bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acyclovir‐resistant varicella infection with atypical lesions in a non‐HIV leukemic infant
Authors: Crassard N , Souillet AL , Morfin F , Thouvenot D , Claudy A , Bertrand Y 
Published: August 2010

ABSTRACTAn HIV‐negative infant presented with VZV primary infection during the maintenance therapy for mega‐karyoblastic leukaemia. The lesions were initially vesicular and necrotic but became verrucous and hyperkerato tic. A clinical resistance to acyclovir was suspected and confirmed by histologic and virologic studies. The patient was successfully treated by foscarnet. Conclusion: resistance of VZV to acyclovir may occur after a short treatment in a non‐AIDS patient. ± Acute leukaemia, acyclovir, foscarnet, Varicella zoster virus
Early identification of children with developmental disabilities
Authors: Sonnander K 
Published: August 2010

This paper provides an overview of research into early identification of children with developmental disabilities in child healthcare, especially those disabilities related to cognitive impairment. The review covers the following related topics: definition of the target group, the predictive value of developmental screening instruments and psychomotor tests, risk indexes, early intervention and evaluation of developmental screening programmes. Empirical research into child development and the predictive value of developmental tests is extensive. However, proportionally few, mostly cohort or case‐control, studies focusing on evaluation of developmental screening programmes conducted within a clinical setting were found. Some sensitivity and most specificity rates reported fell within what is considered acceptable for developmental screening performed in the pre‐school years, i.e. a sensitivity of more than 70% and a specificity between 70% and 80%. Overall, between 1–6% of the children screened were identified.Typically, most children with severe disabilities were identified prior to the screening or excluded from the studies reviewed. The shortcomings of developmental screening (instruments) and difficulties in early identification are discussed.
Secondary prevention in child health: effects of psychological intervention, particularly home visitation, on children's development and other outcome variables
Authors: Lagerberg D 
Published: August 2010

This paper reviews interventions targeting socially deprived families, families with low birth‐weight/premature children, and some other problems (child abuse, sensitivity/attachment, postnatal depression). Conclusions are mainly based on randomized controlled trials. Earlier reviews in the field have emphasized the importance of intensive, enduring home visitation and of early education programmes for young children. Home visitation may positively effect several outcomes, including health behaviour, child safety and stimulation. Rates of child abuse and neglect have proven difficult to influence, but home visitation may result in other gains such as fewer accidents and serious injuries, and greater home safety. The cognitive development of low birthweight and premature children may be positively influenced by home visitation, particularly in combination with an early stimulation programme in the neonatal unit and pre‐school placement. Postnatally depressed mothers have been shown to improve substantially from nurse counselling once a week for 6–8 wk.It is suggested that home visitation should be tried on a systematic basis, and that early pre‐school experiences should be offered to children in different risk situations. Child Health Centres should introduce a screening programme for postnatal depression. Specialist child health units should be encouraged.
Is prevention of allergy and asthma possible?
Authors: Foucard T 
Published: August 2010

Allergy and asthma are common diseases today. Ways to stop the ongoing increase in incidence of these diseases are highly desired. In this review the scientific basis for allergy and asthma prevention is discussed. Results: Although secondary preventive measures are generally regarded as important, the views regarding the possibility of primary prevention vary. There is today only weak evidence that breastfeeding may reduce the risk of developing allergy, and if it does the effect is limited in degree and duration. There is some evidence that prolonged breastfeeding reduces the risk of developing asthma, at least in allergy‐risk infants. There is also some evidence indicating that withholding solid foods in children at risk may have a beneficial effect. A dose‐dependent risk of becoming sensitized to house dust mite and pet animal allergens has clearly been shown, but to what extent this sensitization is combined with asthma or clinical allergy is less well elucidated. Passive smoking increases the risk of wheezing problems and the indoor environment in damp houses seems to act synergistically with passive smoke. Conclusion: Primary prevention is rarely possible, but the risk of developing asthma and allergy may to some extent be reduced by taking certain measures, such as avoidance of tobacco smoke and damp houses. Breastfeeding seems to reduce the risk of wheezing, but as allergy‐preventive measures, breastfeeding and avoiding pet animals have only marginal effects.
Sedation and monitoring of paediatric patients undergoing open low‐field MRI
Authors: Rupprecht T , Kuth R , Böwing B , Gerling S , Wagner M , Rascher W 
Published: August 2010

The purpose of this study was to determine the need, effectiveness and safety of sedation and monitoring in infants and children in a paediatric open low‐field MRI system. Of 274 patients (median age 9 y) examined, only 74 children (median age 25 mo) needed sedation. Sedation was achieved by intravenous administration of midazolam (0.2 mg/kg) and etomidate (0.2 mg/kg). Mean total doses required were 0.28 and 0.27 mg/kg, respectively. With the exception of eight primarily ventilated patients, all children breathed spontaneously. 02 saturation, arterial blood pressure and ECG were monitored. The low resonance frequency of the MRI system required a specially designed high frequency (HF) shielding of the monitor system to avoid HF artifacts. The overall sedation rate was markedly lower (74/274 = 27%) compared to a control group previously examined in a closed high‐field MRI system (52/111 =47%). This was due to a significant lower need for sedation in patients aged up to 10 y (p≤ 0.0001) in the open MRI unit. General anaesthesia could be avoided in all patients. No significant movement artifacts occurred in any of the MRI examinations and no serious side effects were observed. Conclusions: MRI of children is easier in an open MRI system and with fewer sedations, as in closed high‐field systems. Sedation by a combination of midazolam and etomidate is highly effective and safe. Monitoring devices for high‐field systems may have to be modified for low‐field systems. An in‐hose paediatric MRI unit with an open and special paediatric design is of major advantage for imaging pediatric patients.
The birth process initiates an acute phase reaction in the fetus‐newborn infant
Authors: Marchini G , Berggren V , Djilali‐Merzoug R , Hansson L‐O 
Published: August 2010

Our goal was to investigate whether the normal birth process stimulated an acute phase response in healthy infants with physiological changes in the circulating levels of acute phase cytokines and acute phase proteins. We also monitored body temperature, body weight and behavioural state in order to investigate if clinical signs of acute phase reaction were present. We made cross‐sectional measurements of interleukin‐1β, interleukin‐6, C‐reactive protein, serum amyloid A, procalcitonin, prealbumin, body weight, body temperature and the duration of the sleeping period during the first four postnatal days. We found an increase in interleukin‐6 (p < 0.001) during the first day, followed by an increase in C‐reactive protein, serum amyloid A and procalcitonin on the second postnatal day (p < 0.01). The level of prealbumin fell after birth and reached its lowest value at 3 d of age (p < 0,001). Interleukin‐l p remained unchanged. The duration of the sleeping period was longer during the first day (p < 0.01). There was an increase in body temperature during the first day (p < 0.01). Maximal weight loss was during the first 2 d. Conclusions: The normal birth process and extra‐uterine adaptation stimulates an acute phase reaction in the newborn infant with a release of interleukin‐6 and acute phase proteins and a depression of prealbumin. This reaction, as the body's first line inflammatory defence system, probably affects the infant's behaviour, nutritional state as well as the regulation of body temperature.
Undernutrition and childhood infections: a prospective study of childhood infections in relation to growth in the Sudan
Authors: Kossmann J , Nestel P , Herrera MG , El‐Amin A , Fawzi WW 
Published: August 2010

The relationships between both diarrhoea and respiratory infections and linear and ponderal growth were prospectively examined among 28 753 Sudanese pre‐school children. Childhood infections were significantly and inversely associated with attained height and attained weight and gain in height and weight over a 6‐mo period. They were significantly and positively associated also with stunting after adjusting for age, gender, socio‐economic status, dietary variables and previous morbidity. Attained height was on average 17 mm lower (95% CI [‐19 ‐151) for children with diarrhoea and 11 mm lower (95% CI [‐3 ‐91) for children with complicated cough than for those without these symptoms. The association between morbidity and attained weight was significant for diarrhoea and complicated cough, but the differences between children with and without symptoms were negligible. The risk of being stunted 6 mo later was 1.38 times (95% CI [1.20 1.59]), 1.29 times (95% CI [0.97 1.721) and 1.32 times (95% CI [1.13 1.541) greater among normally‐nourished children with diarrhoea, febrile diarrhoea and fever, respectively, than among children without these symptoms. The difference in attained height between children with diarrhoea or complicated cough and those without symptoms increased with age, and was larger among the non‐breastfed children compared with breastfed children.Conclusion: The results underline the need to reduce child morbidity to prevent the impairment of growth and development.
Ethical issues in parental decision‐making. An interview study of mothers of children with hypoplastic left heart syndrome
Authors: Vandvik IH , Førde R 
Published: August 2010

It is unclear how parents make life‐and‐death decisions on behalf of their children. To address this issue we interviewed 20 mothers whose children were born with hypoplastic left heart syndrome (HLHS), 10 whose child survived the operations and 10 mothers who chose comfort care. Semi‐structured interviews lasting from 1.5 to 3.5 h took place on median 4.6 (range 2 .5–6) years after birth. The mothers who chose comfort care had more years of education p= 0.03), reported a better childhood environment (p= 0.05) and had more often been employed in the healthcare services. The two groups described the information received in similar terms. The main motive for choosing surgery was that this was perceived to be the only acceptable choice. The motive for choosing non‐treatment was to prevent the child from suffering.Lack of knowledge about long‐term outcome. a state of shock and short time to deliberate limit the parents’possibilities for making autonomous choices. Autonomous decisions may be neither possible nor desirable for all parents. The care perspective, which highlights the parents’preferences, resources and values, should represent ethical guidelines for care providers willing to decide on behalf of the child.
High serum cardiac troponin T concentrations in preterm infants with respiratory distress syndrome*
Authors: Trevisanuto D , Zaninotto M , Altinier S , Plebani M , Zanardo V 
Published: August 2010

In preterm infants with respiratory distress syndrome (RDS), cardiac function is negatively influenced by the severity of the lung disease. On day 2 of life, cardiac troponin T (cTnT), biochemical marker of myocardial injury, was measured in 46 preterm infants (gestational age ≤32 wk), 26 with RDS and 20 without: median (range) 0.38 (0.02–1.57) μgL vs 0.13 (0.02–0.85) μgL, respectively. Conclusion: High cTnT concentrations in preterm infants with RDS suggest the presence of myocardial damage in this group of high‐risk patients.
Spontaneous speech at 6½ years of age in children who required neonatal intensive care in 1986–1989
Authors: Jennische M , Sedin G 
Published: August 2010

Spontaneous speech at 6½y of age was studied in a follow‐up of 230 children born in 1986–89 who had required neonatal intensive care (NIC) and 71 fullterm neonatally healthy control children. Eight aspects of spontaneous speech were examined: Information, speech motor function, sound pattern, word finding, word selection, grammar, interaction and motivation. The results were analysed in relation to gestational age groups (group I, 23–31 wk; subgroup IA, 23–27 wk; IB, 28–31 wk; group II, 32–36 wk; group III, >36 wk) and a separate group of children with congenital malformations (IWCM). Between 66.7% (group IA) and 55.7% (group III) had no obvious deviations in any aspect of spontaneous speech compared with 80.3% of controls. Children born at <32 wk of gestation (group I) had few pronounced deviations in speech motor function or formal aspects of spontaneous speech. No ability, or hardly any ability, in an aspect of spontaneous speech was only found in children born at >32 wk. Deviations in prosody and poor facial expressions accompanying spontaneous speech were more common in group I than in controls. Conclusion: Most children who needed intensive care neonatally had well‐developed spontaneous speech.
Epilepsy in a representative series of Rett syndrome
Authors: Steffenburg U , Hagberg G , Hagberg B 
Published: August 2010

In a representative series of 53 females with Rett syndrome (RS), aged 5–55 y, a history of epilepsy was present in 50 (94%), 45 of whom had 5‐y active epilepsy. Compared with severe mental retardation in general, the median age of seizure onset was significantly later (4 vs 0.8 y) and partial complex seizures were more frequent (54% vs 23%). Neonatal seizures had occurred in only one and infantile spasms in none compared with 26% and 12%. After teenage, the severity of epilepsy tended to decrease, i.e. lower seizure frequency and relatively more partial seizures. The rate of being seizure‐free for 1 y was 8% after 10 y and 40% after 27 y of epilepsy duration. Frequent seizures were associated with smaller head circumference. Conclusion: This epilepsy profile could fit in with present‐day knowledge of RS as a form of dendrito‐synaptogenic developmental failure with mainly late postnatal consequences, as well as being a relatively stationary condition in adulthood.
Oral sucrose compares favourably with lidocaine‐prilocaine cream for pain relief during venepuncture in neonates
Authors: Abad F , Díaz‐Gómez NM , Domenech E , González D , Robayna M , Feria M 
Published: August 2010

To compare the relative efficacy of oral sucrose versus EMLA® cream for pain relief during venepuncture, 51 full‐term newborns (38M, 13F; postnatal age <4d) in a stable condition were randomly allocated to one of four treatment groups: placebo (2 ml spring water); 2 ml sucrose 24% w/v; 1 g lidocaine‐prilocaine 5% cream (EMLA); or EMLA plus sucrose. Water or a single dose of sucrose solution was administered orally 2 min before venepuncture. EMLA cream was applied in the antecubital fossa 45–60 min before venepuncture and covered by a Tegaderm® dressing. A pacifier was given before skin puncture, but it was not actively held or replaced during the procedure or observation periods. In total, 55 venepunctures were performed blindly, always for clinical reasons. As indicators of pain, the total crying time was recorded and heart rate, respiratory rate and arterial oxygen saturation were measured blindly at baseline, immediately post‐venepuncture, and 2 and 4 min afterwards. The main effects observed were: (i) time spent crying decreased significantly in the sucrose alone (p= 0.001) and EMLA plus sucrose (p= 0.008) groups; (ii) the above treatments attenuated significantly (p < 0.05) the immediate heart rate response to pain; and (iii) the concomitant use of EMLA did not increase further the analgesic efficacy of sucrose. Conclusion: This study shows that a 24% oral sucrose solution compares favourably with EMLA cream as a safe and cheap analgesic procedure to decrease pain responses to venepuncture in newborns.
Clinical aspects on neonatal cholestasis based on observations at a Swedish tertiary referral centre
Authors: Fischler B , Papadogiannakis N , Nemeth A 
Published: August 2010

The aim of the study was to investigate the clinical aspects of neonatal cholestasis. The medical records of 85 cholestatic infants were retrospectively reviewed. A majority of the patients were referred from other parts of the country. The most common diagnoses were extrahepatic biliary atresia (n= 30 patients), α1‐antitrypsin deficiency (n=11) and progressive familial intrahepatic cholestasis (n= 11). On presentation, the biliary atresia group had higher mean serum values of bilirubin, G‐GT and cholesterol than the patients with intrahepatic cholestasis, with no significant differences noticed for any other biochemical parameter. A lack of excretion on hepatobiliary scintigraphy was noticed in all investigated patients with biliary atresia, but also in 9 of 34 patients with intrahepatic neonatal cholestasis. There was no statistical correlation between the age at portoenterostomy and the outcome in patients with biliary atresia. However, both the detection of a partial flow on perioperative cholangiogram and the establishment of a non‐icteric phase within 6 mo after the portoenterostomy correlated to a good outcome. Eight of 11 patients with progressive familial intrahepatic cholestasis were treated with a biliary diversion procedure, five of eight experienced a sustained cholestatic remission. Conclusions: Progressive familial intrahepatic cholestasis may be a more common cause of neonatal cholestasis in Sweden than reported elsewhere and that the experience with biliary diversion is positive. While early referral in patients with extrahepatic biliary atresia remains important, a portoenterostomy should be attempted also in patients referred after 3 mo of age.
Detection of bacterial DNA by PCR and reverse hybridization in the 16S rRNA gene with particular reference to neonatal septicemia
Authors: Shang S , Chen Z , Yu X 
Published: August 2010

Aim: The clinical diagnosis of sepsis is difficult, particularly in neonates. It is necessary to develop a rapid and reliable method for detecting bacteria in blood and cerebrospinal fluid (CSF) Polymerase chain reaction (PCR) and reverse hybridization of the 16S rRNA gene would permit fast and sensitive determination of the presence of bacteria and differentiate gram‐positive bacteria from gram‐negative ones in clinical specimens. Methods: We developed a pair of primers according to the gene encoding 16SrRNA found in all bacteria. DNA fragments from different bacterial species and from clinical samples were detected with PCR, and with reverse hybridization using a universal bacterial probe, a gram‐positive probe and a gram‐negative probe. Results: A 371 bp DNA fragment was amplified from 20 different bacterial species. No signal was observed when human DNA and viruses were used as templates. The sensitivity could be improved to 10T‐12 g. All 26 culture‐positive clinical samples (22 blood samples and 4 CSF samples) were positive with PCR. The gram‐negative and gram‐positive probes hybridized to clinical samples and to known bacterial controls, as predicted by Gram's stain characteristics. Conclusions: Our results suggest that the method of PCR and reverse hybridization is rapid, sensitive and specific in detecting bacterial infections. This finding may be significant in the clinical diagnosis of sepsis in neonates.
Neurological development up to the age of four years of extremely low birthweight infants born in Southern Finland in 1991–94
Authors: Salokorpi T , Rautio T , Sajaniemi N , Serenius‐Sirve S , Tuomi H , Wendt L von 
Published: August 2010

A total of 142 infants with birthweights of less than 1000 g were examined at the age of 4 y by a child neurologist, by a neuropsychologist and by an occupational therapist in order to establish the rate of neurological disorders. A total of 57 (40%) of the children had normal neurological development, 52 (37%) had minor neurological disorders, 27 (19%) were diagnosed with cerebral palsy, and 6 (4%) were mentally retarded (IQ <71) with no motor disability. The rate of cerebral palsy was identical with the figure at age 2y, but the rate of minor neurological disorders increased from 25% to 37%.Compared with international rates, we found a higher rate of cerebral palsy, but the incidence of minor neurological disorders corresponded with figures published previously.
Neurological features in Gaucher's disease during enzyme replacement therapy
Authors: Ono H , Fujiwara M , Ito K , Ueda H , Mizoguchi N , Sakura N 
Published: August 2010

This report describes two patients with Gaucher's disease who had unusual clinical symptoms during enzyme replacement therapy. One patient was a female with type 3 Gaucher's disease. She developed a pericardial effusion at 7 y of age, which contained many Gaucher cells despite enzyme replacement therapy. She died from neurological deterioration during enzyme replacement therapy, despite an improvement in her visceral manifestations. The other patient is a male with type 2 Gaucher's disease, who has achieved long‐term survival after being supported by mechanical ventilation and enzyme replacement therapy. While on enzyme replacement therapy at the age of 4y, he suffered a generalized cutaneous disease which was clinically diagnosed as ichthyosis. Conclusion: These cases suggest that ordinary enzyme replacement therapy is insufficient for some of the non‐neurological manifestations of severe types of Gaucher's disease.
Guidelines for treatment of neonatal jaundice. Is there a place for evidence‐based medicine?
Authors: Hansen TWR 
Published: August 2010

Treatment of neonatal jaundice continues to be a controversial issue. Arguments that traditional practice results in over‐treatment have led to the adoption of more liberal guidelines in some countries. The importation of liberal guidelines from one country to the next, however, is fraught with danger, because differences in epidemiology, sociology and healthcare delivery systems between countries may not be adequately reflected. The unreflected extension of liberalization to non‐target groups of patients can expose the latter to significant risk. It is not clear that the evidence on which guidelines for treatment of neonatal jaundice are based satisfy the requirements for evidence‐based medicine. Evidence of adequate quality may be hard to obtain. Conclusions: Introduction of more liberal guidelines for the treatment of neonatal jaundice, if at all contemplated, must be adapted to local circumstances, and any available evidence pertaining to local epidemiology, sociology and healthcare organization has to be carefully weighed and incorporated. The time is ripe for a joint international effort to secure adequate funding for basic and applied research within the mechanisms of bilirubin encephalopathy in the newborn.