagnosed before 4 y of age, while in most patients with the other lesions, it was diagnosed after this age. Height SDS, weight increase and advancement of bone age were similar in both idiopathic and organic central precocious puberty. Maximal LH responses to GnRH in idiopathic and organic central precocious puberty were similar except for germ cell tumours. Patients with suprasellar tumours without precocious puberty had lower maximal LH (but not FSH) responses to GnRH, with the exception of germ cell tumours. In the latter, elevation of serum β‐hCG indicates that this gonadotropin was responsible for gonadal stimulation. In hypothalamic hamartomas, the prepubertal hiatus in the activity of the GnRH pulse generator was absent. The mechanism of this failure in the inactivation of GnRH is unknown. Data suggest that in glial cell tumours and in subarachnoid cysts, an unknown factor, probably secreted by the tumours, advances the tempo of GnRH maturation. Therefore, the aetiology of organic central precocious puberty is multiple and is directly related to location and type of lesion. Conclusion: This clinical information suggests that the onset of puberty is not the result of the disruption of a putative pulse generator inhibitory influence but the consequence of secretion of stimulatory substances by the lesions.
Spectrum of outcome in infants with extreme neonatal jaundice
Authors: Hankø E , Lindemann R , Hansen TWR 
Published: August 2010

The increasing number of case reports on neurologic sequelae related to hyperbilirubinaemia may represent a re‐emergence of kernicterus in the industrialized world. However, not much has been written about infants who survived extreme levels of serum bilirubin without neurologic damage. We present three cases of extreme neonatal hyperbilirubinaemia, all with peak serum bilirubin levels >600 mmol/L. Two of the infants developed neurologic sequelae, but the third infant did not. In contrast to the two with sequelae, the infant without sequelae was female, had a positive Coombs' test, less clinical signs compatible with bilirubin encephalopathy, and a shorter exposure to serum bilirubin values >400 mmol/L. Conclusion: The basic mechanism of bilirubin neurotoxicity remains unknown, and it is not clear why some infants do not develop neurologic injury at serum bilirubin levels at which others do. We speculate that a comparison between patients with sequelate and those without may yield important information.
Childhood acute rheumatic fever in Greece: Experience of the past 18 years
Authors: Giannoulia‐Karantana A , Anagnostopoulos G , Kostaridou S , Georgakopoulou T , Papadopoulou A 
Published: August 2010

This study reports on the authors' experience with acute rheumatic fever (ARF) during the years 1980–1997. The objectives were to estimate the incidence of the disease an area of Greece to characterize its epidemiology, to determine the frequency of the antecedent symptoms and to describe its clinical presentation. The medical records of 66 confirmed cases admitted to the First Department of Pediatrics, “Aghia Sophia” Children's Hospital, were reviewed. Two outbreaks occurred during this period. In contrast to the 3–4 cases seen every year, 14 cases were diagnosed during the 6 mo period from October 1989 to March 1990. An additional 10 cases were diagnosed in 1993. Most of the children (76%) were between 8 and 14 y old. The children were predominantly from middle‐class families with ready access to medical care. Carditis, evident by auscultation, and arthritis were the dominant major manifestations in 70% and 68% of the cases, respectively. Mild carditis was present in 54% of children with valvular disease.Conclusion:ARF exists in the paediatric Greek population with exacerbations and remissions, but the cardiac manifestations appear mild or moderate.
Early discharge of preterm infants followed by domiciliary nursing care: parents' anxiety, assessment of infant health and breastfeeding
Authors: Örtenstrand A , Winbladh B , Nordström G , Waldenström U 
Published: August 2010

The aim of this study was to evaluate the effect of early discharge of preterm infants, followed by domiciliary nursing care, on the parents'anxiety, their assessment of infant health and breastfeeding. Seventy‐five families including 88 preterm infants who were physiologically stable but in need of further special care, such as gavage feeding, were allocated to an early discharge group (EDG) that was offered home visits (n= 40), or to a control group offered standard neonatal care (CG) (n= 35). Seventy families (37 in the EDG and 33 in the CG) completed the study to the 1‐y follow‐up. Data were collected by means of questionnaires on three occasions: in the EDG, at hospital discharge, on completion of the domiciliary care programme and after 1 y, and in the CG at the corresponding points in time, which were during hospitalization, at hospital discharge and after 1 y. No statistical differences were observed between the groups in emotional well‐being, except that mothers in the EDG had a lower level of situational anxiety at the time of hospital discharge compared with CG mothers whose infants remained in hospital. One year after the birth, the EDG mothers said they had felt better prepared to take responsibility for the care of their babies after completion of the domiciliary care programme, in contrast to CG mothers. However, no statistical differences were observed in the recollection of anxiety, confidence in handling the baby and periods of mental imbalance. No statistical difference was observed in breastfeeding rates between the groups. Fathers in the EDG group tended to perceive their babies as being healthier, compared with CG fathers. Conclusion: Early discharge of preterm infants followed by domiciliary nursing care did not seem to have any major effect on the parents' anxiety and their assessment of infant health.
Screening of rotavirus and adenovirus infections during prolonged hospitalization in a neonatal unit
Authors: Hällström M , Vesikari T , Janas M , Ikonen S , Tammela O 
Published: August 2010

Rotavirus and adenovirus infections in 308 infants hospitalized for longer than 1 wk, and cases with necrotizing enterocolitis, were screened in a neonatal unit during a 15 mo period, covering two rotavirus epidemics in the community. Altogether, 1020 stool samples were collected weekly until hospital discharge, and in necrotizing enterocolitis cases at the onset of symptoms, and tested for rotavirus and adenovirus by means of enzyme‐linked immunosorbent assay. The positive samples were further analysed by polymerase chain reaction. Enzyme‐linked immunosorbent assay revealed five adenovirus‐positive cases, which were tested negative by polymerase chain reaction. Out of 16 necrotizing enterocolitis cases, one was adenovirus‐ and another rotavirus positive when tested by polymerase chain reaction, the latter having a concomitant Candida albicans septicaemia. Conclusion: Routine rotavirus and adenovirus screening in hospitalized neonates seems to be unnecessary. Viral diagnostic examinations should be considered in patients with necrotizing enterocolitis.
Early dexamethasone decreases expression of activation markers on neutrophils and monocytes in preterm infants
Authors: Nupponen I , Repo H , Kari A , Pohjavuori M , Andersson S 
Published: August 2010

Aim: To investigate the effects of early dexamethasone administration on activation of circulating neutrophils and monocytes in preterm infants with respiratory distress syndrome requiring treatment with surfactant. Methods: Neonates (n= 30) with respiratory distress were randomized to receive dexamethasone (DEX group, 29.1 ± 1.2 wk, 1223 ± 156 g, n= 15) from the first postnatal day, or to serve as controls (control group, 29.2 ± 1.4 wk, 1250 ± 148 g, n= 15). Dexamethasone was given as a 4 d course (0.5 mg kg−1 on postnatal days 1 and 2, and 0.25 mg kg−1 on days 3 and 4). Polymorphonuclear leucocyte (PMN) and monocyte surface expression of CD11b, L‐selectin and CD14 was quantified with flow cytometry, and plasma macrophage‐inflammatory protein‐1α (MIP‐1α) with an enzyme‐linked immunosorbent assay. Blood samples were collected on days 1, 2–3 and 5–7. Results: In the DEX group 1/15, and in the control group 7/15 developed bronchopulmonary dysplasia (p < 0.04). PMN CD11b (median 100, range 70‐190 vs 154, 96–213, p= 0.01), monocyte CD14 (235, 102–433 vs 355, 219–533, p= 0.01) and plasma MIP‐1α (20 ng 1−1, 20–32 vs 37 ng 1−1, 20–70, p= 0.005) were lower in the DEX group at days 2–3. All adhesion molecule expression and plasma MIP‐1α levels were comparable at days 5–7, with the exception of monocyte L‐selectin expression levels, which remained lower in the DEX group. Conclusion: In preterm infants with respiratory distress syndrome, early dexamethasone causes downregulation of PMN and monocyte activation. This may attenuate pulmonary inflammation and improve pulmonary outcome.
Asthma hospitalizations continue to decrease in schoolchildren but hospitalization rates for wheezing illnesses remain high in young children
Authors: Wennergren G , Strannegård I‐L 
Published: August 2010

Aim: To analyse changes in hospitalization rates for asthma in children during recent years. Methods: In a population‐based analysis, changes in asthma hospitalization rates were studied in children in Göteborg (Gothenburg), the second largest city in Sweden, during 1985‐2000. The changes in different age groups have been correlated with the delivery of inhaled corticosteroids to the age groups. Results: In the 5 to 18‐y age group, there was a continuous, significant decrease in number of hospital days, admissions and individual patients admitted for asthma not only for the entire study period, 1985‐2000, but also during the past 10‐y period. The number of hospital days in the year 2000 was only 6% of the figure for 1985. An inverse correlation between delivery of inhaled corticosteroids and hospitalization for asthma was seen not only during 1985‐1995, when use of inhaled corticosteroids became widespread (rS=−0.95, p= 0.007 for hospital days), but also when the entire period from 1985 to 2000 was analysed. Conversely, in the 0 to 1‐y and 2 to 4‐y age groups, there was no decrease in hospitalizations for wheezing illnesses or asthma‐like symptoms during the past 10‐y period, 1991‐2000. Conclusion: During the period 1985‐2000 the number of hospital days owing to asthma decreased by more than 90% in the 5 to 18‐y age group. The marked decrease in asthma hospitalization rates among schoolchildren represents a great advance in paediatric respiratory medicine, which has been continuous during the past 10‐y period. However, in young children admissions for wheezing have apparently not decreased.
Effect of a microaerosol filter on spirometry in children with cystic fibrosis
Authors: Rogers D , Doull IJM 
Published: August 2010

Aim: To measure the effect of an in‐line microaerosol filter on spirometric values in cystic fibrosis (CF). Methods: Twenty‐six subjects with CF undertook a randomized, open, cross‐over comparison of spirometry with and without an in‐line filter. Results: The filter had no significant effect on spirometric parameters nor was there any order effect. Measurement error was unrelated to the magnitude of the measurement. Conclusion: In‐line microaerosol filters do not affect spirometric values or variability in children with CF.
ORACLE—antibiotics for preterm prelabour rupture of the membranes: short‐term and long‐term outcomes
Authors: Kenyon S , Taylor DJ , Tarnow‐Mordi WO ,   ORACLE Collaborative Group
Published: August 2010

Preterm prelabour rupture of the foetal membranes (pPROM) is the most common antecedent of preterm birth and can lead to death, neonatal disease and long‐term disability. Previous small trials of antibiotics for pPROM suggested some health benefits for the neonate, but the results were inconclusive. A large, randomized, multicentre trial was undertaken to try to resolve this issue. In total, 4826 women with pPROM were randomized to one of four treatments: 325 mg co‐amoxiclav plus 250 mg erythromycin, co‐amoxiclav plus erythromycin placebo, erythromycin plus co‐amoxiclav placebo, or coamoxiclav placebo plus erythromycin placebo, four times daily for 10 d or until delivery. The primary outcome measure was a composite of neonatal death, chronic lung disease or major cerebral abnormality on ultrasonography before discharge from hospital. The analysis was undertaken by intention to treat. Indications of short‐term respiratory function, chronic lung disease and major neonatal cerebral abnormality were reduced with the prescription of erythromycin. In contrast, the use of co‐amoxiclav was associated with a significant increase in the occurrence of neonatal necrotizing enterocolitis. Conclusion: Prophylactic antibiotics can play a role in preterm prelabour rupture of the membranes in reducing infant morbidity.
Brain damage markers in children. Neurobiological and clinical aspects
Authors: Leviton A , Dammann O 
Published: August 2010

The presence in blood of proteins normally confined to the cytoplasm of brain cells is considered peripheral evidence of brain damage. Only recently have these proteins been measured in the blood of children at risk of brain damage. To show the value and limitations of measuring these proteins, we review their biology and the adult literature that has correlated the blood concentrations of these proteins with lesion size and dysfunction. Conclusion: We conclude that brain damage markers will increasingly be measured in the blood of newborn s and other children at risk of brain damage.
Laboratory‐confirmed reinfections with Bordetella pertussis
Authors: Versteegh FGA , Schellekens JFP , Nagelkerke AF , Roord JJ 
Published: August 2010

Susceptibility to infection with Bordetella pertussis re‐emerges several years after pertussis vaccination. However, the duration of immunity after natural infection with B. pertussis, postulated to be lifelong, is not known. In an ongoing study, the longitudinal course of pertussis antibodies in patients who have had laboratory‐confirmed pertussis is being followed using sera obtained at irregular intervals. In 4 patients a reinfection with Bordetella pertussis is described respectively 7 (patient A), 12 (patients B and C) and 3.5 (patient D) y after the first infection. It seems that the longer the interval between the infections the more severe the complaints. Conclusion: To the authors' knowledge, these are the first patients in whom symptomatic reinfection with B. pertussis has definitely been proven by laboratory confirmation of both episodes. Bordetella pertussis infection should be considered in patients with symptoms of typical or atypical whooping cough, irrespective of their vaccination status or previous whooping cough.
Variation in size at birth in infants born small for gestational age in Lithuania
Authors: Verkauskiené R , Wikland K Albertsson , Niklasson A 
Published: August 2010

The aim of this study was to describe the heterogeneity in body proportions of infants born small for gestational age (SGA), defined by birthweight, and to study the relationship of placental size with neonatal anthropometric measurements. Anthropometry was evaluated in 107 symmetrically and asymmetrically growth‐retarded infants born SGA (birthweight <−2 SD) and compared with 181 appropriate‐for‐gestational age infants (AGA; birthweight and length ± 2 SD). Study children were born at Kaunas University Hospital during the period from 1 January 1998 to 25 August 2000. Two‐thirds of SGA children were light (SGAW) and one‐third was both light and short (SGAWL) for gestational age. Infants in both SGA groups were significantly leaner than AGA children. SGAWL infants had significantly larger heads in relation to their length compared with SGAW and even AGA children, probably indicating a brain‐sparing effect. SGAWL children had the lowest mean placental weight, but the highest placental weight to birthweight (PW/BW) ratio. The PW/BW ratio was inversely correlated with most infant measurements; the strongest negative relationship was observed with birthlength and lower leg length. Conclusion: There is heterogeneity in children born SGA, defined by birthweight. It is suggested that the two SGA groups represent the continuum of intrauterine growth retardation, with an initial reduction in trophic growth and a subsequent retardation of linear growth. The PW/BW ratio is a strong indicator for impaired prenatal linear growth.
Free sialic acid storage (Salla) disease in Sweden
Authors: Erikson A , Aula N , Aula P , Månsson J‐E 
Published: August 2010

The first 23 patients diagnosed with Salla disease in Sweden are presented. A high incidence of the “Finnish” R39C mutation, together with genealogical data, indicates that a large proportion of the mutations are of Finnish origin. All patients had pathologically high levels of free sialic acid in urine and in fibroblasts. The clinical picture confirms what has already been reported from Finland, with early psychomotor retardation, ataxia and speech problems. One‐third of the patients had epilepsy. Conclusions: Salla disease is more common in Sweden than supposed. A large proportion of the mutated alleles seem to be of Finnish origin. The clinical picture is the same as that reported from Finland.
Risk factors for language impairment in Swedish bilingual and monolingual children relative to severity
Authors: Salameh EK , Nettelbladt U , Gullberg B 
Published: August 2010

Aim: To explore potential risk factors for language impairment (LI) relative to degree of severity in bilingual and monolingual children. Methods: Two groups of clinically assessed children were compared, 252 bilinguals whose parents were both non‐Swedish and 446 monolinguals, who were referred over a period of 24 mo to the University Hospital in Malmo for suspected LI. Results: A multivariate linear regression for both groups showed that two risk factors were the same: parental distress (p > 0.0001 in both groups) and short attention span (p > 0.0001 in both groups). Male gender (p > 0.0001) was an additional predictor for LI relative to degree of severity in the monolingual group. Specific risk factors for LI relative to degree of severity in the bilingual children were maternal arrival within 1 y in relation to birth (p > 0.002) and parental need for an interpreter after >5 y in Sweden (p > 0.040). Conclusion: Most risk factors for LI relative to degree of severity in this study seemed to apply to both groups, although they sometimes appeared in another form in the bilingual group. Gender and possibly also hereditary factors seemed to need to interact with environmental factors to appear as risk factors for the bilingual children in this study.