bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison of Likert scale and visual analogue scales as response options in children's questionnaires
Authors: van Laerhoven H , van der Zaag‐Loonen HJ , Derkx BHF 
Published: August 2010

Aim: To examine which response options children prefer and which they find easiest to use, and to study the relative reliability of the different response options. Methods: A consecutive group of unselected children (n= 120) filled out three questionnaires in a paediatric outpatient clinic. Each questionnaire included seven similar questions, but had different response options: the Likert scale, the Visual Analogue Scale (VAS) and the numeric VAS. In general, the questions were not related to the children's particular diseases, but dealt with the frequency of simple activities, their feelings and opinions. The pages with the three different response options were offered in random order. Afterwards, the children rated their preference and ease of use of the different response options on a scale from one to 10. Results: Children preferred the Likert scale (median mark 9.0) over the numeric VAS (median mark 8.0) and the simple VAS (median 6.0). They considered the Likert scale easiest to fill out (median mark 10 vs 9 and 7.5 for the numeric and simple VAS, respectively). Results of the different response options correlated strongly with each other (rho = 0.67–0.90, p < 0.05).Conclusion: Children prefer the Likert scale over the numeric and simple VAS and find it easiest to complete. The Likert scale, the simple VAS and the numeric VAS are of comparable reliability. The Likert scale is recommended for use in questionnaires for children, although research into larger and more diverse samples is needed.
Views on neonatal care of newborns weighing less than 500 grams
Authors: Schollin Jens 
Published: August 2010

AbstractThe limit of viability is intensely debated. Newborns below 500 g birthweight are often small for gestational age with an increased risk of short‐ and long‐term mortality and morbidity. The level of given neonatal care must be individualized. Conclusion: A long‐term follow‐up for newborns with extremely low birthweight is urgently needed.
Tight junctions, leaky intestines, and pediatric diseases
Authors: Liu Z , Li N , Neu J 
Published: August 2010

Abstract Background: Tight junctions (TJs) represent the major barrier within the paracellular pathway between intestinal epithelial cells. Disruption of TJs leads to intestinal hyperpermeability (the so‐called “leaky gut”) and is implicated in the pathogenesis of several acute and chronic pediatric disease entities that are likely to have their origin during infancy. Aim: This review provides an overview of evidence for the role of TJ breakdown in diseases such as systemic inflammatory response syndrome (SIRS), inflammatory bowel disease, type 1 diabetes, allergies, asthma, and autism. Conclusion: A better basic understanding of this structure might lead to prevention or treatment of these diseases using nutritional or other means.
Serum amyloid A (SAA) protein and high‐sensitivity C‐reactive protein (hsCRP) in healthy newborn infants and healthy young through elderly adults
Authors: Lannergård Anders , Friman Göran , Ewald Uwe , Lind Lars , Larsson Anders 
Published: August 2010

Abstract Aim: To determine the levels of serum amyloid A (SAA) protein and high‐sensitivity C‐reactive protein (hsCRP) in different age groups. Methods: Serum samples from 70 healthy newborn infants, 80 blood donors and 81 healthy elderly individuals were analysed using a nephelometric method. The 231 samples were grouped as follows: 35 umbilical cords, 35 newborns, 48 young adults, 28 middle‐aged adults, and 85 elderly adults. Results: Serum levels of both SAA and hsCRP were lower in umbilical cords than in the newborns and young, middle‐aged and elderly adults (p<0.0001). The SAA and hsCRP levels were comparable in newborns, and young and middle‐age adults, but higher in elderly adults (p<0.0001–0.03). SAA (r2=0.159, p<0.0001) and hsCRP (r2=0.059, p<0.0001) were positively correlated with age and to each other (r2=0.385, p<0.0001). Conclusion: Serum levels of SAA and hsCRP in umbilical cord blood are close to the detection limit and lower than in the other age groups investigated. The elderly have generally higher levels than the younger age groups, which require higher decision levels in inflammatory diseases, including infections. In newborns and young and middle‐aged adults, the lower decision levels of 10 mg/l for SAA and 5 mg/l for CRP are suggested.
Is globotriaosylceramide a useful biomarker in Fabry disease?
Authors: Young E , Mills K , Morris P , Vellodi A , Lee P , Waldek S , Winchester B 
Published: August 2010

Abstract Aim: The aim of this study was to determine whether globotriaosylceramide (Gb3) is a useful biomarker in Fabry disease. Methods: The levels of Gb3 were measured in plasma and urine by tandem mass spectrometry in untreated hemizygotes and heterozygotes with Fabry disease and in healthy controls, and the levels were monitored in patients on treatment with enzyme replacement therapy (ERT). Results: Hemizygotes with classic Fabry disease showed elevated levels of Gb3 in both plasma and urine and could readily be distinguished from normal controls. Male patients with the N215S mutation had normal levels in their plasma but 50% had marginally elevated levels in their urine. Thirty‐three percent of proven heterozygotes had elevated Gb3 concentrations in plasma but 97% of those without the N215S mutation (36/37) had an elevated level in urine. The four heterozygotes with the N215S mutation had normal Gb3 levels in urine. The level of Gb3 in plasma initially fell following the start of ERT in all patients who had an elevated level before treatment. However, in a few patients the level subsequently rose. Similar results were found for the levels of Gb3 in urine. Conclusion: Gb3 is not an ideal marker of Fabry disease or the response to treatment in all patients. Plasma and urine levels of Gb3 cannot be used as a marker of Fabry disease in patients with the N215S mutation and many heterozygotes do not have elevated Gb3 levels in plasma. The urine concentration is more informative in heterozygotes and can be used as a measure of the response to therapy. The fall in Gb3 levels in patients receiving ERT was not sustained in some patients, despite a clinical improvement. Additionally, Gb3 cannot be used to monitor the response to treatment in patients who initially have normal plasma and urine concentrations of this glycolipid.
Enzyme replacement therapy in mucopolysaccharidosis type I
Authors: Miebach E 
Published: August 2010

AbstractMucopolysaccharidosis (MPS) type I is a lysosomal storage disorder caused by deficiency of the enzyme α‐l‐iduronidase (IDUA), which presents with a wide spectrum of phenotypes. Recently, enzyme replacement therapy (ERT) became available for patients with MPS I and has been demonstrated to be safe and effective in patients with the milder Hurler–Scheie and Scheie phenotypes. Treatment for 26 weeks with recombinant human IDUA (laronidase) has been shown to significantly increase the percentage of predicted normal forced vital capacity and the distance walked in the 6‐minute walk test. There was also a clear reduction in the volume of the liver and the levels of urinary glycosaminoglycan excretion. The drug was generally well tolerated. There were no drug‐related severe adverse events, and although the majority of patients developed IgG antibodies, these declined by the end of the study. Conclusion: ERT seems to be a very promising new therapeutic regimen for patients with MPS I, especially for those with the less severe variants. However, as laronidase does not cross the blood–brain barrier it will probably not influence the central nervous manifestations in the most severely affected patients with the Hurler phenotype, although it may improve general lung and heart function, making bone marrow transplantation easier to tolerate.
Young children non‐immunized against measles: Characteristics and programmatic implications
Authors: Chowdhury F , Khan Ashraful I , Hossain Mohammad I. , Malek M. A , Faruque A. S. G , Ahmed Tahmeed , Salam Mohammad A. 
Published: August 2010

Abstract Aim: To examine the presenting characteristics, including nutritional status, of young children without measles immunization and to suggest appropriate public health measures to improve immunization status. Methods: In this retrospective case‐control analysis, we studied 4075 children aged 12–23 mo of either sex, who attended ICDDR, B's Dhaka hospital during 1994–2003. Cases included children who reported to this facility without receiving measles vaccine, and the control children were those who received the vaccine. Results: 3181 of 4075 (78%) children, including 1227 (39%) girls and 1954 (61%) boys, received measles immunization. The proportion of vaccinated children increased from 74% in 1997 to 82% in 2001. Some non‐specific effects of measles immunization were observed. Fifty‐one per cent of the children without measles immunization were stunted, 76% were underweight, and 48% were wasted. The non‐immunized children were twice as likely to be stunted, underweight, and wasted than the immunized children; they were more often dehydrated (some or severe dehydration) (28% vs 22%, p<0.001), required longer duration (>72 h) of hospitalization (15% vs 10%, p<0.001), did not receive vitamin A capsule in the previous 6 mo (56% vs 36%, p<0.001), and had more frequent abnormal lung auscultation indicative of acute lower respiratory tract infections (8% vs 5%, p<0.001). Female children, illiterate mother, lack of vitamin A supplementation, and history of measles were significantly associated with non‐immunization against measles after controlling for co‐variables. Results were similar when different nutritional indicators (underweight, stunting, or wasting) were added separately to logistic regression models. Conclusion: Intervention strategies to enhance immunization coverage in infants should target illiterate mothers and their children, particularly the females and malnourished ones, provide them with measles immunization and vitamin A capsule, and encourage their periodic follow‐up visits as part of a preventive nutritional programme.
Dexamethasone reduces reintubation rate due to postextubation stridor in a high‐risk paediatric population
Authors: Lukkassen Ingrid M. A. , Hassing Marre B. F , Markhorst Dick G. 
Published: August 2010

Abstract Objective: To study the effect of dexamethasone on postextubation stridor (PS) incidence and reintubation rate due to PS in a high‐risk paediatric intensive care population. Patients and methods: All children aged between 4 wk and 6 y, who were intubated for at least 24 h and extubated between August 1999 and May 2002, were retrospectively included (n=60). Medical records of the included patients were studied; records of patients treated with dexamethasone prior to and following extubation (n=23) were compared with control patients who had not received prophylactic medication (n=37). Results: Nine patients in the control group developed significant postextubation stridor, necessitating nebulized epinephrine or glucocorticosteroids. In six of these children, reintubation as a result of postextubation stridor was indicated. None of the patients treated with dexamethasone developed severe postextubation stridor or required reintubation. Conclusions: The risk of postextubation stridor is relatively high in the group of children aged between 4 wk and 6 y with intubation exceeding 24 h. We found dexamethasone to be effective in preventing reintubation due to postextubation stridor in this paediatric high‐risk group.
Developmental changes in infant heart rate responses to head‐up tilting
Authors: Myers Michael M. , Gomez‐Gribben Esperanza , Smith Kiersten S. , Tseng Angela , Fifer William P. 
Published: August 2010

Abstract Aim: Newborn infants produce significant heart rate responses to both head‐up and head‐down tilting: heart rate increases with head‐up tilting and decreases with head‐down tilting. However, previously we found that, at 2–4 mo of age, heart rate increases were no longer significant following slow head‐up tilting. This study was designed to determine if 2–4‐mo‐old infants have significant increases in heart rate when tilted rapidly. Methods: Fifty‐four infants were tested as newborns or at 2–4 mo of age. Heart rate was measured while infants were tilted to a 30° head‐up angle either slowly over a period of 30 s or rapidly in 5 s. Results: Newborns exhibited increases in heart rate using both tilt speeds; however, at 2–4 mo of age, heart rate did not change significantly using either speed of tilting. Conclusion: There are significant early developmental changes in cardiac responses to hypotensive challenge. Newborns react like adults, mounting sustained increases in heart rate in response to head‐up tilting, but at 2–4 mo of age sustained heart rate responses are no longer significant. Tilt tests may provide a standardized method for assessing autonomic competence during the period of maximum vulnerability to sudden infant death syndrome.
Rheumatic heart disease and coronary vasculitis in children
Authors: Gunal Nazlihan , Baysal Kemal , Haciomeroglu Pelin , Belet Nursen , Kolbakir Fersat 
Published: August 2010

AbstractRheumatic fever is a systemic inflammatory disease which may also cause vasculitis in multiple organ systems. Conclusion: Two children with rheumatic mitral valve disease and mitral valve replacement developed myocardial ischaemia due to coronary vasculitis. One of them had neurological findings that may be attributed to cerebral vasculitis.
Ototoxic drugs and sensorineural hearing loss following severe neonatal respiratory failure
Authors: Robertson Charlene M. T. , Juzer M. Tyebkhan , Peliowski Abraham , Philip C. Etches , Cheung Po‐Yin 
Published: August 2010

Abstract Aim: To determine relationships between ototoxic drugs and 4‐y sensorineural hearing loss (SNHL) in near‐term and term survivors of severe neonatal respiratory failure. Methods: All 81 survivors of the Canadian arm of the Neonatal Inhaled Nitric Oxide Study (mortality 32, loss to follow‐up 9) received loop diuretics, aminoglycosides, and neuromuscular blockers (NMB), and 50 received vancomycin as neonates. Prospective, longitudinal secondary outcome using audiological tests diagnosed late‐onset, progressive SNHL in 43 (53%); not flat (sloping) in 29, flat (severe to profound) in 14. Risk for SNHL was determined. Results: A combination of duration of diuretic use of >14 d and average NMB dose of >0.96 mg/kg/d contributed to SNHL among survivors (odds ratio 5.2; 95% CI 1.6, 16.7). Markers of illness severity did not contribute. Dosage or duration of aminoglycosides use did not relate to SNHL. Cumulative dosages and duration of use of diuretics; NMB; use of vancomycin; and overlap of diuretics with NMB, aminoglycosides, and vancomycin individually linked to SNHL (p<0.001). Conclusion: Overuse of loop diuretics and/or NMB contributes to SNHL after neonatal respiratory failure; markers of illness severity or the appropriate administration of aminoglycosides do not.
Maternal signs of chorioamnionitis: Persistent cognitive impairment in low‐birthweight children
Authors: Versland Lene B. , Sommerfelt Kristian , Elgen Irene 
Published: August 2010

Abstract Aim: To examine whether chorioamnionitis (CA) is associated with long‐term cognitive impairment in low‐birthweight (LBW) children without major handicaps such as cerebral palsy. Methods: Population‐based long‐term follow‐up study at 11 y of age of 130 LBW children with birthweight less than 2000 g, without major handicaps. Thirteen children with maternal signs of clinical CA were compared with the 117 LBW children without. Main outcome measure was psychometric intelligence, assessed using four subscales from the Norwegian version of the Wechsler Intelligence Scale for Children – Revised. Results: Mean performance IQ for the LBW children with maternal signs of CA (89, SD 13) was significantly lower compared to the other LBW children (98, SD 16) at 11 y of age (difference of mean 10, 95% CI of difference 0.4 to 19, p=0.04). Conclusion: Maternal chorioamnionitis, known to be associated with an increased frequency of cerebral palsy, may have lasting negative consequences for fetal brain development, resulting in long‐term cognitive impairments, even when major handicaps such as cerebral palsy are absent.
Enhanced intensive care for the neonatal ductus arteriosus
Authors: Teixeira Lilian S. , McNamara Patrick J. 
Published: August 2010

AbstractFailure of ductal closure is common in extremely low birth weight infants with significant postnatal morbidities from both pulmonary overcirculation (i.e. chronic lung disease) and/or systemic hypoperfusion (i.e. necrotizing enterocolitis). Early clinical signs of a hemodymanically significant ductus may be non‐specific (i.e. hypotension, increasing ventilator requirements, metabolic acidosis) necessitating early screening by echocardiography. Cyclooxygenase inhibitors remain the first‐line treatment option. Indomethacin remains the most commonly used agent, despite comparable efficacy and reduced risk of adverse events with ibuprofen. Surgical intervention is recommended after failure of medical therapy, contraindications to medical treatment or fulminating duct‐related cardiorespiratory deterioration. Wherever possible, surgical intervention in ELBW infants should be avoided in the first week of life due to the potential risks of ischemia‐reperfusion cerebral hemorrhage. The postoperative course is often complicated by left ventricular failure, pulmonary edema, and/or hemodynamic instability requiring close monitoring and physiologically relevant therapeutic interventions.
Maternal BMI and serum leptin concentration of infants in the first year of life
Authors: Savino Francesco , Alfonsina Liguori Stefania , Oggero Roberto , Silvestro Leandra , Miniero Roberto 
Published: August 2010

Abstract Aim: To evaluate the relationship between serum leptin concentration in infants and infant and maternal BMI. Methods: 75 healthy term infants aged 0–12 mo, 51 exclusively breastfed (BF) for at least 4 mo and 24 formula fed (FF), were included in a cross‐sectional study. Weight, length and cranial circumference of infants and their mothers were measured, body mass index (BMI) was calculated using the formula weight (kg)/height (m)2 and infant serum leptin concentration was determined. Results: A significant positive correlation between infant serum leptin concentration and maternal BMI was observed in BF infants (r = 0.389, p = 0.005), confirmed in a multiple regression model adjusted for infant age and infant BMI (β = 0.065, p = 0.006), but not in FF infants. As regards the first 4 mo of life, we have already observed a positive correlation between infant serum leptin concentration and maternal BMI in BF infants (β = 0.113, p = 0.005), but not in FF infants. Conclusion: In BF infants, serum leptin concentration correlates positively with maternal BMI. Higher maternal BMI values might increase leptin levels in breast milk, and maternal adiposity could be involved in infant energy balance.
Diarrheal illness in a cohort of children 0–2 years of age in rural Bangladesh: I. Incidence and risk factors
Authors: Pathela Preeti , Zahid Hasan K. , Roy Eliza , Huq Fazlul , Kasem Siddique A. , Bradley Sack R. 
Published: August 2010

Abstract Aim: To describe clinical characteristics and age‐ and season‐specific incidences of diarrheal episodes, and to evaluate risk factors associated with the occurrence of diarrheal disease. Methods: A total of 252 infants from rural Bangladesh were followed through household surveillance for 2 y from birth during the years 1993–1996. Demographic and household determinants were linked to the probability of illness using logistic regression models. Results: The overall incidence of diarrhea was 4.25 episodes per child per year. Peak rates of overall, acute, and persistent diarrhea occurred in the 6–11‐mo and 12–17‐mo age groups. Diarrheal rates peaked during the spring and summer. Among host‐related characteristics, having a sibling in the household and having had prior diarrhea were significant risk factors for diarrhea. Among environmental characteristics, spring season remained a highly statistically significant risk factor for diarrhea. Conclusion: Diarrheal disease continues to be a substantial burden in young children in rural Bangladesh. Most diarrheal episodes are of short duration, and should primarily be treated with oral rehydration therapy to prevent diarrhea‐related mortality. Improved knowledge of oral rehydration therapy, feeding during episodes to prevent further malnutrition, prolonged breastfeeding, and the keeping of livestock in corralled areas of the home are advocated.
Familial dysautonomia's impact on quality of life in childhood, adolescence, and adulthood
Authors: Sands Stephen A. , Giarraffa Philip , Jacobson Colleen M. , Axelrod Felicia B. 
Published: August 2010

Abstract Aim: To evaluate the quality of life (QoL) of children, adolescents, and adults treated for familial dysautonomia (FD), a pervasive neurological disorder. Methods: The Child Health Questionnaire was completed by parents of 71 patients, while an additional 74 patients completed the Short Form – 36. Results: FD imposed a greater physical than psychosocial burden on the child, while the young adults reported both mental and physical quality of life within the average range. Self‐esteem was problematic and improved with age, while both groups reported lowering physical quality of life as they grew older, with worsening general health that limited their role at school or work. Conclusion: Younger FD patients should be closely monitored for lowered self‐esteem and referred for counseling when appropriate, while physical and occupational therapy should be provided in advance of expected lowered physical QoL and role fulfillment with increasing age. This becomes important as the need for additional surgical interventions, such as fundoplication with gastrostomy or spinal fusion, contribute to lower physical functioning. Given the high degree of parental involvement required for the varied manifestations of this multisystem disorder, the need for continued parental assessment and psycho‐education about this chronic medical illness is warranted.
Fever of unknown origin in 185 paediatric patients: A single‐centre experience
Authors: Pasic Srdjan , Minic Aleksandra , Djuric Predrag , Micic Dragan , Kuzmanovic Milos , Sarjanovic Ljudmila , Markovic Milanka 
Published: August 2010

Abstract Aim: We conducted a prospective study to evaluate the causes and outcome in children with fever of unknown origin (FUO). Methods: From 1990 to 1999, 185 children with FUO were evaluated. Initial evaluation included routine haematological analysis, Epstein‐Barr virus (EBV) serology, urine, stool or blood cultures, chest X‐ray and tuberculin probe. Results: In 131 (70%) patients diagnosis was established, and 70 (37.8%) had infectious disease. EBV infection was the most common infection followed by visceral leishmaniasis (VL), urinary tract infection (UTI) and tuberculosis. Autoimmune disorders were diagnosed in 24 (12.9%), Kawasaki disease in 12 (6.4%), malignant diseases in 12 (6.4%) and miscellaneous conditions in 15 (8.1%) patients. In the remaining 54 (30%) patients, diagnosis was not established and most of them had self‐limited disease. During the investigation, 26 (14%) patients developed serious organ dysfunction and five patients (two with virus‐associated haemophagocytic syndrome, one with VL and two unknown) died. Conclusion: The most important infectious causes of FUO in our study were EBV infection and VL. Kawasaki disease represented a significant cause of FUO at the beginning of our study because it was not recognized by primary‐care physicians. We report myelodysplastic syndrome as another emerging cause of paediatric FUO. Repeated clinical examination and careful use of specific laboratory examinations, invasive diagnostic procedures or imaging are crucial in approaching paediatric FUO.