bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of iron deficiency in 12‐mo‐old infants from 11 European areas and influence of dietary factors on iron status (Euro‐Growth study)
Authors: Male C , Persson LÅ , Freeman V , Guerra A , van't Hof MA 
Published: August 2010

A prospective longitudinal cohort study was performed to assess the prevalence of iron deficiency in European infants at 12 mo of age, and to study the influence of socio‐economic status, dietary factors, growth and morbidity on iron status. The cohort consisted of 488 normal term infants from primary healthcare centres in 11 European areas. Assessed were socio‐economic variables, dietary intake, anthropometry and morbidity at regular intervals from birth to 12 mo, and haemoglobin, serum ferritin, mean corpuscular volume, transferrin saturation and serum transferrin receptor concentrations at age 12 mo. The prevalence of anaemia was 9.4%, of iron deficiency 7.2%, and of iron deficiency anaemia 2.3%. More than 40% of anaemia was associated with normal iron status and associated with an increased frequency of recent infections. Iron deficiency anaemia was significantly more frequent with low (5.1%) than high socio‐economic status (0%). Dietary factors accounted for most of this variation in multiple regression analysis. Early introduction of cows' milk was the strongest negative determinant of iron status. Feeding of iron‐fortified formula was the main factor positively influencing iron status. Other dietary factors, including breastfeeding, did not play a significant role as determinants of iron status at age 12 mo. Conclusion. Iron deficiency anaemia is present in 2.3% of 12‐mo‐old European infants. The prevalence of iron deficiency anaemia varies strongly with socio‐economic status. Avoidance of cows' milk feeding during the first year of life is the key measure in the prevention of iron deficiency.
Fluid resuscitation in infantile hypertrophic pyloric stenosis
Authors: Miozzari HH , Tönz M , von Vigier RO , Bianchetti MG 
Published: August 2010

The purpose of this analysis was to investigate biochemical disturbances at presentation and initial fluid resuscitation before surgery in infantile pyloric stenosis. The charts of 139 consecutive infants (113 boys and 26 girls) between 7d and 20 wk of age with hypertrophic pyloric stenosis were reviewed. The infants were treated at the Department of Pediatric Surgery, University of Bern, Switzerland, in the period between 1987 and 1997. A trend towards hypokalemia (13 of the 139 patients), hypochloraemia (39 patients) and especially metabolic alkalosis (98 patients) was frequently noted on admission. In 84 patients, data on fluid management and on circulating sodium, potassium, chloride and the acid‐base balance immediately before surgery were also available. In these patients a significant correlation was found between the parenteral chloride dose given for fluid repair (y= 0.310 x; rs= 0.54; p > 0.001) and the changes in plasma bicarbonate. The equation indicates that a chloride dose of 10mmol/kg body weight is required to reduce plasma bicarbonate on average by 3 mmol/l. Conclusion: Since assessment of the fluid volume stated by physical examination and history is inaccurate in infants with vomiting, the severity of metabolic alkalosis helps to define the amount of fluid required for repair.
Effects of growth hormone treatment on the leptin system and body composition in obese prepubertal boys
Authors: Elimam A , Norgren S , Marcus C 
Published: August 2010

Leptin correlates with measures of body fat stores. Growth hormone (GH) treatment may affect leptin levels either directly or indirectly by influencing body composition and circulating insulin level. Here, the effects of GH treatment on the leptin axis and body composition of six severely obese, but otherwise healthy, prepubertal boys were studied. Fasting serum leptin was significantly reduced after only 3 wk of GH treatment. Body fat percentage, but not BMI, decreased significantly (p < 0.05) after 3 mo. The serum leptin concentration per unit fat mass decreased significantly during GH treatment (p < 0.05), suggesting that such treatment might have a direct effect on serum leptin independently of the effects on body composition. Leptin RNA expression in abdominal subcutaneous tissue was not significantly changed by treatment. Conclusions: The data indicate that GH has an early downregulatory effect on the circulating leptin level independently of the concomitant changes in body composition. Whether GH affects leptin production or metabolism needs further study.
Premature cessation of breastfeeding in infants: development and evaluation of a predictive model in two Argentinian cohorts: the CLACYD study*, 1993–1999
Authors: Berra S , Rajmil L , Passamonte R , Fernandez E , Sabulsky J 
Published: August 2010

The objective of this study was to develop a model to predict premature cessation of breastfeeding of newborns, in order to detect at‐risk groups that would benefit from special assistance programmes. The model was constructed using 700 children with a birthweight of 2000 g or more, in 2 representative cohorts in 1993 and 1995 (CLACYD I sample) in Córdoba, Argentina. Data were analysed from 632 of the cases. Mothers were selected during hospital admittance for childbirth and interviewed in their homes at 1 mo and 6 mo. To evaluate the model, an additional sample with similar characteristics was drawn during 1998 (CLACYD II sample). A questionnaire was administered to 347 mothers during the first 24–48 h after birth and a follow‐up was completed at 6 mo, with weaning information on 291 cases. Premature cessation of breastfeeding was considered when it occurred prior to 6 mo. A logistic regression model was fitted to predict premature end of breastfeeding, and was applied to the CLACYD II sample. The calibration (Hosmer‐Lemeshow C statistic) and the discrimination [area under the receiver operating characteristics (ROC) curve] of the model were evaluated. The predictive factors of premature end of breastfeeding were: mother breastfed for less than 6 mo [odds ratio (OR) = 1.84,95% confidence interval (CI) 1.26–2.70], breastfeeding of previous child for less than 6 mo (OR = 4.01, 95% CI 2.58–6.20), the condition of the firstborn child (OR = 2.75, 95% CI 1.79–4.21), the first mother‐child contact occurring after 90min of life (OR =1.88; 95% CI 1.22–2.91) and having an unplanned pregnancy (OR = 1.50, 95% CI 1.05–2.15). The calibration of the model was acceptable in the CLACYD I sample (p= 0.54), as well as in the CLACYD II sample (p= 0.18). The areas under the ROC curve were 0.72 and 0.68, respectively. Conclusion: A model has been suggested that provides some insight onto background factors for the premature end of breastfeeding. Although some limitations prevent its general use at a population level, it may be a useful tool in the identification of women with a high probability of early weaning.
Subjective daytime sleepiness and its predictors in Finnish adolescents in an interview study
Authors: Saarenpää‐Heikkilä O , Laippala P , Koivikko M 
Published: August 2010

The purpose of this study is to evaluate the predictors of subjective daytime sleepiness (SDS) and its chronicity in adolescents. Two groups of adolescents (107 with SDS and 107 without SDS) from our first questionnaire study were invited to an interview after 3 y. A follow‐up questionnaire had been sent to them one year earlier. The interview included questions about sleep, daytime sleepiness, living habits, physical and mental health, and progress at school. The adolescents were also examined clinically. Interviews were conducted with 66 out of 107 subjects with SDS and 64 out of 107 without SDS (age range 12 to 19 y). In this interview 42 out of the 130 adolescents had SDS. A total of 20 adolescents reported SDS in both questionnaire studies and in the interview (chronic SDS). In a multivariate analysis (logistic regression) sleep disorders, frequent medication and depressive emotions were significantly associated with SDS. Chronic SDS was connected in a bivariate analysis (Pearson's chi‐square) with excessive night waking, difficulty in falling asleep, dreaming, frequent medication, frequent alcohol drinking, and irregular breakfast eating, and in our previous studies also with delayed sleep rhythm. Conclusion: Sleep disorders and health problems were more common causes of SDS than undesirable living habits. However, alcohol drinking and delayed sleep rhythm were associated with chronic SDS in addition to sleep disorders and medication.
Vitamin D deficiency in Iranian mothers and their neonates: a pilot study
Authors: Bassir M , Laborie S , Lapillonne A , Claris O , Chappuis M‐C , Salle BL 
Published: August 2010

We conducted a pilot study to assess the prevalence of hypovitaminosis D among Iranian women and their newborns. Blood samples were taken from 50 mothers (age 16–40 yr) and their neonates at term delivery in the largest Tehran hospital. The results showed that 80% of the women had 25‐hydroxyvitamin D (25‐OHD) concentrations of less than 25 nmol/l. Mean maternal plasma calcium and phosphatase alkaline concentrations were in the normal range. The mean maternal serum immunoreactive parathyroid hormone concentration of women with hypovitaminosis D (i.e., 25‐OHD levels < 25 nmol/l) was above normal range and significantly different from that of women without hypovitaminosis D. Conclusion: The mean cord serum 25‐OHD concentration was very low (4.94 ± 9.4 nmol/l) and that of infants of mother with hypovitaminosis D were almost undetectable (1.2 ± 1.2 nmol/l).
Non‐Epstein‐Barr virus‐associated T‐cell lymphoma following cardiac transplantation for Barth syndrome
Authors: Ronghe MD , Foot ABM , Martin R , Ashworth M , Steward CG 
Published: August 2010

Barth syndrome is a metabolic disease characterized by infantile cardiomyopathy, neutropenia and organic aciduria. We report disease evolution in one of the first affected boys to undergo successful cardiac transplantation. Conclusion: Although cardiac status stabilized, he developed disabling skeletal myopathy, protracted lymphopenia and‐5 y after transplant‐fatal Epstein Barr (EBV)‐negative T‐cell non‐Hodgkin's lymphoma.
Torticollis revealing as a symptom of acute lymphoblastic leukaemia in a fourteen‐month‐old girl
Authors: Rauch R. , Jüngert J. , Rupprecht T. , Greil J. 
Published: August 2010

The differential diagnosis of acquired torticollis in infants and children comprises a large variety of disorders, including inflammation, neurologic disease or trauma. Conclusion: Spinal cord tumours in patients with ALL are a rarely reported entity and secondary spinal involvement in leukaemia presenting as head tilt is even more uncommon.
Psychological assessments before and after treatment of early puberty in adopted children
Authors: Mul D , Versluis‐den Bieman HJM , Slijper FME , Oostdijk W , Waelkens JJJ , Drop SLS 
Published: August 2010

Early puberty is frequently observed in adopted children. This randomized trial treated 30 adopted children with early puberty and short stature with either gonadotropin‐releasing hormone agonist (GnRHa) alone or in combination with growth hormone (GH) for 3 y. Before the start of treatment (T1) in the trial and at discontinuation (T2) the children and their parents underwent a psychological evaluation. At the start of treatment the children did not have increased levels of behavioural or emotional problems as assessed by the Child Behaviour Checklist (CBCL). During treatment the CBCL scores did not increase. Self‐perception of the children appeared to be normal, and after 3 y a significantly higher score for acceptance by peers was observed. At T1, an overestimation of future height was present in 80% of the children and 17% of the parents. Lower family stress was observed at T1 and T2 compared with reference values. Intelligence quotient levels decreased significantly during treatment. The findings are discussed with reference to the reported levels of behavioural and emotional problems in adopted children and the psychosocial effects of precocious puberty. Conclusion: This psychological evaluation did not reveal any consistent abnormalities in adopted children with early puberty. Treatment with GnRHa with or without GH did not increase emotional and behavioural problems in adopted children, nor was their self‐perception decreased.
Disruption in cytokine and chemokine production by T‐cells in vertically HIV‐1‐infected children
Authors: Resino S , Bellon JM , Gurbindo D , Muñoz‐Fernández MA 
Published: August 2010

This study measured cytokine production by mitogen‐stimulated peripheral blood mononuclear cells (PBMCs) from 55 human immunodeficiency virus (HIV)‐infected children born to HIV‐infected mothers, and compared it with vertically exposed but uninfected age‐matched children. A significant defect was observed in Th1 cytokine production [interferon‐γ and interleukin‐2 (IL‐2)] in HIV‐infected children compared with controls, but without a concomitant increase in Th2 cytokines. Indeed, IL‐5 and IL‐10 production was even lower in HIV‐infected children than in controls, with the decrease in IL‐5 being the best predictive marker of immunodeficiency. In addition, an increased release of tumour necrosis factor‐a (TNF‐a) that correlated well with CD4+ levels, and a positive correlation of the TNF‐α/IL‐10 ratio with disease progression was observed. A correlation between AIDS‐free status and higher %CD4+ and %CD8+ T‐lymphocytes and RANTES (regulated on activation, normal T‐cell expressed and secreted) production was also found. Conclusion: A dysfunctional cytokine production of PBMCs was observed in HIV‐infected children in both Th1 and Th2 cytokines due to quantitative and qualitative defects induced by HIV‐1. An important observation was an increased RANTES production associated with viral isolates of NSI/R5 phenotype and S/L kinetics.
Manganese intake and cholestatic jaundice in neonates receiving parenteral nutrition: a randomized controlled study
Authors: Fok TF , Chui KKM , Cheung R , Ng PC , Cheung KL , Hjelm M 
Published: August 2010

Infants requiring parenteral nutrition (n= 244) were randomized to receive either 1 (group 1, n= 121) or 0.0182 μmol/kg/d (group 2, n= 123) of manganese supplementation. The whole‐blood manganese and serum direct bilirubin concentrations of the infants were monitored, as was the development of cholestasis (peak serum direct bilirubin concentration >50 μmol/L). Subgroup analysis was carried out on the data of 78 infants in group 1 and 82 in group 2 who had received manganese supplementation and more than three‐quarters of their total daily fluid as parenteral nutrition for >14 d. Of all the infants randomized, the high manganese group (group 1) showed a trend towards developing higher peak whole‐blood manganese concentration [group 1 versus group 2: median (interquartile range): 606.0 (421.0; 1005.0) vs 566.0 (336.0; 858.0); p= 0.061] and higher peak serum direct bilirubin concentration [37.0 (10.5; 122.5) vs 19.0 (8.0; 112.5); p= 0.153], but the differences between the 2 groups did not reach statistical significance. The 2 groups did not differ in terms of the occurrence of cholestasis during parenteral nutrition (63/121 vs 57/123; p= 0.444). Subgroup analysis of infants who had received more than three‐quarters of their total daily fluid as parenteral nutrition showed, however, that the high manganese group developed significantly higher whole‐blood manganese concentration [743.5 (498.0; 1211.0) vs 587.0 (438.0; 982.0); p= 0.037] and serum direct bilirubin concentration [84.0 (28.0; 170.0) vs 25.5 (9.0; 117.0); p < 0.001]. Although there was no significant difference in the occurrence of cholestasis (58/78 vs 49/82; p= 0.073), more infants in the high manganese group developed a more severe degree of direct hyperbilirubinaemia, with peak serum direct bilirubin >100 μmol/L (32/78 vs 20/82; p= 0.038). Conclusion: We conclude that the pathogenesis of parenteral nutrition‐related cholestasis is probably multifactorial, and that high manganese intake is a significant contributory factor.
Low prevalence of large intraventricular haemorrhage in very low birthweight infants carrying the factor V Leiden or prothrombin G20210A mutation
Authors: Göpel W , Gortner L , Kohlmann T , Schultz C , Möller J 
Published: August 2010

The influence of genetic factors that increase coagulation on the extension of intraventricular haemorrhage (IVH) in very low birthweight infants has not been studied previously. This study investigated the frequency and effect of the factor V Leiden and prothrombin G20210A mutations in a population‐based cohort of 305 preterm infants with a birthweight below 1500 g. The overall prevalence of IVH was similar in infants with (n=43) and without (n=262) prothrombotic mutations (18.6% vs 16.4%, respectively). However, infants with prothrombotic mutations had a significantly reduced risk of developing extension to IVH grade II or more [p=0.023, odds ratio (OR) 0.11,95% confidence interval (CI) 0.02‐0.5]. The carrier state of a factor V Leiden or prothrombin G20210A mutation was still predictive for a low rate of IVH grade II‐IV if possible confounding variables were included in a multivariate regression model (OR 0.12; 95%CI: 0.017–0.86). Conclusion: The data suggest that the factor V Leiden and prothrombin G20210A mutations lead to improved control of intraventricular bleeding in very low birthweight infants.
Comparison of two strip test methods of whole blood glucose measurement in the neonatal period
Authors: Papp M , Sharief N 
Published: August 2010

The aim of this study was to compare the performance and accuracy of the BM Strip test used in conjunction with Reflectance photometry, and the new non‐wipe strip test (Advantage) against a reference plasma glucose method. In total, 114 newborns consecutively admitted to the Neonatal Unit over a 6 mo period were enrolled into the study. Each newborn had their venous blood glucose measured by the BM Strip test and Advantage glucometer and the venous haematocrit was also determined. Plasma glucose was measured in the laboratory by the hexokinase method. The mean difference between the BM Strip test and plasma glucose was significantly less than the corresponding value for the Advantage glucometer (0.312,95% confidence interval (CI) 0.11‐0.51 vs 0.766,95% CI 0.57‐0.95], although the limits of agreement between both methods and plasma glucose were wide. Haematocrit did not influence significantly the accuracy of either test. Conclusion: The new Advantage glucose meter does not offer any advantage over the BM Strip test. Owing to the wide limits of agreement of both methods compared with plasma glucose, their clinical value is limited in the neonatal period.
Paediatric trainees and the transportation of critically ill neonates: experience, training and confidence
Authors: Davis PJ , Manktelow B , Bohin S , Field D 
Published: August 2010

Aim: To study the experience of, training in, and confidence in the transportation of critically ill neonates amongst paediatric trainees in one UK region. Design: An anonymized questionnaire was sent to all middle grades with paediatrics National Training Numbers from the Trent region. Results: The response rate was 78%. Less than half (45%) of the respondents reported receiving any training in the transportation of neonates, either in the UK or abroad; 45% (30/66) of the trainees reported having performed 10 or fewer neonatal transfers. The self‐perceived confidence for transporting neonates was scored on a 10‐point scale, to produce a “confidence score”, the median score being 7 (IQ range 5, 8). Both as a group and individually, the trainee paediatricians were more confident in transporting neonates than older infants or children (p < 0.0001). Using multiple analysis of covariance, it was found that the most important and significant variables affecting the “confidence scores” for the inter‐hospital transportation of critically ill neonates were receipt of any relevant transport training, and the current frequency of transports performed. Conclusions: Many training‐grade paediatricians lack both the experience and training in transporting critically ill neonates, factors that were found to affect their confidence in transferring sick neonates. As the overwhelming majority of neonatal transports in the UK are still arranged by individual units and performed by training‐grade paediatricians, concerns regarding both the safety and effectiveness of the current service provision for the inter‐hospital transfer of critically ill neonates remain valid.
Incidence of hospitalizations due to rotavirus gastroenteritis in Denmark
Authors: Fischer TK 
Published: August 2010

To assess the incidence of rotavirus‐related diarrhoea among Danish children <5 y of age, laboratory‐based data obtained from inpatients in two major Danish counties were reviewed. In the period January 1995 to December 1999, samples from 1333 children <5 y of age hospitalized with diarrhoea in Copenhagen County and 813 samples from inpatients <5 y of age in Roskilde County were tested for rotavirus. Rotavirus infection was identified in 237 (18%) and 179 (22%) of the cases, respectively. As in other temperate countries a marked seasonality of rotavirus infections was observed, with a peak in winter and the early spring months of March and April. The hospitalization rate was 2.8 per 1000 in children <5 y and 5.4 in children <2 y of age. Conclusion: These findings suggest that rotavirus gastroenteritis remains a common disease in Danish hospitalized children and causes a substantial burden of disease.
Chronic infantile neurological cutaneous and articular syndrome: two new cases with rare manifestations
Authors: Russo RAG , Katsicas MM 
Published: August 2010

CINCA/IOMID is a systemic inflammatory disorder of unknown aetiology that resembles congenital infection and systemic juvenile chronic arthritis (JCA). This disorder is characterized by neonatal onset, persistent rash, ocular inflammatory lesions, and progressive articular and neurological involvement. We report two new patients with this syndrome. Both children presented periodic bouts of cutaneous rash, fever, organomegaly, articular involvement with typical radiological features, and developmental delay. One of the patients presented neonatal jaundice and elevation of liver enzymes; inflammatory infiltrates were observed in the liver biopsy. The other patient showed retinal vasculitis detected at age 18 mo on fundoscopy and fluorescent angiography. Therapy with azathioprine was associated with prolonged remission of this complication. In both cases, the disease was diagnosed after some delay. Conclusion: Early hepatitis and retinal vasculitis are rare features of CINCA/IOMID that may help differentiate this syndrome from JRA. Azathioprine may have induced the remission of vasculitis in one case.