bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bradycardic response during submersion in infant swimming
Authors: Goksör E , Rosengren L , Wennergren G 
Published: August 2010

The diving response involves reflex bradycardia, apnoea and peripheral vasoconstriction and is known to exist in human infants. The response diminishes with increasing age and has been reported to disappear by the age of 6 mo. This study was performed to analyse the physiological events during natural diving of full‐term healthy infants and describe how these events alter with maturation. Thirty‐six infants were studied during diving exercises in infant swimming. All of the infants who participated showed an immediate decrease in heart rate when submerged. On average, the heart rate decreased by 25% (range –5.0% to –50.7%, p < 0.0001). The bradycardia was sustained during the dive and for some seconds afterwards. The response was often followed by a tachycardia as the bradycardia ceased. A decline of reflex bradycardia was observed with increasing age (p= 0.03), but the response was still clearly evident in infants over the age of 6 mo. Conclusion: This study demonstrates the existence of a diving response in infants, which includes an immediate bradycardic response, suggesting vagal mediation. Although the bradycardic response gradually decreases, the study shows that a clear‐cut response exists in children older than has previously been reported.
Seizures in paediatric Chiari type I malformation: the role of single‐photon emission computed tomography
Authors: Iannetti P , Spalice A , De Felice Ciccoli C , Bruni O , Festa A , Maini CL 
Published: August 2010

Chiari type I malformation is one of the posterior fossa maldevelopments with which different clinical manifestations have been associated. Seizures have only recently been associated with Chiari type I malformation. This study reports on 4 children with epilepsy (2M, 2F; age range 8–15 y) diagnosed with Chiari type I malformation by brain magnetic resonance imaging (MRI), in whom no cortical structural involvement was observed. In these patients an interictal ethylcysteinate‐dimer‐single‐photon emission computed tomographic (ECD‐SPECT) study was performed to define more precisely the relationship between Chiari type I malformation and seizures. In these patients the hypoperfusion area correlated with electroencephalographic (EEG) focal abnormalities. These hypoperfusion s may represent the functional aspect of a cerebral microdysgenesis; seizures and EEG epileptic anomalies may also be linked to the complex network connection between cortices and cerebellar hemispheres. A cerebellar hypoperfusion was also detected in two of the four examined patients, indicating a functional or structural involvement. Conclusion: Interictal SPECT scans are helpful for the clarification of seizures in patients with Chiari type I malformation.
Smoking, nicotine and tar and risk of small for gestational age babies
Authors: Mitchell EA , Thompson JMD , Robinson E , Wild CJ , Becroft DMO , Clark PM , Glavish N , Pattison NS , Pryor JE 
Published: August 2010

Aims: To assess the effect of maternal smoking and environmental tobacco smoke (ETS) on risk of small for gestational age infants (SGA). Methods: Case‐control study of 844 cases and 870 controls. Results: Maternal smoking in pregnancy was associated with an increased risk of SGA (adjusted odds ratio (OR) = 2.41; 95% confidence interval (CI) = 1.78, 3.28). We could not detect an increased risk of SGA with paternal smoking, or with other household smokers when the mother was a non‐smoker, but did find an increased risk with exposure to ETS in the workplace or while socializing. Infants of mothers who ceased smoking during pregnancy were not at increased risk of SGA, but those who decreased but did not stop remained at risk of SGA. There was no evidence that the concentration of nicotine and tar in the cigarettes influenced the risk of SGA. Conclusions: Maternal smoking in pregnancy is a major risk factor for SGA. This study suggests that mothers should be advised to cease smoking completely during pregnancy, and that a reduction in the number of cigarettes smoked or smoking low tar or nicotine concentration cigarettes does not reduce the risk of SGA.
Socioeconomic environmental factors and hospitalization for acute bronchiolitis during infancy
Authors: Jansson L , Nilsson P , Olsson M 
Published: August 2010

Bronchiolitis is a major cause of hospitalization during infancy. The aim of this study was to evaluate the influence of socioeconomic factors on the hospitalization of infants with bronchiolitis. All infants below 1 y of age living in the city of Malmö, Sweden, and hospitalized at the University Hospital, Malmö, owing to bronchiolitis during the years 1998 and 1999 were identified. The bronchiolitis hospitalization rates (BHRs) were determined for the infants living in each of the 10 different administrative residential areas of Malmö and correlated with socio‐economic factors (percentage of immigrants, per capita income, unemployment rate and households receiving social benefit) in the respective residential areas. The severity of the disease on admission and during hospital care was assessed by comparing oxygen saturation, days with supplemental oxygen and length of stay. BHR varied more than fourfold between the 10 residential areas. BHR varied significantly with per capita income and the percentage of immigrants. Infants living in the area with the highest social burden were hospitalized almost twice as often as those from the rest of the city, but the severity of disease was similar. Conclusion: The association between socioeconomic factors and hospitalization indicates that these factors may have a significant influence on the hospitalization rate in bronchiolitis during infancy.
Quality of life in paediatric inflammatory bowel disease measured by a generic and a disease‐specific questionnaire
Authors: Loonen HJ , Grootenhuis MA , Last BF , Koopman HM , Derkx HHF 
Published: August 2010

This study assessed the impact of inflammatory bowel disease (IBD) on the health‐related quality of life (HRQoL) of children and adolescents, using both a generic and a disease‐specific instrument. Three questionnaires were sent to all patients (8–18 y old) from the database of two large secondary/tertiary hospitals in the western part of The Netherlands. In total, 83 (66%) children responded, 18 were between 8 and 12 y old and the remaining 65 were older. HRQoL was measured using a generic instrument, the TNO‐AZL Children's Quality of Life questionnaire (TACQOL), assessing seven domains, and the Impact‐II (NL), a disease‐specific instrument assessing six domains. Disease activity was measured by a five‐item symptom card. Compared with scores from a large reference population (n= 1810), younger children with IBD had a comparable HRQoL (measured by the TACQOL) on six domains, and better cognitive functioning, although they did not have severely active disease. Adolescent patients with IBD had a significantly impaired HRQoL on four domains (body complaints, motor functioning, autonomy and negative emotions). The Impact‐II discriminated well between patients with varying disease activity states on all domains. Conclusion: Adolescents with IBD have a severely affected HRQoL. Impairment on motor functioning and autonomy is a threat to gaining independence from caregivers, and a high occurrence of negative emotions places patients at risk for depressive and behavioural disorders. The Impact‐II is recommended for clinical use because of its high discriminative validity.
Effect of early skin‐to‐skin contact after delivery on duration of breastfeeding: a prospective cohort study
Authors: Mikiel‐Kostyra K , Mazur J , Boltruszko I 
Published: August 2010

Aim: To study the influence on breastfeeding of skin‐to‐skin contact after birth. Methods: Using a prospective cohort study design, a group of 1250 Polish children was investigated with 3 y follow‐up. Results: The implementation of the practice significantly increased mean duration of exclusive breastfeeding by 0.39 mo and overall breastfeeding duration by 1.43 mo. The infants kept with the mothers for at least 20 min were exclusively breastfed for 1.35 mo longer and weaned 2.10 mo later than those who had no skin‐to‐skin contact after delivery. The skin‐to‐skin contact after birth significantly coexisted with the other hospital practices supportive to breastfeeding, especially rooming‐in without separation longer than 1 h per 24 h [relative risk (RR) = 3.18, 95% confidence interval (95% CI): 2.34–4.31] and first breastfeeding within 2 h after birth (RR = 2.94, 95% CI: 2.36–3.67. Multivariate analysis performed by a general linear model with duration of exclusive breastfeeding as the dependent variable indicated skin‐to‐skin contact and mother education as two independent variables influencing the duration of exclusive breastfeeding. Conclusion: The results indicate that extensive mother‐infant skin‐to‐skin contact lasting for longer than 20 min after birth increases the duration of exclusive breastfeeding.
Waist circumference for the screening of the metabolic syndrome in children
Authors: Moreno LA , Pineda I , Rodriguez G , Fleta J , Sarria A , Bueno M 
Published: August 2010

Aim: To identify the best anthropometric predictor of the metabolic syndrome in children. Methods: Screening performance was evaluated in a clinical setting. The study included 140 children: 72 non‐obese and 68 with non‐syndromal obesity. Body mass index (BMI), waist circumference and triceps/subscapular skinfolds ratio were used as predictor variables, and systolic blood pressure, diastolic blood pressure, glucose, uric acid, fasting insulin, triglycerides and HDL‐C as metabolic syndrome variables. Results: The areas under the receiver operating characteristic (ROC) curves were 0.849 (95% CI: 0.780,0.919) for BMI, 0.868 (95% CI: 0.801,0.934) for waist circumference and 0.834 (95% CI: 0.757,0.910) for the triceps/subscapular skinfolds ratio. No statistically significant differences were found for the three areas under the ROC curves. The point on the ROC curve closest to 1 corresponded to the 65th percentile for BMI, to the 70th percentile for waist, and to the 40th percentile for the triceps/subscapular skinfolds ratio. Conclusion: Waist circumference seems to be the best predictor of children with the metabolic syndrome in paediatric clinical settings.
Abnormal heart rate response to hypercapnia in boys with an apparent life‐threatening event
Authors: Edner A , Ericson M , Milerad J , Katz‐Salamon M 
Published: August 2010

Aim: To determine instantaneous cardiac variability responses to increased carbon dioxide (CO2) during quiet sleep in infants who may be at risk for the Sudden Infant Death syndrome (SIDS). Methods: The cardiac rate variability before, during and after a CO2 challenge was examined in 41 infants who had experienced an apparent life‐threatening event (ALTE) and 41 gender‐ and age‐matched control infants. Results: The ALTE infants responded to CO2 breathing with a significant increase in R‐R intervals, i.e. decreases in heart rate, compared to the controls (45.1% increase in R‐R intervals vs. 41.4%; p= 0.005). The differences between ALTE infants and controls depended primarily on the boys' responses. Conclusion: ALTE infants, particularly ALTE boys, have an autonomic dysfunction—lower sympathetic stimulation and/or inhibited vagal withdrawal when stressed with CO2. The outcome might provide clues to the mechanisms underlying the cardiovascular processes contributing to the terminal event in SIDS.
Supplementary oxygen and risk of childhood lymphatic leukaemia
Authors: Naumburg E , Bellocco R , Cnattingius S , Jonzon A , Ekbom A 
Published: August 2010

Aim: Childhood leukaemia has been linked to several factors, such as asphyxia and birthweight, which in turn are related to newborn resuscitation. Based on the findings from a previous study a population‐based case‐control study was performed to investigate the association between childhood leukaemia and exposure to supplementary oxygen and other birth‐related factors. Methods: Children born in Sweden and diagnosed with lymphatic leukaemia between 1973 and 1989 (578 cases) were individually matched by gender and date of birth to a randomly selected control. Children with Down's syndrome were excluded. Exposure data were blindly gathered from antenatal, obstetric and other standardized medical records. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated by conditional logistic regression. Results: Resuscitation with 100% oxygen with a facemask and bag immediately postpartum was significantly associated with an increased risk of childhood lymphatic leukaemia (OR = 2.57, 95% CI 1.21–6.82). The oxygen‐related risk further increased if the manual ventilation lasted for 3 min or more (OR = 3.54, 95% CI 1.16–10.80). Low Apgar scores at 1 and 5 min were associated with a non‐significantly increased risk of lymphatic leukaemia. There were no associations between lymphatic leukaemia and supplementary oxygen later in the neonatal period or other birth‐related factors. Conclusion: Resuscitation with 100% oxygen immediately postpartum is associated with childhood lymphatic leukaemia, but further studies are warranted to confirm the findings.
Rhinitis in 10‐year‐old children and early life risk factors for its development
Authors: Arshad SH , Kurukulaaratchy RJ , Fenn M , Waterhouse L , Matthews S 
Published: August 2010

Aim: To study the prevalence, characteristics of and risk factors for childhood rhinitis. Methods: In a whole population birth cohort study (n= 1456) the prevalence and characteristics of rhinitis among 10‐y‐old children were examined. At this age 1373 children (94%) completed standardized questionnaires, 1043 (72%) skin‐prick testing, 953 (65%) serum inhalant immunoglobulin E antibody screening and 784 (54%) methacholine bronchial challenges. Results: At the age of 10 y the prevalence of hayfever ever was 18.6% and current nasal symptoms (rhinitis) 22.6%. Rhinitis at 10 y was largely seasonal and associated with low morbidity, although 62.7% of cases required pharmacological treatment. Atopy (positive skin test) and other allergic states were associated with rhinitis (p > 0.001). Wheeze or diagnosed asthma was higher with coexistent rhinitis. Among wheezing children physician‐diagnosed asthma (p > 0.024) and inhaled corticosteroid use (p > 0.001) were greater with the presence of rhinitis. Significant bronchial hyperresponsiveness (methacholine concentration giving a 20% fall in forced expiratory volume in 1 s >4.0 mg ml‐1) was greater if rhinitis was present even when the child did not wheeze (p > 0.001). Risk factor analysis for rhinitis identified the independent significance for atopy (p > 0.001) and eczema (p= 0.009) at the age of 4 y plus paternal rhinitis (p > 0.001), maternal rhinitis (p= 0.033) and maternal food allergy (p= 0.016). Conclusion: Rhinitis is common at the age of 10 y, with strong associations with atopy, wheezing, asthma and bronchial hyperresponsiveness. An inherited predisposition towards atopy appears to predominate over environment in the aetiology of this state.
Measurement error associated with spinal mobility measures in children with and without low‐back pain
Authors: Jones MA , Stratton G , Reilly T , Unnithan VB 
Published: August 2010

Aim: Evidence of the reliability of measurements in children is scarce, particularly in children with low‐back pain. The aim of this investigation was to evaluate the measurement error associated with repeated measures of spinal mobility measures in children with and without low‐back pain by establishing 95% limits of agreement. Methods: A repeated measures study was performed involving 119 children aged 11–16 y. Of this sample 30 subjects reported recurrent low‐back pain and were classified as symptomatic, the remaining 89 subjects were asymptomatic. Standardized measures were taken, including the sit‐and‐reach test, hip range of motion (Leighton flexometer), lumbar flexibility (modified Schöber test) and lateral flexion of the spine. The same experimenter performed all testing, with 1 wk between the repeated measures. Results: Correlation coefficients suggested that all measures exhibited good reliability in both the symptomatic (r= 0.80–0.95) and asymptomatic groups (r= 0.88–0.99). In contrast, the limits of agreement showed that all measures exhibited random error. The magnitude of random error was typically greater in the symptomatic subjects, suggesting that low‐back pain may influence the reliability of typical measures used in this population. Conclusion: The magnitude of error must be interpreted in relation to analytical goals and the expected magnitude of change. In the authors' opinion the error presented appears acceptable for the serial monitoring of patients, although this will depend on the differences in mobility typically found.
First information and support provided to parents of children with Down syndrome in Sweden: clinical goals and parental experiences
Authors: Hedov G , Wikblad K , Annerén G 
Published: August 2010

When parents are informed that their newborn child has Down syndrome (DS), they often respond with a traumatic crisis reaction. The aims of this study were to assess the clinical goals regarding the first information and support provided to parents of newborn children with DS at the Swedish paediatric departments, and to analyse the parents' experiences of how they were first informed and treated. Data were collected during 1992–1993 from all of the 51 departments of paediatrics in Sweden. Information on the parents' experiences, collected retrospectively in 1996, was based on recollection by 165 parents of 86 children with DS born between 1989 and 1993 at 10 of the paediatric departments considered representative for Sweden. Seventy‐five percent of the families were informed about the diagnosis within 24 h post partum. Some parents felt they were informed too late, and a few parents that they were told too soon. Half of the parents were satisfied with the timing. About 70% of the parents considered the information insufficient and 60% felt that they had been unsupported. Seventy percent would have liked more frequent information. Parental criticisms concerning the way in which the information was provided were that they received too much negative information about DS and that both the communication skills and the basic knowledge of DS on the part of the professionals could have been better. Conclusion: The Swedish paediatric departments fall short of their reported strong clinical goals regarding the initial information in Sweden, and improvements in this area are desirable.
Cytokine response in cerebrospinal fluid from preterm infants with posthaemorrhagic ventricular dilatation
Authors: Sävman K , Blennow M , Hagberg H , Tarkowski E , Thoresen M , Whitelaw A 
Published: August 2010

Aim: Posthaemorrhagic ventricular dilatation (PHVD) is closely associated with white matter damage and neurological disability in the preterm infant. Proinflammatory cytokines have been implicated in the pathogenesis of white matter injury and subsequent cerebral palsy. The aim of this study was to determine the levels of proinflammatory cytokines in cerebrospinal fluid (CSF) from preterm infants with PHVD and to correlate the levels to white matter damage and neurodevelopmental outcome. Methods: CSF samples were obtained from 24 preterm infants with expanding PHVD and 19 preterm infants with normal ultrasound. Tumour necrosis factor‐α (TNF‐α), interleukin‐β (IL‐1β), interleukin‐8 (IL‐8) and interferon‐γ (IFN‐γ) in CSF were measured by enzyme‐linked immunosorbent assay, and IL‐6 was measured by bioassay. Results: The concentrations of TNF‐α, IL‐1β, IL‐6 and IL‐8 were significantly elevated in CSF from infants with PHVD. TNF‐α was detected in 43% of PHVD infants and 11% of controls (p= 0.04). IL‐1β was detected in 67% of PHVD infants and 0% of controls (p > 0.0001). The concentrations of IL‐6 were 368 (145–460) pg ml‐1 in the PHVD group and 30 (25–41) pg ml‐1 in the control group (p > 0.0001), and those of IL‐8 were 3000 (1620–3400) pg ml‐1 in the PHVD group and 35 (0–230) pg ml‐1 in the control group (p > 0.0001). Cytokine concentrations did not correlate with white matter lesions on ultrasound, shunt dependence or neurological outcome within the PHVD group. Conclusion: There was an intense and prolonged inflammatory reaction in CSF from preterm infants with PHVD and a high risk for subsequent white matter injury and permanent neurological impairment.
Large variability in Performance IQ associated with postnatal morbidity, and reduced Verbal IQ among school‐aged children born preterm
Authors: Gabrielson J , Hård A‐L , Ek U , Svensson E , Carlsson G , Hellström A 
Published: August 2010

Aim: To assess cognitive ability in a population‐based group of prematurely born school‐aged children and to relate these findings to postnatal morbidity. Method: The study group consisted of a cohort of 51 children born preterm, 43 (26 boys, 17 girls) of whom were available for psychological evaluation At evaluation, their median age was 10 y (range 8–11 y). They were all born between 1988 and 1991, with gestational age less than 29 wk (median 27, range 24–28). Their median birthweight was 1060 g (range 450–1450). The Wechsler Intelligence Scale for Children (WISC‐III) was used, and the test results were compared with those of a standardized, age‐matched, normative group of children. Results: Thirteen children (30%) performed below average [intelligence quotient (IQ) >80] for Full Scale IQ (FSIQ). Thirty‐six children had a Verbal IQ (VIQ) below the mean value of 100 [84%, 95% confidence interval 73–95%], p > 0.0001. The Performance IQ (PIQ) was within the expected range of a normal population, although a large variability was observed. Discrepancies between VIQ and PIQ of more than 15 IQ units were found in 42% of the children. High postnatal morbidity (days with assisted ventilation, number of blood transfusions) and low birthweight standard deviation scores (SDS) were associated with lower PIQ than VIQ, while low postnatal morbidity and high birthweight were associated with higher PIQ than VIQ. Conclusion: This cohort of preterm children had reduced overall verbal capacity independent of morbidity, and a large variability in performance capacity that was associated with postnatal morbidity. The findings suggest that there are different mechanisms influencing the outcome of verbal and performance capacity in preterm children.