bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bone isoenzyme of serum alkaline phosphatase and serum inorganic phosphate in metabolic bone disease of prematurity
Authors: Backström MC , Kouri T , Kuusela A‐L , Sievänen H , Koivisto A‐M , Ikonen RS , Mäki M 
Published: August 2010

We wanted to improve detection of low bone mineral density in preterm infants by combining serum measurements of total alkaline phosphatase, its bone‐type isoenzyme and serum inorganic phosphate in a prospective design. The subjects were 43 preterm infants. Total and bone isoenzyme activity of alkaline phosphatase was determined at 3 wk chronological age and at 3 and 6 mo corrected age. The main outcome measure, apparent bone mineral density (BMAD) at the distal forearm and forearm shaft, was assessed by dual energy X‐ray absorptiometry at 3 and 6 mo corrected age. An apparent density below 95 mg/cm3 at 3 mo corrected age was considered to indicate bone disease, based on the distribution of BMAD values of children with non‐complicated courses of prematurity. At 3 mo corrected age, total alkaline phosphatase activities exceeding 900 IU/l revealed low bone mineral density with 88% sensitivity and 71% specificity. Measurements of bone isoenzyme activity did not improve diagnostic performance. Serum inorganic phosphate levels below 1.8 mmol/l reflected low bone density with high specificity (96%), but the sensitivity was only 50%.Conclusion: A combination of the criteria “serum total alkaline phosphatase activity above 900 IU/l” and “serum inorganic phosphate concentrations below 1.8 mmol/l” yielded a sensitivity of 100% at a specificity of 70%. This was the best available screening method for low bone mineral density in preterms.
Do phototherapy hoods really protect the neonate?
Authors: Ostrowski G , Pye SD , Laing IA 
Published: August 2010

The objective of the current study was to evaluate the protection given to the eyes of neonates by an Amber 300 phototherapy hood during blue‐light phototherapy from Drager Phototherapie 800 units, and to make recommendations for clinical practice. Hazard‐weighted blue‐light radiance of phototherapy lamps was measured inside neonatal incubators, with and without the use of a protective phototherapy hood. The study was carried out in a tertiary referral neonatal unit. No patients were involved. A mannequin was used as model of a jaundiced neonate being treated with blue‐light phototherapy. The study shows that hazard‐weighted blue‐light radiance levels detectable from within the space enclosed by the hood may be several times greater than accepted industrial threshold limits for adults.Conclusions: Nursing and medical staff must ensure meticulous care in the positioning of infants, so that the caudal edge of the shadow cast by the hood is always at least 30 mm inferior to the infants' lower eyelids. The vulnerability of the neonatal retina and the relatively high levels of blue‐light radiance visible from within the shadow of the hood may make it advisable to use more effective eye protection. Triple phototherapy using lamps at the foot‐end of the incubator is clearly hazardous and should not be carried out unless the infant's eyes are protected by eye‐patches.
Influence of feeding regimens on non‐invasive inferior vena cava and hepatic vein velocity measurements in infants
Authors: Kurugöl Z , Özyürek R , Dorak C , Levent E , Egemen A , Parlar A 
Published: August 2010

The aim of this study was to investigate the effects of feeding type and osmotic load on intravascular volume status. Ninety term, healthy infants 2 mo of age were included in the study. The breastfed and formula‐fed groups each consisted of 45 infants. Echocardiographic examination was performed before and after feeding. The collapse index of the inferior vena cava (IVCIC) and right atrial pressure (RAP) were calculated. No statistically significant differences were found between before‐ and after‐feeding values of IVCIC, RAP and hepatic vein velocities in breastfed infants. In the formula‐fed group, after‐feeding values of IVCIC were significantly lower and RAP, hepatic vein systolic and diastolic velocities were significantly higher compared to the before‐feeding values. Most of the mothers (78%) were unsuccessful at preparing the formula at appropriate concentrations. No statistically significant differences were found between the before‐and after‐feeding values of IVCIC, RAP and hepatic vein velocities in infants being fed appropriately prepared formula. The after‐feeding values of hepatic vein velocities were higher than those of before‐feeding values; after‐feeding values of IVCIC were lower than before‐feeding values in infants being fed highly concentrated formula. Conclusion: The values of inferior vena cava indices and hepatic vein velocities were not effected by feeding in infants receiving appropriately concentrated formula, like those of infants receiving breast milk. However, feeding with highly concentrated formula may cause intravascular volume expansion.
Reliability of sweat‐testing by the Macroduct® collection method combined with conductivity analysis in comparison with the classic Gibson and Cooke technique
Authors: Mastella G , Di Cesare G , Borruso A , Menin L , Zanolla L 
Published: August 2010

This study was to ascertain the reliability of sweat‐testing by the Macroduct collection method combined with conductivity analysis (MCS) compared with the Gibson and Cooke technique (GCT). Sweat stimulation by pilocarpine iontophoresis was identical for both procedures, sweat being collected for 30 min on a filter paper on one forearm and in the coil of the Macroduct® collector on the other. Chloride, sodium and potassium concentrations were chemically analysed both on paper‐eluted and tube‐collected sweat; the latter was also analysed using a conductivity analyser. Chemical analyses were compared with conductivity analyses. This prospective study was carried out on 318 subjects with MCS (118 CFs, 200 controls) and on 305 of them with the GCT (113 CFs, 192 controls). The pilocarpine iontophoresis produced adequate sweat in 96.4% of collections with GCT and in 90.9% with the MCS. Sensitivity and specificity of the Macroduct®/ conductivity system were comparable to the GCT. No patient detected by the GCT technique was considered negative by conductivity, but one GCT positive was “borderline” with the MCS. Six non‐CF subjects identified as negative by the GCT (3.3%) were in the borderline range with the MCS. Conclusion: Sweat‐testing by the MCS has acceptable sensitivity and specificity when performed by trained CF sweat‐testing technicians. Additional studies will be required to find out if these results can be confirmed in small clinics and hospitals where testing is done infrequently. Wherever the MCS is used all positive or borderline results should be confirmed by the GCT at a reference Cystic Fibrosis Center.
Etiologic spectrum and pattern of antimicrobial drug susceptibility in bacterial meningitis in Sokoto, Nigeria
Authors: Emele FE 
Published: August 2010

Etiologic agents of meningitis were prospectively investigated among patients admitted to Usman Danfodio University Teaching Hospital, Sokoto. Of 1097 cerebrospinal fluid (CSF) samples submitted to the microbiology laboratory from various wards of the hospital, 289 (26%) were microscopically, culturally and/or serologically proven to be bacterial meningitis. The etiologic spectrum was as follows: Neisseria meningitidis (61%), Streptococcus pneumoniae (18%), Haemophilus influenzae (10%), Staphylococcus aureus (6%), Coliform bacilli (3%), Escherichia coli (0.7%), Mycobacterium tuberculosis (0.7%), Listeria monocytogenes (0.4%), Flavobacterium meningosepticum (0.4%) and Pseudomonas putrifasciens (0.4%).Bacterial meningitis was most prevalent (195 or 68%) among children aged 1‐9 y, while adults and neonates were least affected. Coliform bacilli caused five of eight neonatal cases. Males were more frequently affected than females (x2=12.50;p < 0.05). Culture and microscopy were comparatively less efficient than the search for bacterial antigens, especially in the diagnosis of Haemophilus meningitis. Antimicrobial susceptibility of N. meningitidis to ampicillin and benzyl penicillin reduced progressively over the years (F = 406.98;p < 0.001). Nineteen (11%) of the isolates (5 Meningococci, 7 Staph. aureus, 1 Haem. influenza and 6 others) showed simultaneous resistance to chloramphenicol, ampicillin and benzyl penicillin.
Outcome of infants 23‐26 weeks' gestation pre and post surfactant
Authors: Jacobs SE , O'Brien K , Inwood S , Kelly EN , Whyte HE 
Published: August 2010

To describe mortality and neurodevelopmental outcome before and after the introduction of rescue therapy with natural surfactant in two neonatal units in Toronto, Canada, a retrospective cohort study of 891 liveborn 23–26 wk gestational age infants, 421 presurfactant (1982–1987) and 470 postsurfactant (1990–1994) was performed. Overall mortality was stable over time (41% vs 35%, p = 0.077), but declined for inborn 24 (71% vs 43%, p = 0.03) and 26 wk (26% vs 13%, p = 0.01) gestational age infants and was higher in surfactant‐treated infants (p > 0.0001). Chronic lung disease (61% vs 34%, p > 0.0001) and bilateral blindness (8% vs 4%, p = 0.004) declined over time, with stable rates of cerebral palsy (12% vs 15%), cognitive deficit (27% vs 26%) and aided sensorineural hearing loss (5% vs 4%). Sixty‐five percent of surviving infants in both eras were free from neurodevelopmental impairment, and severe impairment declined over time (p = 0.035).This study shows no secular change in overall mortality in a large cohort of 23–26 wk gestational age infants since the introduction of rescue therapy with natural surfactant. However, it does suggest that maternal transfer to and delivery of all extremely preterm infants in high risk perinatal centres is justified.
Family function in families with children of normal height and in families with short children
Authors: Starke M , Erling A , Möller A , Wikland K Albertsson 
Published: August 2010

The purpose of this study was to examine any differences regarding cohesion and adaptability between Swedish families with children of normal stature (group A) and those with children of short stature (group B). Cohesion and adaptability were measured using a Swedish translation of the third version of the self‐report questionnaire FACES (Family Adaptability and Cohesion, Evaluation Scales). Most of the 55 families in group A and most of the 49 families in group B appeared to be well balanced with regard to cohesion and adaptability. There was no statistically significant difference between the two groups concerning the variable cohesion. Significant differences were found in adaptability: fathers in group A had higher values than mothers in group A and than mothers and fathers in group B. Conclusion: There are no major differences between families with children of normal stature and those with short children. However, it was found that fathers with children of normal stature perceived a greater adaptation within their families compared with mothers with children of normal stature and mothers and fathers with children of short stature.
Sexual abuse at a Swedish daycare centre: allegations, confessions and evaluations
Authors: Lindblad F , Kaldal A 
Published: August 2010

In September 1997, sexual abuse at a Swedish daycare centre was disclosed. The suspect, a male member of the staff, admitted having abused six children. A total of 30 children were included in the police investigation. In this study, these cases were evaluated individually using a child psychiatric method. Information was collected from the police investigation and from interviews with parents. The conclusions–categorized as “abuse likely”, “abuse conceivable” or “abuse uncertain”–were compared with the children's own reports, the legal evaluations and the confessions of the suspects.Conclusions: The correspondence of child reports with child psychiatric evaluations was fairly high, indicating that child reports may serve as a good screening indicator of abuse. There was little agreement between child psychiatric evaluations and legal decisions, which were based on the reports of suspects. Some differences may be explained by varied methodology, definitions and criteria. Others reflect real differences in opinion. Our study illustrates the need to establish legal criteria for statements from pre‐schoolers if such evidence is to constitute the basis of a ruling without a confession. Studies comparing professional psychological assessments of children's statements about sexual abuse with independent data stand out as an important line of research for the future.
Kernicterus in term and near‐term infants–the specter walks again
Authors: Hansen TWR 
Published: August 2010

Diagnostic and therapeutic intervention is common in newborns with neonatal jaundice, motivated by the fear of bilirubin‐associated brain damage, kernicterus. In recent years, a resurgence of kernicterus has been noted in countries in which this complication had essentially disappeared. Both early postnatal discharge and relaxation of attitudes to neonatal jaundice have been implicated. Guidelines for the management of neonatal jaundice show significant disparity, attesting to our inadequate understanding of the underlying biology. Aggressive guidelines expose infants to unnecessary risks, risks that are significant when it comes to exchange transfusion, and may also involve improper use of limited resources. Relaxed guidelines, on the other hand, may expose infants to increased risk of brain toxicity. Conclusion: At present we have no tools for ensuring certain identification of individuals with increased vulnerability to bilirubin toxicity. Relaxation of guidelines which have been proven safe through prolonged use should therefore be undertaken only in an atmosphere of increased vigilance. Guidelines that allow for a range of therapeutic and diagnostic options underline the need for careful assessment of each case on its individual merits.
A follow‐up study of serum ferritin and transferrin receptor concentrations in Swedish adolescents at age 17 years compared to age 15
Authors: Samuelson G , Lonnerdal B , Kempe B , Elverby J‐E , Bratteby L‐E 
Published: August 2010

Serum ferritin and serum transferrin receptor concentrations, growth and food habits were studied in healthy Swedish boys (n= 103) and girls (n= 124) at the age of 17 y and compared with those in the same adolescents at age 15. Between these ages, serum transferrin receptor increased significantly in both boys and girls. Serum ferritin increased significantly in boys but not in girls. The transferrin receptor/ferritin ratio increased significantly in girls but not in boys, indicating insufficient iron stores in the 17‐y‐old girls in relation to erythropoiesis and iron needs. Between 15 and 17 y the boys' frequency of consumption of milk and bread decreased, while they more often consumed pasta, cheese and coffee. The girls decreased their frequency intake of fat products, milk and meat. The frequency of meat consumption emerged as the single significant predictor for serum ferritin < 12μg/L in girls, but not in boys. The median daily iron intake, determined in a subsample, decreased in boys from 18.7 to 13.6mg and in girls from 14.1 to 8.8 mg, and the decrease was to a large extent due to cessation of iron fortification of flour.Conclusions: The results indicate insufficient iron stores in the 17‐y‐old girls in relation to erythropoiesis and iron needs, but more favourable iron stores in the boys. The absence of a significant decrease in mean serum ferritin despite rapid growth suggests that the earlier iron fortification of flour only marginally contributed to the iron status of Swedish adolescents of this age group.
Status of children with cow's milk allergy in infancy by 10 years of age
Authors: Tikkanen S , Kokkonen J , Juntti H , Niinimãki A 
Published: August 2010

To assess the development of milk protein tolerance and atopic diseases in children diagnosed for cow's milk allergy (CMA) in infancy, we conducted re‐examinations of 56 CMA subjects at the age of 10 y using 204 age‐matched controls. The children underwent clinical examinations and skin prick tests (SPT), and their IgE‐specific antibodies to milk and five other food allergens were determined. By the age of 10 y, all but four subjects had become tolerant to at least small amounts of milk protein. However, gastrointestinal symptoms relating to more abundant milk consumption were reported by 45% of the study subjects and 15% of the controls (p < 0.001). The incidence figures for asthma, allergic rhinitis and dermatitis, as well as the occurrence of recurrent otitis, were three to four times higher than in the controls. Positive SPTs were seen in two‐thirds of the subjects, the figure being highest (83%) in those with dermatitis onset CMA. Seven subjects showed positive titres of IgE‐class milk‐specific antibodies, and five showed a clinical response. Conclusion: This re‐examination study showed that CMA in infancy, even when properly treated, has significant clinical consequences by posing special risks for respiratory atopy and persistence of atopic dermatitis as well as positive SPT and recurrent ear infections. However, each of these clinical manifestations seems to have an independent curriculum unrelated to the persistence of CMA itself.
Gastroduodenal ulcers in the Helicobacter pyloriera
Authors: Stringer MD , Veysi VT , Puntis JWL , Batcup G , Dixon MF 
Published: August 2010

The aim of the study was to evaluate the current spectrum of gastroduodenal ulcers in children referred to a regional paediatric unit in the United Kingdom. During a 5‐y period (1994–98), all children with a visibly discrete gastric and/or duodenal ulcer diagnosed at endoscopy were prospectively identified. Patients with ulcers associated with Helicobacter pylori gastritis underwent repeat endoscopy 2–3 mo after medical treatment. Thirty‐seven children, 21 boys and 16 girls of median age 11 y (range 7 mo to 16 y), had gastric and/or duodenal ulceration. Specific aetiological factors were identified in 21 of 22 with H. pylori negative ulcers, including Crohn's disease (n = 6), coeliac disease (n = 4) and treatment with ulcerogenic drugs (n = 4). Fifteen children (41%) had ulcers associated with H. pylori gastritis, including all 10 children with a chronic ulcer. Endoscopically confirmed ulcer healing was achieved in 14 of these using a 1 wk triple therapy regimen (omeprazole and a combination of two antibiotics).In conclusion, the recognized spectrum and the management of gastroduodenal ulceration have changed during the last decade. Although H. pylori gastritis is an important aetiological factor, a wide range of other conditions needs to be considered. Surgical intervention is only rarely necessary.
Selected trace elements and minerals in cord blood: association with lipids and lipoproteins at birth
Authors: Bastida S , Vaquero MP , Veldhuizen M , Sánchez‐Muniz FJ 
Published: August 2010

Recent studies have found that some minerals are associated with lipoprotein metabolism, peroxidation and coronary heart disease. The present study was designed to obtain information on the relationship between the concentrations of minerals and trace elements and those of lipids, lipoproteins and apolipoproteins (Apo) in cord blood. Seventy‐nine healthy singleton normoweight full‐term newborns without foetal distress according to Apgar scores were studied. The quartile distribution of neonates, according to serum concentrations of the different minerals studied, displayed significant differences in lipid values between infants in the lowest and highest quartiles of: magnesium, for HDL‐cholesterol, Apo A‐I, Apo B and the HDL‐cholesterol/Apo A‐I ratio; iron, for HDL‐cholesterol and the HDL‐cholesterol/Apo A‐I ratio; copper, for triglycerides and the LDL‐cholesterol/Apo B ratio. With the exception of calcium, several significant correlations were found between the minerals and trace elements and the lipids, Apo and lipoproteins tested.The present data suggest for the first time that minerals and trace elements appear to be involved in the lipoprotein metabolism, particularly in HDL levels, at birth. Moreover, the zinc/copper ratio was positively correlated with total cholesterol and the LDL‐cholesterol/Apo B ratio, while negatively with triglycerides, suggesting a role for the balance between these trace elements and the LDL metabolism and particle size.
Recurrence of kernicterus in term and near‐term infants in Denmark
Authors: Ebbesen F 
Published: August 2010

Classical acute bilirubin encephalopathy (kernicterus) in term and near‐term infants had not been seen in Denmark for at least 20 y until 1994. From 1994 to 1998, however, six cases were diagnosed. Aetiology of the hyperbilirubinaemia was known in two infants; spherocytosis and galactosaemia, most likely known in two infants; possible A‐O blood type immunization, and unknown in two infants. However, one of these last‐mentioned infants had a gestational age of only 36 wk. The maximum plasma total bilirubin concentrations were 531–745 μmol/L. The increase in the number of cases of kernicterus was considered to have been caused by: (i) a decreased awareness of the pathological signs, (ii) a change in the assessment of the risk of bilirubin encephalopathy, (iii) early discharge of the infants from the maternity ward, (iv) so‐called breastfeeding‐associated jaundice, (v) demonstration of bilirubin being an antioxidant, and (vi) difficulty in estimating the degree of jaundice in certain groups of immigrants. Accordingly, for prevention: (a) Attempt to change the healthcare workers' understanding of the risk of bilirubin encephalopathy, (b) give further instructions, both orally and in writing, to mothers before discharge from the maternity ward, (c) be more liberal in giving infant formula supplements, (d) conduct home visits by the community nurse at an earlier stage, (e) follow authorized guidelines for phototherapy and exchange transfusion, (f) lower plasma bilirubin concentration limits as an indication for phototherapy and exchange transfusion, (g) screen all term and near‐term infants, and (h) measure the skin's yellow colour with a device that corrects for the skin's melanin content.Conclusions: Audit of the six cases presented indicates that measures are necessary in both the primary and secondary healthcare sectors if the risk of kernicterus is to be avoided. Screening may be considered, but in order to identify the problems it would first be reasonable to perform a larger prospective study in which audit is performed on all newborn infants, born at term and near‐term, who develop a plasma bilirubin concentration above the exchange transfusion limit.