bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bronze baby syndrome and the risk of kernicterus
Authors: Bertini Giovanna , Dani Carlo , Fonda Claudio , Zorzi Carlo , Rubaltelli Firmino F 
Published: August 2010

Abstract Aim: The problem of kernicterus in infants with bronze baby syndrome (BBS) has been reviewed on the basis of cases reported in the literature. In addition, a new case concerning an infant with severe Rh haemolytic disease, who presented with BBS and who has developed neurological manifestations of kernicterus with magnetic resonance images showing basal ganglia abnormalities, is presented. In this patient, the total serum bilirubin (TSB) concentration ranged from 18.0 to 22.8 mg/dl (306 to 388 μmol/l) and the bilirubin/albumin (B/A) ratio was 6.0 (mg/g) (6.8 is the value at which an exchange transfusion should be considered). The case presented is important due to the fact that kernicterus appeared after an exchange transfusion was performed when the TSB level reached 22.8 mg/dl (388 μmol/l) on 6th day of life while the haematocrit was 30%. From this case and from other cases reported in the literature, we must stress that, even if the level at which hyperbilirubinemia poses a threat remains undefined, BBS may constitute an additional risk of developing kernicterus. Conclusion: The possible strategies for implementing an approach to the management of hyperbilirubinemia (especially the haemolytic kind) in the presence of BBS may include an exchange transfusion carried out at lower TSB concentration than previously recommended or an early administration of Sn‐mesoporphyrin.
Breastfeeding and the Baby Friendly Hospitals Initiative (BFHI): Organization, response and outcome in Sweden and other countries
Authors: Hofvander Yngve 
Published: August 2010

AbstractThe Baby Friendly Hospitals Initiative (BFHI), organized as a global campaign by UNICEF and focusing mainly on the breastfeeding routines, attitudes and knowledge among staff and mothers at maternity centres, was introduced in Sweden in 1993. Four years later, all of the then 65 maternity centres had been designated “baby friendly” (BF). Concomitant with that, the 6‐mo breastfeeding rate increased from about 50% to 73% on a national basis, presumably resulting from adherence to the “10 steps” and the development of a favourable breastfeeding climate. The BFHI has engaged practically all countries throughout the world with close to 20 000 maternity centres. On a global scale, about 30% of these maternity centres have been awarded BF status but with large variations between regions and countries; Europe and other industrialized areas being among the lowest. Conclusion: Strong government support, an organized central lead group and support from the medical profession are necessary prerequisites for BFHI success, but continued work is necessary for sustaining attitudes and knowledge.
Food choices at lunch during the third year of life: Increase in energy intake but decrease in variety
Authors: Nicklaus Sophie , Chabanet Claire , Boggio Vincent , Issanchou Sylvie 
Published: August 2010

Abstract Aim: Modelling the evolution between the ages of 2 and 3 y of the energy intake and the variety of free food choices at lunch time in relation to children's and context variables. Methods: One‐year follow‐up from 2 to 3 y old. In a nursery canteen, food choices at lunch were recorded by trained assistants who monitored portion size. Energy intake and food variety were estimated. Three hundred and ninety‐five children were studied, for 112 meals and over 10 mo on average. Mixed models of analysis of variance were used to take into account the longitudinal character of the data. Results: From 2 to 3 y, energy intake increased. Variety decreased during the first 7 mo and then remained constant. The individual variability in mean values and in evolution was high for both variables. Energy was positively linked to BMI at 2 y. Variety was slightly higher for girls and increased with duration of breastfeeding. Energy was higher in September to November than in December–January. Variety was maximal in December–January and in June–July. Conclusion: During the third year of life, while energy intake increases, the restriction of food variety appears to be a normal transition phase. Long duration of breastfeeding is associated with higher food variety.
A clinical decision rule for management of streptococcal pharyngitis in low‐resource settings
Authors: Steinhoff Mark C , Fischer Walker Christa , Rimoin Anne W , Hamza Hala S 
Published: August 2010

Abstract Background: Most of the world's children live in regions where laboratory facilities are not available. In these regions, clinical prediction rules can be useful to guide clinicians' decisions on antibiotic therapy for streptococcal pharyngitis, and to reduce routine presumptive antibiotic therapy for all pharyngitis. Methods: Prospective cohort study to assess diagnostic signs and develop a prediction rule. Bivariate and multivariate analyses were used to develop clinical rules. Participants were 410 children in Cairo, Egypt, aged from 2 to 12 y, presenting with complaint of sore throat and whose parents provided consent. Main outcome measures included presence of signs and symptoms, and positive group A beta hemolytic streptococcal (GABHS) culture. Results: 101 (24.6%) children had positive GABHS culture. Pharyngeal exudate, tender or enlarged anterior cervical lymph nodes, season, absence of rash, or cough or rhinitis were associated with positive culture in bivariate and multivariate analyses. Three variables (enlarged nodes, no rash, no rhinitis), when used in a cumulative score, showed 92% sensitivity and 38% specificity in these children. Conclusions: The proposed three‐variable clinical prediction rule for GABHS may be useful when diagnostic laboratories are not available. In this setting, the rule identified more than 90% of true cases. Compared to universal treatment of all pharyngitis, the rule will reduce antibiotic use in GABHS‐negative cases by about 40%.
Risk factors of primary thyroid dysfunction in early infants born to mothers with autoimmune thyroid disease
Authors: Fu Junfen , Jiang Youjun , Liang Li , Zhu Hong 
Published: August 2010

Abstract Aim: To assess whether the state of maternal thyroid function and the pattern of thyroid alterations during gestation would affect the infants' thyroid function and to evaluate the risk factors affecting early infants' thyroid function by means of multiple logistic regression. Methods: In a cross‐sectional study, 78 neonates born to mothers with Graves disease or Hashimoto thyroiditis were examined and followed clinically and biochemically. Neonates born to healthy mothers during the same period were set as controls. Tests of thyroid function, antithyroid peroxidase antibody (TPOAb), antithyroglobulin antibody (TGAb), anti‐TSH receptor antibody (TRAb) and antithyroid‐stimulating antibody (TSAb) were performed both in early infants and their mothers. All possible maternal and/or infantile risk factors for thyroid dysfunction during early infancy were analysed by means of multiple‐factor logistical regression. Results: The overall prevalence of underlying subtle thyroid abnormalities in these 78 infants was 52.6%, which was significantly higher than that witnessed among infants from healthy mothers (5.4‰, p<0.01). By using multiple logistic regression analysis, the state of maternal thyroid function in gestation, the type of autoimmune thyroid disease during pregnancy and the level of TRAb in the newborn were significantly correlated with the early infants' thyroid dysfunction. Conclusion: Maternal autoimmune thyroid disease during pregnancy will affect infant thyroid function. Therefore, appropriate management of maternal autoimmune thyroid disease throughout pregnancy is essential in the prevention of undesirable neonatal outcomes.
Glucocorticoid eye drops inhibit growth in the newborn rabbit
Authors: Kugelberg Maria , Shafiei Kayvan , Ohlsson Claes , Sävendahl Lars , Zetterström Charlotta 
Published: August 2010

Abstract Aim: To investigate if postoperative treatment with dexamethasone eye drops has the capacity to affect longitudinal growth in newborn rabbits. Methods: Thirty‐four male and female rabbits had clear lens extraction performed in one eye at 3 wk of age and were then treated either intensively (group 1) or less intensively (group 2) with de‐escalating doses of dexamethasone eye drops for 8 wk (average doses 0.27 and 0.10 mg/kg body weight/day, respectively). The control group (group 3) received vehicle eye drops only. Body weight and crown–rump length were recorded every week. After 8 wk of treatment, all rabbits were killed and the left femur was measured. Results: Rabbits treated with dexamethasone eye drops gained weight slower (711±42 and 989±153 g weight increase for groups 1 and 2, respectively) than control animals (group 3; 1224±87 g weight increase; p<0.001 vs group 1, p<0.01 vs group 2). Longitudinal growth, determined as increase in crown–rump and femur lengths, was impaired by dexamethasone eye drops in a dose‐dependent way. Crown–rump length increased by 8.25±0.86, 10.90±1.19 and 15.35±1.31 cm in groups 1, 2 and 3, respectively (p<0.001 for all comparisons). At endpoint, i.e. after 8 wk of treatment, the average femur length was 6.36±0.21, 7.39±0.27 and 8.37±0.28 cm in groups 1, 2 and 3, respectively (p<0.001 for all comparisons). Conclusion: Dexamethasone, administered topically as eye drops, has systemic effects and impairs longitudinal growth in young rabbits. Therefore, we propose that growth should be closely monitored in all children intensively treated with glucocorticoid eye drops.
Age‐ and sex‐specific body composition of Chinese children
Authors: Li S , Zhang M , Yang S , Okada Tomoo , Iwata F , Harada K 
Published: August 2010

AbstractWe examined age‐ and sex‐specific body compositions of Chinese children by the bioelectrical impedance method. The subjects were a total of 587 children aged 6–14 y who had normal relative weight. In all ages, boys had larger fat‐free mass and lower percent body fat (%BF) than girls did. Even in the subjects with BMI <20 kg/m2, more than one quarter of them had high %BF. Conclusion: Chinese children may have higher %BF than that predicted by BMI.
Recurring acute abdominal pains in an adolescent as the presenting manifestations of hereditary angioneurotic oedema
Authors: Foix‐L'Hélias Laurence , Weiss Laurence , Mollet‐Boudjemline Alix , Fallik David , Trioche‐Eberschweiler Pascale , Labrune Philippe 
Published: August 2010

AbstractAn adolescent was hospitalized for recurring abdominal pains, which had previously led to appendicectomy. Laboratory data finally led to the diagnosis of hereditary angioneurotic oedema, after several hypotheses had been raised and ruled out. Conclusions: Angioneurotic oedema is a rare condition, which should be suspected in children with recurring abdominal pains, especially when there is liquid within the peritoneal cavity.
A non‐handicapped cohort of low‐birthweight children: Growth and general health status at 11 years of age
Authors: Elgen Irene , Johansson Kjell A. , Markestad Trond , Sommerfelt Kristian 
Published: August 2010

Abstract Aims: To describe and compare physical growth, current health status, functional limitations and neurodevelopmental impairments (defined as low IQ, school problems or psychiatric disorder) at 11 y of age in a population of non‐handicapped low‐birthweight (LBW) children with that of normal‐birthweight (NBW) children. Methods: A population‐based sample of 130 LBW children (weighing less than 2000 g at birth) without major handicaps, and a random sample of 131 NBW children born at term. Somatic and mental health and cognitive abilities were assessed through questionnaires to parents, a physical examination, standardized tests of cognitive function (WISC‐R) and a semi‐structured interview (Children Assessment Schedule). Results: General somatic health status was similar for the LBW and NBW children. The LBW children were shorter (mean difference −2.5 cm; 95% CI −0.9 to −4.2) and had a smaller head circumference (mean difference −0.8 cm; 95% CI −0.4 to −1.1) but similar weights and body mass indices. Differences and similarities in anthropometric measures were the same at 5 and 11 y of age. The LBW children had higher systolic (mean difference 3.2 mmHg; 95% CI −0.6 to −0.3) but similar diastolic blood pressure. A higher proportion of LBW children had decreased visual acuity and hearing impairment. Forty per cent of LBW children had neurodevelopmental impairments, compared to 20% of NBW children (OR 2.6; 95% CI 1.5 to 4.5). Conclusion: At 11 y of age, survivors of moderately low birthweight without major handicaps may have generally good health, but are at risk of neurodevelopmental impairments.
Clinical implication of hiatal hernia in patients with right isomerism
Authors: Hsu Jui‐Yu , Chen Shyh‐Jye , Wang Jou‐Kou , Ni Yen‐Hsuan , Chang Mei‐Hwei , Wu Mei‐Hwan 
Published: August 2010

Abstract Objective: Despite a reported association between hiatal hernia in patients with heterotaxy syndrome, the clinical significance has remained unclear. Based on large patient cohorts, this study specifically aimed at defining the implication of hiatal hernia in patients with right isomerism. Methods: From 1994 to 2002, 143 patients were identified as having right isomerism. Among them, 119 received ultrafast computed tomography (CT) to determine the presence of hiatal hernia as well as any cardiovascular anomalies. Results: Hiatal hernia was found in 17 patients (seven females and 10 males, 14.3%). The upper gastrointestinal (GI) series in six patients confirmed the diagnosis of hiatal hernia in all and revealed severe gastro‐oesophageal reflux in four. The most common symptom of hiatal hernia was vomiting (47%), followed by recurrent bronchiolitis or pneumonia (41.2%) and upper gastrointestinal bleeding (11.8%). Three patients with hiatal hernia underwent fundoplication for medically refractory vomiting. Seven patients were found to have midgut malrotation (5.9%), and four of these had both hiatal hernia and malrotation. Pulmonary atresia was closely associated with the presence of hiatal hernia (p=0.02). One patient with hiatal hernia died suddenly at 6 mo. However, overall mortality was similar between those patients with hiatal hernia and those without. Conclusions: The incidence of hiatal hernia was considerably high in patients with right isomerism, especially in those with pulmonary atresia, and it is this that may have led to vomiting and recurrent airway infections. While an association between sudden death and hiatal hernia may well exist, this does require further clarification.
Intra‐ and interindividual variability of glucuronidation of paracetamol during repeated administration of propacetamol in neonates
Authors: Allegaert Karel , Hoon Jan De , Verbesselt Rene , Vanhole Christine , Devlieger Hugo , Tibboel Dick 
Published: August 2010

AbstractBackground:Major changes in drug clearance and metabolism are observed during infancy, in part based on ontogenic regulation of various metabolic pathways. Since paracetamol provides a good substrate to study UGT (1A6) activity, urinary metabolites of propacetamol were determined in neonates in whom propacetamol was repeatedly administered.Methods:Paracetamol glucuronide (APAP‐G), paracetamol sulphate (APAP‐S) and free paracetamol were determined in urine samples of neonates during repeated administration of propacetamol. Spearman rank and linear multiple regression (MedCalc®, Mariakerke, Belgium) were used to study the effect of postnatal age, of postconceptional age and of repeated administration on the relative contribution of APAP‐G to overall urine paracetamol (APAP‐G+APAP‐S+free paracetamol) elimination (G/T ratio).Results:147 samples were collected in 23 neonates. Molar median G/T ratio was 14% (range 1–53). Besides increasing G/T ratio with increasing postnatal (p<0.0001) and postconceptional age (p<0.01), repeated administration (p<0.01) also correlated with an increasing G/T ratio, and repeated administration remained significant (p<0.01) after correction of postnatal and postconceptional age in a multiple regression model.Conclusion:Major variability in the ontogeny of UGT activity to overall elimination of paracetamol was documented in neonates. Besides postnatal and postconceptional age, a significant effect of repeated administration on UGT activity was documented.
Chronic zinc toxicity in an infant who received zinc therapy for atopic dermatitis
Authors: Sugiura Tokio , Goto Kenji , Ito Kouichi , Ueta Akihito , Fujimoto Shinji , Togari Hajime 
Published: August 2010

AbstractIn Japan and many other industrialized countries, zinc is readily available as a nutritional supplement, for cosmetic purposes and for the treatment of atopic dermatitis. The potential risks associated with its use are not, however, fully recognized. As a reciprocal relationship exists between copper and zinc, excessive zinc can produce hypocupraemia, which can cause anaemia and neutropenia. We report on a male infant who presented with anaemia and neutropenia and showed signs of developmental delay after dietary restriction for food allergy and eating difficulties and zinc therapy administered for the treatment of atopic dermatitis at a dose nine times the daily dietary allowance for his age group. After 1 mo of zinc withdrawal, copper and ceruloplasmin concentrations had increased, and the blood cell count had improved, activity was increasing but verbal development remained limited. As development improved after withdrawal of zinc, we cannot rule out a relation between developmental delay and hyperzincaemia and/or hypocupraemia. Conclusion: Caution must be exercised in administering zinc to children during their neurological development.
Natural history of the cerebrovascular complications of Fabry disease
Authors: Mehta A , Ginsberg L 
Published: August 2010

AbstractFabry disease is a rare, X‐linked lysosomal storage disease caused by an inborn deficiency of α‐galactosidase A, which results in progressive accumulation of globotriaosylceramide in a range of cells and tissues. Neurological symptoms of Fabry disease, including peripheral neuropathy and cerebrovascular events, are among the most significant clinical aspects. In this paper we present the natural history and mechanisms involved in the cerebrovascular complications of Fabry disease using data reported in FOS – the Fabry Outcome Survey – and other registries and clinical studies. We discuss ways in which these manifestations can be modified by intervention, including both general measures for cerebrovascular disease and enzyme replacement therapy. Conclusion: Data from FOS have provided important insights into the natural history of the cerebrovascular complications of Fabry disease. Furthermore, the database has demonstrated that significant renal or cardiac disease often co‐exists with cerebrovascular disease, and may predispose patients with Fabry disease to neurological disability and stroke.
Increase of faecal bifidobacteria due to dietary oligosaccharides induces a reduction of clinically relevant pathogen germs in the faeces of formula‐fed preterm infants
Authors: Knol Jan , Boehm Günther , Lidestri Maura , Negretti Franco , Jelinek Jürgen , Agosti Massimo , Stahl Bernd , Marini Antonio , Mosca Fabio 
Published: August 2010

AbstractIn a previous study on formula‐fed preterm infants, we were able to demonstrate that dietary oligosaccharides (a mixture of 90% galacto‐oligosaccharides and 10% fructo‐oligosaccharides in a concentration of 1 g/dl) stimulate the growth of faecal bifidobacteria. In the present explorative analysis of this study, we focus on the effect of the dominance of bifidobacteria on the presence of clinically relevant pathogens (Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Pseudomonas aeruginosa, Enterobacter, Klebsiella, Proteus, Streptococcus group B, Clostridium difficile, Bacillus subtilis and Acinetobacter). Conclusion: The data demonstrate that stimulation of bifidobacteria by prebiotic oligosaccharides reduces the presence of clinically relevant pathogens in the faecal flora, indicating that prebiotic substances might have the capacity to protect against enteral infections.
Calcium and phosphorus nutrition in preterm infants
Authors: Demarini Sergio 
Published: August 2010

AbstractMetabolic bone disease is a common event in preterm infants. Between 24 wk gestation and term, the fetus accrues approximately 80% of body Ca, P and Mg. Consequently, preterm infants miss in part or completely the period of greatest mineral accretion. Ca and P requirements in preterm infants are based on demands for matching intrauterine bone mineral accretion rates and on maintenance of normal serum Ca and P concentrations. Daily physical therapy may be a useful adjunct, as it is associated with a significant increase in bone mineral density and content. Osteopenia/rickets of prematurity seems to be a self‐resolving disease. However, this does not imply that a period of demineralization is acceptable. While the potential long‐term consequences on peak bone mass are unclear at the moment, the short‐term benefits include the avoidance of fractures, less marked dolicocephaly and improved linear growth.
Neonatal necrotizing enterocolitis: An update
Authors: Neu Josef 
Published: August 2010

AbstractNecrotizing enterocolitis (NEC) is a leading cause of mortality and morbidity in neonatal intensive care units. Here we review selected manifestations of NEC, risk factors involved in its pathophysiology as well as putative mechanisms associated with how an immature gut might be more susceptible to NEC. Treatment and potential preventive strategies are discussed.
What is the role of the prevention of allergy in the first period of life?
Authors: Agosti Massimo , Tandoi Francesco , Mosca Fabio 
Published: August 2010

AbstractThe widespread increase in the prevalence of allergic disease, which has occurred over the last 20 y, has created general concern in Europe and in the rest of the world. The reason for this increase is still partially unknown. In this period, despite a greater understanding of the pathogenesis and risk factors of allergies plus the greater efficacy of drugs to control the symptoms, the cost of intervention and the socio‐economic impact are still very high. For these reasons, prevention in the first period of life represents a goal for both developed and developing countries in order to reduce this upward trend.
Advances in the management of digestive problems during the first months of life
Authors: Savino Francesco , Maccario Stefano , Castagno Emanuele , Cresi Francesco , Cavallo Franco , Dalmasso Paola , Fanaro Silvia , Oggero Roberto , Silvestro Leandra 
Published: August 2010

AbstractA study was carried out on 168 full‐term infants with digestive problems such as regurgitation and/or constipation to evaluate the efficacy of new infant formulas containing partially hydrolysed whey protein, modified vegetable oil with a high β‐palmitic acid content, prebiotic oligosaccharides and starch. Infants receiving the new formulas had an increase in stool frequency of 0.60 between day 1 and day 7 (95% CI 0.19–1.01;p=0.004) and 0.53 (95% CI 0.11–0.90;p=0.015) between day 7 and day 14. A reduction of 1.06 in the number of regurgitation episodes was reported between day 1 and day 7 (95% CI 0.24–1.88;p=0.012) and 1.31 (95% CI 0.42–2.21;p=0.005) between day 7 and day 14.Conclusion:A prebiotic mixture of galacto‐/fructo‐oligosaccharides with a high β‐palmitic acid content may reduce digestive problems and improve intestinal tolerance in infants during the first months of life.