bluuebunny/crossref_metadata_2025_split huggingface dataset:
The prevalence of coeliac disease as detected by screening in children with iron deficiency anaemia
Authors: Kalayci Ayhan Gazi , Kanber Yilmaz , Birinci Asuman , Yildiz Levent , Albayrak Davut 
Published: August 2010

AbstractAim:Iron deficiency anaemia is a frequent finding seen in coeliac disease, which can be diagnosed alone or with other findings. In this study, our aim was to determine the prevalence of coeliac disease in children with iron deficiency anaemia without significant gastrointestinal symptoms.Methods:There were 135 children with iron deficiency anaemia in the patient group (group 1), and 223 healthy children without iron deficiency anaemia in the control group (group 2) in this study. Antiendomysial antibody (EMA) IgA test was given to both groups. Antiendomysial antibody‐positive patients underwent small intestine biopsy.Results:The mean age was 7.2±4.6 (2–16) y in the patient group (group 1) and 8.2±3.8 (2–16) y in the control group (group 2), and no significant difference between the two groups was detected. In terms of gender, there was a significant difference between groups 1 and 2 (M/F: 74/61 and 98/125, respectively) ( p<0.05). EMA was positive in six cases in group 1 (4.4%), and villous atrophy and/or inflammation in the lamina propria with increased intraepithelial lymphocytes was seen on small intestine biopsy in these patients. In the control group, EMA was negative in all children. In detailed histories of patients with coeliac disease diagnosis, recurrent iron deficiency anaemia/pica was found in four patients (66.7%) and occasionally foul‐smelling or watery stool attacks were seen in four patients (66.7%). Three of these six patients (50%) had short stature.Conclusion:The prevalence of coeliac disease was high in patients with iron deficiency anaemia; therefore, gastrointestinal findings should be further examined for coeliac disease, and the possibility of coeliac disease should be investigated in patients with recurrent iron deficiency anaemia and short stature.
Maternal consumption of dairy products during pregnancy and lactation, and the development of cow's milk antibodies in the offspring
Authors: Erkkola Maijaliisa , Kronberg‐Kippilä Carina , Savilahti Erkki , Kenward Michael G , Salonen Marja , Ilonen Jorma , Knip Mikael , Äkerblom Hans K , Virtanen Suvi M 
Published: August 2010

Abstract Objective: To assess whether the maternal consumption of milk and milk products affects development of cow's milk (CM) antibodies in infants. Design: A randomized pilot trial using food frequency questionnaires (mothers) and food records (infants). Setting: Families with a newborn infant with increased HLA‐DQB1‐conferred risk of type 1 diabetes and at least one first‐degree relative affected by type 1 diabetes from 16 hospitals in Finland between April 1995 and November 1997. Subjects and intervention: Infants randomized to receive a hydrolysed formula when breast milk was not available during their first 6–8 mo (n=112). Of these, 13 dropped out by the age of 3 mo and two were excluded due to incomplete CM antibody data. Results: Maternal milk protein intake from cheese during pregnancy was inversely related to IgA‐class antibody titres to beta‐lactoglobulin (BLG) and casein (CAS) at 3 mo, and to IgA antibody titres to BLG at 6 mo. Maternal consumption of raw milk products during lactation was positively related to the development of IgA antibody titres to CAS at 6 mo, and inversely correlated to IgG antibody titres to bovine serum albumin (BSA) and IgA antibody titres to CAS at 2 y. Maternal cheese consumption was inversely related to the IgG antibody titres to CM formula and CAS and to the IgA antibody titres to CAS in early infancy. Conclusions: Few associations were established between maternal CM protein intake and CM protein antibody levels in the infants. The milk and milk products taken by the mother differed in their impact on the emerging CM antibody response in the offspring.
Cognitive and educational outcomes in early adulthood for infants weighing 1000 grams or less at birth
Authors: Lefebvre Francine , Mazurier Évelyne , Tessier Réjean 
Published: August 2010

Abstract Aim: To assess the intelligence quotient (IQ) and academic achievement in early adulthood of a cohort of extremely‐low‐birthweight (ELBW 1000 g) subjects. Methods: All 82 ELBW survivors consecutively born in or referred to a single tertiary center in 1976–1981 were traced at a mean age of 18 y. Three disabled children had died. Fifty‐nine subjects (75%) had their IQ tested and 69 (87%) responded to a questionnaire. They were compared to 44 term, normal birthweight (NBW) matched controls. Outcome measures were: IQ (Wechsler Adult Intelligence Scale) and educational outcome. The main outcome variables were compared between groups and analyzed for neonatal and demographic data and in the ELBW group for childhood data. Results: There was a strong relationship (r2=0.55, p<0.0001) between childhood and adult IQ for the 41 ELBW subjects tested at both ages (6.1±1.3 and 18.4±1.9 y). Differences were significant between ELBW and NBW groups: in mean full‐scale IQ (94±12 vs 108±14), verbal IQ (93±12 vs 106±14) and performance IQ (97±14 vs 109±16) (p<0.0001). Differences between ELBW and NBW groups in prevalence of IQ<85 (19 vs 2%, p=0.012), of schooling in a regular curriculum for age (36 vs 68%, p=0.0011), of requirement for special classes or schools (33 vs 9%, p=0.0032), and of obtainment of secondary school diploma for those 18 y or older (56 vs 85%, p=0.018) were largely due to fathers’ socio‐economic score. Conclusion: ELBW subjects had a mean adult IQ in the normal range; however, it was one standard deviation below that of NBW subjects and they had more school failures. Despite this, more than half of ELBW subjects aged 18 y or more had obtained their secondary school diploma.
Aplasia cutis congenita of the scalp: How much therapy is necessary in large defects?
Authors: Bernbeck B , Schwabe J , Groninger A , Schaper J , Messing‐Jünger H , Mayatepek E , Rosenbaum T 
Published: August 2010

Abstract Aim: To show that local antibiotic management and a regular inspection of aplasia cutis congenita of the skull can give an excellent result. Method: This case reports a girl born with aplasia cutis congenita of the skull presenting with a large aplasia of the epidermis, dermis, subcutaneous tissue and galea, including a bone defect without any additional risk factor, e.g. early eschar formation, cerebrospinal fluid leakage or uncommon dural blood vessels. Results: A primarily conservative treatment with local wet and antibiotic dressings together with a systemic antibiotic treatment for the first 2 wk led to an excellent result and thus prevented untimely operative and peri‐operative procedures. Conclusions: Here we have shown that conservative treatment might be an option, even if the wound diameter is greater than 1 cm2, to prevent infants from any untimely operative procedure with an elevated operative risk if any additional risk factors are excluded.
Primary cutaneous aspergillosis (PCA)—a case report
Authors: Andresen Jannicke , André Nygaard Egil , Størdal Ketil 
Published: August 2010

AbstractPrimary cutaneous aspergillosis is a rare diagnosis. Predisposing factors are immunodeficiency and macerated skin. The mortality of infections with Aspergillus species is high, especially in neonatal intensive care units (NICUs). We present a premature (24 wk of gestation) infant with primary cutaneous aspergillosis appearing on the sixth day of life. Predisposing factors in this patient were prematurity, extremely vulnerable skin, treatment with antibiotics and renovation in the radiology department nearby. The patient was treated with amphotericin B intravenously for a total of 40 d. He did not have, nor develop, disseminated aspergillosis, and suffered no side effects from the treatment. The only remaining trace of his infection was scarring in the affected area. Conclusion: After having treated this patient successfully and having gone through the available literature, we conclude that treating primary cutaneous aspergillosis with intravenous amphotericin B prevents disseminated aspergillosis and is the treatment of choice.
Prevalence and aetiology of congenital birth defects, infant mortality and mental retardation in Lahore, Pakistan: A prospective cohort study
Authors: Gustavson Karl‐Henrik 
Published: August 2010

Abstract Aim: To study the health and development of children in a developing and low‐income country. Methods: The health and development of children in Lahore in northern Pakistan have been studied since 1981 in a collaborative project between Pakistani and Swedish university institutions and the Swedish Agency for Research Cooperation with Developing Countries (SAREC). The study described in this paper comprised four different areas in Lahore with different degrees of urbanization and different social conditions. All pregnancies in the four areas were registered during the period March 1984 to July 1986 and were followed up from the 5th month of pregnancy. All 1476 children born after 1 September 1984 were followed up from birth to 12 y of age. Results: The perinatal mortality in the whole material was 5.4%. It was highest in the periurban slum (7.5%) and lowest in the upper‐middle class cohort (3.3%). Overall infant mortality was 10%. It was highest (14%) in the periurban slum and lowest (2%) in the upper‐middle class group. Overall incidence of serious birth defects was 5%. It was highest in the periurban slum community (7%) and lowest in the upper‐middle class cohort (3%). The overall cumulative incidence of severe mental retardation per 100 live births was 1.1. It was highest (2.2) in the periurban slum and lowest (0.4) in the upper‐middle class group. The overall prevalence of mild mental retardation among 6–10‐y‐old children was 6.2 per 100. It was highest in the periurban slum (10.5) and lowest (1.3 per 100) in the upper‐middle class group. Poverty, malnutrition, birth trauma and consanguinity were common causes of infant mortality and mental retardation in Lahore, Pakistan. Conclusion: Preventive measures with provision of obstetric and health services, services for genetic information and risk evaluation, vaccination programmes and identification of children with retarded development for specific stimulation and habilitation measures, e.g. organized play activities, are important in developing and low‐income countries.
Starting the process of mother–infant bonding
Authors: Kennell John , McGrath Susan 
Published: August 2010

AbstractEstablishing a bond between a mother and her newborn is essential for the infant to grow and thrive in the mother's care. Hospital staff can promote the creation of this bond by providing continuous support during labor, by placing the newborn skin‐to‐skin on the mother's chest immediately after delivery until the infant latches on for the first feeding, by encouraging continued breastfeeding, and by keeping mother and infant always together in the first hours and days after delivery. Conclusion: Even in cases where the mother initially rejects her infant, sensitive medical personnel can provide an environment which allows the bond between mother and infant to begin.
A randomized trial comparing beractant and poractant treatment in neonatal respiratory distress syndrome
Authors: Ann Malloy Colleen , Nicoski Pamela , Muraskas Jonathan K 
Published: August 2010

Abstract Aim: To compare the effects of beractant and poractant in neonatal respiratory distress syndrome (RDS). Methods: Infants with RDS were randomized to receive beractant or poractant. The primary outcome measure was fraction of inspired oxygen (FiO2) requirement in the first 48 h after surfactant therapy. Results: 58 infants completed the study. The mean gestational ages for the poractant and beractant groups were 29.6±3.6 and 29.3±2.9 wk, with average birthweights of 1394±699 and 1408±534 g, respectively. In the first 48 h, infants who received poractant had a lower FiO2 requirement compared to those who received beractant (p=0.018). The prevalence of patent ductus arteriosus (PDA) was lower in the group of infants that received poractant (17%) compared to the group that received beractant (45%) (p=0.02). Conclusions: Infants with RDS treated with poractant had a lower FiO2 requirement during the first 48 h compared to infants who received beractant. Infants who received poractant also had fewer PDAs than infants who received beractant. The difference in FiO2 was not associated with a difference in age of first extubation, total intubation time, or incidence of bronchopulmonary dysplasia between groups.
Long‐term circulatory and renal consequences of intrauterine growth restriction
Authors: Simeoni Umberto , Zetterström Rolf 
Published: August 2010

AbstractIntrauterine growth restriction (IUGR) and probably also early postnatal altered nutrition in very‐low‐birthweight babies may, in the long term, be followed by the various disorders that are included in the metabolic syndrome. This discovery has raised a new paradigm about the background to cardiovascular disease, arterial hypertension, obesity, type 2 diabetes and dyslipidaemic disorders that play a prominent role in shortening human life. In this review article, present knowledge about the background to renal dysfunction as seen in IUGR is summarized. The way in which arterial hypertension and cardiovascular dysfunction may be programmed in IUGR is also speculated.Conclusion:During the last decade, knowledge of the long‐term consequences of IUGR has increased at a very rapid rate. At present, it is most important not only to develop efficient methods of preventing and diagnosing IUGR, but to work out follow‐up and treatment programmes for the control of the disorders which may follow this condition. Proper postnatal feeding and infant growth may be essential for long‐term outcome.
Small‐for‐gestational‐age infants need dietary quality more than quantity for their development: The role of human milk
Authors: Agostoni Carlo 
Published: August 2010

AbstractInfants born small for gestational age (SGA) show some forms of developmental delay throughout paediatric age, and up to adolescence. The positive effect of breastfeeding on development, observed in most studies on healthy, term infants, seems to be further stressed in the group of SGA infants, particularly if breastfeeding is protracted. Besides the close maternal–infant contact of breastfeeding, the nutritional factors of human milk, above all long‐chain polyunsaturated fatty acids, including docosahexaenoic acid, may at least partly account for the observed association. Conclusion: SGA infants represent a high‐risk group, not only for developmental delay, but also for long‐term, unfavourable metabolic consequences. Breastfeeding and human milk quality together could help to prevent some of the neurological and metabolic sequelae of being born growth retarded.
Obstetric ectoscopy, also a paediatric concern
Authors: Bergström Staffan 
Published: August 2010

AbstractBy coining a new concept, “obstetric ectoscopy”, attention is drawn to the fact that undergraduate and postgraduate training in obstetrics and perinatal medicine in low‐income countries is not geared towards community obstetrics, rather to more prestigious and lucrative endoscopy. It is argued that the devastation of maternal mortality leaves the clinical profession inactive and indifferent and that a more ectoscopic spirit would better prepare future obstetricians in efforts to enhance maternal and perinatal survival.
Dexamethasone inhalations in RSV bronchiolitis: A double‐blind, placebo‐controlled study
Authors: Bentur Lea , Shoseyov David , Feigenbaum David , Gorichovsky Yilena , Bibi Haim 
Published: August 2010

Abstract Objective: To evaluate the effect of inhaled dexamethasone on hospitalization for respiratory syncytial virus (RSV) bronchiolitis. Study design: A double‐blind, placebo‐controlled study compared nebulization of dexamethasone versus nebulization of 0.9% saline. Both groups were treated with epinephrine nebulizations. Follow‐up continued for 3 mo. Patients and methods: Sixty‐one infants with bronchiolitis aged 3 to 12 mo were included. They were randomly allocated to nebulizations with 0.25 mg dexamethasone every 6 h (group 1) or an equivalent amount of normal saline (group 2). Results: No statistically significant differences with respect to clinical score, oxygen saturation, or IV fluid requirement between the groups were noted. Using Kaplan‐Meyer's method, the cumulative proportion of in‐hospital stay was significantly lower in group 1 compared with group 2, mainly in days 5 and 6 post‐hospitalization (p<0.038). A subgroup of prematurely born children in group 1 had a shorter hospitalization period (6.5±1.7 d) compared with group 2 children (9.1±1.9) (p<0.018). Follow‐up revealed similar wheeze and hospitalization rates in the two groups. Conclusion: Inhaled dexamethasone may reduce the length of hospitalization among infants with acute viral bronchiolitis, especially among those born prematurely.
Learning disabilities in a population‐based group of children with hydrocephalus
Authors: Lindquist Barbro , Carlsson Göran , Persson Eva‐Karin , Uvebrant Paul 
Published: August 2010

Abstract Aim: To assess cognitive functions in a population‐based group of children with hydrocephalus and to analyse differences between children with and without myelomeningocoele (MMC); with hydrocephalus already present at birth and those who developed it later; children born at full term and those born preterm. Methods: Of 103 children with hydrocephalus born in the western‐Swedish region in 1989–1993, 73 were assessed using the Wechsler Intelligence Scales or the Griffith Developmental Scales. Results: One‐third of the children were normally gifted (IQ>85), another 30% had a low average IQ of 70–84 and 37% had learning disabilities with an IQ of <70. The median IQ was 75, verbal IQ 90 and performance IQ 76 (p<0.001). An IQ of <70 was found in 19 of 45 (42%) children without MMC and in 8 of 28 (29%) of those with MMC. Children born preterm had a lower IQ of 68 than those born at full term with an IQ of 76, while children with hydrocephalus present at birth but without MMC had a lower IQ of 60 than the others with an IQ of 77. Children with cerebral palsy and/or epilepsy (n=22) had a lower IQ of 66 than the IQ of 78 in those without these impairments (p<0.01). Conclusion: Cognitive functions in children with hydrocephalus need to be carefully assessed before school age to ensure adequate support and education. Even the one‐third near normally gifted children with an IQ of 70–85 require special attention, due to the profile of relatively well‐preserved verbal functions but greatly impaired perceptual and non‐verbal abilities.
Recombinant human activated protein C, heparin and melagatran in umbilical cord versus adult plasma
Authors: Koestenberger Martin , Cvirn Gerhard , Gallistl Siegfried , Kutschera Joerg , Muntean Wolfgang 
Published: August 2010

Abstract Aim: We investigated the anticoagulant effects of recombinant human activated protein C (rhAPC), unfractionated heparin (UH) and melagatran (a new direct thrombin inhibitor [DTI]), when administered individually and in combinations of rhAPC with either UH or melagatran, in umbilical cord and adult plasma. rhAPC is a promising candidate treatment to improve the outcome of severe sepsis in neonates and adults; the DTI melagatran represents a potential advance in antithrombotic therapy. Methods: The anticoagulant efficacy of these drugs was measured using the standard coagulation assays activated partial thromboplastin time (aPTT) and prothrombin time (PT). Results: Administered individually, rhAPC, UH and melagatran dose‐dependently prolonged aPTT to a significantly greater extent in umbilical cord than in adult plasma. Melagatran alone, but not rhAPC or UH alone, dose‐dependently prolonged the PT in both umbilical cord and adult plasma. Combining rhAPC with either UH or melagatran significantly augmented aPTT prolongation in both umbilical cord and adult plasma. Conclusion: Our results, which facilitate estimation of rhAPC and melagatran dose requirements in umbilical cord plasma, may be of benefit in critically sick newborns with severe sepsis.
Response to resuscitation of the newborn: Early prognostic variables
Authors: Didrik Saugstad Ola , Ramji Siddarth , Rootwelt Terje , Vento Maximo 
Published: August 2010

Abstract Aim: To characterize the development of clinically relevant variables the first minutes after birth and identify early prognostic markers in newborn infants requiring resuscitation. Methods: A database of 591 infants resuscitated with either 21% or 100% oxygen was analysed. Time to first breath, development in heart rate, Apgar scores, arterial oxygen saturation (SaO2), and base deficit (BD) are described in relation to different degrees of birth depression and outcomes. Results: Heart rate and Apgar scores increased quickly even in the most depressed infants but were significantly lower in those having a poor outcome. By contrast, BD normalized at the same rate, 6–7 mmol/l/h, in the first hour of life regardless of the degree of birth depression and outcome. SaO2 values increased as quickly in room air as in 100%‐oxygen‐resuscitated infants. Time to first breath was prolonged threefold, from 1 to 3 min, in the most depressed (1‐min Apgar score <4) compared with the less depressed infants. Highest odds ratio (OR) for death in the first week of life or for development of hypoxic‐ischaemic encephalopathy (HIE) stage 2 and 3 was a 5‐min heart rate 60 bpm (OR 16.5 for both death and HIE) and Apgar <4 (OR 14 and 18.8). Neonatal survival for HIE stage 1, 2, and 3 was 93%, 63%, and 11%, respectively. OR for early neonatal death, if SaO260% at 1 min, was 8.6 (sensitivity 0.82 and specificity 0.65). Conclusion: Apgar scores, heart rate, SaO2, and time to first breath in newly born infants in need of resuscitation may be used for early identification of infants with a poor prognosis. These data may be helpful in describing the severity of depression in single infants and to select infants in need of interventional therapy.
Cerebral blood flow and morphological changes after hypoxic‐ischaemic injury in preterm lambs
Authors: Hilario Enrique , Carmen Rey‐Santano Mari , Goñi‐de‐Cerio Felipe , Jose Alvarez Francisco , Gastiasoro Elena , Eugenia Mielgo Victoria , Caballero Amale , Valls‐i‐Soler Adolfo , Gómez‐Urquijo Sonia , Alvarez Antonia 
Published: August 2010

Abstract Aim: To evaluate the effect of cerebral hypoxia‐ischaemia induced by partial occlusion of the umbilical cord on the relationship of the regional cerebral blood flow and the cerebral cell death in near‐term fetal lambs. Methods: Fifteen near‐term lambs were assigned to two hypoxic‐ischaemic groups with or without life support (3 h), and a healthy one. Hypoxia‐ischaemia was induced by partial occlusion of the umbilical cord (60 min). Routine light and electron microscopy, and the TUNEL method for apoptosis were performed. Regional cerebral blood flow was measured by coloured microspheres. Cardiovascular, gas exchange and pH parameters were also evaluated. Results: Both hypoxic‐ischaemic groups produced a transient acidosis and a decrease of base excess in comparison to the healthy group. Cortical and cerebellar zones, where the regional cerebral blood flow values were similar to baseline, showed an increased number of oligodendrocyte‐like apoptotic cells. In contrast, in the inner zones, where regional cerebral blood flow was increased, the number of apoptotic cells did not increase. Necrotic neurons were observed in the basal nuclei, mesencephalon, pons and deep cerebellar nuclei. Conclusion: Our results suggest that regional cerebral blood flow and the presence of apoptotic cells, 3 h after hypoxic‐ischemic injury, are correlated.