bluuebunny/crossref_metadata_2025_split huggingface dataset:
Seasonal and environmental effects on breast milk fatty acids in Burkina Faso and the need to improve the omega 3 PUFA content
Authors: Thiombiano‐Coulibaly N , Rocquelin G , Eymard‐Duvernay S , Kiffer‐Nunes J , Tapsoba S , Traoré SA 
Published: August 2010

Aim: To determine the Burkinabè breast milk lipid content and fatty acid composition and to compare these values with the recommended adequate intakes. Methods: The study comprised four cross‐sectional surveys conducted in urban and rural Burkina Faso at two different times of the year: during a period of food shortage (lean season) and during a favourable food availability period (post‐harvest season). The subjects were apparently healthy mothers nursing 5‐mo‐old infants. A total of 70 urban and 52 rural mothers and 100 urban and 98 rural mothers, respectively, during the post‐harvest season and the lean season, completed the surveys. The surveys were conducted in January‐February 2001 (urban) and 2002 (rural) corresponding to the post‐harvest season, and in April‐May 1998 (urban) and 1999 (rural), which is the lean season, and were carried out during home visits. The families were informed of the objectives of the study and gave their consent to participate. Breast milk samples were collected from each mother and analysed for lipid and fatty acid concentrations. Results: Noticeable breast milk characteristics were: low lipid content (30‐35 g/L), high C6:0‐C14:0 saturated fatty acids (27%‐33% total fatty acids), high linoleic acid (15%‐20% total fatty acids) and unbalanced linoleic/α‐linolenic acid (20:1 to 53:1) and long‐chain ω6/long‐chain ω3 (3.6:1 to 4.9:1) polyunsaturated fatty acid ratios. In all life conditions and food availability, linoleic acid was in excess of and α‐linolenic was below the recommended adequate intakes. Over 80% of breast milk samples had linoleic/α‐linolenic acid and long‐chain ω6/ω3 polyunsaturated ratios well above the recommendations. Conclusion: Improvement in breast milk ω3 PUFA seems to be recommendable in Burkina Faso, where breastfeeding is the primary infant feeding practice.
Phentolamine administration increases blood S100B protein levels in pediatric open‐heart surgery patients
Authors: Gazzolo D , Masetti P , Kornacka M , Abella R , Bruschettini P , Michetti F 
Published: August 2010

Aim: Phentolamine administration during open‐heart surgery shortens the cooling and rewarming phases of cardiopulmonary bypass (CPB) and hastens weaning from mechanical ventilation and extubation. Data on the effects of phentolamine on cerebral circulation and function in this setting are lacking. This study reports the cerebral effects of phentolamine using blood S100B protein levels and the middle cerebral artery pulsatility index (MCA PI). Methods: Sixty pediatric patients undergoing congenital heart disease repair were randomly assigned to receive either phentolamine 0.2 mg kg‐1 i.v. (n= 30) or placebo (n= 30) before the cooling and rewarming phases of CPB. Samples for S100B measurement were collected at seven predetermined time‐points before, during and after surgery. MCA PI values were recorded at the same times as sampling. Results: S100B blood levels were higher in the phentolamine‐treated group than in controls after rewarming (3.53 ± 1.88 vs 1.58 ± 0.53 μg l‐1; p < 0.001), remained persistently higher at the end of surgery (2.95 ± 0.91 vs 0.79 ± 0.21 μg l‐1; p < 0.001) and returned to normal ranges 12 h later than in the placebo group (p > 0.05). MCA PI values were also significantly higher at the end of surgery in the phentolamine‐treated group (1.83 ± 0.50 vs 1.22 ± 0.34; p < 0.01). Cooling and rewarming times were shorter in the phentolamine‐treated group (p < 0.01, for all). Conclusion: Despite improved peripheral vasodilatation and perfusion, phentolamine administration in pediatric open‐heart surgery is correlated with increased cerebrovascular resistance and brain damage.
Unilateral submandibular suppurative sialadenitis in a premature infant
Authors: de Haan TR , Grooters E , Frijns JHM , Walther FJ 
Published: August 2010

Isolated submandibular suppurative sialadenitis is extremely rare in newborn infants and is associated with prematurity and prolonged gavage feeding. This report describes a premature infant who developed a life‐threatening airway obstruction due to suppurative submandibular sialadenitis. The diagnosis was made on clinical grounds and confirmed by ultrasonography. Staphylococcus aureus was grown from the pus expressed from the Wharton's duct orifice. Upper airway obstruction and respiratory failure were managed with intubation and mechanical ventilation, and the sialadenitis resolved quickly and completely with flucloxacillin treatment. Possible causes of sialadenitis include dehydration, decreased saliva flow and stasis during gavage feeding, duct obstruction by stones and direct bacterial inoculation. Ultrasonography is the diagnostic imaging of choice to exclude congenital tumours, lymphadenitis, congenital malformations of the Wharton's duct or the gland itself, and subcutaneous fat necrosis. Conclusion: Early diagnosis and antibiotic treatment of suppurative submandibular sialadenitis may prevent complications such as abscess formation, septicaemia and respiratory failure.
Goldenhar syndrome and neuroblastoma: a chance association?
Authors: Michel‐Adde C , Laquerrière A , Eurin D , Drouin‐Garraud V , Marret S 
Published: August 2010

Oculoauriculovertebral dysplasia, also called Goldenhar syndrome, includes several anomalies: epibulbar dermoids or lipodermoids, microtia, mandibular hypoplasia, vertebral, skeletal, cardiac and kidney anomalies, among others. Tumours have also been observed in patients with oculoauriculovertebral dysplasia. We report the first case of oculoauriculovertebral dysplasia associated with a neuroblastoma. This tumour consists of cells identical to early migratory neural crest cells in the embryo. Several theories have been proposed regarding the pathogenetic explanation of oculoauriculovertebral dysplasia. Currently, some researchers have suggested a deficiency in mesodermal formation or defective interaction between neural crest and mesoderm as a possible aetiology. Conclusion: It is suggested that the case reported here is an additional argument for an anomaly in neural crest cell migration or interaction with the mesoderm in the pathogenesis of oculoauriculovertebral dysplasia.
Cholesterol metabolism in 8 to 12‐year‐old children born preterm or at term
Authors: Mortaz M , Fewtrell MS , Cole TJ , Lucas A 
Published: August 2010

Studies in animals have indicated that cholesterol metabolism is susceptible to manipulation by diet and growth in early life. In humans, low birthweight has been associated with increased risk of coronary heart disease. Aim: To establish whether plasma lipids and indicators of cholesterol absorption, synthesis and breakdown differ in children born preterm and at term. Methods: Plasma total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, triacylglycerols, apolipoprotein A1, apolipoprotein B, lathosterol (indicator of cholesterol synthesis), campesterol (indicator of cholesterol absorption), 7‐α hydroxycholesterol (indicator of cholesterol breakdown) were measured in up to 407 children born preterm and 36 children born at term. Results: Children born preterm had lower cholesterol synthesis (p= 0.002) and lower cholesterol breakdown (p < 0.001) than those born at term, but their plasma cholesterol concentration was not significantly different. After adjusting for current size, birthweight and gestational age were significantly related to plasma lathosterol and 7‐α hydroxycholesterol. However, when both birthweight and gestational age were adjusted, only gestational age remained significant. There were no significant differences in plasma campesterol between the two groups. Conclusion: Being born preterm may have a long‐term effect on cholesterol metabolism in children 8–12 y later. Those born prematurely had lower cholesterol synthesis and breakdown, but their plasma cholesterol concentration was similar at this age. These parameters need to be studied in older cohorts.
Vincristine in childhood leukaemia: no pharmacokinetic rationale for dose reduction in adolescents
Authors: Frost B‐M , Lönnerholm G , Koopmans P , Abrahamsson J , Behrendtz M , Castor A , Forestier E , Uges DRA , de Graaf SSN 
Published: August 2010

Aim: To investigate whether there is any pharmacokinetic rationale for the common practice of administering vincristine to adolescents at relatively lower doses than those to younger children. Methods: A total of 98 children, aged 1.3–17.3 y, with acute lymphoblastic leukaemia (ALL) were studied on day 1 of induction therapy. Plasma samples were drawn before and 10, 30, 360 and 1380 min after injection of vincristine 2.0 mg/m2 (maximum dose 2.0 mg) and analysed by high‐performance liquid chromatography. Results: The median value (and range) for distribution half‐life was 6.4 min (0.8–11.8), elimination half‐life 1014 min (258–2570), volume of distribution 445 L/m2 (137–1241) and total body clearance 362 ml/min/m2 (134–2553). No correlation was found between age and any of these pharmacokinetic parameters. The area under the concentration time curve (AUC) was significantly correlated to age (p= 0.002; ρ– 0.31), as expected from the dosage of vincristine. The lower AUC in children with a body surface area > 1 m2, which is reached at 8–9 y of age, indicates that they received a less intense treatment because of the capping of the vincristine dose at 2.0 mg. Conclusions: Vincristine pharmacokinetics were not age dependent in this paediatric population. Thus, we found no pharmacokinetic rationale for dose reduction in adolescents. The common practice of limiting the vincristine dose to 2.0 mg should be carefully reconsidered.
In the eye of the beholder: how accurate is clinical estimation of jaundice in newborns?
Authors: Riskin A , Kuglman A , Abend‐Weinger M , Green M , Hemo M , Bader D 
Published: August 2010

Aim: Hour‐specific serum total bilirubin (STB) percentiles have proved useful in predicting which babies will develop significant neonatal hyperbilirubinemia (NHB) requiring intervention. This study investigated whether this assessment could be performed visually instead of by blood test. The aim was to evaluate the ability of experienced clinicians to determine accurately the level of clinical jaundice in neonates by visual means. Methods: Four neonatologists were asked to estimate the level of bilirubin in a group of 283 term clinically jaundiced infants before discharge from the nursery on day 3 of life. Their clinical estimation was compared with actual measurement of STB from samples drawn simultaneously. Results: Clinical estimation of STB had a high correlation to actual serum bilirubin levels (Pearson's correlation coefficient = 0.682, p < 0.001). Conclusion: Clinical impression of jaundice by the eye of an experienced clinician is a reliable method to assess newborns for significant NHB and may diminish the need for universal serum sampling.
Thymic size in preterm neonates: a sonographic study
Authors: Jeppesen DL , Hasselbalch H , Nielsen SD , Sørensen TU , Ersbøll AK , Valerius NH , Heilmann C 
Published: August 2010

Aim: To assess the variation in size of the thymus in vivo in preterm neonates and to identify relations between thymic size and gestational age (GA), birthweight, occurrence of postnatal infections and maternal alcohol and tobacco intake during pregnancy. Methods: Eighty preterm neonates with a GA between 24 and 36 wk, and a birthweight between 490 and 4110 g were examined between days 0 and 19 after birth. The thymic size was assessed by sonography as a volume estimate, the so‐called thymic index (Ti). The median Ti was 5.2 (1.2–17.9). Ti was positively correlated with birthweight and GA and negatively correlated with occurrence of postnatal infection (p < 0.01, p= 0.03, p= 0.05, R2= 0.68). A correlation between thymic size and maternal alcohol and tobacco intake was not demonstrated. Conclusion: It is possible to assess the size of the thymus by sonography in very low‐birthweight and preterm neonates. A normal range for Ti in preterm neonates has been established. The sonographic method is a safe and effective technique for measuring the size of the thymus in preterm infants.
Short‐ and long‐term effects of neonatal glucocorticoid therapy: is hydrocortisone an alternative to dexamethasone?
Authors: van der Heide‐Jalving M , Kamphuis PJGH , van der Laan MJ , Bakker JM , Wiegant VM , Heijnen CJ , Veen S , van Bel F 
Published: August 2010

Aim: To compare short‐term effects and neurodevelopmental outcome of neonatal glucocorticoid therapy between two centres. Methods: A retrospective study was performed in two centres using a tapering course of either 5 to 1 mgkg−1 hydrocortisone (HC; 22 d) or 0.5 to 0.1 mg kg−1 dexamethasone (DEX; 21 d). In both centres glucocorticoid‐treated infants and control patients were matched for gestational age, birthweight, severity of infant respiratory distress syndrome and periventricular‐intraventricular haemorrhage. The following short‐term glucocorticoid‐induced effects were investigated in 25 HC‐treated and 25 control patients in centre A, and in 23 DEX‐treated and 23 control patients in centre B: oxygen dependency (inspiratory oxygen fraction), arterial pressure, blood glucose and urea concentrations, weight gain and head circumference before, during and after therapy (in treated infants), or at an interval comparable to treated infants (in control infants). Neurological outcome, psychomotor development and school performance at 5–7 y of age was evaluated in all groups. Results: HC and DEX were equally potent in reducing oxygen dependency. Mean arterial pressure as well as blood glucose and urea concentrations were significantly increased during DEX, but not during HC treatment. Weight gain stopped during DEX therapy, but not during HC. Head circumference in both treatment groups was decreased after therapy compared with controls. Neonatally DEX ‐treated children needed special school education significantly more often (p < 0.01) than controls at 5–7 y of age. No differences between neonatally HC‐treated children and controls on neurodevelopmental outcome were found at 5–7 y of age. Conclusion: Neonatal HC therapy has fewer short‐ and long‐term adverse effects than neonatal DEX therapy.
Vertical transmission of HIV‐1 infection and dilemma of infant feeding
Authors: Ehrnst A , Zetterström R 
Published: August 2010

The problem of giving proper recommendations on early feeding of infants of HIV‐1‐positive mothers in countries with deficient hygienic conditions is discussed. Even in exclusive breastfeeding, which is associated with a lower risk of HIV transmission than when supplements are given, the risk that the infant will acquire HIV‐1 has to be balanced against the risk of formula feeding. Furthermore, it also has to be stressed that exclusive breastfeeding is a rarity in many poor countries. Conclusion: The dilemma of recommending appropriate early feeding to HIV‐1‐positive mothers will persist until further studies of the type performed by the Coutsoudis group in South Africa have been performed.
Overnight central and peripheral temperature changes in normal infants
Authors: Tappin DM , Ford RPK , Price B , Macey PM , Larkin J 
Published: August 2010

Aim: To explore the relationship between central and peripheral temperature in normal infants after being put down to sleep. Methods: Overnight shin and rectal temperatures of 21 normal infants were continuously recorded at home for three nights at 2 wk, 6 wk, 3 mo and 5 mo of age. Parents documented the start and end of feed/nappy changes during the night. Results: An initial fall in rectal temperature was recorded on 149 out of 161 nights. This was linearly correlated with a rise in shin temperature for 106/149 (71%) nights (median R2= 0.95, lower quartile 0.92, upper quartile 0.97). It was not possible to rule out a change in thermal insulation over the shins as a confounding variable in this strong association. However, a similar inverse relationship was seen between shin and rectal temperature during 111 of 121 (92%) feed/nappy changes. Conclusion: The fall in rectal temperature after being put down to sleep may be due to redistribution of heat rather than decreased production or heat loss. If causal, the development in early infancy of an inverse relationship between shin and rectal temperature may be important for cardiovascular homeostasis. Further sleep laboratory work is required to distinguish peripheral temperature changes on falling asleep from those associated with changes in thermal insulation.
Urinary 8‐hydroxydeoxyguanosine excretion in children before and after therapy for eradication of Helicobacter pylori infection
Authors: Shimizu T , Lee T , Shoji H , Kudo T , Satoh Y , Yamashiro Y 
Published: August 2010

Aim: A number of reports have implicated oxygen free radicals in the pathogenesis of Helicobacter pylori (H. pylori)‐associated disease. 8‐hydroxydeoxyguanosine (8‐OHdG) has recently been accepted as a sensitive marker for reflecting the oxidative DNA damage. However, there have been no previous studies comparing the changes in urinary 8‐OHdG excretions before and after therapy for eradication of H. pylori infection, or to examine 8‐OHdG excretions in children with H. pylori infection. The aim of this study was therefore to examine the DNA damage in gastric mucosal cells in children with H. pylori infection. Methods: Urinary 8‐OHdG excretions were measured before and after therapy for eradication of H. pylori infection in 15 children diagnosed with the H. pylori infection and 13 parents who were also suffering from the same infection. Results: In both the children and their parents, no significant differences were found in urinary 8‐OHdG excretions either before or after the eradication therapy. Furthermore, there was no significant difference in urinary 8‐OHdG excretions between 8 children with peptic ulcers and 7 children without ulcers, either before or after the therapy. Conclusion: These results suggest that measurement of urinary 8‐OHdG levels is not useful for evaluation of the DNA damage in H. pylori‐infected gastric mucosa in children.
Chediak‐Higashi syndrome: four cases from Northern Finland
Authors: Möttönen M , Lanning M , Baumann P , Saarinen‐Pihkala UM 
Published: August 2010

Chediak‐Higashi syndrome (CHS) is a rare multiorgan disease entity with autosomal recessive inheritance characterized by oculocutaneous albinism, bleeding tendency, recurrent bacterial infections and various neurological symptoms. Intracellular vesicle formation is deficient, resulting in giant granules in many cells, e.g. giant melanosomes in the melanocytes. Diagnosis has been based on morphological examination of peripheral blood and bone marrow, with giant granules seen in cells of the myeloid lineage and in lymphocytes. The ultimate diagnostic test is to look for a mutated LYST gene. Most patients develop an accelerated phase of the disease with deposition of lymphohistiocytes in the liver, spleen, lymph nodes and bone marrow, resulting in hepatosplenomegaly, bone marrow infiltration and haemophagocytosis. Peripheral blood neutropenia becomes more profound as anaemia and thrombocytopenia develop. Most patients succumb before the age of 10 years. Four patients with CHS are described, one of whom is a long‐term survivor after successful allogeneic bone marrow transplantation, two succumbed during the accelerated phase and one is living with a chronic form of the disease. Conclusion: Allogeneic bone marrow transplantation from an HLA‐matched sibling is the therapy of choice and should be performed early. If there is no matched family donor, an unrelated donor or a placental blood graft is a good alternative. The clinical picture of CHS is heterogeneous and therapeutic decisions need to be made on an individual basis.
Development of the coronary vasculature and its implications for coronary abnormalities in general and specifically in pulmonary atresia without ventricular septal defect
Authors: Groot AC Gittenberger‐de , Eralp I , Lie‐Venema H , Bartelings MM , Poelmann RE 
Published: August 2010

Aim: Coronary vascular anomalies are an important factor in congenital heart disease in the neonate. However, our knowledge of the pathomorphogenesis is still defective. Material and methods: 1) Study of coronary anomaly variations in congenital heart disease using specimens and 2) study of the role of epicardium‐derived cells (EPDC) and neural crest cells in coronary vascular formation using quail‐chicken chimeras. Results: The clinical and pathological data revealed the existence of ventriculo‐coronary arterial communications during fetal life before pulmonary atresia was established. This supported a primary coronary developmental anomaly as the origin of some cases of pulmonary atresia as opposed to other cases in which the pulmonary orifice atresia was the primary anomaly. Our experimental work showed the high relevance of the development of the epicardium and epicardium‐derived cells for the formation of the coronary vasculature, and showed the coronary vascular ingrowth into the myocardium and subsequently into the aorta and the right atrium. The absence of epicardium‐derived cells leads to embryonic death, while delayed outgrowth could result in the absence of the main coronary arteries to pinpoint orifice formation. In these cases, the circulation was maintained through ventriculocoronary arterial communications. Neural crest cells were important for the patterning of the coronary vasculature. We have extended this knowledge to a number of other heart malformations. Conclusions: Coronary vascular anomalies are highly linked to the development of extracardiac contributors like the epicardium and the neural crest. A proper interaction between these cell types and the myocardium and aortic arterial wall are important for normal vascular development.
Epicardial and microvascular graft vessel disease in children
Authors: Hiemann NE , Wellnhofer E , Abdul‐Khaliq H , Hetzer R , Meyer R 
Published: August 2010

Aim: Graft vessel disease (GVD) is one of the main limiting factors to long‐term survival after adult heart transplantation (HTx). The incidence of epicardial and microvascular GVD in paediatric patients was studied.Methods: A total of 137 coronary angiographies from 130 paediatric HTx and heart and lung transplant (HLTx) patients (70 male, 60 female, aged 0–18 y) were evaluated according to the Stanford classification and its supplements (minor vessel alterations). In H&E stainings from right ventricular endomyocardial biopsies (EMB = 397), light microscopic diagnosis of acute cellular rejection (ISHLT classification) and vascular reaction (morphology of endothelial cells and vessel walls) was performed.Results: Moderate rejection was present in 32.8% and severe rejection in 13.3% of EMB. Microvascular EC swelling was found in 33.5% and vessel wall thickening in 53.8% of EMB. The results of the coronary angio‐graphic investigations were: Stanford lesions = 61.2%, peripheral obliterations = 52.5%, diameter fluctuations = 86.3%, pathologic tapering = 64.0%, calcifications = 10.8%. Long‐term survivors (≥5 y) showed macrovascular alterations in 78% of cases and microvascular alterations in 67% of cases.Conclusion: The development of micro‐ and macrovascular GVD is one of the predominant complications in long‐term survivors after paediatric HTx and HLTx.