bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short‐term outcome after active perinatal management at 23–25 weeks of gestation. A study from two Swedish perinatal centres. Part 3: neonatal morbidity
Authors: Serenius F , Ewald U , Farooqi A , Holmgren P‐Å , Håkansson S , Sedin G 
Published: August 2010

Aim: To determine major neonatal morbidity in surviving infants born at 23–25 weeks, and to identify maternal and infant factors associated with major morbidity. Methods: The medical records of 224 infants who were delivered at two tertiary care centres in 1992–1998 were reviewed retrospectively. At these centres, policies of active perinatal and neonatal management were universally applied. Of the 213 liveborn infants, 140 (66%) survived to discharge. Data were analysed by gestational age and considered in three time periods. Logistic regression models were used to identify factors associated with morbidity. Results: Of the survivors, 6% had intraventricular haemorrhage grade ± 3 (severe IVH) or periventricular leukomalacia (PVL), 15% retinopathy of prematurity ± stage 3 (severe ROP) and 36% bronchopulmonary dysplasia (BPD). On logistic regression analysis, severe IVH or PVL was associated with duration of mechanical ventilation (odds ratio, OR: 1.53 per 1‐wk increment in duration; 95% confidence interval, CI: 1.01–2.33). Severe ROP was associated with the presence of a patent ductus arteriosus (PDA) (OR: 3.31; 95% CI: 1.11–9.90) and birth in time period 3 versus time periods 1 and 2 combined (OR: 6.28; 95% CI: 2.10–18.74). BPD was associated with duration of mechanical ventilation (OR: 2.71 per 1‐wk increment in duration; 95% CI: 1.76–4.18) and with the presence of any obstetric complication (OR: 2.67; 95% CI: 1.07–6.65). Gestational age and birthweight were not associated with major morbidity. Of all survivors, 81% were discharged home without severe IVH, PVL or severe ROP.Conclusions: Increased survival as a result of active perinatal and neonatal management was associated with favourable morbidity rates compared with those in recent studies. Among survivors born at 23–25 weeks, neither gestational age nor birthweight was a significant determinant of major morbidity.
PCDDs, PCDFs and Co‐PCBs in human breast milk samples collected in Tokyo, Japan
Authors: Tajimi M , Watanabe M , Oki I , Ojima T , Nakamura Y 
Published: August 2010

Aim: To observe the distribution of PCDD/Fs and Co‐PCBs in samples of human breast milk collected in Japan. Methods: Using high‐resolution gas chromatography, milk samples for poly‐chlorinated dibenzo‐p‐dioxins (PCDDs; 14 congeners), poly chlorinated dibenzofurans (PCDFs; 15 congeners) and coplanar poly chlorinated biphenyls (Co‐PCBs; 12 congeners) from 240 mothers residing in Tokyo were analysed. There were 120 donors each of primiparae and secundiparae, each group including 60 donors aged 25 to 29 y (“the younger group”) and 60 aged 30 to 34 y (“the older group”). Individual milk samples (about 50 ml) were obtained 30 d after delivery in 1999 and in 2000. Results: The mean toxic equivalent (TEQ) level of PCDD/Fs (the sum of PCDDs and PCDFs) was 14.9 pg TEQ/g fat, of Co‐PCBs 10.6 pg TEQ/g fat, and the total sum of PCDD/Fs and Co‐PCBs was 25.6 pg TEQ/g fat. The mean TEQ levels of PCDD/Fs, Co‐PCBs, and total PCDD/Fs and Co‐PCBs were higher in primiparae than in secundiparae. In each of these, the levels were higher in the subgroup of older mothers. In the secundiparae, the mean levels were lower in the group of mothers who had breastfed their first babies than in those who bottle‐fed or partly bottle‐fed their first born.Conclusions: The concentrations of PCDD/Fs and Co‐PCBs in the breast milk of Japanese women were slightly lower than those described in previous studies conducted in Japan and other countries; and the concentrations of PCDD/Fs and Co‐PCBs in the breast milk were influenced mainly by the mother's age and nursing history.
Home breastfeeding support by health professionals: findings of a randomized controlled trial in a population of Italian women
Authors: Di Napoli A , Di Lallo D , Fortes C , Franceschelli C , Armeni E , Guasticchi G 
Published: August 2010

Aim: We conducted a randomized controlled trial to assess the effectiveness of a support intervention delivered by health professionals to increase the rate and duration of breastfeeding.Methods: A randomized controlled intervention study was conducted in the period 2000–2001 among 605 mothers who had given birth in a public maternity ward located in the city of Rome, Italy. The intervention consisted of a home visit by a midwife from the maternity ward of the hospital. The outcome of the study was the infant's feeding habits, assessed by a 24‐h recall. The effect of the intervention on the duration of breastfeeding was estimated by the Kaplan‐Meier method and by the Cox multivariate regression model.Results: According to intention‐to‐treat analysis, there was no significant difference between the intervention and the control group, after controlling for confounding factors (hazard ratio (HR) 1.04; 95% confidence interval (95% CI): 0.85–1.26). The duration of breastfeeding was shorter (HR 1.61; 95% CI: 1.13–2.31) for women in the intervention group who refused the obstetric visit.Conclusion: Our study shows that an early home support programme delivered by health professionals was not effective in increasing breastfeeding initiation and duration.
Hantavirus Puumala infection as a cause of fever of unknown origin in a child
Authors: van der Werff ten Bosch J , Heyman P , Potters D , Peeters S , Cochez C , Piéerard D 
Published: August 2010

Hantavirus infection due to Puumala virus causes nephropathica epidemica, a disorder characterized by fever, haematological abnormalities, mild renal dysfunction and ophthalmological abnormalities. The prevalence in most European countries is low, but the virus can be endemic. In children, hantavirus infection is rare. This paper describes a young girl diagnosed with hantavirus infection. The patient presented with high fever, proteinuria, haematuria and eye lesions, but other typical hallmarks of the disease, such as thrombocytopenia and renal dysfunction, were absent.Conclusion: This case report demonstrates the need to consider the diagnosis of hantavirus infection in children with prolonged fever of unknown origin. The diagnosis is based on serological tests.
Low‐dose acyclovir for HSV‐2 meningitis in a child
Authors: Kohlhoff SA , Marciano TA , Rawstron SA 
Published: August 2010

A 7‐y‐old girl with genital herpes following sexual abuse presented with dysuria, fever and meningeal signs. Acyclovir (15 mg/kg/d for 10 d) was administered for severe genitourinary symptoms. The CSF culture was positive for HSV type 2.Conclusion: Complete resolution of all symptoms demonstrates that, as in adults, HSV‐2 meningitis does not require high‐dose or prolonged acyclovir therapy.
Flawed reports of immunization complications: consequences for child health
Authors: Zetterström R 
Published: August 2010

Flawed studies about complications in vaccination programmes may have serious consequences for community health, as illustrated by a previous report on the adverse effect of pertussis vaccination and a more recent report about a suspected link between MMR vaccination and autistic spectrum disorders. Conclusion: The Editorial Board of The Lancet has apologized for having published a paper which has misled its readers about the risk of MMR vaccination. Due to the important role of TV and newspapers in giving information about health promotion, these media should also be willing to correct false information.
A novel technique to measure position‐dependent resistance changes in the vertebral arteries postmortem: new insights into the aetiology of SIDS?
Authors: Wald M , Klupp N , Lawrenz K , Puig S , Heimberger K , Reiter C , Pollak A , Ipsiroglu O 
Published: August 2010

Aim: A central respiratory regulation disturbance—triggered by impaired oxygen supply to the brainstem—is being discussed as an aetiological factor in sudden infant death syndrome. In this experimental study, further insight was sought into how far cervical spine movements may induce critical narrowing of the vertebral arteries. Methods: In 10 infant bodies, the vertebral arteries were cannulated close to their origin and perfused with a fluid bolus of 5 ml in 2 s. The intravascular peak pressure created was memorized. Individual resistance indices were computed for every vertebral artery by relating the average pressure maximum from 10 measurements each with maximal rotation of the neck to either side alone and then with additional hyperextension of the cervical spine to the average peak pressure in neutral head position. Results: Alterations of position‐induced pressure changes occurred in the vertebral arteries of all children. Considering exclusively the combined movements of rotation plus extension, resistance increased ipsi‐ and contralaterally—no matter which side the head was turned—in three infants. A further three reacted with resistance surges only contralateral to the direction of rotation, and one only ipsilateral. Double contralateral associated with only one‐directional ipsilateral rise was observed twice, and vice versa once. Conclusion: The presented method enables crude quantification of postmortem dynamic resistance alterations in the vertebral arteries. How far such measurements reflect authentic circulatory conditions during life remains to be assessed.
General joint laxity in 1845 Swedish school children of different ages: age‐ and gender‐specific distributions
Authors: Jansson A , Saartok T , Werner S , Renström P 
Published: August 2010

Aim: To evaluate general joint laxity in growing children with the aim of determining a cut‐off point for joint hypermobility. Methods: Using the Beighton score, 1845 children from 48 geographically randomly selected schools were evaluated for general joint laxity. The Beighton score evaluates the ability to perform a selection of manoeuvres involving five different joints. The children made up three different age groups (9, 12 and 15 y old) at the time of testing and were approximately equally distributed concerning age and gender in all groups. Results: There were significant differences in Beighton scores concerning both age and gender. Whereas boys presented significant decreases in the degree of general joint laxity with increasing age, girls presented the highest degree of general joint laxity at the age of 15. At all ages girls had a higher degree of general joint laxity Conclusion: Based on this study of a normal population of Swedish school children, the normal distribution of general joint laxity as well as the limits for hypermobility is age and gender specific. It is necessary to take into consideration both age and gender if setting a cut‐off point for hypermobility when evaluating general joint laxity in growing individuals.
Induction of anti‐secretory factor in human milk may prevent mastitis
Authors: Svensson K , Lange S , Lönnroth I , Widström A‐M , Hanson LÅ 
Published: August 2010

Aim: The aim of the study was to try to induce anti‐secretory factor (AF) in human milk and possibly prevent mastitis. Methods: Forty mothers who had normal deliveries and healthy full‐term infants were randomly divided into two groups, 3–7 days postpartum. The experimental group received a food inducing AF. The control group received the same type of food, without AF‐inducing properties. Milk was tested for AF after the mothers had eaten the cereals for 4–5 wk. AF was determined by intravenous injection of milk samples into rats measuring their capacity to prevent secretion into a gut loop of the rat injected with cholera toxin. Results: The median levels of AF differed between the experimental (n= 12) and control groups (n= 16): 1.1 (0.7–1.25) units vs 0.1 (0.0–0.25) units, Z =–4.492, p > 0.0001 (11 mothers dropped out and one milk sample is missing from one of the control mothers). The frequency of mastitis in the experimental compared with the control group was reduced (p= 0.0086, permutation test). The median AF levels in mothers with or without mastitis differed; 0.0 (0.0–0.1) vs 0.5 (0.2–1.1), Z =–2.399, p= 0.017. Conclusion: We suggest a specially treated cereal induces AF in human milk and protects against clinically manifested mastitis.
Socio‐economic status and surgery in children: myringotomies and tonsillectomies in Ontario, Canada, 1996–2000
Authors: Croxford R , Friedberg J , Coyte PC 
Published: August 2010

Aim: To examine the relation between socio‐economic status and (1) receipt of paediatric otolaryngological surgery, and (2) inclusion of adjuvant procedures. Methods: Using data on myringotomies with insertion of tympanostomy tube and tonsillectomies for all children in Ontario, Canada, from 1996 to 2000, and census data on socio‐economic status, we examined the association between socio‐economic status and (1) the probability of surgery (myringotomy or tonsillectomy), and (2) the probability that surgery was accompanied by an adjuvant procedure. Results: Lower socio‐economic status was associated with increased likelihood that a child's initial surgery was a tonsillectomy rather than a myringotomy (odds ratio per unit increase in the deprivation index = 1.09, p= 0.01, confidence interval 1.06–1.11), and with increased likelihood that those children having a myringotomy would undergo a tonsillectomy during the same hospitalization (odds ratio 1.14, p > 0.0001, confidence interval 1.11—1.16). Children from neighbourhoods with larger immigrant populations were less likely to receive either procedure (odds ratios per 1% increase in the proportion of immigrants = 0.97 (p > 0.0001, confidence interval 0.96–0.97) for myringotomies and 0.97 (p > 0.0001, confidence interval 0.97–0.98) for tonsillectomies). Conclusions: Socio‐economic status was associated with treatment selection for the two most common paediatric surgical procedures. Further research should examine whether differences in treatment arise at the level of the primary care physician, the specialist, and/or are due to parental preference.
Phenotypic heterogeneity in AAAS gene mutation
Authors: Barat P , Goizet C , Tullio‐Pelet A , Puel O , Labessan C , Barthelemy A 
Published: August 2010

We report the cases of two sibs of North African origin with AAAS gene mutation characterized by the heterogeneity of their phenotype. While an 8‐y‐old boy presented with acute adrenal insufficiency and mental retardation, the diagnosis was suggested by the clinical history of his 6‐y‐old sister who had symptomatic achalasia and chronic adrenal failure. Conclusion: Our observations corroborate the phenotypic heterogeneity reported in triple A syndrome, and underline the possibility of a variable intra‐familial expression.
Optic nerve glioma and colonic polyposis: report of a new association
Authors: Sheta SS , El Toukhy EA , Khattab HM 
Published: August 2010

Aim: The authors describe the clinical, radiological and histopathological features of an optic nerve glioma associated with colonic polyposis. The association between colonic polyposis and neuroepithelial tumours of the central nervous system has been previously described, but no association with optic nerve gliomas has ever been reported. Methods: We report a 14‐y‐old girl with colonic polyposis and unilateral proptosis for whom an excisional biopsy of the orbital lesion was performed. Results: Histopathological evidence of juvenile pilocytic astrocytoma grade 1 was detected. Correlation with criteria for Turcot's syndrome was established. Conclusion: Optic nerve tumours should be included in the spectrum of central nervous system lesions associated with colonic polyposis.
Defective assembly of the respiratory chain
Authors: Esteitie N , Larsson N‐G 
Published: August 2010

A functional respiratory chain is dependent on protein components encoded by both mtDNA and nuclear DNA. Isolated cytochrome c oxidase (COX) deficiency is often caused by mutations in nuclear genes regulating the assembly of the 13 protein subunits of this complex. The accompanying paper by Zeman and co‐workers reports that mutations in SCO2 are common in infantile COX deficiency and are associated with a very poor prognosis. Conclusion: Molecular diagnosis is often feasible in patients with COX deficiency and particular attention should be paid to mutations in COX assembly genes.
Perinatal health in Pakistan: a review of the current situation*
Authors: Jalil F 
Published: August 2010

The perinatal mortality rate of 63–92/1000 births as reported from two provinces of Pakistan is unacceptably high. A vast majority of births and neonatal deaths occur at home and remain unregistered. In spite of a number of child survival programmes of proven efficacy in place, the impact on perinatal health is poor. Conclusion: Initiatives such as behaviour change communication, skill‐based training of birth attendants and reaching the un‐reached may be the key future strategies to reduce perinatal losses.
The effects of iron deficiency on infants' developmental test performance
Authors: Akman M , Cebeci D , Okur V , Angin H , Abali O , Akman AC 
Published: August 2010

Aim: To assess the effects of iron deficiency on developmental test scores in infants. Methods: This prospective, single‐blind, controlled clinical intervention study was made on 108 children aged 6–30 mo who applied to our paediatric outpatient clinic. The cases were classified as control (n= 31, haemoglobin ± 11 g/dl, serum ferritin >12 μg/l, MCV ± 70 fl), non‐anaemic iron deficiency (NAID, n= 40, haemoglobin ± 11 g/dl, serum ferritin ± 12 μg/l, MCV ± 70 fl) and iron deficiency anaemia (IDA, n= 37, haemoglobin < 11 g/dl, ferritin ± 12 μg/l, MCV >70 fl) due to their anaemia status. In each group, MCV, haemoglobin and ferritin levels were measured, and Denver Developmental Screening Test (DDST) and Bayley Scales of Infant Development (BSID‐I) were administered before and after a 3‐mo follow‐up. IDA and about half of the NAID subjects were treated with oral iron for 3 mo. Results: Subjects with iron deficiency showed significantly lower developmental test scores both with BSID‐I and DDST‐II compared to their iron‐sufficient peers (p < 0.05). After 3 mo of iron treatment, lower mental developmental test scores were no longer observed among the IDA and NAID groups whose anaemia and iron deficiency were also corrected. No significant differences were found between control NAID and control IDA groups on DGTT‐II results after treatment. The difference in motor and mental developmental scores did not appear to depend on environmental and family factors considered in the analyses. Conclusion: These findings support the conclusions that iron deficiency may cause lower mental and motor test scores in infants and these adverse effects can be improved by iron therapy.
A classification of end‐of‐life decisions in neonates and infants
Authors: Provoost V , Deliens L , Cools F , Deconinck PG , Ramet J , Mortier F , Vandenplas Y 
Published: August 2010

Aim: Valid and reliable data are needed to gain insight into the decisions of paediatricians concerning the end of life of newborns and infants. Such data could throw light on the poorly documented aspects of medical practice regarding these end‐of‐life decisions (ELDs). In this article a classification of ELDs is developed.Methods: The classification is developed from knowledge generated from large‐scale epidemiological studies on ELDs.Results: This classification sets out from considerations of the various possible medical end‐of‐life procedures for newborns and infants and from important ethical aspects of the decision‐making process. From both ethical and legal viewpoints the life‐shortening intention of the physician is a significant factor for the qualification of ELDs. Furthermore, the consultation of the parents is an important factor in absence of the possibility of the patient's self‐determination.Conclusion: This classification has been devised with the aim of making reliable and valid descriptions of both the incidence and nature of ELDs in this specific population of newborns and infants.
Prevention of neonatal cold injury in preterm infants
Authors: Tunell R 
Published: August 2010

In many parts of the world neonatal cold injury still contributes to neonatal death in preterm or growth‐retarded neonates. Kangaroo Mother Care might improve the situation and is the only effective, affordable and available method to prevent neonatal hypothermia in most developing countries. In developed countries, highly sophisticated incubators and radiant warmers are available but there is increasing concern about the long‐term effects of high levels of sound, disturbing light and unplanned procedures which can have a bearing on the use of these tools. A controlled clinical trial of cot‐nursing with a heated, water‐filled mattress is presented in this issue of Acta Pædiatrica. Conclusion: The results from the new trial and the recently published systematic reviews by the Cochrane Library of technologies to provide warmth to preterm infants in modern neonatal intensive care units, makes it possible to suggest the place of available tools: incubators, radiant warmers, heated water‐filled mattresses and care in skin‐to‐skin contact.
Detection of Mycobacterium tuberculosis in gastric aspirate and sputum collected from Ethiopian HIV‐positive and HIV‐negative children in a mixed in‐ and outpatient setting
Authors: Palme I Berggren , Gudetta B , Bruchfeld J , Eriksson M , Giesecke J 
Published: August 2010

Aim: To investigate, through a prospective study, the detection rate of Mycobacterium tuberculosis in sputa and gastric aspirate from tuberculous children in a low‐income country with high prevalence of tuberculosis and an increasing HIV epidemic. Methods: Gastric aspirates and/or sputum samples were collected from 355 children with pulmonary tuberculosis as follows: from 136 children under 5y only gastric aspirate was taken, for 159 children aged 5 to 9 y both methods were used, and for 60 children over 10 y only sputum was analysed. The diagnosis of tuberculosis was based on clinical data, tuberculin test and chest radiography. All children were tested for HIV infection. Results: Direct microscopy for acid‐fast bacilli was positive for 55 (15%) and mycobacterial culture for 183 (52%) children. The proportion of positive cultures was similar in all age groups. Among the 5 to 9 year‐old children who could produce a sputum sample, sputum gave just as good culture yield of M. tuberculosis as gastric aspirate. Of the clinical or radiological findings only weight loss was associated with a higher yield. Repeat gastric aspirate increased the culture yield by 6%. Mycobacterial culture from HIV‐positive children gave lower yield compared with HIV‐negative children. Conclusion: Our data suggest that one gastric aspirate for children less than 6 y and three sputum samples for the older children collected at an outpatient TB clinic, is enough to provide a close to 50% yield of M. tuberculosis available for culture and further analyses. However, with an increasing prevalence of HIV, this detection rate may be reduced.