bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment strategies for bronchopulmonary dysplasia with postnatal corticosteroids in Europe: the EURAIL survey*
Authors: Truffert P , Empana J‐P , Bréart G , Saugstad OD , Goelz R , Halliday HL , Anceschi M 
Published: August 2010

Aim: To survey practices in 14 European countries and describe strategies for the prevention and treatment of bronchopulmonary dysplasia with postnatal steroids (PNS). Methods: In 1999–2000 questionnaires covering the use of PNS were sent to every neonatal unit taking very preterm newborns in charge, in population‐based areas covering at least 20000 births annually. One questionnaire was sent to surveyed unit. The participating areas were chosen by an expert from each country participating in the Europe Against Immature Lung (EURAIL) study group. Results: Responses to 331 questionnaires were received; the mean response rate by countries was 84% (range 64–100%). Teaching hospitals accounted for 19% of the responding units. The number of extremely premature newborns (less than 28 wk of gestation) admitted yearly to these units was 0 in 16%, < 20 in 62%, 20–39 in 11% and > 39 in 11%. Overall, 67% of the centres used PNS: 48% initiated treatment in non‐intubated infants and 53% at 7–14 d. Treatment duration was 4–15 d in 62% and > 15 d in 21%. PNS administration was limited to intubated infants less often in smaller units [odds ratio (OR) 0.2, 95% confidence interval (95% CI) 0.1–0.6] and more often in non‐teaching hospitals (OR 2.5, 95% CI 2.5–5.0). Conclusions: Although PNS have important side effects, they were still widely used in 1999 to treat or prevent chronic lung disease. Surprisingly, steroids are still prescribed in non‐ventilated infants. PNS use should be based on guidelines derived from the evidence from randomized controlled trials. This evidence should be regularly updated and disseminated.
Bone and joint infection after traumatic implantation of Scedosporium prolificans treated with voriconazole and surgery
Authors: Studahl M , Backteman T , Stålhammar F , Chryssanthou E , Petrini B 
Published: August 2010

Scedosporium prolificans is an environmental mould that may cause local infection in bone and joints after traumatic implantation, or generalized infection in immunocompromised patients. The fungus is highly drug resistant, both in vitro and in vivo. We present a case of osteomyelitis and arthritis caused by S. prolificans in a 9‐y‐old boy whose knee had been punctured by a hawthorn spike. Treatment with different drugs was difficult and arthrodesis was necessary. Concomitantly, voriconazole was given, and after three months bone biopsies were sterile despite a high in vitro MIC‐value of the fungus against voriconazole. Reversible skin depigmentation and fingernail oncholysis appeared toward the end of 17 months of voriconazole treatment. Twelve months after discontinuation of treatment, no signs of relapse were detected. Conclusion: Voriconazole may be a valuable adjunct to surgical treatment of bone and joint infection by Scedosporium prolificans.
Ganciclovir treatment in Ménétrier's disease
Authors: Hoffer V , Finkelstein Y , Balter J , Feinmesser M , Garty BZ 
Published: August 2010

A 2‐y‐old girl with severe edema, oliguria and hypoalbuminemia caused by protein‐losing gastritis was diagnosed with cytomegalovirus‐associated Ménétrier's disease. After almost two weeks, during which the patient required repeated albumin transfusions, she was treated with intravenous ganciclovir. Within five days her condition had improved, and no additional albumin replacement was needed. Complete recovery was observed after several weeks. Conclusion: In patients with severe Ménétrier's disease, a course of ganciclovir treatment may be of benefit and should be considered.
Monitoring breastfeeding rates in Italy
Authors: Banderali G , Riva E , Scaglioni S , Agostoni C , Giovannini M 
Published: August 2010

Aim: to determine the rates of initiation and duration of breastfeeding in Italy in 1995 and 1999, and to examine the adherence to the ten steps to successful breastfeeding recommended by WHO. Methods: Two cohorts of mothers who delivered healthy infants in November 1995 (n= 2400) or November 1999 (n= 3500) were interviewed by telephone within 4 wk of delivery when their infants were 3 months of age. Type of breastfeeding was classified according to the WHO definitions. Adherence to the WHO ten steps was evaluated. Results: Initiation and duration of breastfeeding increased during the 1995–1999 period (p < 0.0001). The rate of breastfeeding at discharge and when the infants where 3 months of age was 83% and 42% in 1995, and 89% and 66% in 1999. The rate of exclusive/predominant breastfeeding at discharge was higher in 1999 than 1995 (78% vs 72%). Conclusion: An increase in initiation and duration of breastfeeding through the first 3 months of age occurred in Italy during the 1995–1999 period, but both breastfeeding duration and observance of the WHO's ten steps are not completely satisfactory yet.
Initiation of breastfeeding
Authors: Zetterström R 
Published: August 2010

Breastfeeding is a biological process that is highly influenced by various physiological and environmental factors such as the plans for infant feeding of pregnant women, their education and work situation, family support and nutrition. Conclusion: The way in which breastfeeding is initiated in the early postnatal period is of importance both for how long the process is likely to continue and for the growth of the infant.
“Minor” feeding problems during the first months of life: effect of a partially hydrolysed milk formula containing fructo‐ and galacto‐oligosaccharides
Authors: Savino F , Cresi F , Maccario S , Cavallo F , Dalmasso P , Fanaro S , Oggero R , Vigi V , Silvestro L 
Published: August 2010

Background: Colic, regurgitation and constipation are common feeding problems in formula‐fed infants that might benefit from dietary treatment. A formula containing fructo‐ and galacto‐oligosaccharides, partially hydrolysed proteins, low levels of lactose and palmitic acid in the β position and higher density has been tested to reduce the occurrence of these symptoms. The aim of this prospective study was to describe the effects of such a formula in infants with minor gastrointestinal disorders. Methods: An observational prospective trial involving practising Italian paediatricians was performed. Formula fed‐infants up to 90 d of age with minor gastrointestinal problems such as infantile colics and/or regurgitation and/or constipation were enrolled in the study from January 2001 to May 2001. The study was completed within 14 d of treatment. On days 1, 7 and 14 the infants were visited by the paediatricians. Parents were given a structured diary to record daily episodes of colic, regurgitation and type and number of stools. Results: Of the 932 infants enrolled, 604 completed the study. Of the 214 infants with colic, 169 (79%) demonstrated a reduction in frequency of colic from 4.1 ± 2.0 per day at the beginning of the study to 2.0 ± 1.8 at the end of the study (I.C. 95%: 1.72–2.39; p < 0.005). A reduction in the number of episodes of colic of 1.8 per day at the beginning of the study (I.C. 95%: 1.49–2.11; p < 0.05) was recorded between day 1 and day 7, and of 0.26 (I.C. 95%: 0.15–0.37; p < 0.05) between day 7 and day 14. Of the 201 infants with regurgitation problems, 141 (70%) demonstrated a reduction of frequency of the symptoms from 4.2 ± 2.0 per day at the beginningof the study to 2.1 ± 2.2 at the end of the study (I.C. 95%: 1.75–2.35; p < 0.005). A reduction of 1.87 in the number of regurgitation episodes was reported between day 1 and day 7 (I.C. 95%: 1.57–2.16; p < 0.05) and of 0.18 (I.C. 95%: 0.06–0.31; p < 0.05) between day 7 and day 14. Of the 232 infants with constipation, 147 (63%) demonstrated an increase in the daily number of stools of 0.42 (I.C. 95%: 0.5–0.3; p < 0.005). An increase in stool frequency of 0.41 (I.C. 95%: 0.51–0.23; p < 0.05) was reported between day 1 and day 7, and of 0.04 (I.C. 95%: 0.22–0.14; p= ns) between day 7 and day 14. Parents’evaluation of the formula was 7.9 ± 1.8 (score 0–10); 550 parents (91%) gave a positive judgement (score >6). The evaluation by the paediatricians of the improvement in symptoms after the treatment was 8.2 ± 1.5; 574 (95%) a positive effect (score >6). Conclusion: This study shows that the majority of infants followed by paediatricians for minor gastrointestinal symptoms improve within 2 wk of feeding with this new formula. Further double‐blind, controlled studies are needed to confirm whether the amelioration of symptoms observed in this trial is in fact due to the new formula.
Oligosaccharides might stimulate calcium absorption in formula‐fed preterm infants
Authors: Lidestri M , Agosti M , Marini A , Boehm G 
Published: August 2010

Among other components of human milk, oligosaccharides might contribute to the high efficiency of calcium absorption of breastfed infants. In adults, it can be shown that dietary oligosaccharides can improve calcium absorption. The present analysis was performed to evaluate a possible influence of dietary oligosaccharides on parameters of calcium metabolism in preterm infants. The concentrations of calcium and phosphorus in plasma and in spot urine samples as well as the plasma activity of the alkaline phosphatase were measured in preterm infants fed either a standard formula (n= 15) or a formula supplemented with dietary oligosaccharides (n= 15) at the end of a 4‐wk feeding period. Conclusions: There was no influence of the different diets on the plasma concentration of calcium and phosphorus or on the plasma activity of alkaline phosphatase. In urine, there was a tendency towards higher calcium concentrations in the group fed the supplemented formula compared concentrations in the group fed the standard formula. The concentrations of phosphate were not significantly different and, as a consequence, there was a tendency towards a higher Ca/P molar ratio in the group fed the supplemented formula. The data indicate that the calcium absorption might be influenced by the dietary oligosaccharides. Thus, the possible effect of dietary oligosaccharides on calcium homeostasis should be included in the discussion concerning the consequences of the use of dietary oligosaccharides in preterm infant nutrition.
Outcome of wheezing in early childhood
Authors: Wennergren G 
Published: August 2010

In Acta Pædiatrica 50 y ago, Boesen published a follow‐up of children with “asthmatic bronchitis”. Recent reinvestigations of children hospitalized because of wheezing in early childhood are remarkably consistent with Boesen's observations. Conclusion: Young children admitted to hospital because of wheezing have a clearly increased risk of subsequent asthma. Recent studies confirm Boesen's observations of the prognostic importance of eosinophilia and an inverse relation between age at admission with wheezing and risk of subsequent asthma. Allergy or atopic dermatitis is predictive of subsequent asthma, whereas family history of allergy has low predictive value in infants.
The difficult balance between dietary polyunsaturated fatty acids
Authors: Agostoni C 
Published: August 2010

The evidence emerging from developing countries indicates a wide variability in the fat composition of human milk. The linoleic:alpha linolenic acid ratios, suggested to be included within the range of 5:1 and 15[20]:1, tend to fluctuate, and could indicate the capability of humans to selfadapt according to different dietary and environmental conditions. Conclusion: When referring to optimal “standard” dietary intakes for infants, the complex interactions between genetics and environment should be considered in interpreting observations from different settings.
Cataract in children
Authors: Foster A , Gilbert C 
Published: August 2010

Of the estimated 1.4 million children world‐wide who are blind, cataract is responsible for an estimated 190000 (14%). The incidence varies from 1 to 3/10000 live births or 10 per million of the total population in low‐income countries. Early diagnosis, referral and surgery are important in improving results. A recent study from Sweden indicates that examination of babies in maternity wards results in earlier referral compared with well‐baby clinics or no formal screening. Conclusion: It is important that standardized protocols be developed and implemented to screen children for ocular anomalies, especially cataract, before discharge from maternity units.
Normal studies are essential for objective medical evaluations of children who may have been sexually abused
Authors: Adams JA 
Published: August 2010

The findings of carefully conducted research studies of non‐abused children should be used in medical evaluations for suspected sexual abuse if they are to be legally defensible. These studies have shown that a “wide” hymenal opening and a “narrow” rim of hymen should not be used as markers of abuse. Conclusion: The study by Myhre and associates is another addition to a growing collection of good science in a field of medicine where objectivity is essential.
Effects of passive smoking on common respiratory symptoms in young children
Authors: Shiva F , Nasiri M , Sadeghi B , Padyab M 
Published: August 2010

Aim: To observe the effects of fathers' smoking on respiratory symptoms in children between the ages of 6 mo and 5 y living in Tehran during the period January to December 2001. Methods: The caregivers of 622 children attending resident‐based clinics in two university hospitals were interviewed about the respiratory illnesses incurred by the child during the previous 12 mo and the smoking habits of those living with the child. Children who lived in households in which any person, other than the father, smoked were excluded. Results: The analysis included 595 children, 40.6% of whom were living in homes where fathers smoked cigarettes. About 35% of smokers admitted to unrestricted smoking at home. In children not living with a smoker, 81.6% had experienced at least one episode of upper respiratory tract infection (URTI) during the previous year and the rate increased to 95.2% in passive smokers whose fathers were not restricted from smoking in front of the children, (p‐value <0.01). A similar pattern was found for otitis media and asthma (p‐value <0.05 and <0.01, respectively). The average number of URTI episodes during the previous year was significantly higher in children exposed to unrestricted smoking (p < 0.01). Conclusion: The study outlines the detrimental effects of paternal smoking on the respiratory health of children from a part of world in which this problem has not been studied previously, and highlights the importance of educating fathers to alter their smoking habits so that even if they do not stop smoking altogether, they should discontinue smoking indoors.
Relationship between vasoactive intestinal peptide and intrapulmonary vascular dilatation in children with various liver diseases
Authors: Chongsrisawat V , Ampai S , Chotivitayatarakorn P , Sirisopikul T , Poovorawan Y 
Published: August 2010

Aim: To evaluate the potential of vasoactive intestinal peptide (VIP) as a pathogenic factor of intrapulmonary vascular dilatation (IVD) in hepatopulmonary syndrome (HPS). Background: HPS comprises a triad comprising liver dysfunction, IVD and hypoxaemia. Although the pathogenesis of the process has not been elucidated, many vasodilating substances, such as VIP, have been implicated in the development of pulmonary vascular abnormalities. IVD can be detected by contrast‐enhanced echocardiography (CEE) before the development of abnormal gas exchange. Methods: Forty‐two children (20M, 22F; mean age 4.39 ±4.17 y) with various liver diseases who attended the paediatric liver clinic of King Chulalongkorn Memorial Hospital between March 2000 and February 2001 were recruited to the study. Each patient was tested for transcutaneous O2 saturation, CEE (applying the agitated normal saline technique), liver function test and serum VIP level. Results: Fourteen of the 42 patients (33%) were CEE positive. Only one of the 14 patients had associated hypoxia and clinical cyanosis. The serum VIP levels of children with liver disease were significantly higher than those of the controls (60.21 ± 35.04 pg/ml vs 43.71 ± 34.61 pg/ml, p= 0.03). CEE‐positive children tended to have higher serum VIP levels than CEE‐negative children (72.65 ± 40.31 vs 53.99 ±31 pg/ml, p= 0.3). The serum VIP levels of biliary atresia (BA) patients with favourable outcomes (serum bilirubin ±34μmol/L) were not significantly different from those with unfavourable outcomes (serum bilirubin >34μmol/L) (42.95 ± 14.53 pg/ml vs 66.07 ± 32.17 pg/ml, p= 0.5).Conclusions: CEE is a non‐invasive test for early detection of IVD in children with liver disease. VIP is not solely responsible for the pathogenesis of IVD in HPS. Further studies are required to determine which substances cause the development of IVD.
Neurological assessment at five years of age in infants born preterm
Authors: Fily A , Truffert P , Ego A , Depoortere MH , Haquin C , Pierrat V 
Published: August 2010

Aim: To evaluate the agreement between Touwen's neurological examination and a derived simplified one, created to be applied at the age of 5 y to infants born preterm. Methods: 185 children born at a gestational age (GA) of <33 wk and/or with a birthweight <1501 g, free of cerebral palsy, underwent Touwen's neurological examination at a mean age of 5 y and 8 mo (5‐6.5 y). One‐hundred and seventy had a full examination and were included into the study. They were born at a mean GA of 30 wk (range 24–35 wk) with a mean birthweight of 1250 g (range 600–2690 g). A simplified examination, based on the clinical experience of two of the authors, was created a priori. The data were reviewed retrospectively and the concordance between the two forms was assessed. The reviewers were blinded to the original categorization from the long form. Results: On the basis of the original Touwen's neurological examination, the 170 children were classified into 122 with a normal neurological examination, 41 with grade 1 minor neurological dysfunction (MND) and 7 with grade 2 MND, giving 28% of the cohort with MND. The concordance between the two forms was excellent, with an agreement in 169 out of 170 subjects. None of the infants with the most complex form of MND was misclassified. Conclusion: The simplicity of this examination could allow its diffusion and its use in follow‐up programmes. It could improve the quality of routinely collected follow‐up data of preterm neonates.
Effect of methotrexate and folinic acid on skeletal growth in mice
Authors: Iqbal MP , Ahmed M , Umer M , Mehboobali N , Qureshi AA 
Published: August 2010

Aim:To investigate whether chronic administration of medium doses of methotrexate (MTX) causes suppression of skeletal growth in young mice and to determine whether folinic acid supplementation could reverse this effect.Methods: Four equal groups of Balb/c young male mice (6 animals in each group; mean body weight 11.9 ± 0.25g, in their rapid growth phase) were subjected to the following drug treatment for a period of 3 wk. Group 1 was given intraperitoneal MTX (3.5 mg kg‐1body weight) every second day. Group 2 received folinic acid (7.0 mg kg‐1body weight) intraperitoneally every second day. Group 3 was given both drugs (MTX every second day and folinic acid 8 h post‐MTX injection). Group 4 was injected with physiological saline every other day to serve as a control group. Total body weight of the animals in each group was monitored every second day for the entire study period. The animals were sacrificed, the bilateral femurs and tibias of each animal were harvested and X‐rays of the bones were taken. The length of each femur and tibia was measured using a micrometer. Measurements from the radiographs were also recorded using image analysis software. The MTX concentrations in the plasma and the folate levels in erythrocytes were determined. The heights of the distal femoral and the proximal tibial growth plate for each animal were measured on histological tissue sections.Results: Mean lengths of both the tibia and femur of animals were compared in the four treatment groups. A significant decrease in the mean lengths (one‐way ANOVA,p< 0.005) was observed in the group receiving MTX alone. Similarly, there was a significant decrease (p< 0.001) in the height of the femoral and tibial growth plate in this group when compared with the other groups. The main effect of MTX seemed to be on the hypertrophic proliferative zone of chondrocytes in the growth plate. Furthermore, animals in this MTX‐treated group also showed increased levels of MTX in plasma and low levels of erythrocyte folate.Conclusion: These data show that chronic administration of MTX induces suppression of skeletal growth in mice, possibly through the inhibition of the pathway ofde novoDNA synthesis. Folinic acid treatment following MTX administration appears to reverse this growth inhibition. Based on these observations, children suffering from juvenile rheumatoid arthritis, osteosarcoma or acute lymphoblastic leukaemia and receiving MTX over long periods of time could be at risk of short‐term suppression of skeletal growth. If this is the case, it is possible that they could benefit from dietary supplementation with folinic acid.
Do adult patients with phenylketonuria improve their quality of life after introduction/resumption of a phenylalanine‐restricted diet?
Authors: Gassió R , Campistol J , Vilaseca MA , Lambruschini N , Cambra FJ , Fusté E 
Published: August 2010

Aim: To evaluate the possible influence of dietary treatment on the quality of life of adult patients with PKU (phenylketonuria) following late introduction or resumption of a Phe‐restricted diet. Methods: Fifteen adult patients with classical PKU (10F, 5M; mean age: 27.5 y, range: 16.4–37.5 y) were selected for the study. These patients had either resumed a restricted diet after a period of discontinuation, or were placed on a restricted diet after late diagnosis. All of them were interviewed about their quality of life using a 24‐item questionnaire. Results: The index of dietary control was poor (median Phe: 954 μmol/L) in 8/15 patients, regular (Phe: 514 μmol/L) in 4/15 and good (Phe: 354 μmol/L) in 3/15 patients. Fifty‐three percent of patients reported that their state of health was very good, 47% described it as good, and 40% felt that their present health on‐diet was better than it had been off‐diet; 53% believed that they were calmer, quieter and less easily upset and 40% were more alert and were more able to maintain attention while on‐diet. Thirty‐three percent of the patients felt happier, and 27% felt more vital; 20% thought that they were less impulsive and aggressive, and that they were now less argumentative than before. Sixty percent of the patients felt that their quality of life had improved on‐diet compared with the situation off‐diet. Conclusion: More than half of our patients believed that their quality of life improved with a Phe‐restricted diet; they reported feeling calmer, quieter, and less easily upset. Only 47% attained regular to good dietary control.