bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developmental profiles and auditory perception in 25 children attending special preschools for language‐impaired children
Authors: Fernell E , Norrelgen F , Bozkurt I , Hellberg G , Löwing K 
Published: August 2010

Aim: To study different developmental profiles and auditory perception in a representative group of children with language impairment (LI). Methods: A multidisciplinary investigation was carried out in a group of 25 children attending units specifically for language‐impaired children. An assessment of the cognitive level, motor performance, behaviour and auditory perception was performed and the results were compared with those for age‐matched groups of children. Results: Among those with moderate or severe language impairment (LI), around 90% had additional developmental disorders. In three tests of auditory perception, children with LI had problems with working memory and speech discrimination. No problems were found with the children's temporal resolution in auditory perception. Another conclusion from the auditory perceptual tests was that the children's cognitive abilities were important for their success in these tests. Conclusion: Neurodevelopmental deviations are very common in LI children. The optimal route for the assessment and treatment of these children would be a multidisciplinary approach.
Spontaneous haemothorax: an uncommon presentation of Glanzmann thrombasthenia
Authors: Kara A , Yaral N , Fsgn T , Duru F 
Published: August 2010

Glanzmann thrombasthenia is a rare hereditary qualitative platelet disorder characterized by a lifelong bleeding tendency due to quantitative and qualitative abnormalities of the platelet integrin αIIbβ3. Common clinical manifestations include purpuric type skin bleeding, prolonged bleeding from minor cuts, epistaxis, gingival bleeding and menorrhagia. Less frequently, gastrointestinal system bleeding may occur. Haemarthrosis, haematuria, intracranial and visceral haemorrhage are very rare symptoms. This study reports a 3‐y‐old girl with Glanzmann thrombasthenia who presented with life‐threatening haemothorax. There was no history of recent trauma or drug usage and no vascular or parenchymal abnormalities to explain the development of haemothorax. Conclusion: To the authors’knowledge this is the first case of Glanzmann thrombasthenia complicated by spontaneous haemothorax.
Regression of autoimmunity and abnormal glucose homeostasis in an adolescent boy with silent coeliac disease
Authors: Banin P , Perretta R , Ravaioli E , De Sanctis V 
Published: August 2010

We report on a 15‐y‐old adolescent boy affected by silent coeliac disease, abnormalities in glycoregulation and with autoantibodies specific to diabetes mellitus type I (ICA: islet cell antibodies) and GAD 65 (autoantibodies against glutamic acid decarboxylase), in whom normalization of glycoregulation and disappearance of the immunological markers of pre‐diabetes were observed after 6 mo on a gluten‐free diet. The patient was followed‐up for 36 mo and showed a normal insulin response to an intravenous glucose tolerance test and no markers of autoimmunity. It is possible that undiagnosed coeliac disease over a long period could lead to a direct autoimmune mechanism against pancreatic β cells. Conclusion: Our findings seem to confirm the theory that undiagnosed coeliac disease can induce an autoimmune process against the pancreatic β cells and that, following a gluten‐free diet, the immunological markers for diabetes mellitus type 1 will disappear.
Does heredity modify the association between farming and allergy in children?
Authors: Remes ST , Pekkanen J , Soininen L , Kajosaari M , Husman T , Koivikko A 
Published: August 2010

Aim: It has been suggested that living on a farm decreases the risk of childhood allergy, especially if farming involves livestock. The aim of this study was to examine the association between farming and allergy in children, and the influence of atopic heredity in this association. Methods: The cross‐sectional data of the 7981 children aged 13‐14 y who participated in the Finnish ISAAC study between the years 1994 and 1995 were used to evaluate the association between farming and allergy. Results: Living on a farm was associated with a decreased risk of current symptoms of allergic rhinoconjunctivitis among all children (aOR 0.79; 95% CI 0.63,0.99), and with a decreased risk of hay fever, especially among those children with a parental history of hay fever (aOR 0.60; 95% CI 0.40‐0.89, p= 0.072 for interaction). The children of farmers with a history of hay fever also had a decreased risk of current wheeze (aOR 0.38; 95% CI 0.12‐1.24, p= 0.040 for interaction). No significant association was found between farming and either asthma or eczema. Children living on a farm with livestock had the lowest risk of allergic rhinoconjunctiviti s (aOR 0.69), followed by those living on a farm without livestock (aOR 0.89) compared with the non‐farming children (p‐value for trend 0.024). Conclusion: Our results support the recent findings on a decreased risk of allergy among the children living on farms. A possible differential effect of parental history of hay fever on the relation of farming environment and the risk of allergic symptoms warrant further investigation.
Differential diagnosis and clinical course of autoimmune neutropenia in infancy: comparison with congenital neutropenia
Authors: Taniuchi S , Masuda M , Hasui M , Tsuji S , Takahashi H , Kobayashi Y 
Published: August 2010

Aim: Autoimmune neutropenia in infancy (AIN) is caused by granulocyte‐specific autoantibodies. Clinical presentation and diagnosis have not been well studied, resulting in cumbersome diagnostic investigations and unnecessary treatment such as granulocyte colony‐stimulating factor (G‐CSF) therapy. Methods: Clinical, laboratory and immunological data of 18 infants with AIN were evaluated. Granulocyte‐specific autoantibodies were detected by the direct granulocyte immuno‐fluorescence test (D‐GIFT), indirect granulocyte immunofluorescence test (I‐GIFT) and immuno‐blotting. Results: The average age of onset and resolution of neutropenia in AIN was 7.4 ± 3.4 mo (mean ± SD) and 20.4 ± 4.9 mo, respectively. Sixteen of the 18 patients presented with mild infectious symptoms; the other 2 patients were detected by chance and presented with no infectious symptoms. D‐GIFT was positive in all patients, and I‐GIFT was positive in 17 of these 18 patients. Most patients showed preferential binding to neutrophils from NA(1 + 2−)‐phenotyped donors by I‐GIFT and immunoblotting. An antibiotic (sulfamethoxazole‐trimethoprim) was given to 15 patients for prophylaxis. G‐CSF was given to only one infectious patient. Conclusion: A combination of diagnostic tests for the detection of granulocyte‐specific autoantibodies was useful in diagnosing AIN, thus avoiding unnecessary investigations. Continuous treatment with G‐CSF was not necessary for prophylaxis, even if neutrophil counts were extremely low.
Soluble forms of the selectin family in children with Kawasaki disease: prediction for coronary artery lesions
Authors: Furui J , Ishii M , Ikeda H , Muta H , Egami K , Sugahara Y , Himeno W , Akagi T , Kato H , Matsuishi T 
Published: August 2010

Aim: To investigate the relationship between the plasma levels of soluble forms of the selectin family and the incidence of coronary artery lesions (CALs) in patients with Kawasaki disease (KD). Methods: Thirty‐three patients with KD, including group A patients (n= 22) who had no CALs and group B patients (n= 11) who had CALs, as well as age‐matched febrile (n= 10) and afebrile controls (n= 11), were studied. Results: Peak plasma E‐selectin levels (172.0 ± 58.6 ng ml‐1) occurred during the acute phase of KD, while peak plasma P‐selectin levels (260.3 ± 43.2 ng ml‐1) occurred during the subacute phase of the illness (p± 0.05). Plasma L‐selectin levels (1757.3 ± 244.3 ng ml‐1) during the convalescent phase tended to be higher than in either the acute or the subacute phase (not significant). Before intravenous immunoglobulin treatment, the plasma levels of E‐ (225.1 ± 46.8 ng ml‐1) and P‐selectin (259.4 ± 76.2 ng ml‐1) of patients with CALs (n= 11) were significantly higher than those of patients (n= 22) with no CALs (E‐selectin, 131.6 ± 36.9 ng ml‐1; P‐selectin, 184.9 ± 84.6 ng ml‐1; p± 0.05). When a plasma E‐selectin value before immunoglobulin treatment of ± 184.7 ng ml‐1 was used as the cut‐off point, the sensitivity and specificity for the incidence of CALs were 81.8% and 90.9%, respectively. These findings demonstrate the relationship between plasma levels of selectins and disease severity of Kawasaki vasculitis. Conclusion: Higher plasma levels of E‐selectin may have potential as a predictor of the incidence of coronary artery lesions in Kawasaki disease patients.
Feeding behaviour of infants with cleft lip and palate
Authors: Mizuno K , Ueda A , Kani K , Kawamura H 
Published: August 2010

Aim: To determine whether the feeding behaviour of infants with cleft lip and palate is improved with a type‐P teat, which is widely used in Japan by such infants, compared with a standard teat. The difference in intra‐oral movements between the type‐P teat, modified for the evaluation of feeding behaviour, and an unmodified type‐P teat was also compared using ultrasonography. Methods: In part 1 of the study, 15 infants aged 2 to 3 mo and 7 infants aged 2 wk were evaluated for sucking pressure, expression pressure, frequency and duration of sucking. All the infants had a complete unilateral cleft lip and palate without any other abnormalities. In part 2, an ultrasonographic analysis of intra‐oral movement was done for 5 infants enrolled in part 1 of the study. Results: Sucking pressure did not occur in all infants. It was found that feeding efficiency improved with the type‐P teat compared with the standard teat. The expression pressure with the type‐P teat was significantly higher than that with the standard teat, and the feeding frequency with the type‐P teat was lower than that with the standard teat. Conclusion: A type‐P teat is suitable for infants with cleft lip and palate who have sucking difficulties. However, a type‐P nipple with a squeezable bottle does not fully solve the feeding problems of infants with cleft lip and palate. New artificial teats that allow a higher expression pressure are desirable, and the measurement of the expression pressure may be helpful in the evaluation of artificial nipples.
The burden of asthma as reflected by the prevalence defined by doctor's diagnosis and the use of healthcare services by preschool children in a Swedish region
Authors: Hederos C‐A , Janson S , Bornehag C‐G , Hedlin Gunilla 
Published: August 2010

Aim: Epidemiological data and reports on the prevalence and burden of preschool asthma are mainly based on questionnaires and generally give a prevalence of above 6% in Sweden. In this study we used other ways of studying the prevalence, risk factors and the use of healthcare services in a defined region. Methods: The catchment area included 9410 children aged 0‐6 y. All outpatient clinics had computerized records of patients and visits to the outpatient clinic could be studied as well as admissions to hospital for asthma between 1988 and 1998. Results: According to patients’record data, the prevalence of doctor‐diagnosed asthma was 4.5% in 1998. Seventy‐nine percent of recorded patients are seen outside the hospital, thus the burden of asthma for the health system is mainly on the outpatient clinics. Admissions and especially readmissions to the hospital have decreased during the past decade. One‐third of the children with newly diagnosed asthma had recurring exacerbations and risk for persistent asthma. Conclusions: The prevalence of doctor‐diagnosed asthma as measured by total mapping in a region is lower than that reported from questionnaire‐based studies. Hospital admissions for preschool asthma have decreased possibly as a result of improved medical care in the paediatric outpatient clinics where asthma is a dominating diagnose. In one‐third of identified new asthmatics, there is a high risk of developing persistent asthma.
Severe liver haemorrhage during laparotomy in very low birthweight infants
Authors: Pumberger W , Kohlhauser C , Mayr M , Pomberger G 
Published: August 2010

A review is presented of severe liver haemorrhage as a serious complication in surgery on very low birthweight (VLBW) infants. Clinical data and pathological findings, as well as the outcome of the treatment, of five VLBW infants (< 1000 g) who experienced liver haemorrhage during surgical exploration for necrotizing enterocolitis or spontaneous intestinal perforation were reviewed retrospectively. At the time of surgery, all infants had signs and symptoms of impending sepsis. The bleeding was predominantly “spontaneous” without obvious iatrogenic liver damage. In three infants, severe liver haemorrhage could be stabilized by early liver tamponade using absorbable thrombostatic sponges and polyglactin mesh. Conclusion: Intraoperative liver haemorrhage potentially life‐threatening complication of surgery in preterm infants, which is not frequently investigated. Immediate perihepatic liver packing may be used to achieve adequate bleeding control.
Role of oxidant injury in the pathogenesis of neonatal lung disease
Authors: Davis Jonathan M 
Published: August 2010

Bronchopulmonary dysplasia (BPD) is a chronic lung disease that develops in newborn infants treated with oxygen and mechanical ventilation for a primary lung disorder. With significant improvements in survival of many critically ill infants, BPD has become an extremely important complication of newborn intensive care. The pathogenesis of BPD is complex and involves a variety of causative factors. However, increasing evidence has suggested that an oxidative insult could be an extremely important component of the injury process. Premature infants are especially sensitive to oxidant injury since they are exposed to supraphysiological concentrations of oxygen at birth while endogenous antioxidant enzyme activity may be relatively deficient. Conclusion: Superoxide dismutase is an antioxidant enzyme that has been shown in numerous basic and clinical studies to protect cells against oxidant injury.
Child health in an urbanizing world
Authors: Gracey M 
Published: August 2010

The aim of this study is to document and comment on the effects of urbanization on child health, internationally, using published reports and the author's personal experience. Urbanization is having profound effects on the health and well‐being of infants and children in industrialized and developing countries. This will affect generations into the future. The changes are not confined to cities and large towns; they rapidly influence transitional societies in remote and rural areas, because globalization is changing infant feeding practices and children's diets and lifestyles. In developing countries, overcrowding and environmental pollution are massive problems made worse by undernutrition and infections, particularly respiratory and diarrhoeal diseases. In developed societies there are many other problems, e.g. injuries, poisonings, violence, drug abuse, exposure to industrial and atmospheric pollutants, including pesticides, sexually transmissible diseases, and “lifestyle”, diseases including obesity and cardiovascular disease risk. There is an urgent need for paediatricians, health planners, policy‐makers, governments and the community to understand these issues and work towards minimizing their harmful effects on children. Conclusion: Urbanization has profound effects on child health, globally; these must be recognised so that harmful influences of urbanization can be reduced for the benefit of all children.
Coeliac disease is associated with intrauterine growth and neonatal infections
Authors: Sandberg‐Bennich S , Dahlquist G , Källén B 
Published: August 2010

To investigate whether factors in the fetal or neonatal period influence the risk of later development of coeliac disease we conducted a population‐based register study. The Swedish Medical Birth Register was linked with the Hospital Discharge Register and identified 3392 singleton infants born in the period 1987‐97 who developed coeliac disease. Perinatal data for these children were compared with all children born in these years. Exposure variables: Maternal age, parity and smoking habits in early pregnancy, preeclampsia, pregnancy duration and birthweight, birthweight by gestational week, Apgar score, neonatal icterus, neonatal infections, maternal‐fetal blood group incompatibility, exchange transfusion, phototherapy. Odds ratios and test‐based confidence intervals were calculated. Analyses were made with stratification for year of birth and other risk factors. The risk of developing coeliac disease decreased with maternal age and was lower in first‐born than in second‐born children. Maternal smoking in early pregnancy was a weak risk factor, as was low birthweight. The most evident risk factors were being exposed to neonatal infections (OR = 1.52, confidence limits 1.19; 1.95) and being small for gestational age (OR = 1.45, confidence limits 1.20; 1.75). These risk factors were independent of each other. Conclusions: We have demonstrated that the intrauterine environment, mainly as mirrored by a low birthweight for gestational age and, independently, neonatal infection diagnosis, is associated with the risk of developing coeliac disease, supporting the idea of a multifactorial aetiology of the disease.
Folic acid supplementation on red kidney bean‐induced diarrhoea and enteric bacterial translocation into mesenteric lymph nodes in rats: a pilot study
Authors: Shoda R , Mahalanabis D , Islam KN , Wahed MA , Albert MJ 
Published: August 2010

Deaths following childhood diarrhoea, a major health problem in developing countries, are often associated with malnutrition and septicaemic complications. Folic acid has been used in the treatment of acute and chronic diarrhoea in the tropics. Using a rat model, we evaluated the protective effect of large doses of folic acid on diarrhoea, small intestinal bacterial overgrowth and translocation of enteric bacteria into mesenteric lymph nodes induced by a raw red kidney bean‐based diet containing lectin (phytohemagglutinin). Long‐Evans rats in 2 groups of 5 each (60 g to 70 g in weight, 28 d old) were used. All 10 rats, individually kept in metabolic cages, received a raw red kidney bean‐based diet for 10 d, and 5 of them also received a daily folic acid supplement (160 μg/g feed) both during and for 10 d before the experiment. The faecal weight was measured and a quantitative aerobic bacterial culture of the small intestinal mucosal scrapings and of the mesenteric lymph nodes was made. Folic acid supplementation did not reduce faecal output nor did it prevent loss of body weight associated with lectin‐induced diarrhoea. However, the mean total count of enteric bacteria translocated to the mesenteric lymph nodes was significantly reduced in the supplemented rats (1.27 ± 0.61 vs 2.66 ± 0.84, p= 0.028) and a trend towards reduced bacterial count in the small intestinal mucosal scrapings (0.40 ± 0.89 vs 1.42 ± 1.31, p= 0.16) was documented. A significant positive correlation was also seen between the bacterial count in the jejunal mucosal scrapings and in the mesenteric lymph nodes. Conclusion: Although large‐dose folic acid supplementation did not prevent diarrhoea and malnutrition induced by a lectin‐based diet, it substantially reduced the count of enteric bacteria translocated into the mesenteric lymph nodes and showed a trend towards a reduction in indigenous bacteria adhering to jejunal mucosa. These findings could be of relevance in the prevention of septicaemic complications following many clinical conditions, including diarrhoea with malnutrition in children known to have bacteraemic and septicaemic complications.
Antibiotic treatment for five days is effective in children with acute cystitis
Authors: Abrahamsson K , Hansson S , Larsson P , Jodal U 
Published: August 2010

Short courses of antibiotics are often recommended to treat children with acute cystitis despite lack of firm evidence to support such management. The aim of this study therefore was to analyse the short‐term outcome of such treatment. The retrospective analysis included 300 children (252F, 48M) fulfilling the criteria of first‐time acute cystitis and managed according to a protocol recommending 5 d treatment. In 214 (71%) the treatment was given according to the protocol and in the others for 7 or 10 d. Nitrofurantoin was used in 150 (50%) and trimethoprim without or with sulfonamide in 129 (43%). The short‐term results were excellent with 96% of the children being free from symptoms at the first follow‐up visit after a median of 6 d. Only 2 girls had persisting bacteriuria and thus the frequency of bacteriological treatment failure was 1%. Recurrence within 30 d occurred in 4 girls (2%). Conclusion: A 5 d treatment with antibiotics is adequate in children with acute cystitis. Routine follow‐up visits after a first acute cystitis may not be necessary, providing that the bacteria causing the infection are sensitive to the prescribed antibiotic and that there is no history of defective bladder or bowel emptying.
Rickettsia typhi infection in childhood
Authors: Bitsori M , Galanakis E , Gikas A , Scoulica E , Sbyrakis S 
Published: August 2010

Rickettsia typhi infection (murine typhus) is generally underdiagnosed in childhood, as clinical presentations are often non‐specific. We present the manifestations in nine children hospitalized in the Department of Paediatrics of the University Hospital, Heraklion, Crete, over a 3‐y period from 1998 to 2000. Titres >1:400 for IgM and >1:960 for IgG and/or a fourfold increase in a second sample were considered strongly suggestive of acute infection. Children presented with prolonged fever, hepatosplenomegaly and lymphadenopathy. Five children presented with a rash. Unusual manifestations included aseptic meningitis and Kawasaki‐like presentation. Laboratory findings included anaemia, leucopenia, and thrombocytopenia. Three children were treated with appropriate antibiotic regimens and all nine had a complete recovery. Conclusion: Rickettsia typhi infection should be considered in the differential diagnosis of children residing in or returning from Southern Europe countries who present with prolonged fever, rash and lymphadenopathy.
Agreement between capillary and arterial lactate in the newborn
Authors: Fauchère J‐C , Bauschatz AS , Arlettaz R , Zimmermann‐Bär U , Bucher HU 
Published: August 2010

Arterial blood lactate is a reliable indicator of tissue oxygen debt and is of value in expressing the degree and prognosis of circulatory failure as a result of various diseases. Therefore, the practical issue of whether capillary lactate measurements might be of equal value was investigated in newborns. In total, 193 simultaneous measurements of capillary and arterial blood lactate concentrations were performed in 25 newborn babies with an indwelling umbilical arterial catheter. A strong linear correlation was found between capillary and arterial lactate concentration (Lcap= 1.02 Lart+ 0.04; r= 0.98; p < 0.001). The mean difference was −0.08 mmol/1 and the limits of agreement (± 2 SD) were ± 0.69 mmol/1 (−0.77 to 0.61 mmol/1). Conclusion: Our data show that capillary blood lactate measurements in newborn babies yield lactate concentrations equivalent to arterial measurements over a large concentration range.