bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of different types of feeding on fatty acid composition of erythrocyte membrane lipids in full‐term infants
Authors: Minda H , Molnár S , Bums I , Decsi T 
Published: August 2010

Significantly higher levels of arachidonic acid (AA) and docosahexaenoic acid (DHA) in plasma lipids have previously been reported in 2 to 8‐wk‐old as well as in 6 to 12‐mo‐old full‐term infants fed exclusively human milk than in infants exclusively receiving formula without AA and DHA. However, in real life many infants receive both human milk and breast milk substitute formula. Healthy, full‐term infants aged 2 to 12 mo and fed exclusively human milk (n= 29, age: 29.2 [14.6] wk, mean [SD], no human milk substitute formula), exclusively formula without AA and DHA (n= 30, age: 26.6 [15.2] wk, no human milk after the age of 1 mo) or combined diet (n= 38, age: 30.3 [12.8] wk, human milk for >1 mo and breast milk substitute formula) were investigated in this cross‐sectional study. Fatty acid composition of erythrocyte membrane phosphatidylethano‐lamine (PE), phosphatidylcholine and sphingomyeline lipids was determined by high‐resolution capillary gas‐liquid chromatography. The most pronounced diet‐related differences were seen in PE lipids. Values of PE α‐linolenic acid (0.07 [0.05] vs 0.26 [0.18] vs 0.19 [0.19], median [range from the 1st to the 3rd quartile], exclusively breastfed vs. exclusively formula fed vs combined diet), eicosapentaenoic acid (0.19 [0.13] vs 0.35 [0.23] vs 0.27 [0.31]) and dihomo‐γ‐linolenic acid (1.34 [0.42] vs 1.86 [0.62] vs 1.58 [0.73]) were significantly lower in exclusively breastfed infants than in those fed formula, exclusively or partially. In contrast, PE AA (26.48 [2.50] vs 24.34 [4.74] vs 24.94 [3.64]) and DHA (4.93 [2.91] vs 3.51 [2.14] vs 3.58 [2.27]) values were significantly higher in exclusively breastfed infants than in the other two groups. Conclusion: In full‐term infants aged 2 to 12 mo, erythrocyte membrane AA and DHA values are significantly higher with exclusive breastfeeding than with partial breastfeeding or exclusive feeding of formula without AA and DHA.
New approach to osteopenia in phenylketonuric patients
Authors: Pérez‐Dueñas B , Cambra FJ , Vilaseca MA , Lambruschini N , Campistol J , Camacho JA 
Published: August 2010

Aim: To study bone mineralization in a group of phenylketonuric patients and to search for a possible relationship between bone mineral density, dietary control, serum minerals and nutrition intake. The response to treatment with low‐dose 1.25‐(OH)2 vitamin D in patients with osteopenia was evaluated. Methods: Twenty‐eight phenylketonuric patients (age range: 10–33 y) on dietary treatment were investigated. Bone density at the lumbar spine (Dual Energy X‐ray Absorptiometry), bone formation markers (osteocalcin and bone alkaline phosphatase), serum minerals, index of dietary control and protein, vitamin D and mineral intakes were determined. Results: Of the patients studied, 78.6% had good dietary compliance (462 ± 89 μmol/L). Mean protein, vitamin D and mineral intakes met the recommended dietary allowances (RDAs). Nevertheless, 8 patients had calcium intakes lower than 1000 g/d, and a positive correlation between Z‐score and calcium (r= 0.585; p= 0.002) or phosphorus intake (r= 0.546; p= 0.005) was observed. Osteopenia was detected in 14 patients (50%). Moreover, bone alkaline phosphatase in phenylketonuric patients older than 18 y of age was significantly lower than that in controls (p > 0.0001). No correlation was found between bone mineral density, age, serum minerals, bone formation markers or index of dietary control. Treatment with 0.25 μg/d calcitriol significantly increased bone density in 6 patients. Conclusion: A defect in bone mineralization was detected in 50% of patients in our series. The correct amount of formula intake seems to be necessary for bone mineralization in phenylketonuric patients. Calcitriol can be a useful treatment for these patients, although more studies are needed to confirm these results. Hypercalcaemia and hypercalciuria need to be carefully monitored.
Inhibitors in the Swedish population with severe haemophilia A and B: a 20‐year survey
Authors: Knobe KE , Sjörin E , Tengborn LI , Petrini P , Ljung RCR 
Published: August 2010

Aim: To survey the entire population (n= 116) afflicted with severe haemophilia A or B born in Sweden over a 20‐y period (1980–1999), and to examine the epidemiological, genetic and clinical aspects of development of inhibitors to factors VIII and IX (FVIII/FIX). Methods: One hundred of the subjects had haemophilia A and 16 had haemophilia B. All of these subjects had received prophylactic treatment and had a check‐up of inhibitor status at least twice a year. Sixty‐one were born between 1980 and 1989 and 55 between 1990 and 1999. Results: Nineteen percent (19/100) of those with haemophilia A and 37% (6/16) with haemophilia B developed inhibitors at 12–18 mo of age, after exposure to FVIII/FIX concentrates for an average of 14 d in the case of haemophilia A and 16 d in haemophilia B. All patients with inhibitors carried mutations that impaired protein synthesis. The high incidence of FIX inhibitors may have been due to the large number of complete deletions (13%) in the Swedish haemophilia B population. Patients with haemophilia A showed no significant increase (p= 0.65) in incidence of inhibitors (n= 10/48, total incidence 21%) in the 1990s, when they were treated mainly with recombinant products, as compared to the 1980s (n= 9/52,17%), when they received intermediate/high‐purity plasma‐derived concentrates. Conclusion: Our population‐based study verifies that genotype has a general impact on the incidence of FVIII/FIX inhibitors, and that recombinant FIII/FIX concentrates are not a predisposing factor for inhibitor development.
Neutrophil regeneration precedes healing of tissue destruction, as indicated by serum C‐reactive protein, in children with cancer recovering from neutropenic fever
Authors: Vettenranta K , Hovi L , Mäkipernaa A , Jalanko H , Saarinen‐Pihkala UM 
Published: August 2010

Aim: To evaluate the relationship between absolute neutrophil count and C‐reactive protein (CRP) in the recovery phase of neutropenic fever among paediatric patients with cancer. Methods: A total of 102 paediatric oncology patients with 177 episodes of fever and neutropenia was studied prospectively in a two‐centre setting. Antimicrobial therapy was discontinued 9 d (mean) post‐initiation with a mean absolute neutrophil count of 1.8 ± 109l‐1 and CRP of 32 mg l‐1. Results: The mean level of CRP below 20 mg l‐1 was reached on day 12. The level of CRP peaked on the day following the commencement of antimicrobial therapy. Throughout the episodes of fever and neutropenia higher levels of CRP were associated with a lower absolute neutrophil count. Following defervescence the pace of marrow recovery as evidenced by an increasing absolute neutrophil count to < 0.2 and < 0.5 ± 109l‐1 was more rapid than the normalization of serum CRP. There was a 2–3 d lag period between absolute neutrophil count exceeding the level of 200 ± 106l‐1 and the return of CRP to a baseline level. All episodes were treated successfully and there were no fatalities. Conclusion: Among patients recovering from neutropenia and fever the signs of marrow recovery remain the key criterion in evaluating the safety of discontinuing antimicrobial therapy, with serum CRP remaining more of an indicator of ongoing tissue repair.
Effect of Dry Bed Training on behavioural problems in enuretic children
Authors: HiraSing RA , van Leerdam FJM , Bolk‐Bennink LF , Koot HM 
Published: August 2010

Children with nocturnal enuresis (n= 91) selected by school doctors in the Netherlands from 1991 to 1994 were included in a study to assess the course of behavioural problems especially when the children became dry after the Dry Bed Training (DBT) programme. The Child Behaviour Checklist (CBCL) questionnaire was completed by 88 parents (96%) prior to DBT (T1) and by 83 parents (91%) 6 mo after DBT (T2). The mean CBCL total problem score at T1: 24.0 (range 2–91, SD 16) was significantly higher than that of a Dutch norm group: 20.45, (p= 0.025). Compared to T1, the mean CBCL total problem score at T2 was 16.8 (range 0–73; SD 14.7; p > 0.0001). Of the children with CBCL total problem scores at T1 in the borderline or clinical range, 92% became dry and 58% improved to the normal range. At T2, the children seemed to have less internal distress, fewer problems with other people, and were less anxious and/or depressed. Conclusion: Children with behavioural/emotional problems who wet their beds need not first be treated for their behavioural/emotional problems. Bedwetting can be treated successfully with DBT when other treatments such as normal alarm treatment have failed, and alarm treatment/DBT can have a positive influence on behavioural/emotional problems.
Findings in familial haemophagocytic lymphohistiocytosis prior to symptomatic presentation
Authors: Hafsteinsdóttir S , Jónmundsson GK , Kristinsson JR , Winiarski J , Henter J‐I , Haraldsson Á 
Published: August 2010

Familial haemophagocytic lymphohistiocytosis (FHL) is a rare, autosomal recessive disease of infancy and early childhood clinically characterized by fever, hepatosplenomegaly, lymphadenopathy, rash, neurological symptoms and icterus. Common laboratory findings include cytopenia, elevated liver enzymes, hyperbiliriubinaemia, hypofibrinogenaemia and hypertriglyceridaemia. The natural killer cell function is frequently decreased or absent. A diffuse lymphohistiocytic infiltration is seen in the reticuloendothelial system, often with haemophagocytosis. Molecular diagnosis is available in a minority of FHL families. Without adequate treatment and bone‐marrow transplantation, the disease is fatal. A 6‐wk‐old child with FHL is presented. Shortly before the clinical onset of the disease, blood testing and bone‐marrow examination had been carried out. All results were considered normal at that time. Conclusion: Blood tests and bone‐marrow examination may be normal shortly before the clinical presentation and therefore do not exclude the diagnosis of FHL. There is a need for extended molecular diagnostic possibilities.
Plasma homocysteine and lipoprotein (a) levels as risk factors for atherosclerotic vascular disease in epileptic children taking anticonvulsants
Authors: Türner L , Serdaroǧlu A , Hasanoǧlu A , Biberoǧlu G , Aksoy E 
Published: August 2010

Aim: To assess the effect of anticonvulsant treatment on plasma homocysteine level and lipoprotein (a) in epileptic children. Methods: Plasma total homocysteine, folate, vitamin B12 and lipoprotein (a) concentrations were measured in 111 epileptic children taking anticonvulsant drugs for longer than 12 mo. Forty‐six healthy, sex‐ and age‐matched children served as controls. Results: Patients and controls differed significantly in concentrations of homocysteine (p > 0.05) and lipoprotein (a) (p > 0.001). The number of patients with homocysteine concentrations of >9 μM was significantly higher in the patient group than in the control group. A significant inverse relationship was found between vitamin B12 folate levels and plasma homocysteine levels in the patient group; 28.8% of the patient group had lipoprotein (a) concentrations above the cutoff value (30mg/dl) for increased risk of early atherosclerosis, whereas none of the control patients had concentrations above this value. Conclusion: These data indicate that prolonged anticonvulsant treatment could increase plasma homocysteine and lipoprotein (a) concentrations and that it may be useful to measure the levels routinely in order to prevent atherosclerosis in epileptic children taking anticonvulsant drugs.
Dietary supplementation of long‐chain polyunsaturated fatty acids in preterm infants: effects on cerebral maturation
Authors: van Wezel‐Meijler G , van der Knaap MS , Huisman J , Jonkman EJ , Valk J , Lafeber HN 
Published: August 2010

Aim: To study the influence of dietary‐supplied long‐chain polyunsaturated fatty acids on structural brain maturation in preterm infants and to investigate parameters of functional brain development, relating them to structural maturation. Other studies have suggested that dietary supplementation of long‐chain polyunsaturated fatty acids in preterm infants may enhance their visual development. The influence on structural brain development has never been evaluated. Methods: In a prospective, double‐blind study, 42 formula‐fed premature infants were randomized to be fed either a standard preterm formula without long‐chain polyunsaturated fatty acids or an identical formula supplemented with docosahexaenoic acid (0.015 g/100 ml) and arachidonic acid (0.031 g/100ml). Infants with significant cerebral damage, retinopathy, chronic disease or feeding problems were excluded. Follow‐up was focused on assessment of cerebral myelination by MRI. Psychomotor, mental and visual development was analysed and flash‐visual evoked potentials were recorded. Results: It was found that progress of myelination, mental and motor development and latencies of visual evoked potentials were not positively influenced by supplementation of long‐chain polyunsaturated fatty acids. At each test age, visual acuity was slightly better in the supplemented infants than in the non‐supplemented infants, but the difference never reached significance level Conclusion: Supplementation of long‐chain polyunsaturated fatty acids did not have a demonstrable positive influence on structural brain maturation. Related to this finding, in this small cohort of preterm infants without significant neurological damage, sample size being restricted by strict inclusion criteria and MRI procedures, no significant positive effects were found on psychomotor, mental and visual development.
Predictors of coping strategy selection in paediatric patients
Authors: Landolt MA , Vollrath M , Ribi K 
Published: August 2010

Aim: To assess the prevalence of specific coping strategies and predictors of coping strategy selection in 179 patients (mean age= 10.2 y). The children were investigated one month after the occurrence of an accident (n= 105), diagnosis of cancer (n= 26) or diagnosis of diabetes mellitus type I (n= 48). Results: Patients used a great variety of coping strategies. The most frequent strategies were cognitive avoidance, positive cognitive restructuring and avoidant actions. The strategies of seeking problem‐focused support and emotion‐focused support were rarely used. Diagnostic category, length of hospital stay, and gender were not associated with coping strategy use. Age, socioeconomic status and functional status of the patient were found to predict coping strategy selection. Younger children made less use of active coping, distraction and seeking support. Patients of lower socioeconomic status used religious coping strategies significantly more often, whereas patients with lower functional status used avoidance and support‐seeking strategies more often. Conclusion: In this study it was found that paediatric patients used a wide variety of coping strategies, irrespective of diagnosis and gender. Age of the child and functional status were the most important predictors of coping strategy selection.
Treatment of children with cystic fibrosis: central, local or both?
Authors: van Koolwijk LME , Uiterwaal CSPM , van der Laag J , Hoekstra JH , Gulmans VAM , van der Ent CK 
Published: August 2010

Owing to a lack of longitudinal studies, the effect of centralization of care on pulmonary function and survival remains unclear. Three different levels of involvement of centralized care in the treatment of paediatric cystic fibrosis patients were compared with regard to longitudinal pulmonary function and nutritional and microbiological status in a 3‐y period, and the literature was reviewed on the possible advantages and disadvantages of centralized care. The study included 105 paediatric patients attending the Cystic Fibrosis Centre between January 1997 and January 2001. Twenty‐three patients were treated by local paediatricians according to the protocol of the Centre and were seen only once a year at the Centre, for an annual check‐up (local care). Forty‐one patients were treated at the Centre only (centralized care). The remaining 41 patients were treated in close cooperation between the Centre and local hospitals, with patients visiting the doctors alternately (shared care). The mean annual changes in pulmonary function and body mass index from all patients, as well as a microbiological survey, were reviewed. No significant differences were found between the three groups for annual changes in FEV1, FVC and body mass index, nor did the review of microbial colonization show any significant differences between the groups. Because the groups in this study were relatively small, the results might have been influenced by lack of power. Conclusion: In this relatively small group, no differences in pulmonary function, nutritional status or microbiological colonization between the three levels of involvement of centralized care could be found. This could signify that local paediatricians have a special role in the care for patients with cystic fibrosis, in close cooperation with the specialists at the Centre.
Urge incontinence and voiding postponement in children: somatic and psychosocial factors
Authors: Lettgen B , von Gontard A , Olbing H , Heiken‐Löwenau C , Gaebel E , Schmitz I 
Published: August 2010

Aim: To analyse the number of urinary tract infections, uroflowmetry, behavioural symptoms and intrafamilial interaction in two groups of daytime wetting children in a paediatric and a child psychiatric unit. Methods: Ninety‐four children with either voiding postponement (52) or urge incontinence (42) were examined prospectively for history of urinary tract infections (UTIs), uroflowmetry, the syndrome scales of the Child Behaviour Checklist (CBCL 4/18‐Achenbach) and the Family Adaptability and Cohesion Evaluation Scales (FACES‐III) (Olson) questionnaire. Results: Children with urge incontinence had a significantly higher rate of previous urinary tract infections (50%) than children with voiding postponement (19.2%; p > 0.001), who showed a high rate of plateau (12.2%) and staccato (20.4%) curves and were characterized by a wide variety of behavioural symptoms, including withdrawn (11.6%), aggressive (11.8%), delinquent (19.6%) behaviour and attention problems (13.7%). Clinically relevant behavioural scores were 4–10 times higher for the voiding postponers, and 2–3 times higher for children with urge incontinence. Furthermore, families of voiding postponers had significantly fewer balanced types of intrafamilial function (FACES‐III). Problematic “rigid/disengaged” and “rigid/separated” types predominated. Conclusion: Urge incontinence is characterized by a higher rate of UTIs, a lower urine volume in uroflowmetry, a lower rate of behavioural scores in the clinical range and well‐functioning families. Voiding postponement children, on the other hand, have a higher, though not significant, rate of abnormal uroflow curves, a wide variety of clinically relevant behavioural symptoms, which were significantly higher for attention and delinquent problems. Conduct problems predominated; only 13.7% of the children had attention problems in the clinical range. The findings lend empirical support to the entity of voiding postponement as an acquired or behavioural syndrome characterized by wetting in association with a delay of micturition and other externalizing conduct problems.
Born small for gestational age: relation to future allergy and asthma
Authors: Hesselmar B , Dahlgren J , Wennergren G , Åberg N , Albertsson‐Wikland K 
Published: August 2010

Aim: To evaluate whether intrauterine growth retardation (IUGR) protects against the development of allergy. Methods: A case‐control study of 1515 subjects (15–25 y), of whom 430 were cases (birthweight/length below – 2 SD for gestational age). Birth data were from the national birth register. The frequencies of allergic diseases were evaluated by questionnaire. Results: For the 950 who replied, the frequencies of allergic diseases were similar in cases and controls. Conclusion: IUGR does not protect against the development of allergy.
Developmental biology of the dendritic cell system
Authors: Schibler KR , Georgelas A , Rigaa A 
Published: August 2010

Aim: To determine whether an imbalance of dendritic cell subsets might contribute to diminished adaptive host responses observed in newborn infants. It was hypothesized that the proportion of lymphoid dendritic cells would be greater than that of myeloid dendritic cells in cord blood. Methods: To investigate this, dendritic cell subsets were evaluated in whole cord blood by flow cytometry. Circulating dendritic cells were also isolated from cord blood based on CD1c and BDCA‐2 expression. Myeloid dendritic cells were also obtained by culturing cord and adult blood monocytes. Surface phenotypes of these cells were determined by flow cytometry using monoclonal antibodies directed against lineage, major histocompatibility, adhesion, co‐stimulation and cytokine receptor molecules. Antigen‐presenting functions of dendritic cell subsets were determined by mixed leukocyte reactions. Results: Circulating myeloid dendritic cells were higher in cord blood than previously reported in adult blood, whereas lymphoid dendritic cell numbers were similar between cord and adult blood. Expression of CD11c, CD45RA and CD45RO did not accurately differentiate between dendritic cell subsets circulating in cord blood. Fresh and culture‐derived cord blood myeloid dendritic cells stimulated adult allogeneic leukocyte proliferation, while lymphoid dendritic cells were less effective inducers of an adult allogeneic leukocyte response. Culture‐derived dendritic cells induced modest autologous cord blood leukocyte proliferation, but freshly isolated myeloid and lymphoid dendritic cells did not stimulated autologous leukocytes. Conclusion: Contrary to the hypothesis, an imbalance in the ratio of circulating myeloid to lymphoid dendritic cell subsets does not exist and, therefore, does not contribute to diminished adaptive immune responses in newborn infants.
Roles of erythropoietin in human milk
Authors: Kling PJ 
Published: August 2010

Erythropoietin (Epo) is one of many biologically active growth factors present in human and animal milk. Accumulating evidence shows important developmental roles for these milk‐borne growth factors. Although Epo is present in biologically relevant amounts in mammalian milk, the roles of Epo in milk are incompletely defined. A significant proportion of milk‐borne Epo resists proteolytic degradation. Epo receptors (EpoR) have been found on gastric mucosa and intestinal mucosa, and in mesenteric vessel endothelium. Evidence to date shows that intact Epo reaches these local organs, as well as distal organs. After feeding Epo, local gastrointestinal physiological effects are seen in suckling rats. In humans and rats, short‐term feeding of high‐dose Epo increases reticulocytes, but it is unclear whether sustained treatment increases red cell mass.Conclusion: Further work towards understanding the physiological and potential pharmacological roles of enterally administered Epo is necessary.SummaryEvidence to date supports the theory that Epo is present in biologically relevant amounts in mammalian milk, is protected from gastrointestinal proteolytic degradation and probably plays a role in local neonatal gastrointestinal development. Animal data show that milk from hypoxic mothers appears to stimulate erythropoiesis better than pharmacological doses of Epo added to normal milk or formula. The lack of efficacy of pharmacological doses of rhEpo in studies to date may be secondary to several factors, including local utilization of the hormone, the need for Epo to work in conjunction with another hematopoietic growth factor in milk, or nutritional factors, such as iron deficiency, interfering with the rhEpo response. Whether milk‐borne Epo plays a significant role in stimulating erythropoiesis is still unclear and more work is necessary to determine the physiological and pharmacological roles of milk‐borne Epo.