bluuebunny/crossref_metadata_2025_split huggingface dataset:
A placebo‐controlled trial of low‐dose erythromycin to promote feed tolerance in preterm infants
Authors: Oei J , Lui K 
Published: August 2010

The aim of this study was to assess the efficacy of erythromycin, a motilin agonist, in promoting enteral feed tolerance in preterm infants of ±32 wk gestation. Eligible infants were randomized to receive either low‐dose (2.5 mg kg−1 per dose 6 hourly) oral erythromycin ethylsuccinate or placebo for 10 d from the time of the first oral feed. The data from 22 erythromycin and 21 placebo infants were analysed. Birthweights (erythromycin 1216 ± 380 g, placebo 1355 ± 228 g, p= 0.25), gestation (erythromycin 28.6 ± 2.2 wk, placebo 29.3 ± 1.7 wk, p= 0.24) and other clinical variables were not different between the groups. Almost all infants were fed expressed breast milk. Erythromycin infants had significantly fewer episodes of large residual gastric aspirates (>30% of the previous 6 h worth of feeds) over 10 d (erythromycin 1.1 ± 1.9, placebo 3.6 ± 2.2 episodes, p= 0.0007). Infants in the erythromycin group achieved full oral feeds more quickly (6.0 ± 2.3 vs 7.9 ± 3.5 d, p= 0.04). There were no significant differences between the groups with regard to the number of days on total parenteral nutrition or to the time needed to regain birthweight. One enrolled infant from each group died of necrotizing enterocolitis.Conclusion: Low‐dose erythromycin promoted gastric emptying and feed tolerance in premature infants at a lower gestational age than previously reported. Increased exposure to broad‐spectrum antibiotics may not be free of risk. Further studies are recommended to assess its efficacy in premature infants with established feed intolerance.
Inhaled corticosteroids for maintenance treatment in childhood pulmonary sarcoidosis
Authors: Kiper N , Anadol D , Ouzçelik U , Göçmen A 
Published: August 2010

We present our experience with sequential oral and inhaled corticosteroid therapy in childhood pulmonary sarcoidosis. Fifteen children were followed‐up for a mean of 7y. Treatment consisted of oral prednisolone 2mg/kg/d on initial diagnosis. After remission was reached, alternate day therapy with 1 mg/kg was continued. The dose was tapered to a maintenance dose which controlled the activity of the disease. When patients were free of symptoms and had no clinical and laboratory findings, inhaled corticosteriod treatment was started. Relapse treatment consisted of cessation of inhaled corticosteroids and start of oral corticosteroids at a dosage of 2 mg/kg/d and then a tapered dose. Five patients were given oral corticosteroids only. Nine patients were given inhaled steroids after oral corticosteroid therapy had been discontinued. Clinical and radiological remissions were achieved in every patient.Conclusion: Sequential oral and inhaled corticosteroid therapy may be an alternative treatment regimen for sarcoidosis in children.
Association between maternal pre‐existing or gestational diabetes and health problems in children
Authors: Åberg A , Westbom L 
Published: August 2010

There is general consensus that children of women with pre‐existing diabetes mellitus (PDM) have an increased risk of malformations and neurodevelopmental problems. Whether this is also true for children of women with gestational diabetes mellitus (GDM) is a matter of debate. This study investigated inpatient hospital care up to 10 y of age of children born to GDM and PDM women as a rough estimate of child morbidity. Hospital care of children born to 82 684 GDM women, 3874 PDM women and 1213 957 controls was compared by linking the Swedish Medical Birth Registry with the Hospital Discharge Registry. Similar comparisons were performed in a local well‐controlled group of 326 children born to GDM women in the Lund area. Children of PDM women and to a lesser degree children of GDM women had a statistically significant increase in hospitalizations, evident at least up to 10 y of age. Significantly increased risks of hospitalization were found for neurological/developmental disorders [odds ratio (OR) 2.30 and 1.36 for PDM and GDM, respectively)], malformations (OR 2.05 and 1.23), infections (OR 1.56 and 1.20) and accidents (OR 1.32 and 1.14). Conclusion: The high hospitalization rates of these children indicate an increased morbidity, including neurodevelopmental disorders.
Infantile genetic agranulocytosis, morbus Kostmann: Presentation of six cases from the original “Kostmann family” and a review
Authors: Carlsson G , Fasth A 
Published: August 2010

In 1956 Rolf Kostmann reported on six children with severe neutropenia associated with a block in myelopoiesis at the promyelocyte/myelocyte stage and an autosomal recessive inheritance. He named the new syndrome infantile genetic agranulocytosis. Today it is known as Kostmann's syndrome or severe congenital neutropenia. In 1975 an additional 10 cases from northern Sweden were published. This article reports on the only long‐term survivor from the 1975 report plus another five patients born after 1975 who belong to the original “Kostmann family”. Treatment and survival have changed dramatically since Kostmann's first publication. In the pre‐antibiotic era, Kostmann's syndrome was inevitably fatal during the first year of life. Conclusion: Since the introduction of recombinant human granulocyte colony‐stimulating factor (G‐CSF) about 10 y ago, most patients now enjoy a normal life span and a greatly improved quality of life. Although the threat of death has disappeared, patients still have problems with infections, especially chronic gingivitis and periodontitis. In other groups of severe neutropenia, not related to the original “Kostmann family”, an increased incidence of myeloid leukaemia has been observed. However, in this small cohort none of the children on chronic G‐CSF therapy have developed malignancies.
Danaparoid sodium (Orgaran®) in four children with heparin‐induced thrombocytopenia type II
Authors: Zöhrer B , Zenz W , Rettenbacher A , Covi P , Kurnik K , Kroll H , Grubbauer HM , Muntean W 
Published: August 2010

We report on four children with heparin‐induced thrombocytopenia type II. In three patients, therapy with unfractionated heparin was associated with development of cardiac thrombi or with thrombosis progression up to the inferior vena cava or with aggravation of peripheral arterial occlusion. In the fourth child, the disease was recognized early on, and no complication occurred. Heparin‐induced thrombocytopenia type II was confirmed by heparin‐induced platelet activation assay and/or heparin/platelet factor 4‐ELISA. Concomitant elevated antiphospholipid antibodies were seen in all patients. Danaparoid sodium applied at a dosage of between 1.2 and 7.1 U/kg/h stopped the disease progression in each patient. Three children had a clinical recovery with partial recanalization, but for the child with peripheral arterial occlusion disease, amputation of some of the toes became necessary. Conclusion: Our data indicate that heparin‐induced thrombocytopenia type II is a potential life‐ threatening disease in children and danaparoid sodium is beneficial in this age group.
Ventilatory responses to rebreathing in infants exposed to maternal smoking
Authors: Campbell AJ , Galland BC , Bolton DPG , Taylor BJ , Sayers RM , Williams SM 
Published: August 2010

This study assessed the effect of maternal smoking during pregnancy on ventilatory and waking responses of infants to a respiratory challenge. This challenge mimicked the time‐course and concentration of gases that an infant would experience rebreathing face‐down into soft bedding. Control (C;n= 97) and smokers' infants (SM;n= 96) were studied at ages 1 and 3 mo. Asphyxial gas (hypercapnia/hypoxia) was delivered to the supine sleeping baby via a hood by slowly altering the inspired air: CO2maximum 5% and O2minimum 13.5%. Respiratory pattern was recorded by inductive plethysmography as the sum of ribcage and abdominal movements. The change in ventilation with inspired CO2was measured over 5–6 min of the test. The slope of a linear curve fit relating inspired CO2to the logarithm of ventilation was taken as a quantitative measure of ventilatory asphyxial sensitivity (VAS). Protective responses were graded from 1: no waking and an estimated arterial carbon dioxide tension (PaCO2) ±60mmHg (least protective), to 4: fully awake (most protective). The results showed VAS was higher in SM infants than controls: +0.03 (p= 0.04). The oxygen saturation (SaO2) of SM infants fell ‐0.4% (p= 0.02) more thanSaO2of controls despite a greater tidal volume increase: +13.0% (p= 0.04). Overall protective responses were the same between groups, but grade 1, although rare, was found in 7 SM infants and only 4 control infants; this difference was not significant.Conclusion: The study did not confirm the postulate that infants of mothers who smoked during pregnancy have a reduced ventilatory response or raised waking thresholds.
Water‐miscible tocopherol is not superior to fat‐soluble preparation for vitamin E absorption in cystic fibrosis
Authors: Soltani‐Frisk S , Gronowitz E , Andersson H , Strandvik B 
Published: August 2010

Vitamin E deficiency is a major problem in cystic fibrosis. Modern pancreatic enzymes may improve the absorption of fat‐soluble vitamins to make water dispersion less important. In order to compare the absorption of fat‐soluble (F) and water‐miscible (W) tocopheryl acetate, equivalent amounts (10 mg/kg body weight) were given to five patients with cystic fibrosis (CF) and five age‐and sex‐matched healthy controls. Serum was analysed for vitamin E using HPLC before and 1, 2, 3, 4, 6, 8, 10, 24 and 28 h after the oral intake. The median peak concentrations in the sera of controls were 41.9 μmol/L after F and 39.8 μmol/L after W preparations, corresponding values in CF patients being 21.3 and 26.8 μmol/L, and corresponding means ± SD were 41.6 ± 6.7 and 38.4 ± 3.3, and 27.1 ± 14.5 and 28.8 ± 8.3, respectively. Although the area under the curve was lower for W than F preparations in both CF patients and controls, these differences were not significant.Conclusion: The results in our study are consistent with those of an earlier study using the same preparation and suggest that it is not necessary to use water‐miscible preparation of α‐tocopheryl acetate in CF patients receiving modern pancreatic enzyme supplementation.
Pain assessment in children with juvenile chronic arthritis: a matter of scaling and rater
Authors: Berntson L , Svensson E 
Published: August 2010

Twenty‐six children with juvenile chronic arthritis and their parents participated in the study. We compared the assessments of pain perceived by the children on a visual analogue scale (VAS) with assessments on a 4‐point verbal descriptor scale (VDS‐4). In children aged 10 y and older, the pain assessment results of the children and the parents were compared. The discordance in paired data from the scale comparisons and from the inter‐rater comparisons was evaluated using a statistical method developed for ordinal data. The preference of scale and motivation of the older children were summarized. Conclusion: The parents and children used the VAS and the VDS‐4 differently. The children showed a higher inter‐scale discordance compared with the parents and they gave their pain a higher rating on the VAS but a lower rating on the VDS‐4 than their parents. The VAS was preferred by the children but did not show the most reliable results.
Behavioural correlates of early‐treated congenital hypothyroidism
Authors: Kooistra L , Stemerdink N , van der Meere J , Vulsma T , Kalverboer AF 
Published: August 2010

Parents' and teachers' ratings were used to evaluate the behavioural characteristics of children with early‐treated congenital hypothyroidism (CH). Comparisons were made between 63 children with early‐treated CH and 34 healthy controls at the ages of 7.5 and 9.5 y. Additional comparisons were made between the two largest CH subgroups (thyroid agenesis, thyroid dysgenesis) and controls. The most marked differences were found on the introversion cluster and the motor clumsiness scale within it. Children with CH, particularly those with thyroid agenesis, showed introversion and motor clumsiness rather than social negativity and inattention. It is suggested that this behavioural profile may well have its origins in the often‐reported inefficient motor behaviour of these children. Results are discussed in the light of recent findings suggesting an association between thyroid hormone problems and attention deficit hyperactivity disorder. Conclusion: Early‐treated CH is associated with introversion rather than with social negativity.
Adjustment and intelligence among children with phenylketonuria in Sweden
Authors: Lundstedt G , Johansson A , Melin L , Alm J 
Published: August 2010

In this investigation we present a recent survey of treatment effects among 8 to 19‐y‐old Swedish children and youths with phenylketonuria (PKU). The results from intelligence tests and a questionnaire comprising four scales, work capacity, social competence, and internalising and externalising problems, were used. Severity of disease, early treatment, and contemporary phenylalanine levels were assessed. The results showed that development of the patients' intelligence was normal. Adjustments were rated by the patients, their parents and their teachers, and the results were compared with those of a healthy reference group. The PKU patients did not differ from the reference group except for externalising problems judged by the children themselves. None of the patients with PKU showed signs of externalising problems in contrast to the reference group, where such behaviour was observed. Patients with severe PKU, however, showed less social competence compared with patients with a milder form of the disease, according to their own and their parents’ratings. Phenylalanine level in blood tests was in accordance with treatment norms, although the teenagers had higher levels of phenylalanine than the younger patients.Conclusion: Normal intelligence and adjustment is found among patients with PKU when plasma phenylalanine levels are within treatment norms.
Acute postnatal increase of extracellular antioxidant defence of neonates: the role of iron metabolism
Authors: Szabó M , Vásárhelyi B , Balla G , Szabó T , Machay T , Tulassay T 
Published: August 2010

In this study we investigated the extracellular antioxidant capacity of neonates during the first two postnatal days and its association with iron metabolism. Cord blood and blood samples at 47 ± 6 postnatal hours were taken from 10 healthy neonates and their antioxidant capacity was determined using Randox Antioxidant kits and the heme‐specific antioxidant activity (HSAA). Randox indicates the chain‐breaking antioxidant capacity; HSAA corresponds to the ability to limit lipid peroxidation. Iron, ferritin and transferrin levels were also measured. Randox and HSAA values were 30% higher, ferritin was 100% higher and iron was 60% lower postnatally. The amount of change in HSAA values correlated with the change in ferritin level (r= 0.67, p < 0.05). Conclusion: These results suggest that extracellular antioxidant capacity (both chain‐breaking and heme‐specific antioxidant activities) increases shortly after birth. Lower iron and higher ferritin levels could also be responsible for this phenomenon.
Brain‐specific proteins in the cerebrospinal fluid of severely asphyxiated newborn infants
Authors: Blennow M , Sävman K , Ilves P , Thoresen M , Rosengren L 
Published: August 2010

Upcoming trials of neuroprotective strategies in severely asphyxiated newborn infants emphasize the need for early and objective markers of both good and bad long‐term prognosis. Traditional markers such as neurological depression and seizures are not specific. Aim: To study whether measurement in the cerebrospinal fluid of some proteins known to be specific to the central nervous system was in covariance with the clinical course and long‐term prognosis. Methods: Twenty‐two asphyxiated infants were included in the study and compared with a control group of 8 infants without signs of perinatal asphyxia. Cerebrospinal fluid (CSF) was collected during the first 4 d of life and analysed for neurofilament protein (NFp), glial fibrillary acidic protein (GFAp), protein S‐100 and neuron‐specific enolase (NSE). Results: The concentrations of all four proteins were significantly increased in the CSF of asphyxiated infants. The concentrations correlated significantly with other indicators of long‐term prognosis and to neurological impairment at 1 y of age, or death before that time. Specifically, concentrations were excessively high in the five infants who died. Conclusions: High concentrations of brain‐specific proteins are released into the CSF of asphyxiated infants. It might therefore be useful to measure these concentrations when excluding patients with the gravest prognosis from neuroprotective trials.
Changes in body temperature and urinary cortisol after routine immunization in babies with intrauterine growth retardation
Authors: Jackson JA , Wailoo MP , Petersen SA , Thompson JR , Davies T 
Published: August 2010

Aim: To investigate whether infants with intrauterine growth retardation (IUGR) experience different changes in temperature and cortisol excretion after routine immunization compared with normal healthy infants. Methods: Overnight deep body temperature and urinary cortisol to creatinine ratios were measured on the night after immunization and a control night in normal and IUGR infants. Results: In 60 normal infants, first vaccination at about 10 wk of age led to a significant increase in minumum overnight temperature compared to the control night, mean rise 0.25°C (95% CI, 0.12 to 0.38). In 35 IUGR infants the mean rise in temperature between immunization night and control night was 0.35°C (95% CI, 0.15 to 0.55). The increases in minimum temperature did not differ significantly between the normal and IUGR infants (p= 0.11). Cortisol to creatinine ratios measured from overnight urine samples showed that 23 IUGR infants had consistently higher levels than 39 normal infants; control night medians 34 and 15 (p= 0.01) and immunization night medians 56 and 26 (p= 0.02), respectively. However, the percentage increase did not differ significantly between the IUGR infants and the normal infants. A smaller number of second immunizations were studied, but no significant differences were found. Conclusion: These results suggest that although the impact of immunization is the same for IUGR and normal infants, because IUGR infants are less mature and at greater stress before immunization, the absolute levels that they experience after immunization are higher than those for normal infants.
Gender‐specific effects of apolipoprotein E genotype on plasma lipid levels in a population‐based sample of 6–7‐year‐old children in Spain
Authors: Garcés C , Benavente M , Lasunción MA , Ortega H , Nájera G , Oya M de 
Published: August 2010

Aim: The effects of gender on the association between apolipoprotein E genotype and plasma lipid levels remain unclear in children. The aim of the present work was to evaluate these gender differences in a large population‐based sample of 6–7‐y‐old children, free of the effects of sex hormones. Methods: Lipid levels and apo E genotypes were studied in a sample of 1255 (631 M, 624 F) Caucasian schoolchildren, aged 6–7 (mean age, 6.7) y in Spain. Results: A significant effect of the apo E genotype on plasma total cholesterol, LDL‐C (low‐density lipoprotein cholesterol) and apo B levels was observed. Taking the homozygous ɛ3ɛ3 genotype as reference, the presence of the ɛ2 and ɛ4 alleles is associated with substantially lower and higher plasma levels, respectively, of these variables. It was found that the effect of the apo E polymorphism on total cholesterol, LDL‐C and particularly on apo B levels was greater in girls than in boys. Conclusion: At this prepubertal age, the influence of the apo E genotype on total cholesterol, LDL‐C and apo B levels is more evident in girls than in boys. This difference in effect is not due to sex hormones. In our opinion, the earlier increase in adrenal androgens in girls than in boys at this age related to pubertal maturation could be responsible for these differences.
Effects of magnesium sulphate on amplitude‐integrated continuous EEG in asphyxiated term neonates
Authors: Groenendaal F , Rademaker CMA , Toet MC , de Vries LS 
Published: August 2010

In this study it is hypothesized that magnesium sulphate in asphyxiated full‐term neonates could lead to a gradual improvement in background pattern of the amplitude integrated EEG (aEEG), an early marker of hypoxic‐ischaemic brain injury. In a double‐blind, randomized, controlled pilot study of 22 asphyxiated full‐term neonates 8 received magnesium sulphate, reaching serum Mg2+levels of 2.5 mmol/L. Magnesium sulphate had no immediate effect on aEEG‐patterns. At 12 h of age, aEEG was more depressed compared with aEEG at 3 h in 6 of the 8 magnesium‐treated neonates, and in 3 of the 14 placebo‐treated neonates (Mg2+vs placebo:p< 0.05, Mann‐Whitney). No further significant changes in aEEG were seen between 12 and 24 h. Outcome was unfavourable in 4 of the 8 magnesium‐treated neonates, and in 8 of the 14 placebo‐treated neonates.Conclusion: Magnesium sulphate did not have a positive effect on aEEG patterns in this small group of asphyxiated term neonates.
Can severity‐of‐illness indices for neonatal intensive care predict outcome at 4 years of age?
Authors: Eriksson M , Bodin L , Finnström O , Schollin J 
Published: August 2010

Aim: To test four neonatal severity‐of‐illness indices (CRIB, NTISS, SNAP, SNAP‐PE) for their ability to predict short‐ and long‐term outcome in very low‐birthweight infants receiving neonatal intensive care. Methods: Data on 240 newborns with birthweights below 1500 g from two Swedish neonatal units were collected. The predictive values of the indices for an adverse outcome in the neonatal period and at 4 y of age were compared with those of gestational age and birthweight. Results: An early adverse outcome (in‐hospital death, severe haemorrhagic‐ischaemic brain lesion, retinopathy, chronic lung disease) was better predicted with CRIB (area under ROC curve (Az) = 0.87) and SNAP‐PE (Az = 0.86), while SNAP‐PE was best for predicting late problems (deviations in growth and psychomotor development, neurosensory impairment, difficulties in concentration, and impairment in vision, and hearing,) (Az = 0.63). All indices predicted the early outcome better than the outcome at the 4‐y follow‐up. Severity‐of‐illness indices can be used as instruments to follow and improve the level of neonatal intensive care, but unfortunately seem to be of little value in long‐term follow‐up. Conclusion: CRIB and SNAP‐PE indices are better in predicting hospital mortality than birth‐weight. None of the systems can predict adverse outcome at 4 y of age.