bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immunoglobulin heavy G2 chain (IGHG2) gene restriction in the development of severe respiratory syncytial virus infection
Authors: Aurivillius Magnus , Øymar Knut , Oxelius Vivi‐Anne 
Published: August 2010

Abstract Aim: Respiratory syncytial virus (RSV) is a prominent cause of airway morbidity in children under 1 y of age. It is assumed that host factors influence the severity of disease presentation, and thus the need for hospitalization. The variation of IGHG genes from chromosome 14q32 are linked to serum IgG subclass levels but also to the variations in IgG responses to pneumococcal, meningococcal and Haemophilus influenzae antigens. The aim of this investigation was to clarify whether IGHG genes are involved in the development of severe RSV lower respiratory tract infection (LRTI). Methods: The alternative expressions of IGHG3(b) and (g), IGHG1(f) and (a), and IGHG2(n) and (‐n) genes were studied in a cohort of 49 previously healthy children hospitalized for RSV LRTI. The gene frequencies were compared to a population of healthy individuals. Results: The homozygous IGHG2(‐n/‐n) genotypes dominated in hospitalized children with severe RSV infection: 55.1%, compared with 34.2% in the healthy population (OR 2.3; p=0.004). The IGHG2 genotypes containing (n/n) and (n/‐n) were significantly decreased. The IGHG(bf‐n) alleles were significantly increased (OR 1.7; p=0.025) and the IGHG(bfn) alleles significantly decreased (OR 0.5; p=0.005). Conclusion: The IGHG(bf‐n) allele and homozygous IGHG2(‐n/‐n) genotypes are associated with the development of severe RSV LRTI.
Accuracy of acute otitis media diagnosis in community and hospital settings
Authors: Asher Elad , Leibovitz Eugene , Press Joseph , Greenberg David , Bilenko Natalya , Reuveni Haim 
Published: August 2010

Abstract Aim: To evaluate the accuracy rates of acute otitis media (AOM) diagnosis in the community by analyzing the initial AOM diagnosis (according to information from the referral letters to the Pediatric Emergency Department [PED]) among children with AOM diagnosis confirmed by tympanocentesis at PED. Methods: A descriptive, retrospective study conducted during the year 2000, including 590 children aged 0–48 mo diagnosed with AOM at PED. AOM was confirmed by tympanocentesis. We defined: (1) simple AOM as <3 or <4 episodes during the last 6 or 12 mo, respectively; (2) complicated AOM as 3 or 4 episodes during the last 6 or 12 mo, respectively, and/or not improving with antibiotics. Results: 571 (96.8%) were <24 mo of age; 355 (60%) were Arab Bedouins and 235 (40%) Jews. Seventy‐three pediatricians, 57 general practitioners and 27 family practitioners provided referral letters. Information on disease severity was available in 471/590 (79.8%) patients, of whom 320 (68%) had simple and 151 (32%) complicated AOM. Three hundred and sixty‐five (62%) of 590 patients were accurately diagnosed by referring physicians, more frequently in patients with complicated than simple AOM ( p<0.001). Diagnostic accuracy was similar among physician specialties ( p=0.33) and ethnic groups ( p=0.11). Multivariable logistic regression analysis showed that complicated AOM, adjusted for age, sex, ethnic origin, and physician specialty, was the only predictive factor for accurate AOM diagnosis (odds ratio 4.0, p<0.001). Conclusions: Inaccurate diagnosis of AOM in community settings is common, occurring more frequently in simple than in complicated AOM, and is unrelated to physician specialty and children's ethnicity.
Trends in the epidemiology of neonatal sepsis of vertical transmission in the era of group B streptococcal prevention
Authors: López Sastre José B , Fernández Colomer Belen , Coto Cotallo GD , Ramos Aparicio Antonio 
Published: August 2010

Abstract Aim: To assess trends in the epidemiology of culture‐proven and clinical neonatal sepsis of vertical transmission in the era of intrapartum antibiotic prophylaxis. Methods: Since 1995, the neonatal services of 28 acute‐care teaching hospitals in Spain (“Grupo de Hospitales Castrillo”) have been involved in the prospective surveillance of neonatal infection of vertical transmission. We here report the comparison of the incidence for the periods 1996–1997 and 2000–2001, and look separately at two groups of hospitals according to the time at which the official hospital policy to provide intrapartum antibiotic prophylaxis for group B Streptococcus (GBS) prevention was adopted. In 16 hospitals the policy was adopted in 1999 and in 10 before 1998 (nine hospitals in 1996, one in 1997). Results: The incidence of proven sepsis decreased significantly by 22% and 54% in the hospitals that started prophylaxis in 1999 and before 1998, respectively. The incidence of GBS sepsis also declined significantly by 36.4% and 65.4% in both groups of hospitals, respectively. Significant variations in the incidence of clinical vertical sepsis as well as in the incidence of sepsis caused by Haemophilus influenzae and Klebsiella were not found. Sepsis caused by Escherichia coli increased in the hospitals with prophylaxis from 1999 and decreased in those that began prophylaxis before 1998, in which the mortality rate of proven and clinical sepsis also decreased significantly by 58.6%. Conclusions: There was a substantial decline in the incidence of proven vertical sepsis, with a significant reduction of GBS sepsis, although decreases were more marked when antibiotic prophylaxis was started before 1998. In this group of hospitals, there was also a decrease in the mortality rate. Fluctuations in the incidence of E. coli infection suggest the need for continuing epidemiological surveillance.
Role of physical activity and eating behaviour in weight control after treatment in severely obese children and adolescents
Authors: Deforche Benedicte , de Bourdeaudhuij Ilse , Tanghe Ann , Debode Patrick , Peter Hills Andrew , Bouckaert Jacques 
Published: August 2010

Abstract Aim: To investigate the role of physical activity and eating behaviour in weight control 1.5 y after a weight‐reduction programme in severely obese children. Methods: Forty‐seven children (13.4±2.1 y) were measured 1.5 y after the completion of a 10‐mo residential treatment programme. Stature and body mass were measured; physical activity, fat and fibre intake, and self‐efficacy in relation to physical activity and healthy eating behaviour were assessed using validated structured interviews. The total sample was divided into four subgroups according to unhealthy versus healthy physical activity and eating behaviour at follow‐up. Results: One‐and‐a‐half years after treatment, subjects had regained 34±19% overweight, but were on average still 20±19% less overweight than before treatment (p<0.001). The four subgroups did not differ in level of overweight at the beginning or end of treatment. At follow‐up, there was a significant difference in overweight between the four subgroups (p<0.05). The least healthy group (unhealthy physical activity and unhealthy eating behaviour) had a significantly higher level of overweight 1.5 y after treatment (183±36%) in comparison with the other groups (unhealthy physical activity and healthy eating: 150±21%; healthy physical activity and unhealthy eating: 156±14%; healthy physical activity and healthy eating: 138±16%) (p<0.05), whilst the healthiest group showed the lowest level of overweight after treatment when compared to the other groups (p<0.05). Conclusion: Results suggest that both physical activity and nutritional habits play an important role in weight maintenance after initial weight loss in obese children and that one healthy behaviour can not compensate for another unhealthy behaviour.
Alarming prevalences of overweight and obesity for children of Turkish, Moroccan and Dutch origin in The Netherlands according to international standards
Authors: Miranda Fredriks A , van Buuren Stef , Hira Sing Remy A , Maarten Wit Jan , Pauline Verloove‐vanhorick S 
Published: August 2010

Abstract Aim: Prevalences of overweight in The Netherlands, defined by international cut‐off points, are presented in 14 500 children of Dutch origin, 2904 of Turkish and 2855 of Moroccan origin, aged 0–21 y. Results: The mean prevalence for Turkish boys and girls was 23.4% and 30.2%, for Moroccans 15.8% and 24.5%, for Dutch youths in large cities 12.6% and 16.5%, and for other Dutch participants 8.7% and 11.3%, respectively. Conclusion: The development of adequate prevention strategies is urgently needed.
Ghrelin, leptin and the neurometabolic axis of breastfed and formula‐fed infants
Authors: Agostoni Carlo 
Published: August 2010

AbstractThe possible long‐term effects of prolonged breastfeeding in preventing obesity have led to the reconsideration of different growth curves of breastfed and formula‐fed infants in the light of haematochemical markers. Leptin, ghrelin, insulin‐like growth factors and other compounds may not only represent mediators involved in the metabolism of fat tissues, but may also potentially be able to explain the complex relationships between the gastrointestinal tract and the hypothalamic regulation of the sense of hunger and satiety. Conclusion: Diet‐related differences in the circulating levels of mediators implicated in energy metabolism during infancy might explain anthropometric and behavioural differences between breastfed and formula‐fed infants with potential long‐term consequences.
Ghrelin, leptin and IGF‐I levels in breast‐fed and formula‐fed infants in the first years of life
Authors: Savino Francesco , Fissore Maria F , Grassino Erica C , Nanni Giuliana E , Oggero Roberto , Silvestro Leandra 
Published: August 2010

Abstract Aim: To establish ghrelin, leptin and IGF‐I serum levels in breastfed (BF) and formula‐fed (FF) infants during the first period of life. Methods: A cross‐sectional study was conducted on fasting blood venous samples obtained from exclusively BF (n=106) and FF (n=100) infants to measure total ghrelin (RIA test), leptin (RIA test) and IGF‐I (chemiluminescence). Anthropometrical measurements of weight, length and cranial circumference were performed. Results: During the first 4 mo of life, FF infants compared to BF ones showed higher ghrelin levels (2654.86 vs 2132.96 pg/ml; p<0.032), higher IGF‐I levels (3.73 vs 3.15 ng/ml; p=0.00) and lower leptin levels (0.68 vs 1.16 ng/ml; p<0.04). Leptin values were higher in females than in males (0.80 vs 0.47 ng/ml; p<0.03), while no gender‐related difference was found for ghrelin and IGF‐I. No differences were found in anthropometrical measurements comparing the two groups of infants. A multiple regression analysis showed an inverse correlation between ghrelin and leptin values (p<0.04) and between IGF‐I and leptin levels (p=0.00). Conclusion: Our finding suggests that breastfeeding influences hormones such as ghrelin, leptin and IGF‐I in infancy, mainly during the first 4 mo of life. Further evidence is needed to confirm and clarify the role of a protective link from mother to infants as seen in our observations.
A doctor's ability to assess the severity of childhood asthma by simple clinical features
Authors: Linna Olavi 
Published: August 2010

Abstract Aims: To ascertain whether the severity of childhood asthma can be reliably assessed by simple clinical features, 94 newly diagnosed, school‐aged asthmatic children were investigated. Methods: The study included parental interviews, physical examination, skin prick tests, lung function studies, including a brief visual interpretation of the flow–volume curve, and a 6‐min exercise challenge test on a treadmill, which was used as a reference. Results: Baseline lung function studies showed a concave‐shaped flow–volume curve in 40 (43%) patients, reduced maximal mid‐expiratory flow (MMEF) in 25 (27%) and a reduced ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC) in 14 (15%). The drop in peak expiratory flow (PEF) after exercise ranged from 0 to 79% of the baseline (mean 21.3%) and exceeded 12.5% in 52 (55%) patients. There was a small but significant correlation between the baseline FEV1/FVC and MMEF values and the response to exercise (r=−0.39 and −0.35; p=0.000, respectively), but when studied by linear regression analysis, the response to exercise was best predicted by the past symptom rate and a concave pattern in the pre‐test maximal expiratory flow–volume curve. The values of traditional lung function tests or age, atopy, duration of symptoms or history of exercise‐induced wheezing did not remain in the model. Conclusions: These results show that the severity of asthma in school‐aged children can be predicted at the first visit based on the past rate of symptoms and a visual interpretation of the maximal expiratory flow–volume curve.
Predictive value of umbilical cord blood bilirubin for postnatal hyperbilirubinaemia
Authors: Knüpfer Matthias , Pulzer Ferdinand , Gebauer Corinna , Robel‐Tillig Eva , Vogtmann Christoph 
Published: August 2010

Abstract Aim: The study investigated the predictive value of umbilical cord serum (UCS) bilirubin for the postnatal course of bilirubinaemia in healthy term and near‐term newborns. Methods: Term appropriate‐for‐gestational‐age (AGA; n=1100), small‐for‐gestational‐age (SGA; n=163) and near‐term infants (GA 34–36 wk; n=78) were included and separated according to their UCS bilirubin levels, starting from <20 (group 1), 20–<30 (2), 30–40 (3) and >40 (4) μmol/l. The newborns were followed for at least 5 postnatal days, and UCS bilirubin values were correlated with the development of hyperbilirubinaemia and phototherapy (PT) treatment. Results: A clear relation between UCS bilirubin and the development of hyperbilirubinaemia was found in all three patient populations. None of the 75 AGA patients of group 1 developed postnatal bilirubin values above 300 μmol/l, whereas 0.3, 3.4 and 8.6% of the patients in groups 2–4, respectively, did so. The frequency of PT increased from 0% in group 1 up to 9.6% in group 4. For the prediction of further need of PT using a UCS bilirubin cut‐off level of 30 μmol/l, we found a sensitivity of 90% and a negative predictive value of 99.1%, indicating that all patients with UCS bilirubin values below 30 μmol/l (443/1100 or 40.2%) were at a very low risk of developing dangerous hyperbilirubinaemia. Similar results were obtained in SGA children with a sensitivity of 94.1% and a negative predictive value of 98.6%. In comparison to term newborns, we generally found higher bilirubin values in preterms. A total of 6.4% of preterm children developed bilirubin values over 300 μmol/l, compared with 3% of term children, and 47.4% of preterms had to be treated with PT. Predicting the need of PT by using a UCS bilirubin cut‐off level of 30 μmol/l revealed a sensitivity of 70.3% and a negative predictive value of 65.6%. Conclusion: These data suggest that UCS bilirubin is useful in predicting the postnatal bilirubin values in term and near‐term newborns. We presume that the use of UCS bilirubin values may help detect infants at low risk for postnatal hyperbilirubinaemia and minimize an unnecessary prolongation of hospitalization.
Socio‐demographic determinants of initiation and duration of breastfeeding in northwest Russia
Authors: Grjibovski Andrej M , Yngve Agneta , Olov Bygren Lars , Sjöström Michael 
Published: August 2010

Abstract Aim: This study examines socio‐demographic determinants of initiation and duration of breastfeeding in a community‐based cohort in northwest Russia. Methods: All infants born to women who were registered at the antenatal clinics in Severodvinsk in 1999 comprised the cohort (n=1399) and were followed up at 1 y. Data on maternal and infant characteristics as well as the duration of breastfeeding were obtained from medical records. Proportional hazard analysis was applied to quantify the effect of the selected factors on the risk of breastfeeding discontinuation adjusted for potential confounders. Results: Only 1.3% of infants were never breastfed. Breastfeeding rates were 75.0% and 47.2% at 3 and 6 mo, respectively. Maternal age and early initiation of prenatal care were positively associated with breastfeeding initiation rates. Increased risks of breastfeeding discontinuation were found in teenage mothers (OR=1.45, 95% CI: 1.06–1.99), in mothers with basic education (OR=1.68, 95% CI: 1.06–2.66) and in unmarried mothers (OR=1.19, 95% CI: 1.03–1.38). Women with no previous deliveries were more likely to breastfeed longer (OR=0.74, 95% CI: 0.62–0.90). Conclusions: Compared with previous studies in Russia, almost universal initiation and considerably higher rates of breastfeeding at specific time points were found. Social variations in initiation and duration of breastfeeding should raise concern of inequalities in breastfeeding practices in transitional Russia.
Group discussions with parents have long‐term positive effects on the management of asthma with good cost‐benefit
Authors: Hederos Carl‐Axel , Janson S , Hedlin G 
Published: August 2010

Abstract Aim: To investigate if an intervention with extra information and support in a group setting to parents of preschool children could improve adherence and clinical outcome. Methods: This is a controlled, prospective study where the parents of 60 newly diagnosed preschool asthmatic children aged 3 mo–6 y were randomized to either a control group or to an intervention that consisted of four group sessions in close connection with the diagnosis. The basic education on asthma and the written treatment plan were the same in both groups. The outcome measures were questionnaires to the parents and classification of the children according to symptoms and medication. The adherence rate and the burden of asthma were calculated with the help of diaries and weighing of the MDIs used between 12 and 18 mo after inclusion. Results: The follow‐up rate was 85% after 18 mo. The parents’ presence in the sessions was around 70%, with no gender difference. The parents’ view on adherence issues improved significantly in the intervention group. In the control group, 30% had poor adherence compared to 8% in the intervention group (p=0.015). Both the parents and the paediatricians underestimated the number of children with poor adherence. The children in the intervention group had significantly fewer exacerbation days during the last 6 mo—2.1 compared to 3.9 d/child—although they had lower inhaled steroid doses after 18 mo. An economic calculation showed that the intervention was profitable. Conclusion: This intervention resulted in an improvement in the parents’ view on adherence, in the measured adherence rates and in the clinical outcome.
A comparison of high and standard blood transfusion volumes in premature infants
Authors: Wong Hubert , Connelly Robert , Day Andrew , Flavin Michael P 
Published: August 2010

AbstractWe compared high volume (20 ml/kg) with standard volume (15 ml/kg) packed red blood cell (PRBC) transfusions in a randomized trial. Ten high volume babies received a mean of 2.8 transfusions, while 10 standard volume babies received a mean of 3.4 (p=0.58). No adverse events were attributed to the use of the high volume transfusions. Conclusion: Higher transfusion volumes appear to be well tolerated. The data can be used in the planning of larger controlled trials in VLBW infants.
Cardiac tamponade and pericardial effusion due to venous umbilical catheterization
Authors: Traen Marijke , Schepens Elisabeth , Laroche Sabine , van Overmeire Bart 
Published: August 2010

Abstract Aim: We present three cases of neonatal cardiac tamponade due to umbilical venous catheterization, a rare, but potentially fatal complication. Methods: Timely diagnosis was made by echocardiography, and an urgent pericardiocentesis revealed TPN fluid. Perforation of the cardial wall was proven by contrast X‐ray showing contrast diffusing into the pericardial space. Discussion: Most frequently, perforation has a delayed course and results from endothelial injury, caused by the hyperosmolar fluids, leading to transmural necrosis and thrombosis. Subsequently, the fluid diffuses transmurally across the myocardium into the pericardium. As migration of the catheter tip can occur, we suggest that its position should be checked immediately after insertion and twice a week thereafter. Conclusion: Pericardial effusion and cardiac tamponade should be considered in any infant with a central venous line who develops a rapid, unexplained clinical deterioration. Timely diagnosis and drainage has been proven to be life‐saving.
Modifiable risk factors for SIDS in Germany: Results of GeSID
Authors: Vennemann Mechtild M T , Findeisen Martina , Butterfaß‐Bahloul Trude , Jorch Gerhard , Brinkmann Bernd , Köpcke Wolfgang , Bajanowski T , Mitchell Ed A 
Published: August 2010

Abstract Background: The incidence of sudden infant death syndrome (SIDS) has been falling in Germany over the last decade. However, little is known about the prevalence and the importance of well‐known risk factors in Germany since a local prevention campaign in 1992. Design: A 3‐y, population‐based, case‐control study was conducted in half of Germany, consisting of 333 cases. All sudden and unexpected deaths in infancy, if they fitted the inclusion criteria, were included in the study. Parental interview was carried out soon after the death, and three living control infants, matched for age, gender, region and sleep time, were recruited. Results: The prevalence of placing infants prone to sleep was only 4% in the control group, but this was associated with a markedly increased risk of SIDS (adjusted odds ration, aOR=6.08). Other modifiable risk factors for SIDS were: maternal smoking during pregnancy, breastfeeding for less than 2 wk (aOR=1.71) and co‐sleeping (aOR=2.71), while using a pacifier during the last sleep reduced the risk (aOR=0.39). Conclusions: Previously recognized risk factors for SIDS also occur in Germany. Despite knowledge about the major modifiable risk factors for SIDS, these factors are still present in Germany. To reduce the incidence of SIDS in Germany, a continued effort is needed to inform all parents about preventable risk factors for SIDS.
Comparison of clinical characteristics between astrovirus and rotavirus infections diagnosed in 1997 to 2002 in Hungary
Authors: Jakab Ferenc , Péterfai János , Meleg Edina , Bányai Krisztián , Mitchell Douglas K , Szűcs György 
Published: August 2010

Abstract Aim: To determine the severity and clinical characteristics of human astrovirus (HAstV) infections among hospitalized children and compare them with children infected by rotavirus. Methods: Retrospective, case‐control study of astrovirus‐infected and rotavirus‐infected children. Astroviruses were detected in stool samples by enzyme immunoassay and/or reverse transcriptase‐polymerase chain reaction. All stool samples were tested for rotavirus and bacterial pathogens, and all negative samples were further tested for human astrovirus. Children with astrovirus‐positive stool samples and complete clinical data were included in this study. Results: Astrovirus was detected in 29 (1.8%) children, and 63 rotavirus‐infected children were included as controls. Astrovirus‐infected children had shorter duration of diarrhea than rotavirus‐infected children (median 4 and 6 d, respectively; p<0.05), and 79% of the astrovirus infections were associated with a short duration of vomiting (median 1 and 4 d, respectively; p<0.0001). Rotavirus‐infected children had longer hospitalization (p<0.050) than astrovirus‐infected children. Conclusion: HAstV‐infected children had similar symptoms to those occurring in rotavirus infection. However, astrovirus‐infected patients had a significantly shorter duration of diarrhea and vomiting, and they required a shorter hospitalization. On the basis of the clinical data and severity scores, children with rotavirus infection had more severe illness.