bluuebunny/crossref_metadata_2025_split huggingface dataset:
Children's nutrient intake at preschool and at home
Authors: Sepp H , Lennernäs M , Pettersson R , Abrahamsson L 
Published: August 2010

A preschool‐based dietary survey, using 7‐d records, was carried out in a suburb of Stockholm. The aim was to assess the intake of food and the quality of the diet of preschool children aged 3–5y at preschool and at home, and to compare the dietary intake with the Swedish dietary recommendations for preschool children. The respective mean intakes of protein, fat, carbohydrates and sucrose, expressed as a percentage of total energy intake were 14, 38, 50 and 9 at preschool, and at home 14, 36, 52 and 12 on weekdays, 14, 34, 55 and 16 on weekend days. The mean intakes of seven vitamins and minerals were low only for selenium as compared with the recommended level. No differences were found in nutrient density between diet at preschool and diet at home, with the exception of dietary fibre (higher at preschool). On weekdays there was a significantly higher nutrient density for calcium, zinc, selenium, vitamin A, riboflavin, vitamin C and dietary fibre compared with weekend days. Conclusion: The average intakes of energy and nutrients per meal at preschool compared with the recommended levels for children aged 4–6 y were low for all meals (breakfast, lunch and afternoon snack). This, however, was compensated for by home meals.
Person, time and place coordinates of pedestrian injuries: a study in Athens
Authors: Moustaki M , Petridou E , Trichopoulos D 
Published: August 2010

The aim of this study was to investigate whether socioeconomic status of town of residence is associated with risk for childhood pedestrian injuries. The study population consisted of all pedestrian victims, aged 0–14 y, who lived in towns of Greater Athens and who presented to the Emergency Department of a major Children's Hospital during the period 1996–98. The towns were divided into three categories by socioeconomic status according to the proportion of (a) adult household heads with a higher education degree and (b) households with less than one person per room. The rate of pedestrian injuries was estimated by socioeconomic status of the residential town and by place of accident (inside or outside the respective town). The pedestrian injury rate ranged from 5.5 to 12 injured children among a 10000 childhood population per year, with an almost twofold excess among children residing in the less wealthy towns compared with the wealthier ones. The social gradient was steeper for injuries occurring outside the residential town. The population fractions of pedestrian injury rates attributable to educational level and household crowding differentials, regardless of the place of accident, were 39% and 25%, respectively.Conclusions: There is a considerable social gradient for childhood injuries irrespective of place of accident, a finding that could be partly attributable to lower socioeconomic background rather than to adverse environmental factors prevailing in less wealthy towns. Our findings indicate that there is a need for preventive programmes targeting people as well as places of low socioeconomic status.
Regional differences in stillbirth and neonatal death rate in Sweden with a cause‐of‐death specific analysis
Authors: Serenius F , Winbo I , Dahlquist G , Källén B 
Published: August 2010

Regional differences in stillbirth and neonatal death rates in Sweden were studied and a cause‐of‐death analysis was done in the 4 counties (among 24) with an increased mortality. The study is based on a computerized evaluation of infant cause of death, using a slightly modified Wigglesworth classification and a hierarchical classification (NICE: Neonatal and Intrauterine death Classification according to Etiology). Differences between the identified counties with respect to specific causes of death were demonstrated. Conclusion: There are differences between Swedish counties with respect to the risk for stillbirth or neonatal death. The NICE cause‐of‐death classification can be used for the routine surveillance of stillbirths and neonatal deaths in a population and can help in pinpointing weak elements in antenatal, delivery and neonatal care.
Cerebral palsy in southern Sweden I. Prevalence and clinical features
Authors: Nordmark E , Hagglund G , Lagergren J 
Published: August 2010

The prevalence, clinical features and gross motor function of children with cerebral palsy in southern Sweden were investigated. The study covered the birth year period 1990–1993, during which 65514 livebirths were recorded in the area. On the census date (1 January 1998), 68 366 children born in 1990‐1993 lived in the area. The study comprised 167 children, 145 of them born in Sweden and 22 born abroad. The livebirth prevalence was 2.2 per 1000, and the prevalence including children born abroad was 2.4 per 1000. The distribution according to gestational age, birthweight and subdiagnoses was similar to that in earlier Swedish studies, except for a higher rate of dyskinetic syndromes in this study. Conclusion: The point prevalence of cerebral palsy was 2.4 and the livebirth prevalence was 2.2. Children born abroad had a higher prevalence and were more often severely disabled. Severe disability was often combined with associated impairments such as mental retardation, epilepsy and visual impairment.
Paroxysmal tonic upgaze of childhood: effect of age‐of‐onset on prognosis
Authors: Verrotti A , Trotta D , Blasetti A , Lobefalo L , Gallenga P , Chiarelli F 
Published: August 2010

Paroxysmal tonic upgaze (PTU) is a syndrome of childhood manifesting as sudden ocular movements with sustained upward deviation of the eyes. We describe the outcome of 6 patients, after a follow‐up of 10 years, with onset of the disease in childhood. The aims of this study were to clarify some clinical features of this syndrome and to evaluate the long‐term prognosis of these children. In all the patients, tonic upgaze episodes disappeared with time to remission, varying from 1 to 4 y, without any therapy and without any change in psychomotor development, EEG and neuroimaging. Only one child had pathologic interictal EEG with temporo‐occipital spikes, which persisted after the offset of the disease. Conclusion: From a long‐term follow‐up, we can confirm the good prognosis of PTU and suggest it is possible to define a distinct syndrome of childhood without any neurological abnormalities and with spontaneous resolution.
Prevalence of overweight and obesity in children and adolescents in a county in Sweden
Authors: Berg I‐M , Simonsson B , Brantefors B , Ringqvist I 
Published: August 2010

Overweight among young people in Sweden is increasing. The aim of the present study was to investigate the frequency of overweight and obesity based on body mass index (BMI) values among children and adolescents. Overweight was defined as a BMI value 91st percentile and obesity as a BMI value 98th percentile on an international reference BMI curve. The study population included boys and girls from four age groups: 9, 12, 15 and 18 y. The data consisted of self‐reported measures of height and weight that were obtained from questionnaires used in a cross‐sectional study in December 1997. A validation study was performed using a part of the study population. A total of 7011 (81.7%) participants completed the questionnaire. The correlation between self‐reported estimations and objective measures of height and weight was high in the oldest age groups (0.88–0.98), but lower in the 9‐y‐old age groups (0.37–0.72). These self‐reported estimations in the 9‐y‐olds were excluded from further analysis. It was found that 12.3%, 11.6% and 11.4% of the boys in the 12‐, 15‐ and 18‐y‐old age groups and 6.8%, 5.5% and 4.8% of the girls in the same age groups were overweight and 7.9%, 8.9% and 7.3% of the boys and 5.1%, 4.2% and 3.9% of the girls were obese. Conclusion: The prevalence of overweight and obesity was found to be high in the study population and is a serious public health problem. The prevalence of obesity was significantly higher (p <0.05) in 15‐y‐old boys living in rural areas than in city and town dwellers of the same age.
Cornelia de Lange syndrome associated with cecal volvulus: report of a case
Authors: Masumoto K , Izaki T , Arima T 
Published: August 2010

Cornelia de Lange syndrome is known to be occasionally associated with gastrointestinal malformation. However, the occurrence of cecal volvulus in such anomalies is very rare. We report a 15‐y‐old Japanese boy with Cornelia de Lange syndrome associated with a cecal volvulus secondary to non‐fixation of the cecum and ascending colon. The patient was admitted to our hospital because of abdominal pain and bilious vomiting. At emergent laparotomy, cecal volvulus with non‐fixation of the ascending colon and cecum was diagnosed. Release of the cecal volvulus and the fixation of the cecum and ascending colon to the right retroperitonium were performed. The postoperative course was uneventful, except for sepsis caused by aspiration pneumonia soon after the operation. Conclusion: Clinicians treating patients with this syndrome should be aware that such patients may be at risk for developing severe gastrointestinal anomalies, including cecal volvulus.
Levels of certain metals, organochlorine pesticides and dioxins in cord blood, maternal blood, human milk and some commonly used nutrients in the surroundings of the Aral Sea (Karakalpakstan, Republic of Uzbekistan)
Authors: Ataniyazova OA , Baumann RA , Liem AKD , Mukhopadhyay UA , Vogelaar EF , Boersma ER 
Published: August 2010

Since the 1960s a massive decline in the volume of the Aral Sea has occurred as a result of the diversion of the supplying rivers to cotton irrigation schemes. The contaminated sediment of the former seabed has been disseminated over the surrounding area by strong winds. This deterioration of the ecosystem has created a hazardous situation for the health of approximately 3.5 million people. This pilot study was undertaken to assist Karakalpak health workers in investigating the degree of exposure to metals, persistent organochlorine pesticides (OCPs) and dioxins during the most vulnerable prenatal and postnatal period and to provide guidelines for future research. All subjects came from areas located within 200 km of the southern border of the Aral Sea. Blood was obtained from 18 pregnant women and 28 newborns (cord blood) to determine the levels of metals, lead, cadmium, zinc and selenium and the OCPs a‐, b‐ and g‐hexachlorocyclohexane (HCH; lindane is the product name of g‐hexachlorocyclohexane), hexachlorobenzene (HCB), and isomers and metabolites of dichlorodiphenyltrichloroethan e (DDT), i.e. op‐DDT, pp‐DDT, pp‐DDE and pp‐TDE. Levels of metals were also determined in blood from 28 non‐pregnant women. In addition, levels of 17 dioxins were determined in 41 human milk samples and 1 batch of formula. Information about possible dietary sources of the fat‐soluble OCPs and dioxins was obtained from a pooled sample of butter and from seven cottonseed oil samples. A mass‐selective detector coupled to a gas chromatograph equipped with a large volume injector was used to analyse the selected OCPs, whereas the dioxins were determined by gas chromatography with high‐resolution mass spectrometry. The levels of metals in cord and maternal blood were consistent with concentrations observed in European countries. Only three women (7%) had lead levels greater than 100 ppb. The most notable pollutants in maternal and cord blood were the OCPs, notably HCB, β‐HCH, pp‐DDE and the most toxic dioxin, 2,3,7,8‐TCDD, when calculated as TEQs. A similar pattern was observed in human milk: β‐HCH and pp‐DDE levels of more than 1000 ng g−1 fat were found in 68 and 43% of the subjects, respectively. Levels of 2,3,7,8‐TCDD were six times higher than those observed in Western Europe. Traces of pp‐DDE were detected in the batch of formula milk. Contaminated animal fat, but not cottonseed oil, is the most likely dietary source of OCPs and dioxins. Conclusion: Further epidemiological research is needed to elucidate the health implications of these pollutants on perinatal and maternal health, including lactation. More importantly, an investigation should be initiated to identify the emission sources of persistent organic pollutants in Karakalpakstan and adjacent regions.
Low‐dose oral etidronate therapy for immobilization hypercalcaemia associated with Guillain‐Barré syndrome
Authors: Go T 
Published: August 2010

A low dose of oral etidronate (3.7 mg kg−1 d−1) was administered for immobilization hypercalcaemia associated with Guillain‐Barré syndrome in a 12‐y‐old boy. There was a slight increase in osteoblastic bone formation reflected by alkaline phosphatase and in particular bone‐specific alkaline phosphatase during the treatment and serum calcium decreased to the normal range within 2 wk. No adverse side effects were observed and the patient's linear growth subsequently progressed. Conclusion: A low dose of oral etidronate is safe and effective for treatment of immobilization hypercalcaemia in children, without inhibiting bone formation.
Predictional need for supplementing breastfeeding in preterm infants under Kangaroo Mother Care
Authors: Ruiz JG , Charpak N , Figueroa Z 
Published: August 2010

It has been estimated that 95% of low‐birthweight infants are born in developing countries. Nevertheless, most of the globally available resources are invested in developed countries, both for sophisticated, expensive technological care and for research focused on solving problems in scenarios in which access to expensive resources is available. Very little research on scientifically sound, economically accessible interventions reaches internationally recognized scientific journals. For instance, one accepted scientific dogma is that all premature infants must receive breast‐milk fortifiers. Thus, healthcare workers consider that not offering fortification or supplementation to all preterm infants under 2000 g is unethical, as it denies them the proven benefits of this intervention. This approach oversimplifies the problem by assuming that infants under 2000 g are a homogeneous population, with similar needs and risks. The largest proportion of preterm survivors in developing countries comprises infants weighing <1200g, and their nutritional needs differ from those weighing >1200g, who represent a significantly smaller proportion. In developing countries, fortification of breast milk is seldom a feasible option. Even supplementing breast milk with formula implies an expense that cannot always be covered. In addition, many preterm infants (particularly those weighing >1200g) can grow properly on exclusive breastfeeding. In our experience, about 45% of infants under ambulatory Kangaroo Mother Care (KMC) thrive properly. The choice between giving and withholding supplementation for all preterm infants is not an ethical issue, because there is no choice. This was the justification for conducting the study reported here, which attempts to answer the question of how to identify, as early as possible, those premature infants who survive the early neonatal period and have no obvious risk factors for inadequate growth other than prematurity, but who are less likely to thrive with exclusive breastfeeding. Conclusion: The answer to this question will allow us to use our meagre resources in the most reasonable way, as supplementing breast milk involves not only the direct cost of the formula but also that of training the mothers in techniques for feeding their infants without compromising breastfeeding or increasing the risk of infectious diseases.
Positive experiences and the relationship between stress and asthma in children
Authors: Sandberg S , McCann DC , Ahola S , Oja H , Paton JY , McGuinness D 
Published: August 2010

Ninety children aged 6 to 13 y and suffering from chronic asthma were included in a prospective follow‐up study lasting 18 mo in order to assess whether life events involving substantial positive effects on the child can protect against the increased risk associated with stressful life events. The main outcome measures included positive life events, positive long‐term experiences, severely negative life events, chronic psychosocial stress and new asthma exacerbation. The results showed that, provided they occurred in close proximity to severely negative life events, positive life events, generally related to the child's own achievements, afforded protection against the increased risk of a new asthma exacerbation precipitated by severe events in children whose lives were marked by low to medium levels of chronic stress. No such effect was found in children exposed to high chronic stress nor did long‐term positive experiences, such as when the child has a rewarding hobby, affect the asthma risk. Conclusion: Life events with a definite positive effect can counteract the increased risk of an asthma exacerbation precipitated by a severely negative life event, provided the chronic stress is only of low to medium level. Because this protective influence does not apply where there is high chronic stress, reducing this condition must be seen as a priority in children suffering from asthma, as these children are also more vulnerable to negative life events precipitating asthma exacerbation.
Hypothalamo‐pituitary hypothyroidism detected by neonatal screening for congenital hypothyroidism using measurement of thyroid‐stimulating hormone and thyroxine
Authors: Asakura Y , Tachibana K , Adachi M , Suwa S , Yamagami Y 
Published: August 2010

The optimal strategy in neonatal screening for congenital hypothyroidism is still a subject of controversy. In Kanagawa Prefecture in Japan, simultaneous thyroid‐stimulating hormone (TSH) and T4/fT4 determination has been used, while the results of our program may provide valuable information. Cumulative findings were analysed to determine the type and frequency of thyroid disorders in infants detected by simultaneous TSH and f4/fT4 determination, and the TSH and T4/fT4 screening strategy was validated. A total of 1284130 neonates were screened between October 1979 and September 1997 and infants followed because of low T4/fT4 without elevated TSH (T4 < 51.5 nmol/L or fT4<9 pmol/L and TSH<15 mU/L) were retrospectively analysed. The first survey was carried out within 6 mo of birth and the second in 1998; 258 infants were diagnosed with congenital hypothyroidism at the first medical evaluation, 15 of them with hypothalamo‐pituitary hypothyroidism. However, in the second survey, only 8 children were confirmed as having hypothalamo‐pituitary hypothyroidism, therefore the incidence detected by the present strategy was 1/160516. Of 8 children with hypothalamo‐pituitary hypothyroidism, mental retardation was prevented in 3 owing to early treatment. Conclusions: Simultaneous measurement of TSH and T4/fT4 is a useful strategy for detecting hypothalamo‐pituitary hypothyroidism, but more studies are needed to show the cost‐benefits of using this strategy.
Coeliac disease in children and adolescents with type 1 diabetes: a study of growth, glycaemic control, and experiences of families
Authors: Saukkonen T , Väisänen S , Åkerblom HK ,   E Savilahti and the Childhood Diabetes in Finland Study Group
Published: August 2010

The aim of this study was to evaluate whether coeliac disease affects growth, glycaemic control, and general well‐being of children and adolescents with type 1 diabetes. Eighteen subjects were found to have coeliac disease by a screening program. Gastrointestinal symptoms, changes in growth and the levels of glycated haemoglobin (GHbA1) were analysed, as well as subjective well‐being before and after diagnosis of coeliac disease. Overt gastrointestinal symptoms and deterioration of growth prior to disclosure of coeliac disease were seen only in one patient who had both of these conditions. Retrospectively, most subjects reported mild gastrointestinal complaints, which resolved on a gluten‐free diet. Introduction of a gluten‐free diet did not have any positive effect on glycaemic control, but was associated with an increase in weight‐for‐height (from 4.3 ± 18.1 to 8.2 ± 15.4% deviation from population median, p= 0.02). This increase in weight‐for‐height was inversely correlated with changes in GHbA1 (r=– 0.574, p= 0.02). Conclusion: Coeliac disease is rarely associated with signs of malabsorption in children and adolescents with type 1 diabetes. Introduction of a gluten‐free diet may be associated with excess weight gain. We recommend intensified follow‐up for these subjects.
Anaphylaxis after first exposure to ceftriaxone
Authors: Ernst MR , van Dijken PJ , Kabel PJ , Draaisma JMTh 
Published: August 2010

Life‐threatening anaphylaxis developed in a 5‐y‐old boy with septic shock within minutes of receiving his first intravenous injection of ceftriaxone. Hypersensivity could not be demonstrated by skin testing and ceftriaxone‐specific IgE. However, an in vivo, controlled, intravenous challenge was clearly positive. Conclusion: Clinicians should be aware of the possibility of anaphylaxis occurring with the first dose of ceftriaxone, especially since such a reaction could go unnoticed in patients with life‐threatening infections and unstable vital signs.
Cerebral palsy in preterm infants: a population‐based case‐control study of antenatal and intrapartal risk factors
Authors: Jacobsson B , Hagberg G , Hagberg B , Ladfors L , Niklasson A , Hagberg H 
Published: August 2010

Previous studies have indicated that foetomaternal infection increases the risk of spastic cerebral palsy (CP) in term infants, whereas this association appears to be less evident in preterm infants. The aim of this study was to analyse infection‐related risk factors for spastic CP in preterm infants. A population‐based series of preterm infants with spastic CP, 91 very preterm (>32wk) and 57 moderately preterm (32–36 wk), born in 1983–90, were included and matched with a control group (n= 296). In total, 154 maternal, antenatal and intrapartal variables were retrieved from obstetric records. In the entire group, histological chorioamnionitis/pyelonephritis, long interval between rupture of membranes and birth, admission‐delivery interval >4 h and Apgar scores of >7 at 1 min just significantly increased the risk of CP, and Apgar scores of >7 at 5 and 10 min were strongly associated with an increased risk. Abruptio placentae, Apgar scores >7 at 1 min and pathological non‐stress test (reason for delivery) were significant risk factors of CP only in the moderately preterm and hemiplegic groups, whereas fever before delivery was a significant risk factor in the very preterm and spastic diplegic groups. Antibiotics during pregnancy was associated with CP only in the spastic diplegic CP group. Conclusion: Antenatal infections marginally increased the risk of CP. Low Apgar score and abruptio placentae were associated with CP, especially in moderately preterm infants with hemiplegic CP.