bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Centers for Disease Control and Prevention 2000 growth charts and the growth of breastfed infants
Authors: de Onis M , Onyango AW 
Published: August 2010

Aim: To evaluate the performance of the 2000 Centers for Disease Control and Prevention (CDC) growth charts in comparison with the National Center for Health Statistics/World Health Organization (NCHS/WHO) reference as a tool for assessing growth in healthy breastfed infants. Methods: Weight and length measurements were obtained from a pooled longitudinal sample of 226 healthy breastfed infants. Weight‐for‐age (WA), length‐for‐age (LA) and weight‐for‐length (WL) z‐scores based on the CDC and NCHS/WHO references were computed for each child. Age‐specific mean z‐scores and proportions below and above specific cut‐off points were calculated. Results: Breastfed infants grow more rapidly in the first 2 mo of life and less rapidly from 3 to 12 mo in relation to the CDC WA curves. Similarly, breastfed infants experience greater linear growth than the CDC median until age 4 mo. Thereafter, the mean LA z‐score declines until month 9. Apart from a 1‐mo difference in the time when linear growth begins to falter, the pattern of growth is remarkably similar when compared with the two references. The growth trajectories indicate that infants in the CDC reference are heavier and shorter than the NCHS/WHO reference population. Combining the two measurements as WL reveals that higher weight overrides lower length in the CDC versus the NCHS population, thus the estimated prevalence of wasting is higher by the CDC reference. Conclusion: As was the case when compared with the NCHS/WHO reference, there are notable differences in the growth trajectory of breastfed infants examined against the CDC reference. A reference based on healthy breastfed infants is required if the growth patterns of infants following international feeding recommendations are to be correctly assessed.
Late relapse of adrenocortical carcinoma in Beckwith‐Wiedemann syndrome. Clinical, endocrinological and genetic aspects
Authors: Hertel NT , Carlsen N , Kerndrup G , Pedersen IL , Clausen N , Hahnemann JMD , Jacobsen BB 
Published: August 2010

We report on a girl with an unusual Beckwith‐Wiedemann syndrome (BWS) and hemihypertrophy, who developed an adrenocortical carcinoma with atypical clinical behaviour. At 4 y of age the girls was admitted to hospital with cushingoid features, virilization, increased excretion of steroids and low serum ACTH. A right‐sided adrenocortical carcinoma was removed. At age 12.5 y the cushingoid features reappeared together with a tumour in the left thigh. A CT scan of the thorax and abdomen revealed pulmonary metastasis only. Corticosteroid excretion was increased and serum ACTH level suppressed. The femoral and the pulmonary metastases were removed and histology showed adrenocortical carcinoma. Excretion of corticosteroids subsequently normalized. Meningeal and pulmonary metastases with similar histologies appeared one year later with normal hormone values. Twenty‐two months after the recurrence the girl died of an intracranial metastasis. Southern blot analysis of the LIT1 transcript in the KvLQT1 gene in the BWS region on chromosome 11p15 revealed hypomethylation of the maternal allele. Conclusion: Adrenocortical carcinoma in childhood may recur years after onset and at rare sites and hormonal levels may be an insufficient indicator of small metastases.
Treatment of children with Osteogenesis imperfecta in Estonia
Authors: Maasalu K , Haviko T , Märtson A 
Published: August 2010

Aim: To analyse the changes in fracture rate, bone density and histology in children with Osteogenesis imperfecta receiving treatment with alendronate (oral bisphosphonate) and calcitriol. Methods: Children treated at Tartu University Hospital from 1995 to 2001 were examined for Osteogenesis imperfecta. Radiographs and bone density measurements were obtained for all patients at the beginning of the study. Four patients also had bone biopsies prior to and one year after beginning treatment. The children were then given alendronate in weight‐dependent dosages and also calcitriol. The number of fractures during the treatment period was recorded and follow‐up bone density measurements were made. Results: Fifteen patients were treated during the 6‐y period; mean follow‐up approximately 3 y. It was found that the number of bone fractures had decreased significantly (p < 0.0001). Bone density improved in all 15 patients. Histologic studies revealed an increased number of osteoblasts and thickness of bone trabeculae as well as a more regular bone lamellar structure at the time of the second operation. Conclusion: The complex treatment of Osteogenesis imperfecta should include alendronate and calcitriol to decrease fractures and improve bone mineral density.
Calprotectin levels in meconium
Authors: Laforgia N , Baldassarre ME , Pontrelli G , Indrio F , Altomare MA , Di Bitonto G , Mautone A 
Published: August 2010

Aim: To evaluate the effect of gender, gestational age, birthweight, mode of delivery, 5′‐Apgar score and maternal conditions on calprotectin concentrations in meconium. Methods: Calprotectin was measured in 131 neonates, in the first passed meconium. Results: Calprotectin levels (mean ± SD) resulted in 145.2 ± 78.5 mg kg−1 meconium, significantly correlated with birthweight (r=–0.333; p < 0.001), gestational age (r =–0.206; p = 0.018) and 5′‐Apgar score (r= ‐0.243, p= 0.035). The estimated regression model was: calprotectin levels (mg kg−1) = 269.58–41.54 weight (kg); r = 0.383, p < 0.001. No differences were found in relation to gender, mode of delivery and maternal conditions. Conclusion: Calprotectin is already present in the first passed meconium, with higher levels in preterm and low birthweight neonates, as well as in neonates with some degree of perinatal asphyxia, as indicated by the negative correlation with 5′‐Apgar score. These findings are probably secondary to both the immaturity of the intestinal mucosa and its hypoxic‐ischaemic damage.
Seasonality of growth and the relationship between weight and height gain in children under three years of age in rural Malawi
Authors: Maleta K , Virtanen SM , Espo M , Kulmala T , Ashorn P 
Published: August 2010

Aim: To describe the seasonal pattern of growth and analyse the relationship between weight and height gain in children under 3 y of age. Methods: A population‐based cohort of 767 children was prospectively followed from birth until 36 mo of age in rural Malawi, southeast Africa. Weight and height measurements were collected at monthly intervals until 18 mo of age and quarterly thereafter. Gains in weight and height and prevalence of malnutrition in different seasons were calculated. The relationship between weight and height gain was analysed using a series of correlation analyses. Results: Both weight gain and linear growth velocity showed an age‐dependent seasonal pattern. After infancy, periods of maximal or minimal height increments systematically occurred 3 mo after those for weight gain. The prevalence of malnutrition also followed a seasonal pattern, peaking a few months after periods of reduced growth. Despite the overall pattern, weight gain and subsequent linear growth were not correlated on an individual level. At any point, however, a child's weight for height was directly, albeit weakly, correlated to height gain in the subsequent 3‐mo interval. Conclusion: Growth of children under 3 y of age followed an age‐dependent seasonal pattern. The poor correlation between children's weight and height increments suggests that seasonality affected weight gain and linear growth through different mechanisms.
Carnitine‐acylcarnitine translocase deficiency: case report and review of the literature
Authors: Rubio‐Gozalbo ME , Vos P , Forget PPh , Van Der Meer SB , Wanders RJA , Waterham HR , Bakker JA 
Published: August 2010

Aim: Carnitine‐acylcarnitine translocase (CACT) deficiency is an inborn error of metabolism involving the mitochondrial beta‐oxidation of long‐chain fatty acids. The aim of this study was to report on a new case (neonatal phenotype) and review the literature data on 24 previously reported cases. Methods: Clinical data of the new case are described and compared with the previous reports. Results: The patient with a novel mutation had clinical features and biochemical findings similar to those of the other reported patients. Conclusion: CACT is an entity in which clinical encephalopathy, hepatomegaly and arrythmias are common. Hyperammonaemia and elevation of creatine kinase seem to be constant findings as in other disorders of mitochondrial beta‐oxidation of long‐chain fatty acids. The mortality rate is very high.
Splenic abscess caused by group A β‐haemolytic streptococcus
Authors: Chang K‐W , Chiu C‐H , Jaing T‐H , Wong H‐F 
Published: August 2010

A case of a pyoderma complicated with splenic abscess and bacteraemia caused by group A streptococcus was treated successfully with antibiotics alone for 4 weeks. To our knowledge, this is the first reported case of splenic abscess associated with group A streptococcal bacteraemia. Advances in antibiotic therapy and imaging techniques have improved the management and outcomes of splenic abscesses. Clinicians should be aware of the possibility of splenic abscess after a pyoderma or a sepsis‐like episode. Conclusion: Splenic abscesses can be diagnosed by serial ultrasound or CT scan examinations and should be treated with antibiotics for 4–6 weeks.
Detection of interferon‐γ‐inducible chemokines in human milk
Authors: Takahata Y , Takada H , Nomura A , Nakayama H , Ohshima K , Hara T 
Published: August 2010

Aim: To assess the immunological role of human milk by analysing the concentrations of interferon‐γ‐inducible protein of 10kda (IP‐10) and monokine induced by interferon‐γ (MIG) in human milk from mothers of preterm and term infants.Methods: IP‐10 and MIG levels of colostrum, early milk, mature milk and sera were measured by enzyme‐linked immunosorbent assay (ELISA). IP‐10 and MIG mRNA expression levels in cellular components of human milk were determined by RT‐PCR. IP‐10 and MIG protein expression in mammary gland tissues was analysed by immunohistochemistry.Results: Significant amounts of IP‐10 and MIG were detected in human milk. The concentrations of IP‐10 and MIG in colostrum and early milk were significantly higher than those of sera from healthy controls or lactating mothers. These chemokine concentrations in colostrum and early milk were significantly higher than those of mature milk. Premature delivery or pregnancy complications of mothers had no significant correlation with these chemokine concentrations in breast milk. There were significant correlations between MIG and interferon‐γ (IFN‐γ) or IP‐10 levels (p< 0.001) in human milk. Expression of IP‐10 and MIG genes and proteins in the milk cells as well as in mammary gland epithelial tissues was detected by RT‐PCR and immunohistochemistry.Conclusion: IP‐10 and MIG in human milk, probably derived from milk cells and mammary gland epithelial cells, may contribute to the migration and activation of intestinal T lymphocytes to enhance mucosal immunity during the early neonatal period.
Orlistat treatment in obese prepubertal children: a pilot study
Authors: Norgren S , Danielsson P , Jurold R , Lötborn M , Marcus C 
Published: August 2010

Aim: This study investigated orlistat treatment in obese prepubertal children with regard to tolerance, safety and psychological well‐being. Methods: 11 healthy, severely obese prepubertal children (age 8.3–12.3 y, body mass index standard deviation score 5.3–9.2) were recruited for a 12wk open treatment. Before, during and after treatment, the participants were investigated by psychological evaluation, blood chemistry, and parameters reflecting obesity and fat mass. Results: The participants were able to comply with the treatment, as indicated by pill counts and self reports, and expressed a desire to continue the treatment after the study period. Gastrointestinal side effects were mild and tolerable. No negative effects on psychological or physical well‐being were detected, and the psychological evaluation demonstrated increased avoidance of fattening food, body shape preoccupation and oral control (p= 0.011). The median weight loss was 4.0 kg (range –12.7 to +2.5 kg, p= 0.016) and was highly correlated to decreased fat mass (regression coefficient 0.953, p < 0.01). Conclusion: This pilot study indicates that obese prepubertal children were able to reduce their fat intake to avoid gastrointestinal side effects. Thus, orlistat may be suitable as a component in behaviour‐modification programmes for obese children, and the results prompt a placebo‐controlled investigation of its effectiveness in promoting weight loss.
Azithromycin in the treatment of cholera in children
Authors: Bhattacharya MK , Dutta D , Ramamurthy T , Sarkar D , Singharoy A , Bhattacharya SK 
Published: August 2010

Aim: To evaluate the efficacy of azithromycin in the treatment of cholera in children. Methods: A double‐blind, randomized, controlled clinical trial on 80 children with acute watery diarrhoea and moderate to severe dehydration compared the efficacy of azithromycin and erythromycin in treating cholera. Data were analysed for 56 patients who were stool culture positive for Vibrio cholerae. In conjunction with rehydration therapy, 29 patients received azithromycin and 27 patients received erythromycin. Patients in the two treatment groups had comparable clinical and blood biochemical characteristics on admission. Results: Patients who received azithromycin had significantly less stool output, shorter duration of diarrhoea and lower fluid intake compared with patients who received erythromycin. Conclusion: Azithromycin appears to be superior to erythromycin for treating cholera in children.
Decreased bone mineral density in normal‐growing patients with cystic fibrosis
Authors: Gronowitz E , Garemo M , Lindblad A , Mellström D , Strandvik B 
Published: August 2010

Aim: To study bone mineral density (BMD) in normal‐growing patients with cystic fibrosis (CF) and its relation to clinical and biochemical markers of nutrition and lung function. Methods: Seventy consecutive patients aged 6–49 y with CF were investigated using dual X‐ray absorptiometry and the findings related to anthropometric data. Energy intake was calculated and basal metabolic rate and serum values for calcium, phosphorus, calcitonin and 25(OH) calcidiol measured. Working capacity, lung function and pseudomonas colonization were determined as parameters of physical fitness and severity of pulmonary disease. Results: The average z‐score of BMD was decreased in the lumbar spine in both children and adults, being –0.7 ± 1.0 and –0.5 ± 1.0, respectively, as was the femoral neck BMD z‐score, being –0.3 ± 0.9 and –1.1 ± 1.0 for children and adults, respectively. BMD was correlated to lung function and working capacity, but not to anthropometric data at multiple regression analysis compensating for age and calcitonin. No correlation was found with energy intake, basal metabolic rate or biochemical markers, with the exception of calcitonin. Conclusion: BMD z‐scores were significantly lower than those in the normal population despite normal anthropometry. Osteoporosis was rare. The strongest correlation was found with lung function. Our data indicate that BMD at all ages might be a sensitive indicator of the general status of patients with CF.
Aspects of activities and participation in daily life related to body structure and function in adolescents with obstetrical brachial plexus palsy: a descriptive follow‐up study
Authors: Strömbeck C , Fernell E 
Published: August 2010

Aim: To analyse whether activities and participation in daily life differed between adolescents with obstetrical brachial plexus palsy (OBPP) and their able‐bodied peers. Method: Fifty‐one teenagers born in 1985–1987 with OBPP and a comparison group consisting of 116 age‐matched adolescents in a socioeconomically and socioculturally representative area answered a self‐report questionnaire concerning their daily life, school performance and friendships. The OBPP group was divided into three functional groups according to the degree of severity of the OBPP. Results: Subjects with OBPP had interests, activities and a social life very similar to those of the teenagers in the comparison group. Differences were, however, found in self‐esteem for sport/motor activities, with self‐esteem being significantly lower in teenagers with the most severe type of OBPP. The OBPP groups were concerned about the risks for their affected and unaffected limb. Conclusion: In our society, adolescents with OBPP report a typical teenage life today. However, the indications for distress and worry related to the disability have to be considered
Nutritional status of mentally retarded children in north‐west Spain. I. Anthropometric indicators
Authors: Sánchez‐Lastres J , Eirís‐Puñal J , Otero‐Cepeda JL , Pavón‐Belinchón P , Castro‐Gago M 
Published: August 2010

Aim: To evaluate the nutritional status of mentally retarded children in the region of Galicia in north‐west Spain, on the basis of anthropometric variables. Methods: The following variables were determined in a sample of 128 mentally retarded children (81 M, 47 F): birth weight, body weight, height/length, head circumference, mid‐arm circumference, mid‐arm muscle circumference, triceps skinfold thickness, subscapular skinfold thickness, arm area, arm muscle area, arm fat area, arm lean‐to‐fat ratio, Shukla's nutrition index and Quetelet's body mass index (BMI). A preliminary statistical analysis indicated that most information content could be maintained considering only eight of these variables. A factor analysis of the resulting 8 × 128 (variables by subjects) data matrix was performed, identifying two factors (FA1 and FA2) that together explained 82% of total variance. Taking these factors as indicators of nutritional status, the data were analysed for possible effects of age, gender, socioeconomic and family environment, intelligence quotient (IQ), presence/absence of cerebral palsy, quality of diet, appetite and antiepileptic use. Results: The analysis suggested that most subjects were in the normal nutrition range, but about 33% showed either borderline or definite malnutrition. Mean score on FA2 showed a significant negative correlation with age. Children with cerebral palsy had lower mean scores on both factors, and scores on both factors varied with IQ. Children with definite malnutrition had a significantly lower IQ than those in the normal nutrition range. Mean score on both factors varied with appetite and quality of diet. The mean FA1 score of children from inland‐rural areas was significantly lower than that of children from coastal or urban areas. Mean FA1 score increased with increasing age of the parents. The prevalence of obesity was 13% when obesity was defined on the basis of Shukla's nutrition index, and 19% when defined on the basis of FA1 score. Conclusion: Malnutrition as revealed by anthropometric variables occurs with a high prevalence among mentally retarded children. The prevalence increases with age, increasing IQ deficit and cerebral palsy.
Automotive child restraint systems in Northeastern Italy
Authors: Valent F , Barbone F 
Published: August 2010

Aim: To evaluate the use of automotive restraint systems among children in Northeast of Italy and to describe parental knowledge and reasons for either use or non‐use. Methods: This population survey included subjects recruited at three Vaccination Services serving approximately 24000 children aged 0–12 y. From March 8, 2002 to June 7, 2002 parents of children being vaccinated were asked to complete a self‐administered structured questionnaire. A total of 1093 questionnaires were collected. Data were analysed using contingency tables, χ2 tests, and multivariable logistic regression. Results: Although 98% of children were restrained when riding in a car, less than 90% were using the restraint system appropriate to their body size, and 38% of parents were making some errors in the way they transported their children. Parents of children ≥3 y of age were significantly more likely to make errors. Less than half of the respondents had ever received any information on child restraint systems and it was found that being given information significantly reduced the likelihood of parents making errors when transporting children. Conclusion: Many children ride unrestrained or inappropriately restrained in cars. Parents should be provided with information on child restraint systems in order to decrease the frequency of incorrect child transportation. Special attention should be devoted to the parents of children ≥3 y of age.
Paediatric utilization of a general emergency department in a developing country
Authors: Goh AY , Chan TL , Abdel‐Latiff ME 
Published: August 2010

Aim: Knowledge of the spectrum and frequencies of paediatric emergencies presenting to an emergency department (ED) of individual developing countries is vital in optimizing the quality of care delivered locally. Methods: A prospective 6 wk review of all paediatric (< 18y) attendees to an urban ED was done, with patient age, presenting complaints, diagnoses, time of arrival and disposition recorded. Results: Complete data were available on 1172 patients, with an age range of 4 d to 18 y (mean ± SD 6.9 ± 5.6 y); 43% were aged ≤4 y. The main presenting complaints were injuries (26.9%), fever (24%) and breathing difficulties (16.6%). The most common diagnosis was minor trauma (24.2%), with soft‐tissue injuries predominating (80.6%). The other diagnoses were asthma (12.6%), upper respiratory infections (12.1%), other infections (12.1%) and gastroenteritis (11.8%). Equal proportions of patients were seen throughout the day. 25% of patients were admitted. Young age (<1 y); presence of past medical history, general practitioner referrals, diagnosis of bronchiolitis and pneumonia were significantly associated with risk of admission. Conclusion: A wide spectrum of paediatric illnesses was seen in the ED, with an overrepresentation of young children. This supports the decision to have either a separate paediatric ED or paediatric residents on the staff. The training curricula should emphasize the management of paediatric trauma, infections and asthma. Alternatively, developing guidelines for the five most common presenting complaints would account for 82% of all attendees and could be directed towards all staff on the ED.
Successful thrombolysis by prolonged low‐dose alteplase in catheter‐directed infusion
Authors: Ruud E , Holmstrøm H , Aagenæs I , Hafsahl G , Handeland M , Kyte A , Brosstad F 
Published: August 2010

Catheter‐directed thrombolysis is a sophisticated method in the treatment of thromboembolism with maximum effect on the thrombus and minimal systemic effect. The consequences are enhanced local thrombolysis and a reduction in general bleeding tendency, compared with systemic thrombolysis. At our institution, two children had successful thrombolysis by prolonged continuous catheter‐directed low‐dose alteplase. The first patient, a boy with Fontan physiology, was successfully treated for a massive pulmonary thromboembolism by catheter‐directed very low‐dose alteplase for five days. The second patient, who suffered from relapsing nephrotic syndrome, achieved satisfactory thrombolysis of an arterial leg thrombosis after four days of continuous catheter‐directed low‐dose alteplase. Conclusion: Although catheter‐directed thrombolysis seems to be a valuable method in thrombolytic therapy, there is a lack of evidence‐based recommendations concerning dosage, effect of bolus, simultaneous anticoagulation and duration of treatment for children.