bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neonatal Escherichia coli infections: concerns regarding resistance to current therapy
Authors: Friedman S , Shah V , Ohlsson A , Matlow AG 
Published: August 2010

Currently recommended antibiotic treatment of suspected neonatal sepsis is ampicillin and an aminoglycoside. Recently, we observed increasing ampicillin and gentamicin resistance in strains of Escherichia coli isolated from neonates at our institution. We therefore reviewed clinical and laboratory records of all neonates with systemic infection, hospitalized from 1994 through 1998, from whom E. coli was isolated from blood and/or cerebrospinal fluid. The influence of perinatal variables (e.g. rupture of foetal membranes > 24 h, group B Streptococcus (GBS) colonization, urinary tract infection during pregnancy and the use of antepartum and/or intrapartum antibiotics), and neonatal variables (e.g. gestational age, age at onset of sepsis (early: 72h, late: >72h), number of E. coli septic recurrences, and associated underlying medical and/or surgical conditions) on antimicrobial susceptibilities of invasive E. coli isolates was studied. Twenty‐three neonates with invasive E. coli infection were identified; most [19 (83%)] presented as late‐onset sepsis (LOS). Ampicillin‐resistant E. coli were isolated in 75% and 53% of neonates in the early‐ and late‐onset groups, respectively. Gentamicin resistance was found in 50% of early‐onset sepsis (EOS) isolates compared with 16% in the late‐onset group. Isolates from two neonates with EOS were resistant to both ampicillin and gentamicin. One neonate with EOS and three with LOS had recurrent E. coli sepsis; all isolates were ampicillin‐resistant and one was gentamicin‐resistant. All these neonates were initially treated with ampicillin and gentamicin. Both groups had associated underlying medical and/or surgical conditions (50% early‐onset, 47% late‐onset). Maternal GBS colonization occurred in 2 (50%) versus 3 (16%) of EOS and LOS cases, respectively. All GBS colonized women received intrapartum ampicillin prior to delivery.Conclusions: Ampicillin and gentamicin resistance is emerging in neonatal E. coli isolates from invasive infection. Current empiric management of neonatal sepsis requires re‐evaluation given changing antimicrobial susceptibilities.
Umbilical artery catheter blood sampling decreases cerebral blood volume and oxygenation in very low birthweight infants
Authors: Roll C , Hüning B , Käunicke M , Krug J , Horsch S 
Published: August 2010

The aim of this study was to assess whether blood sampling from umbilical artery catheters reduces cerebral blood volume and cerebral oxygenation in very low birthweight infants. A total of 20 infants, median birthweight 890 g (530‐1500 g), median gestation age 26 +4 wk (range: 22 +5 to 30 +6 wk) were studied from 10min before until 10min after routine blood sampling from umbilical artery catheters placed in the high position. Using near infrared spectroscopy, changes in concentrations of cerebral oxygenated and deoxygenated haemoglobin were measured, and changes in cerebral blood volume and cerebral oxygenation index were calculated. Heart rate, oxygen saturation, transcutaneous PO2 and PCO2 were registered continuously. Mean arterial blood pressure was measured before and after sampling. Oxygenated haemoglobin decreased significantly from baseline during blood sampling, whereas deoxygenated haemoglobin did not change significantly. This resulted in a decrease in cerebral blood volume and cerebral oxygenation index. Heart rate increased slightly, but significantly, from baseline. Oxygen saturation, blood pressure, transcutaneous PO2 and PCO2 did not change significantly.Conclusion: Blood sampling from umbilical artery catheters induces a significant decrease in cerebral blood volume and cerebral oxygenation.
Plasma immunoreactive endothelin levels in children with cystic fibrosis
Authors: Siahanidou T , Nikolaidou P , Doudounakis S , Georgouli E , Kanavakis M , Papadimitriou A , Karpathios Th 
Published: August 2010

Plasma immunoreactive endothelin levels were determined in 31 children and adolescents with cystic fibrosis and it was examined whether these levels correlated with the severity of the disease. The study comprised 16 cystic fibrosis patients (mean (SD) age 13.0 (4.9) y) with impaired lung function (Group A), 15 cystic fibrosis patients (11.2 (5.5) y) with unimpaired lung function (Group B) and 28 healthy controls (10.6 (4.3) y) (Group C). The selection and classification of patients into groups was based on criteria including the grade of finger‐clubbing, the Brasfield chest radiograph score and spirometric and arterial blood gas values. In all subjects, plasma immunoreactive endothelin, atrial natriuretic peptide, renin, serum aldosterone levels and serum and urine electrolytes were measured.Conclusions: Plasma endothelin levels were significantly higher in Group A (range 2.5‐8.4 pg/ml, median 3.2 pg/ml) than those in Group B (1.3‐3.8 pg/ml, median 2.0 pg/ml,p<0.001) and Group C (1.5‐3.5 pg/ml, median 2.5 pg/ml,p<0.001), whereas they did not differ between groups B and C. They correlated positively with the severity of finger‐clubbing, heart rate, arterial blood PCO2, plasma atrial natriuretic peptide levels and serum aldosterone levels and negatively with the arterial blood PO2, forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1) and the Brasfield chest radiograph score. In multivariate regression analysis PO2was the only independent factor found to significantly affect plasma endothelin levels. In conclusion, plasma immunoreactive endothelin levels are increased in cystic fibrosis patients with impaired pulmonary function and are related to the severity of the disease.
Gastric emptying of solids is delayed in celiac disease and normalizes after gluten withdrawal
Authors: Perri F , Pastore M , Zicolella A , Annese V , Quitadamo M , Andriulli A 
Published: August 2010

Several gastrointestinal motor abnormalities have been detected in patients with celiac disease, but it is unclear whether they are able to influence the gastric emptying rate. The aim of this work was to evaluate the gastric emptying rate of solids in children with celiac disease before and after a gluten‐free diet. Nine children with celiac disease and nine healthy controls (age range 4‐16 y) underwent a 13C‐octanoic acid breath test to measure gastric emptying. Half emptying time (t1/2) and lag phase (tlag) were calculated. After 6 mo of a gluten‐free diet, all celiac children underwent a repeat 13C‐octanoic acid breath test. The gastric motility parameters, t1/2 and tlag, were significantly longer in patients than in controls. No significant correlation between abnormal gastric emptying and specific symptom patterns or severity of histological damage was found. On a gluten‐free diet, the gastric emptying rate normalized in all celiac patients. This finding supports the hypothesis that gluten‐driven mucosal inflammation might determine motor abnormalities by affecting smooth muscle contractility or impairing the release of neurotransmitters. Alternatively, nutrient malabsorption might determine significant changes in intraluminal milieu, which, in turn, may affect intestinal motor functions. Conclusion: patients affected by celiac disease have a markedly delayed gastric emptying of solids, which returns to normal after gluten withdrawal.
Diagnostic test meal in childhood enteropathy using simultaneous carbohydrate and fat loading
Authors: Ejderhamn J , Nemeth A , Strandvik B 
Published: August 2010

The diagnostic value of a combined test meal consisting of glucose, D‐xylose and dairy cream was studied in 230 infants and children with gastrointestinal symptoms. The simultaneous absorption of the three compounds was rated according to their serum concentrations at different times 0‐240 min after intake and compared to the histological changes of jejunal biopsy specimens. Conclusion: The results showed that the simultaneous loading test had higher specificity and sensitivity than D‐xylose alone in patients with subtotal villous atrophy.
Assessment of eating behaviours and attitudes to eating, dieting and body image in pre‐adolescent Swedish girls: a one‐year follow‐up
Authors: Halvarsson K , Lunner K , Sjöden P‐O 
Published: August 2010

A 1‐y follow‐up of fifty 8‐y‐old Swedish girls was performed to assess changes in eating attitudes and dieting behaviour. Individual structured interviews using the Children's Eating Attitudes Test (ChEAT) and Body Image silhouettes were used. The question, “Have you ever tried to lose weight?” was employed to discriminate dieters from non‐dieters. Dieting behaviours according to the ChEAT increased over the follow‐up period. Conclusion: Discrimination between dieters and non‐dieters on the basis of a single question is highly unstable. A classification based on repeated assessment appears to be more promising.
Investigation of the transport of trace elements across barriers in humans: studies of placental and mammary transfer
Authors: Rossipal E , Krachler M , Li F , Micetic‐Turk D 
Published: August 2010

The barrier function of the human mammary gland for selected trace elements was evaluated by analysing 27 maternal sera and corresponding colostrum samples for 14 trace elements. To investigate the impact of the human placenta at the end of gestation on the transfer of 17 trace elements from the mother to the baby, 29 maternal and corresponding umbilical cord sera (UCS) were studied. The uptake of trace elements from the UCS by the fetus was investigated in nine pairs of arterial and venous UCS. In colostrum, the concentration of Cu was 19%, of Se 47%, of Co 80%, of Mg 146%, of Ca 222%, of Sn 228%, of Mn 275%, of Mo 814%, and of Zn 1470% of that of the maternal sera. For Cd and Pb the corresponding values were 200% and 325%, respectively. These data show that the mammary gland can exert an activating as well as an inhibiting effect on the trace element transfer. A concentration gradient mode of action for the transfer of Li, Mo and Sr could be found. In UCS the concentration of Cu was 20%, of Se 55%, of Co 60%, of Sn 85%, of Mo 100%, of Mg 105%, of Ca 120%, of Zn 148%, and of Mn 150% of that of the maternal sera. The corresponding values for Cd were 66% and for Pb 50%. Conclusions: These findings indicate that the placenta can exhibit an activation or inhibition on transfer as well as a gradient mode of action as for Mo, Cs, Li and Sr. The uptake of essential trace elements from venous UCS by the unborn ranged from 2.5% for Ca to 16.7% for Mo. Both the placenta and the mammary gland can exert an activating, inhibiting or gradient mode of action for selected trace elements, the biological impact of which needs to be further elucidated.
Cervical lymph node infections with non‐tuberculous mycobacteria in preschool children: interferon gamma deficiency as a possible cause of clinical infection
Authors: Nylén O , Berg‐Kelly K , Andersson B 
Published: August 2010

Epidemiological studies have demonstrated a prevalence of positive PPD reactions to non‐tuberculous mycobacteria (NTM) in 9% of 4–5‐y‐old children in the Göteborg area. Very few children of this age develop suppurative infections in lymph nodes that require surgical procedures. The hypothesis was that these children might have T cell deficiencies with abnormalities of macrophage functions, particularly with type 1 cytokines. Twenty‐four children who needed operations were investigated immunologically and compared to 10 children of the same age operated on for non‐infectious reasons. The methods used were flow cytometry analysis of lymphocytes in blood, blood lymphocyte stimulation assays and interferon gamma analyses. The patients had significantly lower levels of interferon gamma than the controls after stimulation with Candida antigens or Con A. The numbers of T and B lymphocytes were higher in patients than in controls. Conclusion: Children with necrotic lymph node infections in the cervical region due to NTM had lower interferon gamma production after stimulation than healthy age‐matched controls.
Comparison of self‐administration and face‐to‐face interview for surveys of low back pain in adolescents
Authors: Staes F , Stappaerts K , Vertommen H , Nuyens G , Coppieters M , Everaert D 
Published: August 2010

The aim of this study was to compare self‐administration with face‐to‐face interview in the investigation of low back pain in adolescents. Fifty‐seven adolescents with low back pain (mean age 17.3 y; range 16–18) first completed a questionnaire and were then invited to an interview. Analysis included item completion, percentages of agreement and weighted kappa. Item completion rates were high and comparable between self‐administration and interview. Information between both methods was analogous for severity and localization of problems, sleep behaviour, medical consultation and sports/leisure activities. Onset, progression, duration of low back pain and some items on the influence of movement/positions presented less comparable data. Conclusion: Even when two different methods of data acquisition are used, results suggest that the method used does not change the interpretation of results in the case of most items.
Downregulatory cytokines in tracheobronchial aspirate fluid from infants with chronic lung disease of prematurity
Authors: Jonsson B , Li Y‐H , Noack G , Brauner A , Tullus K 
Published: August 2010

Chronic lung disease of prematurity (CLD) is associated with an inflammatory response in the preterm lung and increased levels of proinflammatory cytokines in tracheobronchial aspirate fluid (TAF). We investigated TAF levels of transforming growth factor‐ß1(TGF‐ß1), interleukin‐10 (IL‐10), interleukin‐4 (IL‐4) and interleukin‐12 (IL‐12) cytokines possibly important in downregulating the proinflammatory response and/or inducing lung fibrosis in infants with developing and established CLD. Infants with CLD (n = 24) were compared with preterm infants with RDS that resolved (n = 22) and postoperative infants without lung disease (n= 23). TAF levels of TGF‐ß1, IL‐10, IL‐4 and IL‐12 were studied by quantitative enzyme immunoassay. Levels of TGF‐ß1 were significantly higher during the first week of life in infants who developed CLD, remained high at 2 wk and past 4 wk of age. TAF levels of TGF‐ß1 did not decrease significantly in six infants with CLD after treatment with steroids. TAF IL‐10 was detected in 12/46 (26%) preterm infants. Infants with CLD or RDS were more likely to have measurable TAF levels of IL‐10, compared with the postoperative infants without lung disease (p < 0.02 and 0.04, respectively). TAF levels of IL‐4 or IL‐12 were below the detection limits in all samples. Conclusions: We have demonstrated a sustained increase of TGF‐ß1 levels in TAF from preterm infants who develop CLD, suggesting an important role for TGF‐ß1 in the fibrotic response in the CLD lung. The elevated TGF‐/J1 levels, combined with an absent or irregular secretion of IL‐4, IL‐10 and IL‐12, can have importance for the increased tendency for the development of CLD in preterm infants.
A future for neonatal α1‐antitrypsin screening?
Authors: Sveger T , Thelin T 
Published: August 2010

A WHO expert group recommends neonatal screening for α1‐antitrypsin deficiency (α1ATD). Homozygous α1ATD PiZZ occurs in 1 in 5000 of the U.S. Caucasian population and up to 1 in 500 individuals of the European population, with a large regional variation. It is a risk factor that predisposes mainly to liver disease in early infancy and emphysema in early adulthood. Most importantly, smoking decreases the duration of the asymptomatic phase and life expectancy by 10‐20 y. The Swedish α1AT screening programme and subsequent information and advice prevented the majority of adolescents from starting to smoke. The involved parents and α1ATD adolescents retrospectively recommended neonatal screening. Potential advantages of neonatal α1AT screening are: early diagnosis and treatment of neonatal liver disease, optimal treatment of fever and bacterial infections theoretically preventing liver cell damage, genetic advice and information about the consequences of passive and active smoking. Potential advantages of postponing screening until age 11‐12 y are: identification of α1ATD close to the age when smoking may start, and possibility for the child to take part in the screening decision. Disadvantages of α1AT screening are: psychosocial reactions–the mother probably being most vulnerable in the neonatal period–and discrimination by insurance companies and employers.Important uncertainties are: lack of knowledge concerning participation in a voluntary α1AT screening, psychosocial reactions and the efficacy of anti‐smoking advice if the information is given to school‐age children and families. Thus the question whether and when to screen for α1ATD is still the topic of lively debate.
High total antioxidant activity and uric acid in tracheobronchial aspirate fluid of preterm infants during oxidative stress: an adaptive response to hyperoxia?
Authors: Vento G , Mele MC , Mordente A , Romagnoli C , Matassa PG , Zecca E , Zappacosta B , Persichilli S 
Published: August 2010

The effect of O2 exposure, expressed by mean daily fractional inspired oxygen concentration (FiO2), was evaluated during the first 6 d of life in the tracheobronchial aspirate fluid of 16 mechanically ventilated preterm infants in terms of both antioxidant response and oxidative damage, by measuring total antioxidant activity, uric acid concentrations and protein carbonyl content. Each day linear regression analysis was performed and a positive correlation was found between total antioxidant activity and FiO2 during the study period, especially on day 2 of life (r= 0.91, p < 0.0001), but uric acid correlated only in the first 3 d, especially on the 2nd day (r= 0.83, p < 0.0001). No correlation was found between carbonyl content and FiO2. The highest values of total antioxidant activity (416 and 790 μmol l−1) were found in 2 babies ventilated with highest FiO2: 1 and 0.80, respectively. Total antioxidant activity was not detectable or was very low in the babies not requiring O2 therapy. The highest value of uric acid (270 μmol l−1) was found in the baby ventilated with 100% oxygen. Uric acid concentrations obtained in these babies were much higher then those reported in the bronchoalveolar lavage fluid of adults.Preterm babies seem to have an antioxidant response in the tracheobronchial aspirate fluid following an oxidative stress and uric acid may be physiologically important as an antioxidant of the respiratory tract, especially during the first days of life.
Recurrent pain symptoms in children and parents
Authors: Borge AIH , Nordhagen R 
Published: August 2010

Recurrent pain in five different areas (stomach, arms & legs, head, back and neck & shoulders) in a population of 348 school children and their parents has been investigated. The study presented here is restricted to 229 mother‐father‐child trios. Forty‐four percent of the children reported pain in at least one area compared to 60% of the mothers and 51% of the fathers. Headache and pains in arms and legs were most common in boys. The most frequent pain sites for girls were head and back. Overall, girls complained more than boys. No significant associations between complaints in parents and their children were demonstrated, analysed by logistic regression analysis. Furthermore, there was no significant association between the reported pain in the mother and father. Conclusion: Children's pain did not associate with parental pain in this study. The results do not support previous hypotheses that recurrent pain clusters in families.
Diagnosis and prognosis of wheezing disorders in young children in the city of São Paulo, Southeast Brazil
Authors: Cardoso MRA , Cousens SN , Alves FM , Ribeiro MMM , Neto BP Abreu 
Published: August 2010

Three‐hundred‐and‐ninety‐seven children aged 2–59 mo presenting to the paediatric emergency departments of five public hospitals in São Paulo, Brazil, with an acute episode of lower respiratory disease were examined. The children were classified into the following diagnostic categories: acute bronchitis, acute bronchiolitis, pneumonia, asthma, post‐bronchiolitis wheezing and wheezing of uncertain aetiology. Three years after the initial study, the homes of the children diagnosed as asthmatic or as having wheezing of uncertain aetiology were visited to collect information on subsequent episodes of lower respiratory disease. This paper reports the proportional incidence of different categories of lower respiratory disease and the results of an analysis to investigate clinical features that might distinguish wheezing children between those with asthma and those with an infectious disease. The predictions made for children with wheezing of uncertain aetiology were then compared with the follow‐up data. Recurrent wheezing disorders (asthma, post‐bronchiolitis wheezing) were common in the study sample (47% of children). Thirty‐six percent of children with an initial diagnosis of wheezing of uncertain aetiology were diagnosed as asthmatic by another doctor over the next 3 y. We were unable to identify any clinical features that were useful in identifying those children likely to be diagnosed subsequently as asthmatic. Conclusions: The use of a diagnostic category similar to that which we have called “wheezing of uncertain aetiology” might help to alert physicians early to the possibility of asthma without interfering in the management of the illness. Such a classification might also be useful in epidemiological investigations of the aetiology of lower respiratory diseases.
Quality of evidence for the present Swedish child health surveillance programme
Authors: Bremberg S 
Published: August 2010

The present Swedish health surveillance programme includes 15 examinations by a nurse, 5 examinations by a physician, 7 assessments of development, 2 assessments of hearing and 1 assessment of visual acuity. The WHO criteria for evaluation of screening programmes can be applied to the Swedish health surveillance programme. These criteria state that the health problem must be important, that there should be an early phase during which the condition is only detectable by medical professionals and that treatment at an early phase should favourably affect the prognosis. The quality of evidence for fulfilment of these criteria has been graded I‐III. Grade II‐2 refers to evidence obtained from well‐designed cohort or case‐control analytical studies. The following disorders might be affected by health surveillance at child health centres: amblyopia, ADHD/DAMP, failure to thrive, cerebral palsy, congenital heart failure, congenital luxation of hip, hearing impairment (severe or moderate), mental retardation, retentio testis and hydrocephalus. None of these conditions fulfils the WHO criteria with quality of evidence grade II‐2 or better.Thus, the evidence for the present Swedish health surveillance programme is problematic.