bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of interleukin‐6, tumour necrosis factor‐α and interleukin‐1β for early diagnosis of neonatal sepsis
Authors: Silveira RC , Procianoy RS 
Published: August 2010

Silveira RC, Procianoy RS. Evaluation of interleukin‐6, tumour necrosis factor‐α and interleukin‐1β for early diagnosis of neonatal sepsis. Acta Pædiatr 1999; 88: 647‐50. Stockholm. ISSN 0803‐5253The objective of this study was to assess the contribution of interleukin‐6 (IL‐6), tumour necrosis factor‐α (TNF‐α) and interleukin‐1β (IL‐1β) to an early diagnosis of early‐onset neonatal sepsis. A cohort of 117 newborn infants delivered during a 1‐y period had IL‐6, TNF‐α and IL‐1β, blood and cerebrospinal fluid (CSF) cultures, leucocyte and platelet count collected on the initial evaluation of possible early‐onset sepsis. They were divided into four groups: I, positive blood and/or CSF cultures; II, probably infected with clinical sepsis but negative cultures; III, same as group II but mother received antibiotic antepartum; and IV, newborn infants that did not receive any antibiotic therapy. There were no differences among the four groups with respect to mean gestational ages and birthweights, median Apgar scores, type of delivery, or number of newborn infants with leucocyte count <5000mm−3 or >25 000 mm−3, platelet count <100 000mm−3, immature/total neutrophil ratio >0.2, absolute neutrophil count <1000mm−3 and median IL‐1β levels. Median IL‐6 and TNF‐α levels were significantly higher in groups with patients with a diagnosis of clinical sepsis than in controls. The optimal cut‐off point was 32 pg ml−1 for IL‐6 and 12pgml−1 for TNF‐a. The combination of both provided a sensitivity of 98.5%. In conclusion, the combination of IL‐6 and TNF‐α is a highly sensitive marker of sepsis in the immediate postnatal period. □Cytokine, infection, newborn infant
Partial trisomy 13q22→qter and monosomy 18q21→qter as a result of familial translocation
Authors: Čekada S , Kilvain S , Brajenović‐Milić B , Brečević L , Kirinčić‐Paučić E , Franulović J 
Published: August 2010

Čekada S, Kilvain S, Brajenović‐Milić B, BreČević L, KirinČić‐PauČić E, Franulović J. Partial trisomy 13q22→qter and monosomy 18q21→qter as a result of familial translocation. Acta Pædiatr 1999; 88: 675‐8. Stockholm. ISSN 0803‐5253We report on a patient with a partial trisomy of chromosome 13q22→qter and partial monosomy of chromosome 18q21→qter showing distinct malformations. The phenotype of this unbalanced karyotype has not been previously described. The proband had a craniofacial dysmorphism, neck pterygium, closed fists with overlapping fingers, cutaneous appendix of the left fist, equinovarus and postaxial hexadactyly of the feet, atrial septum defect, unilateral cryptorchidism and hypertrophic pyloric stenosis. Using fluorescence in situ hybridization (FISH) the father's karyotype 46,XY.ish t(13;18)(13pter→13q22::18q21→18qter; 18pter→18q21::13q22→13qter) and the child's 46,XY.ish der(18)(18pter→18q21::13q22→13qter)pat were established. The mother's karyotype was normal. A risk of unbalanced offspring in carriers of a balanced reciprocal translocation depends on the length and genetic constitution of the exchanged segments. Risk figures should come only from empirical data. A phenotypically normal child with a balanced or normal karyotype could be born in the case of alternate segregation. Amniocentesis should therefore be recommended in any further pregnancy. □FISH, karyotype, malformations, prenatal diagnosis
Impact factor and the future of Acta Pædiatrica and other European medical journals
Authors: Zetterström R 
Published: August 2010

Most European medical journals attain very low impact factors, as reported in Journal Citation Reports, and from the European point of view the depressing outlook is continually falling values. Among many reasons behind the low impact factor of European journals is citation bias as a consequence of the low prestige of European journals. In the case of Acta Pædiatrica, which has published between 4 and 15 supplements annually during the period 1994—98, the low impact factor of the articles included in these supplements reduces the overall impact factor to less than half of what it would be had no supplements been published, i.e. from 1.88 to 0.81. It is obvious that by refusing to publish supplements the impact factor of Acta Pædiatrica would be dramatically elevated. Some of the supplements, such as the one on persistent diarrhoeal disease which had to be reprinted as the original edition was sold out (1), are undoubtedly of great educational value and have an important role as sources of references. However, it is difficult for Acta Pædiatrica to continue to publish supplements because of the load imposed on the impact factor of the journal.It is suggested that a scientific committee within the European Union seriously considers the importance of supporting European Biomedical Science, and that one way of doing so is to improve the prestige and quality of European journals. □Acta Paediatrica, European journals, impact factor, supplements
Fatty acid composition of serum cholesterol esters as a reflector of low‐saturated‐fat, low‐cholesterol diet in young children: the STRIP project
Authors: Salo P , Viikari J , Hämäläinen M , Lapinleimu H , Routi T , Niinikoski H , Rask‐Nissilä L , Tammi A , Rönnemaa T , Seppänen R , Jokinen E , Välimäki I , Simell O 
Published: August 2010

STRIP (the Special Turku coronary Risk factor Intervention Project) is an ongoing intervention trial which aims at a permanent reduction in the intake of saturated fat and cholesterol starting in childhood. A total of 75 intervention and 63 control children was studied consecutively at the ages of 7 and 13 mo, and 2, 3 and 5 y to evaluate the influence of such intervention on serum cholesterol ester (CE) fatty acid composition, a widely used biomarker of fatty acid intake. Analysis of 4‐d food records showed that total intake of fat and of saturated fat increased with age in both groups of children but was constantly lower in intervention than in control children, e.g. at the age of 5 y the mean intakes of total fat and of saturated fatty acids were 31.1 E% and 33.9 E% and 12.1 E% and 14.6E% in intervention and control children, respectively (p = 0.009 and 0.0001, respectively). Serum CE fatty acid compositions did not differ between the 2 groups at any age; the mean proportion of CE linoleic acid was 52.4% and 52.0% in 5‐y‐old intervention and control children, respectively. Correlation analysis showed, however, that the percentage of linoleic acid and of polyunsaturated fatty acids in CE reflected well the respective dietary intakes (r= 0.36; p = 0.0001 for both coefficients).In conclusion, CE fatty acid composition did not differ between the intervention and control groups, whereas CE linoleic and total polyunsaturated fatty acids reflected well the differences in their intakes at the individual level.
Sodium intake of 1 to 5‐year‐old children: the STRIP Project
Authors: Heino T , Kallio K , Jokinen E , Lagström H , Seppänen R , Välimäki I , Viikari J , Rönnemaa T , Simell O 
Published: August 2010

The aim of this study is to examine sodium intake and dietary sodium sources of 1‐5‐y‐old children in a prospective, randomized long‐term coronary heart disease prevention trial, focused on dietary fat modification. Counselling included no advice about reducing salt in the children's diets. Food consumption of 100 intervention children and 100 control children was recorded for 3 consecutive days at the age of 13 mo and for 4 consecutive days at the ages of 3 and 5 y. Sodium intakes were calculated using the Micro Nutrica program. Children's mean daily sodium (NaCl) consumption (intervention and control children combined) was 1600 ± 527 mg (4.0 ± 1.3 g), 1900 ± 504 mg (4.8 ± 1.3 g) and 2200 ± 531 mg (5.5 ± 1.3 g) at the ages of 13 mo and 3 and 5 y, respectively. The intervention children consumed as much or slightly more sodium than the control children at all ages studied. Half the sodium consumption was derived from added salt in commercially prepared or homemade foods. Milk, meat products, bread and cereals were other important sodium sources.In conclusion, nutrition counselling in the Special Turku Coronary Risk Factor Intervention Project (STRIP) trial, with its main focus on the quality of fat in child nutrition, has had minimal influence on children's sodium intake. To avoid excessive sodium intake in children, dietary counselling should include information about salt use, and food manufacturers should be encouraged to provide more low‐sodium products.
Hypo‐osmolar oral rehydration salts solution in dehydrating persistent diarrhoea in children: double‐blind, randomized, controlled clinical trial
Authors: Dutta P , Mitra U , Dutta S , Manna B , Chatterjee MK , De A , Bhattacharya SK 
Published: August 2010

A double‐blind, randomized, controlled trial was conducted to compare the clinical efficacy of hypo‐osmolar oral rehydration salts (ORS) solution (224 mmol/L) and standard ORS solution (311mmol/L) in children with persistent diarrhoea who were prone to develop dehydration. Initially, 95 children aged between 3 and 24 mo were included in the study for overnight observation. Of these, 70 children who passed stool more than 2 g/kg/h were finally enrolled in the study and were randomly assigned either standard ORS or hypo‐osmolar ORS. After decoding the identity of ORS, it was observed that 37 children were in the standard ORS group and 33 in the hypo‐osmolar ORS group. Clinical parameters and microbiological findings of stool samples were comparable in the two groups at the time of enrolment. Total stool output (2.5 ± 1.1 vs 3.2 ± 1.6 kg; p= 0.04), duration of diarrhoea (114.8 ±38.3 vs 145.4 ± 40.0 h; p = 0.002), total intake of ORS (5.4 ± 1.6 vs 7.8 ± 1.8 l; p = 0.002) and total fluid intake (7.9 ± 2.6 vs 10.0 ±4.1 l, p= 0.01) were significantly less in the hypo‐osmolar ORS group compared to the standard ORS group. However, the percentage of weight gain on recovery in the hypo‐osmolar group was less compared to that of the standard ORS group, though the difference was statistically insignificant. Thirty‐five (95%) children in the standard ORS and 33 (100%) children in the hypo‐osmolar group recovered within 10 d of initiation of therapy and modified dietary management.Conclusion: Our findings suggest that hypo‐osmolar ORS has beneficial effects on the clinical course of dehydrating persistent diarrhoea.
Vulvar symptoms in paediatric and adolescent patients
Authors: Piippo S , Lenko H , Vuento R 
Published: August 2010

Vulvovaginal symptoms in children and young adolescents are not yet very well understood, nor is the actual incidence known. This study evaluates the character and possible infectious aetiology of vulvar symptoms of females aged up to 16 y. The signs, symptoms and bacteriological findings of 68 consecutive cases were studied. The study was conducted in the University Hospital of Tampere at a special gynaecological consultation clinic for children and adolescents. Sixty‐eight patients were included in the study: 48 girls (71%) were prepubertal, at Tanner stage M1P1, 26 patients were 2‐4‐y‐old and 15 were 5‐7‐y‐old. The duration of symptoms was known for 46 patients: 41% had had symptoms for >1 mo and 20% for >6 mo. Forty‐eight patients had abnormal clinical findings on examination and 16 (33%) of them had an infectious aetiology. Streptococcus pyogenes infection was identified in 11 (16%) patients, all of whom had symptoms. Candida was identified in 6 (9%) patients. No infectious aetiology was found among 26 patients who had symptoms and abnormal clinical findings. Vulvovaginal symptoms during childhood are more common among younger children (<7 y). In 67% of patients no infectious aetiology could be found. Samples for microbiological culture should be taken from symptomatic patients and symptomatic areas. Cultures of Candida and bacteria are necessary but usually sufficient. If a microbiological aetiology is established, treatment can be assigned accordingly.Patients with vulvar symptoms and findings but with an unclear aetiology need support and advice on proper hygiene and can intermittently use mild corticosteroids locally.
Simultaneous stimulation of growth hormone, adrenocorticotropin and cortisol with L‐dopa/L‐carbidopa and propranolol in children of short stature
Authors: Philippi H , Pohlenz J , Grimm W , Koffler T , Schönberger W 
Published: August 2010

In 59 otherwise healthy children of short stature, the simultaneous response of growth hormone, cortisol and plasma adrenocorticotropin (ACTH) to L‐dopa/L‐carbidopa and propranolol at 45 and 90min after administration were investigated. A growth hormone response of 10 μg/l or higher was considered positive. The definition of a positive cortisol response included either a hormone increase of at least 193 nmol/l or a peak hormone level of at least 497 nmol/l. The ACTH increase had to be fourfold above 11 pmol/l to be considered positive. In the 59 investigated children, the median basal growth hormone levels increased from 1.35 p.g/l to 18.05 ug/l and 10.15 p.g/l at 45 and 90 min after stimulation (p <0.05). The median cortisol levels rose from 242 nmol/l to 439 nmol/l and 612 pmol/l, and the corresponding median ACTH levels from 2.94 pmol/l to 9.63 pmol/l and 11.13 pmol/l at 45 and 90 min after stimulation. Significant positive hormone response rates were 88.1% for growth hormone, 88.1% for cortisol and 69% for ACTH. These results could be attributed to the enhanced stimulating effect of the additional administration of L‐carbidopa and propranolol.We conclude that the administration of L‐dopa/L‐carbidopa and propranolol is useful for the simultaneous evaluation of growth hormone, cortisol and ACTH secretion in children of short stature.
Bone turnover in children with vitamin D deficiency rickets before and during treatment
Authors: Baroncelli GI , Bertelloni S , Ceccarelli C , Amato V , Saggese G 
Published: August 2010

Biochemical markers of bone formation [alkaline phosphatase, osteocalcin, and carboxyterminal propeptide of type I procollagen (PICP)] and bone resorption [cross‐linked carboxyterminal telopeptide of type I collagen (ICTP) and cross‐linked N‐telopeptides of type I collagen (NTX)] were measured in 14 children aged 8.5–10.5 mo with vitamin D deficiency rickets before and longitudinally during vitamin D treatment (3000–4000 IU/daily). Forty‐four healthy children aged 8–10.5 mo were enrolled as sex‐ and age‐matched controls. Before treatment, serum levels of alkaline phosphatase, PICP, and ICTP, and urinary excretion values of NTX were significantly higher, and serum osteocalcin levels significantly lower than controls (31.4 ± 3.5 mμkat/L and 9.8 ± 2.9 μkat/L, p < 0.001; 1025 ± 89 μg/L and 952 ± 97.4 μg/L, p < 0.02; 15.6 ± 2.6 μg/L and 14.2 ± 1.3 μg/L, p< 0.01 370.7 ± 109.4 nmol BCE and 201.8 ± 69.2 nmol BCE, p < 0.001; 17.6 ± 9.1 μg/L and 22.5 ± 7.6 μg/L, p <0.05, respectively). During treatment, serum alkaline phosphatase levels progressively declined in association with the radiographic healing of the skeletal lesions. Serum levels of osteocalcin, PICP, and ICTP, and urinary excretion values of NTX showed a transient but significant (p < 0.05 to p < 0.001) increase in comparison with baseline values during the first 2–4 wk of treatment, and decreased slowly thereafter. They were within the mean 2 SD of controls before the recovery of the skeletal lesions.Conclusions: These findings suggest that children with vitamin D deficiency rickets have increased bone turnover before and during the first weeks of treatment. Alkaline phosphatase is a more reliable marker than osteocalcin, PICP, ICTP and NTX for diagnosing and monitoring these patients.
Leukocyte adhesiveness/aggregation test (LAAT) to discriminate between viral and bacterial infections in children
Authors: Urbach J , Lebenthal Y , Levy S , Berliner S , Leibovitz E , Aronson M , Branski D 
Published: August 2010

Objectives: We previously noted that white blood cells (WBC) have increased adhesive properties during bacterial infections. Here, we aim to explore the possibility of using the different adhesive properties of WBC as a means of differentiating between viral and bacterial infections, a common problem in paediatrics. Methods: The adhesive properties of WBC in the peripheral blood of 25 children with documented bacterial infections, 15 with documented viral infections and 36 with probable viral infections, were studied by means of a leukocyte adhesiveness/aggregation slide test (LAAT). The results of the LAAT were compared with those of the other acute phase reactants, namely WBC, differential count and erythrocyte sedimentation rate (ESR), which were taken in the same blood sample in each patient. Results: The sensitivity, specificity and positive predictive value were 92%, 96%, and 92%, respectively for the LAAT; 83%, 87% and 80% for the ESR; 56%, 78% and 56% for the white blood cell count; and 54%, 74% and 50% for the differential count.Conclusions: The presence of bacterial infections in children can be tested using a simple slide test to reveal the increased state of leukocyte adhesiveness/aggregation in the peripheral blood. The LAAT is a reliable, rapid and inexpensive test, and it can be a useful laboratory tool for the paediatrician treating a child with acute febrile illness.
Association of prenatal phenobarbital and phenytoin exposure with small head size at birth and with learning problems
Authors: Dessens AB , Cohen‐Kettenis PT , Mellenbergh GJ , Koppe JG , van de Poll NE , Boer K 
Published: August 2010

Small head size has been observed in prenatally anticonvulsant‐exposed neonates. In infancy, cognitive impairments were revealed. It is presently unknown whether these impairments are permanent or disappear after puberty. We studied the link between the prenatal influence of anticonvulsants on brain development and cognitive functioning in adulthood: a retrospective study on head size and a follow‐up assessing cognitive capacities among adults who had been included in the retrospective study. The retrospective study comprised 172 exposed and 168 control neonates, matched with respect to age, sex and their mothers' age. Prenatally phenobarbital + phe‐nytoin‐exposed neonates had a significantly smaller occipitofrontal circumference (OFC) than prenatally phenobarbital‐monotherapy‐exposed and control neonates (mean difference of 0.7 cm). In the follow‐up, no difference in cognitive functioning was found between the exposed and the control groups. Most of the prenatally anticonvulsant‐exposed subjects had normal intellectual capacity. However, 12% of the exposed subjects versus 1% of the controls had persistent learning problems. In addition, more of the exposed subjects were mentally retarded. There was no clear relationship between learning problems and small OFC, maternal epilepsy or unfavourable family climate.Conclusions: We conclude that the combination of phenobarbital + phenytoin affects the fetal OFC. The smaller OFC does not seem to be related to cognitive functioning in adulthood, but learning problems and mental retardation proved to be more prevalent among exposed subjects. Phenobarbital and phenytoin may therefore affect cognitive capacity but only in infants who are susceptible to this particular influence of the drugs.
Long‐term prospective study on the natural history of Wolff‐Parkinson‐White syndrome detected during a heart screening program at school
Authors: Inoue K , Igarashi H , Fukushige J , Ohno T , Joh‐o K , Hara T 
Published: August 2010

In the period 1985 to 1993, a total of 802 school‐aged children (284 first‐graders and 518 seventh‐graders) were referred to our hospital for further evaluation of electrocardiographic abnormalities. Among them, 57 (male 24 and female 33) children were confirmed as having Wolff‐Parkinson‐White (WPW) syndrome based on the findings of 12‐lead surface electrocardiograms (ECG). According to Lindsay's criteria, the locations of the accessory pathways were as follows: Left‐lateral in 10 (18%), left‐posterior in 2 (4%), right‐free‐wall in 28 (49%), anterior‐septum in 13 (23%) and posterior‐septum in 3 (5%). One 12‐y‐old girl had multiple accessory pathways. Six patients had associated diseases: Ebstein's anomaly in 4, epilepsy in 1 and mental retardation with scoliosis in 1. Follow‐up periods ranged from 2.0 to 13.0 y (mean SD: 8.0 ± 3.3 y) for 23 first‐graders with WPW syndrome, and from 2.0 to 13.0 y (mean SD: 7.3 ± 4.2 y) for 34 seventh‐graders, respectively. Initially, 5 children had at least one episode of supraventricular tachycardia (SVT) by history and 6 children developed SVT during the follow‐up. One girl with multiple accessory pathways and recurrent SVT required long‐term drug therapy.Conclusions: The outcome of children with WPW syndrome detected by a heart screening program at school was favorable. Our 8 y follow‐up of 57 children with WPW syndrome will serve as additional information concerning the indication of radio‐frequency catheter ablation therapy for WPW syndrome in children.
Morphometry of the head of the caudate nucleus in patients with velocardiofacial syndrome (del 22qll.2)
Authors: Sugama S , Bingham PM , Wang PP , Moss EM , Kobayashi H , Eto Y 
Published: August 2010

Velocardiofacial syndrome (VCFS) is a chromosomal anomaly syndrome characterized by multiple congenital malformations, including cleft palate and cardiac anomalies. Many patients have attention‐deficit (hyperactivity) disorders (AD[H]D) in childhood and schizophrenia in adulthood. We reviewed cranial magnetic resonance imaging (MRI) scans with particular attention to the head of the caudate nucleus and found that in control subjects, the head of the caudate was larger on the left than on the right, whereas VCFS patients showed a reversed right > left pattern or no significant asymmetry. A similar right > left asymmetry or a lack of this asymmetry has been reported in patients with AD(H)D.Conclusions: These results suggest a common pathophysiological mechanism of behavioural and cognitive problems in patients with AD(H)D and those with VCFS.
Parental perception, worries and needs in children with epilepsy
Authors: Kwong KL , Wong SN , So KT 
Published: August 2010

Despite advancement in medical care, prejudice and misunderstanding of epilepsy still exist. In this study, we investigate the problems faced by epileptic children, at home and in school, and make suggestions for improvement. Questionnaires were randomly distributed to parents of epileptic children attending normal and special classes (groups A and B, respectively). Return of questionnaires was anonymous. Ninety‐one percent responded. Of the responders, 56 children were in Group A and 30 in Group B. Chronic and intractable epilepsy was more frequently observed in Group B than in Group A patients (47% vs 14%, p < 0.05). Main family concerns were seizures, school performance and side effects of medication. Half of the parents complained that their children were more restless and short‐tempered. Only 43% of parents were aware that seizures were caused by abnormal brain discharges. Twenty percent thought swimming should be prohibited even if seizures could be controlled. Schools were informed of the disease by 84% of the families. Only 29% of parents knew the name and dose of the current medication. Information was considered adequate in 27% of patients. Drug compliance was better in epileptic children with associated handicaps than in those without handicaps. Half of the parents requested more information about epilepsy and closer communication between teachers and physicians.Conclusions: To establish comprehensive care that satisfies the needs of epileptic children and their families, further training of medical specialists in epilepsy and enhancement of networks among relevant organizations are needed.