bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nitric oxide in neonatal transposition of the great arteries
Authors: El‐Segaier Milad , Hellström‐Westas Lena , Wettrell Göran 
Published: August 2010

AbstractThree newborn infants with transposition of the great arteries (TGA) and intact ventricular septum (IVS) developed postnatal persistent pulmonary hypertension of the newborn (PPHN) and were successfully treated with inhaled nitric oxide (iNO). Intervention with balloon atrial septostomy (BAS) was performed in two of the infants before the iNO treatment, but they continued to be severely hypoxic with metabolic acidosis. However, the iNO immediately improved oxygenation and the clinical condition. The third neonate had a moderately large atrial communication and echocardiographic signs of PPHN. He received iNO before BAS with dramatic clinical improvement, which therefore postponed BAS. Conclusion: Early diagnosis of PPHN and treatment with iNO may improve final outcome in neonates with TGA and IVS. In the presence of moderately large atrial communication and PPHN, treatment with iNO might be considered before BAS.
Infant milk feeding practices in the Netherlands and associated factors
Authors: Lanting Caren I , van Wouwe Jacobus P , Reijneveld Sijmen A 
Published: August 2010

Abstract Aim: The aim of the study was to describe infant feeding practices and associated factors, and to explore mothers' main reasons for starting and stopping breastfeeding. Methods: We performed a national inquiry into milk feeding practices among 9133 Dutch infants aged <7 mo by means of a questionnaire. Results: 78% of mothers initiated breastfeeding. At 1 and 4 mo, respectively, 51 and 25% of infants were fed primarily on human milk; after 6 mo, only 15% of mothers still provided human milk as the only source of milk feeding. During the whole 6‐mo period, another 11 to 18% was fed on both breast and formula milk. Women initiating breastfeeding were more likely to be higher educated, have a higher‐educated partner, be non‐smokers, have a full‐time job, and be primipareous. In addition, breastfeeding initiation rate was higher for women born outside the Netherlands. Longer duration of breastfeeding was mostly found amongst higher‐educated, non‐smoking women. The odds for continuation of breastfeeding after 4 mo increased when mothers' working hours did not exceed 16 h/wk. Infant delivery at home was associated with a higher initiation rate as well as longer duration of breastfeeding compared to hospital delivery. Infants born after 38 wk of gestation, with a birthweight of 3500 g had higher odds to be breastfed for a longer period. Conclusion: Only a minority of Dutch infants is breastfed for 6 mo. Maternal and infant characteristics are important predictors of breastfeeding initiation and duration.
Substance use and suicidal conduct: A study of adolescents hospitalized for suicide attempt and ideation
Authors: Méan Marie , Camparini Righini Nadia , Narring Françoise , Jeannin André , Michaud Pierre‐André 
Published: August 2010

Abstract Aim: To study the prevalence of psychoactive substance use disorder (PSUD) among suicidal adolescents, psychoactive substance intoxication at the moment of the attempt, and the association between PSUD at baseline and either occurrence of suicide or repetition of suicide attempt(s). Methods: 186 adolescents aged 16 to 21 y hospitalized for suicide attempt or overwhelming suicidal ideation were included (T0); 148 of them were traced again for evaluations after 6 mo (T1) and/or 18 mo (T2). DSM‐IV diagnoses were assessed each time using the Mini International Neuropsychiatric Interview. Results: At T0, 39.2% of the subjects were found to have a PSUD. Among them, a significantly higher proportion was intoxicated at the time of the attempt than those without PSUD (44.3% vs 25.4%). Among the 148 adolescents who could be traced at either T1 or T2, two died from suicide and 30 repeated suicide attempts once or more times. A marginally significant association was found between death by suicide/repetition of suicide attempt and alcohol abuse/dependence at baseline (OR=3.3, 95% CI 0.7–15.0; OR=2.6, 95% CI 0.7–9.3). More than one suicide attempt before admission to hospital at T0 (OR=3.2, 95% CI 1.1–10.0) and age over 19 y at T0 (OR=3.2, 95% CI 1.1–9.2) were independently associated with the likelihood of death by suicide or repetition of suicide attempt. Conclusion: Among adolescents hospitalized for suicide attempt or overwhelming suicidal ideation, the risk of death or repetition of attempt is high and is associated with previous suicide attempts—especially among older adolescents—and also marginally associated with PSUD; these adolescents should be carefully evaluated for such risks and followed up once discharged from the hospital.
Familial haemophagocytic lymphohistiocytosis: Survival of a premature twin with immuno‐chemotherapy and bone marrow transplantation from an HLA‐identical unrelated donor
Authors: Rugolotto Simone , Luigi Marradi Pier , Balter Rita , Maccario Rita , Maria Padovani Ezio , Locatelli Franco 
Published: August 2010

AbstractWe describe a premature twin born at 30 wk of gestational age, affected with familial haemophagocytic lymphohistiocytosis. Two different mutations were identified in his DNA: one inherited from the mother and one from the father. Haemophagocytosis had been confirmed in his twin brother, who died soon after birth, as well as in the re‐evaluation of the autopsy of his older sister, who died 1 y earlier. At 26 d of age, chemotherapy and immune‐suppressive treatment were started according to the HLH‐94 protocol. At 6 mo of age, a bone marrow transplant from an HLA‐identical, unrelated volunteer was performed. Now at 32 mo of age, the infant is healthy and without signs of graft‐versus‐host disease. Conclusion: This case report shows that immuno‐chemotherapy and allogenic bone marrow transplant are feasible even in premature infants affected with familial haemophagocytic lymphohistiocytosis, which should be ruled out in unknown bleeding disorders of neonates.
Death in two female Prader‐Willi syndrome patients during the early phase of growth hormone treatment
Authors: Riedl Stefan , Blümel Peter , Zwiauer Karl , Frisch Herwig 
Published: August 2010

AbstractReports on sudden death in Prader‐Willi syndrome (PWS) patients after the start of growth hormone (GH) treatment have been published recently. We observed a 4.7‐y‐old girl who showed a continuous increase in pulmonary artery pressure and died of cardiorespiratory failure 7 wk after GH therapy had been initiated, and a 9.3‐y‐old girl with additional trisomy 21 who died during a minor respiratory infection 6 mo after GH had been started. Both patients were overweight (weight for height 127% and 224%, respectively). GH‐induced fluid retention may have occurred in the younger girl. In contrast to the reported cases, our PWS patients were female. Conclusion: Our cases illustrate the difficulty of differentiation between possible GH side effects and the natural course of disease, in particular with respect to obesity‐related comorbidity and mortality.
A six‐year old with fatal pulmonary embolism
Authors: Sridhar Arani V , Naveen Rao K , Chakraborty Supratik 
Published: August 2010

AbstractPulmonary thromboembolism is rarely recognized in young children, even in hospital settings. All current management decisions for children with deep vein thrombosis (DVT) are directly extrapolated from treatment recommendations for adults with no further validation. We report the case of a 6‐y‐old child presenting with deep vein thrombosis of the leg veins and fatal pulmonary embolism. The fatal outcome in our case highlights the need for more epidemiological studies in children, not only to predict the recurrence of pulmonary emboli but also to prepare standard treatment guidelines for the management of DVT and pulmonary emboli in children. We speculate that there may be a role for temporary inferior vena cava filters in young children with extensive DVT of the legs. Conclusions: This case highlights the need for more epidemiological studies to predict the recurrence of pulmonary emboli and effective guidelines for the management of paediatric DVT and pulmonary emboli in children.
Dysmetabolic syndrome in childhood and adolescence
Authors: Bitsori Maria , Kafatos Anthony 
Published: August 2010

AbstractThe dysmetabolic syndrome, consisting of dyslipidaemia, hypertension, hyperinsulinaemia and central obesity, has been well recognized as a major risk for cardiovascular disease in adults. Although the clustering of cardiovascular risk factors has also been identified in childhood, the occurrence of full‐blown dysmetabolic syndrome at younger ages has only recently been investigated. In this article we attempted an overview of the data for children and adolescents, focused on the mechanisms and natural history of the disease, the prevalence among paediatric populations, the assessment and the treatment approaches. Conclusion: There is substantial evidence that the dysmetabolic syndrome has its origins in childhood. In the face of the epidemic increase of obesity in children and adolescents, the development of effective screening and preventive strategies would be a major challenge for paediatricians.
Thyroid dysfunction in the offspring of mothers with autoimmune thyroid diseases
Authors: Péter Ferenc 
Published: August 2010

AbstractAn integrated three‐compartment thyroid model exists during gestation: pregnancy influences thyroid function in several ways, the placenta plays an active role in TRH–thyroid and iodide transport and metabolism, and the fetus develops its own hypothalamic–pituitary–thyroid axis. This commentary reviews some basic and new data, especially in the maternal–offspring relationship in the case of maternal autoimmune thyroid diseases. Conclusion: The careful control of maternal autoimmune thyroid disease is essential in order to avoid pathological changes in the offspring.
Growth tracking of femoral and humeral strength from infancy through late adolescence
Authors: Ruff Christopher 
Published: August 2010

Abstract Aim: To determine to what degree femoral and humeral strengths “track”, or remain at the same ranked position relative to other individuals during the entire growth period. Methods: Radiographs of 20 individuals, equally divided by sex, were measured at 6‐mo or annual intervals from 6 mo to 17 y of age. The section modulus, a measure of bending/torsional strength, was derived from cortical and subperiosteal breadths taken at the femoral midshaft and at 40% of the bone length from the distal end of the humerus. Body size was also assessed as the product of body weight and bone length. Growth tracking was evaluated in two ways: as Spearman rank‐order correlations between strengths at each age point and strengths at 17 y of age, and as the number of individual changes in rank over specified age intervals. All analyses were carried out within sex. Results: The degree of growth tracking varied by sex, skeletal location, and age. Correlations were higher for the humerus (r=0.56–0.83) than for the femur (r=0.10–0.63). Males showed particularly poor tracking for the femur, most likely due to late and variable adolescent growth spurts in body size. Standardizing for body size improved tracking for the male femur, but not for the humerus. Over the entire growth period, individuals averaged 5–8 out of a possible 9 changes in rank. Early childhood (<6 y) was the least stable period. Conclusion: Previously documented growth tracking of skeletal parameters over relatively short (1–6‐y) time periods can not necessarily be extrapolated to longer time intervals, nor can results from one skeletal region or time period be applied to another region or time period. Variation in timing of growth events, and body size for weight‐bearing elements, may have important influences on growth tracking.
Severe hypothyroidism due to atrophic thyroiditis from second year of life influenced developmental outcome
Authors: Joergensen JV , Oerbeck B , Jebsen P , Heyerdahl S , Kase BF 
Published: August 2010

AbstractFrom the second year of life a girl showed an insidious development of clinical hypothyroidism due to a non‐goitrous lymphocytic thyroiditis without traceable circulating levels of thyroid antibodies measured by routine immunoassays. The diagnostic delay of this rare variant of atrophic thyroiditis caused persistent neuropsychological deficits. Conclusion: Her difficulties with speed of processing and working memory in particular could suggest a frontal deficit, possibly in the dorsolateral prefrontal circuit. This contrasts with findings in congenital hypothyroidism, suggesting a relatively preserved frontal function, and could illustrate different neuropsychological deficits of hypothyroidism at different ages in early childhood.
Congenital heart defects: The patients who die
Authors: Meberg Alf , Lindberg Harald , Thaulow Erik 
Published: August 2010

Abstract Aims: To register mortality and causes of death in patients with congenital heart defects (CHDs). Methods: Prospective population‐based observational study. Results: 553 infants with CHD (1.1% of live born) were observed for 1–22 y (median 10 7/12 y). Sixty‐four died (11.6%), of whom 32 (50%) died during the first 4 wk, and 51 (79.7%) during the first year of life. Of the total neonatal deaths in the population (3 per 1000), CHDs occurred in 21.5%. Mortality for children with CHDs was not significantly different between the cohorts born in 1982–1991 and 1992–2002, for either neonatal deaths or deaths later on (p>0.05). Out of 170 patients in whom therapeutic procedures (surgery, catheter interventions) were undertaken, 34 (20%) died. Nine cases (1.6%) died with unrecognized CHDs; seven of these on the first day of life with severe extracardiac malformations. In 50 (78.1%) cases, death was judged to be caused directly or indirectly from the CHD, and in 14 (21.9%) from extracardiac malformations or other conditions. Conclusion: CHDs occur in a substantial number of neonatal deaths. Most deaths are caused by cardiac insufficiency. The mortality rate remained unchanged.
Human torovirus: A new virus associated with neonatal necrotizing enterocolitis
Authors: Lodha Abhay , de Silva Nicole , Petric Martin , Moore Aideen M 
Published: August 2010

Abstract Aim: Toroviruses have been associated with gastroenteritis in both animals and humans. The aim of this study was to examine the fecal excretion of torovirus in infants with necrotizing enterocolitis (NEC). Methods: We reviewed all infants with NEC admitted to our tertiary care NICU over a 5‐y period who had stool specimens sent for microbial culture and virology. Infants in the NICU during the same period with diagnoses other than NEC served as controls. Results: Forty‐four infants with NEC stages I–III were identified, and pathogenic organisms were identified in 27 (61%). Toroviruses were identified in stool cultures in 48% of patients with NEC, and 17% of the non‐NEC controls (p<0.001). There was no significant difference in illness severity or mortality between the torovirus‐positive and ‐negative infants with NEC. Conclusion: Torovirus should be added to the list of infectious agents associated with NEC in newborn infants. The exact role torovirus plays in the etiology and progression of NEC warrants further investigation.
Integrated care of childhood disease in Brazil: Mothers' response to the recommendations of health workers
Authors: Alves da Cunha Antonio JL , Dos Santos Sílvia Reis , Martines José 
Published: August 2010

Abstract Aim: To describe the process of follow‐up in primary care facilities where the Integrated Management of Childhood Illness (IMCI) strategy was implemented. IMCI was developed by WHO and UNICEF as an integrated approach to manage sick children under 5 y of age and aims to reduce mortality and morbidity. Methods: From August 2001 to February 2002, 229 sick children who had a health condition included in the IMCI case management guidelines were seen in six family healthcare facilities in Brazil. We analysed the care provided to 153 children who were recommended for a 2‐ or 5‐d follow‐up visit. Children who did not return were visited and assessed at home. Results: Only 87 children (56.9%) timely returned for follow‐up: 70 had improved, eight presented the same health conditions, five were worse and four had a new problem. The main reasons given for not returning for follow‐up were: the child had improved (35.1%) and other family priorities (47.4%). Home visits showed that, although most children had improved (n=49), some had a new health problem and one child was sick enough to be referred. Prescription of antibiotics was associated with increased probability of returning for a follow‐up visit (RR =1.64 [1.22–2.20], p=0.001). Conclusion: Adherence to follow‐up was just over 50%, mostly because the condition had already resolved, but some children were still sick and needed intervention. Training on counselling on the recognition of danger signs and when to return for a follow‐up visit must be reinforced.
Vaccination coverage among adolescents in certain provinces of Greece
Authors: Bitsori Maria , Ntokos Michail , Kontarakis Nikolaos , Sianava Ourania , Ntouros Thomas , Galanakis Emmanouil 
Published: August 2010

Abstract Aim: To estimate the vaccination coverage in a sample of adolescents in Greece. Methods: Vaccination status was estimated in 483 adolescents aged 15–19 y in four prefectures. The criteria for full vaccination were based on the recommendations of the Greek National Vaccination Schedule. Results: The participation rate in the study was 78.7% (380/483 adolescents). The rates of full vaccination were 94.2% for poliomyelitis, 78.4% for hepatitis B, 77.4% for BCG, 65.0% for tetanus and 54.4% for diphtheria. The rates of full vaccination for measles, rubella and mumps were 65.0%, 57.6%, and 56.0%, respectively. For pertussis, the full vaccination rate was only 36.0%, and 7.1% of the study population was totally unvaccinated. The most missed dose for all vaccines was the final booster dose, which is usually administered in older children or adolescents. Conclusion: Adolescent vaccination coverage was not satisfactory in this study, mainly due to non‐compliance to the final booster dose. Completion of missing vaccines at this age represents the last opportunity for massive intervention and would be of essential value for individual and community protection against common preventable diseases.
Hypertrophic osteoarthropathy in two children with cholestatic hepatic disease
Authors: Katsicas M , Ciocca M , Rosanova M , Russo Ricardo AG 
Published: August 2010

Abstract Aim: To describe two children with hypertrophic osteoarthropathy associated with cholestatic hepatic disease. Both patients suffered from chronic progressive cholestatic liver disease and developed digital clubbing, polyarthritis and periosteal reaction. In one of them, clinical and radiological features normalized after liver transplant. Conclusion: Hepatic hypertrophic osteoarthropathy is a rare disabling condition that responds poorly to conservative management, while liver transplantation appears to be the only effective therapeutic intervention.
Purpura fulminans as a sequel to erythema nodosum in a child with homozygous Leiden mutation and acquired protein S deficiency
Authors: Foyn Bruun Cathrine , Langbakk Bodil , Eriksson Steigen Sonja 
Published: August 2010

AbstractA 6‐y‐old boy presented with generalized, bruise‐like swelling of both legs. Three weeks later, he developed purpura fulminans in one of the affected feet. Histology of the leg swelling was in accordance with erythema nodosum. The boy proved to be homozygous for the Factor V Leiden mutation and to have acquired protein S deficiency. He recovered, with partial loss of two toes. Conclusion: In contrast to what is often stated, erythema nodosum is not always a benign condition. On the basis of this report, we suggest that if extensive erythema nodosum develops in an individual without any known thrombophilic disorder, investigations with respect to the latter should be performed.
Informed consent and hypoplastic left heart syndrome
Authors: Byrne Paul J. , Murphy Aisling 
Published: August 2010

AbstractWe present an ethical analysis from the perspective of shared decision‐making and informed consent of a change in clinical management of infants born with hypoplastic left heart syndrome (HLHS). We reported a change in treatment of HLHS at the University of Alberta away from comfort care to life‐saving surgery (LST) between 1987 and 1998. In a second review (1996–2001), 49/62 infants received LST, with 81% survival from the NICU and 58% at 35 mo. Eleven infants died preoperatively of non‐cardiac conditions and two received elective comfort care. Sixteen infants had 18‐mo Bayley Mental Development Index, mean score 84±19, but five scored <70. Although we continue to present the comfort care option to parents, since 2001 LST use for HLHS at our center is almost universal despite serious complications. Conclusion: We conclude that these findings are inconsistent with an open, shared decision‐making model of informed consent and we suggest that comfort care should remain an ethically valid choice until the rate of serious long‐term complications of LST decreases.
Macronutrient and energy contents of human milk fractions during the first six months of lactation
Authors: Saarela Timo , Kokkonen Jorma , Koivisto Maila 
Published: August 2010

Abstract Aim: To study the macronutrient and energy contents of human milk fractions during the first 6 mo of lactation. Study design: A total of 483 milk samples, including 52 pairs of fore‐ and hindmilk samples from 20 mothers, 253 samples from 53 donor mothers and 126 samples from 36 mothers of preterm infants, were collected longitudinally, starting at 1 wk postpartum and continuing monthly up to 6 mo. Protein, lactose and fat contents were measured and energy density estimated. Results: The protein content was significantly lower in fore‐ and hindmilk than in donor or preterm milk during the first months of lactation. In donor and preterm milk, the protein content declined consistently from 2.0 g/100 ml at 1 wk to half of that at 6 mo, and a similar trend was observed in fore‐ and hindmilk. Lactose content showed no significant changes between the groups or in the course of lactation. The fat content was highest in hindmilk, being approximately two‐ to threefold that of foremilk. Accordingly, hindmilk included 25–35 kcal/100 ml more energy on average than foremilk. Conclusions: The fat content of human milk increases in relation to breast emptying, while the other macronutritients of milk show only slight changes. When enteral feeding with high‐energy human milk is preferred, as in the case of very preterm infants, hind milk, with its higher fat content, would be a natural choice.