bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cord blood levels of cytokines as predictors of early neonatal sepsis
Authors: Santana C , Guindeo MC , González G , García‐Muñoz F , Saavedra P , Doménech E 
Published: August 2010

Aim: To investigate whether cord blood levels of C‐reactive protein, interleukin‐1β, interleukin‐6, interleukin‐8, tumour necrosis factor‐α and the soluble receptor of interleukin‐2, are useful markers in the diagnosis of early neonatal sepsis. Design: Umbilical cord blood samples were obtained at birth from 261 neonates, but 5 of these newborns were excluded from the study. Group I included 10 newborns that developed early neonatal sepsis with a positive blood culture; Group II included 11 newborns with non‐infectious perinatal diseases; Group III, which served as the control group, included 10 randomly selected patients, matched for gestational age, among the 235 healthy newborn babies. Results: There were no differences among the three study groups in levels of C‐reactive protein, interleukin‐1 β, tumour necrosis factor‐α and the soluble receptor of interleukin‐2. Interleukin‐6 was significantly elevated in Group I (360.4 ± 157.8 pg/ml) and Group II (158.8 ± 122.3 pg/ml), when compared with Group III (8.6 ± 3.12 pg/ml) (p < 0.01), whereas interleukin‐8 was significantly elevated in Group I (389.3 ± 115.9 pg/ml) compared with Groups II (30.2 ± 5.1 pg/ml) (p < 0.05) and III (33.9 ± 8.6 pg/ml) (p < 0.05). A cut‐off of 100.8 pg/ml for interleukin‐6 obtained by the ROC (receiver operating characteristic) method gave a sensitivity of 50% and a specificity of 87%, and a cut‐off of 111.7 pg/ml for interleukin‐8 showed a sensitivity of 78% and a specificity of 91%. Conclusion: While cord blood levels of interleukin‐6 appear to be related to pathological conditions in the perinatal period (infectious and non‐infectious), interleukin‐8 seems to be a good predictor of early bacterial neonatal infection.
Genetic variants of the tumour necrosis factor‐alpha promoter gene do not influence the development of necrotizing enterocolitis
Authors: Treszl A , Kocsis I , Szathmari M , Schuler Á , Tulassay T , Vásárhelyi B 
Published: August 2010

Previous studies indicated that elevated tumour necrosis factor‐alpha (TNF‐α) levels may play a role in the development of necrotizing enterocolitis (NEC). The A–238 and A–238 variants of the promoter region of the TNF‐α gene are reportedly associated with altered TNF‐α production. The aim of our study was to determine the impact of these gene polymorphisms on the development and course of NEC in very‐low‐birthweight (VLBW) infants. Dried blood samples from 46 VLBW neonates with NEC were analysed using the method of restriction fragment length polymorphism. Samples from 90 VLBW neonates without NEC were used as controls. The prevalence of alleles with guanine‐adenine transition in the –308 and –238 positions was the same in NEC and control subjects (12% vs 10% and 3% vs 4%, respectively). Conclusion: The investigated genetic variants of the TNF‐α gene promoter region have no influence on the risk and course of NEC in VLBW infants.
A relatively low prevalence of Helicobacter pylori infection in a healthy paediatric population in Riga, Latvia: a cross‐sectional study
Authors: Daugule I , Rumba I , Lindkvist P , Bergström M , Ejderhamn J 
Published: August 2010

The aim of this study was to investigate the prevalence, age of acquisition and risk factors for Helicobacter pylori (H. pylori) among asymptomatic children. 13C‐urea breath tests and questionnaires were obtained from 142 children and 40 parents. The prevalence of H. pylori was 19%. H. pylori positivity was higher in children with a positive parent (p= 0.003) and independently inversely related to antibiotic treatment during the previous year in preschool children (p= 0.045). Conclusion: The prevalence of H. pylori in children in Riga is higher than that in Western countries, but lower than that in Eastern European countries. H. pylori is present during the second year of life and is influenced by parental H. pylori status and previous treatment with antibiotics.
Potentiation of vincristine toxicity by itraconazole in children with lymphoid malignancies
Authors: Kamaluddin M , McNally P , Breatnach F , O'Marcaigh A , Webb D , O'Dell E , Scanlon P , Butler K , O'Meara A 
Published: August 2010

Eight consecutive paediatric patients with acute lymphoblastic leukaemia (ALL) (n=7) and T‐cell non‐Hodgkin's lymphoma (NHL) (n=1) presenting within a 5‐wk interval were started on a standard induction protocol which included weekly treatment with vincristine for 4 wk. Itraconazole was commenced as antifungal prophylaxis, 1–21 d after the first injection of vincristine. Within 2 to 4 wk, enhanced vincristine neurotoxicity was noted in all patients, abdominal cramps and constipation occurred most frequently, and one patient developed a bowel perforation associated with paralytic ileus. Hyponatraemia associated with SIADH was observed in three patients and four patients developed seizures. An additional patient with B cell NHL developed seizures 5 d after an injection of vincristine. Recovery was complete in all patients and ranged from 2 d to 15 wk. Conclusion: The extent and consistency of adverse effects documented in this study support the recommendation that concurrent administration of vincristine and itraconazole should be avoided.
Whole‐body mineral measurements in Swedish adolescents at 17 years compared to 15 years of age
Authors: Bratteby L‐E , Samuelson G , Sandhagen B , Mallmin H , Lantz H , Sjöström L 
Published: August 2010

Aim: To provide reference data for bone mineral variables in 15‐ and 17‐y‐old adolescents and to analyse the relationships between these variables and measures of bone and body size, gender, puberty, growth, various lifestyle and environmental factors and socioeconomic background. Methods: In the same 321 randomly selected adolescents (147 boys and 174 girls) living in two different regions of Sweden, the total bone mineral content (TBMC), bone area (BA) and total bone mineral density (TBMD) were assessed by dual‐energy X‐ray absorptiometry at ages 15 and 17 y. The effects of bone and body size, gender, growth, sexual maturity, physical activity, region of domicile, social conditions, food habits, smoking and alcohol intake on TBMC and TBMD were examined in multivariate analyses. Results: In the 15‐y‐old adolescents, BA, height, gender, physical activity, maturity and weight explained 91% and 48%, of the variance in TBMC and TBMD, respectively. In similar analyses in the 17‐y‐olds, the corresponding figures were 92% and 62%, respectively, when BA, height, growth, physical activity, gender and region emerged as significant in the model. In all these analyses, BA explained most of the variance in TBMC and TBMD. No significant reduction of variance was found when different measures of social conditions, smoking, food habits, alcohol or dietary intakes of energy, calcium or vitamin D were included in the models. The reason why region of domicile had a significant impact on TBMC in the 17‐y‐olds is not known. The fact that the normal fluoride concentration in drinking water (1.1 mg/L) is 10 times higher in the region where TBMC was higher than in the other region is an interesting observation. Conclusion: Almost 90% of the variance in TBMC and 50% of that in TBMD was explained by measures of bone and body size and only a few percent by gender, physical activity, Tanner stage, growth and region of domicile.
Extremely high prevalence of hypercalciuria in children living in the Aral Sea region
Authors: Kaneko K , Chiba M , Hashizume M , Kunii O , Sasaki S , Shimoda T , Yamashiro Y , Dauletbaev D , Caypil W , Mazhitova Z 
Published: August 2010

The Aral Sea region is a natural area seriously polluted by human activities. In addition to the increased prevalence of diverse chronic diseases in children, the risk of developing urolithiasis is reported to be high in this region. This study was undertaken to clarify the prevalence of hypercalciuria in children of the Aral Sea region. A group of 205 children living in Kazalinsk, close to the Aral Sea, and a group of 187 children living in Zhanakorgan, far from the Aral Sea, were screened for hypercalciuria. Urinary sodium excretion (sodium per creatinine, uNa/Cr) in addition to calcium excretion (calcium per creatinine, uCa/Cr) was also calculated for each subject. Mean uCa/Cr (mmol/mmol) and uNa/Cr (mmol/mmol) excretions were significantly higher in Kazalinsk than in Zhanakorgan (uCa/Cr: 0.75 ± 0.74 and 0.33 ± 0.30; uNa/Cr: 3.54 ± 2.27 and 2.89 ± 1.69, respectively, mean ± SD, p < 0.01). Hypercalciuria regarded as an uCa/Cr of more than 0.703 was observed in 79 out of 205 Kazalinsk children (38.6%) while this was seen in only 24 out of 187 Zhanakorgan children (12.8%). Linear regression analysis revealed a direct positive correlation between urinary calcium and sodium excretion (p < 0.01) in Kazalinsk children. Conclusion: The prevalence of hypercalciuria in children around the Aral Sea region is extremely high. This may be associated with excessive intake of calcium and sodium, or due to impaired renal tubular function caused by toxic chemicals. Therefore, hypercalciuria that may lead to urolithiasis should be taken into account when considering the health problems of this area.
Enuresis, sleep and desmopressin treatment
Authors: Nevéus T , Bader G , Sillén U 
Published: August 2010

Aim: To detect effects of desmopressin on sleep in enuretic children and to look for polysomnographical differences between responders and non‐responders to desmopressin treatment. Methods: Twenty‐one children with primary nocturnal enuresis were examined polysomnographically before treatment. All but one of the children then received treatment with desmopressin in standard dosage, and the response was documented. Seven of the children underwent a second polysomnographic registration while on treatment. Results: The time interval (±1 SD) between sleep onset and the enuretic episode was 92 ± 67 min without medication and 372 ± 157 min when desmopressin was given (p= 0.003). Standard polysomnographic variables were not affected by the drug. Ten children were desmopressin responders and 10 were non‐responders. The total sleep time was 455 ± 56 min in the former and 408 ± 31 min in the latter group (p= 0.04). The responders spent 27.4 ± 5.5% of their total sleep time in rapid eye movement sleep, compared with 18.2 ± 6.5% in the non‐responder group (p= 0.004). Conclusion: Desmopressin has no major effects on sleep as such but does delay bladder emptying. Enuretic children responding to desmopressin treatment have more rapid eye movement sleep than therapy‐resistant children.
Small bowel biopsy in Swedish paediatric clinics
Authors: Stenhammar L , Ascher H , Danielsson L , Dannaeus A , Hernell O , Ivarsson A , Lindberg E , Lindquist B , Nivenius K 
Published: August 2010

Aim: A correct diagnosis of coeliac disease, one of the most common chronic diseases in Swedish children, demands small bowel biopsy, which can be performed endoscopically or by means of a peroral capsule. Recently there was a debate among Swedish paediatric gastroenterologists, with some advocating the cessation of capsule biopsy in favour of endoscopic biopsies. To gain information on which to base a recommendation for which technique to use, the Swedish Working Group for Childhood Coeliac Disease was commissioned to carry out a national questionnaire study on current small bowel biopsy routines in Swedish paediatric clinics. Methods: A questionnaire concerning biopsy routines in the year 2000 was sent to all paediatric clinics performing biopsies. A reply was obtained from 39 of 40 clinics, covering 98% of the Swedish population. Results: Some 1400 biopsies were performed, 64% of which were capsule biopsies and 36% endoscopic. Three clinics performed all biopsies endoscopically and 11 clinics all via a capsule. At endoscopy all children were under deep sedation or full anaesthesia, while most children undergoing capsule biopsy were under light or deep sedation. The oxygen saturation was monitored during endoscopy but less often or never during routine capsule biopsy. The presence of the parents during biopsy varied according to the degree of sedation: at 97% of the clinics performing capsule biopsy on children under light sedation, the parents were present during the whole procedure, whereas no parents were present at clinics where the biopsy was performed endoscopically under anaesthesia. Conclusion: Compared with the results of a similar questionnaire concerning biopsy routines performed in the early 1990s, children are now more effectively sedated. Furthermore, there is an obvious trend from capsule towards endoscopic biopsy. Both the endoscopic and the capsule biopsy techniques are useful and satisfactory for obtaining small bowel mucosal samples providing that the children are effectively sedated. For practical and economic reasons the capsule biopsy technique will probably continue to be used, although to a lesser extent than today.
Recurrent pneumonia in children: clinical profile and underlying causes
Authors: Lodha R , Puranik M , Natchu UCM , Kabra SK 
Published: August 2010

Aim: To study the clinical profile and describe the predisposing causes of recurrent pneumonia in Indian children. Methods: The clinical details and the investigations of children presenting with recurrent pneumonia to the paediatric chest clinic services of a tertiary care centre in northern India were reviewed. Results: Seventy children (44M, 26F) presented with recurrent pneumonia over a period of 5 y. Based on the clinical features and the results of the investigations, underlying illness could be identified in 59 children (84%). The most frequent underlying cause for recurrent pneumonia was recurrent aspiration (24.2%), followed by immunodeficiency (15.7%), asthma (14.2%) and structural anomalies (8.6%). Conclusion: The underlying cause of recurrent pneumonia was identified in more than 80% of children. Recurrent aspirations were the most common cause.
Surfactant improves oxygenation in infants and children with pneumonia and acute respiratory distress syndrome
Authors: Herting E , Möller O , Schiffmann J‐H , Robertson B 
Published: August 2010

Aim: Pneumonia in childhood may be associated with surfactant dysfunction and severe acute respiratory distress syndrome (ARDS). The aim of this study was to investigate the effects of surfactant treatment on oxygenation in 8 infants (age range: 1 mo to 13 y) with severe respiratory failure owing to viral, bacterial or Pneumocystis Carinii pneumonia. Methods and results: Instillation of a modified porcine surfactant (Curosurf®) improved gas exchange immediately. Median paO2/FiO2 increased from 66 to 140mmHg (8.8–18.7 kPa; p < 0.01) within 1 h of surfactant treatment. Seven of the 8 patients received multiple surfactant doses. Four patients (50%) died 3–62 d after surfactant treatment. However, 6 patients (75%) were immunodeficient, so that the observed mortality rate was mainly due to the underlying disease. Conclusion: Surfactant dysfunction probably plays a role in the pathophysiology of severe paediatric ARDS triggered by pneumonia, as it was found that surfactant instillation rapidly improved gas exchange in the majority of the affected infants in our study. Larger randomized controlled studies are necessary to evaluate the effects of surfactant treatment on morbidity and mortality.
Follow‐up into young adulthood after cardiopulmonary resuscitation in term and near‐term newborn infants. II. Neuropsychological consequences
Authors: Viggedal G , Lundälv E , Carlsson G , Kjellmer I 
Published: August 2010

Aim: Brain injury after neonatal cardiopulmonary resuscitation in the term baby is often described as an all‐or‐nothing phenomenon, but little is known about possible late cognitive consequences. The aim of this study was therefore to investigate whether children who needed cardiopulmonary resuscitation because of presumed mild and moderate intra‐partum asphyxia with no evidence of neurological impairments at 18 mo of age may display neuropsychological impairments later in life. Methods: A long‐term follow‐up of young adults was carried out. A blinded comprehensive neuropsychological assessment of the main aspects of cognitive functions was made. The subjects who were resuscitated were divided into two groups according to the clinical course: 20 cases with mild asphyxia and 11 cases with moderate asphyxia, all followed prospectively and compared with 18 healthy controls. The 31 subjects were born at term or near‐term and selected randomly from 59 infants born in 1969–1978 at Sahlgren's Hospital, Göteborg. All infants with early neurological impairments were excluded. Results: No major differences could be established between the two clinical groups and normal controls in any aspects of cognitive function or intelligence. All the groups performed within the normal range in all tests. A tendency toward minor deficits in verbal ability in the mild group compared to the controls was found. Only one subject had a clear, defined memory deficit. Conclusions: Infants who underwent cardiopulmonary resuscitatation at birth without neurological deficits at 18 mo of age did not show any cognitive deficits or neuropsychological impairments in adulthood even though inferior performance on some verbal subtests was observed compared to the control group.
Lack of effect of the European guidance on clinical investigation of medicines in children
Authors: Jong GW‘t , Strieker BHCh , Choonara I , van den Anker JN 
Published: August 2010

Aim: To evaluate the registration for paediatric use of new chemical entities (NCEs) granted a marketing authorization (product licence). Methods: European Public Assessment Reports (EPARs) published on the Internet from January 1995 to May 2001 were analysed. Results: Of 120 new substances licensed since January 1995, 70 (58%) were of potential use in children. Of these, only 17 were licensed for all paediatric uses, and 15 for some paediatric age groups. Hence, the majority (54%) of these substances were probably not tested in paediatric age groups. Conclusion: Many of the new drugs granted marketing authorization lack sufficient paediatric labelling. The proportion of drugs for which full labelling was available has not increased in recent years. The European Medicines Evaluation Agency should make an effort to improve this I situation.
Measles virus genome detected up to four months in a case of congenital measles
Authors: Nakata Y , Nakayama T , Ide Y , Kizu R , Koinuma G , Bamba M 
Published: August 2010

To determine how long the measles virus genome was detected in a patient with congenital measles, the peripheral blood mononuclear cells were tested for 203 d. The measles virus genome was detected up to 140 d. Conclusion: The period for which the measles virus genome was detected in this patient with congenital measles was much longer than in normal children with measles.
Role of platelet‐activating factor in the pathophysiology of necrotizing enterocolitis
Authors: Ewer AK 
Published: August 2010

Necrotizing enterocolitis (NEC) is a devastating gastrointestinal illness that affects predominantly preterm infants. Treatment options are limited and NEC remains a significant cause of morbidity and mortality. The precise aetiology of NEC remains unclear but evidence strongly suggests that the cause is multifactorial and there are four main aetiological factors: prematurity, hypoxia, enteral feeding and bacterial colonization. The presence of similar intestinal lesions, regardless of aetiological trigger, strongly implicates a final common pathway in the pathogenesis. There is now a substantial body of evidence to indicate that endogenous inflammatory mediators, particularly platelet‐activating factor (PAF), play a vital role in this final pathway. Conclusion: The use of agents that antagonize PAF may provide therapeutic options in the management of NEC.
Respiratory mechanical unloading and proportional assist ventilation in infants
Authors: Schulze A 
Published: August 2010

Conventional patient‐triggered ventilation attempts to synchronize the upstroke in ventilator pressure with the onset of spontaneous inspiration. Other parameters of the mechanical cycle such as the peak inspiratory pressure are preset by the clinician. They will be imposed on the infant regardless of the actual spontaneous respiratory drive. Proportional assist ventilation (PAV) and respiratory mechanical unloading of spontaneous breathing (RMU, resistive and elastic unloading) are based on fundamentally different concepts. In contrast to the conventional perception of the ventilator being a pump, RMU/PAV servo‐controls the applied ventilator pressure continuously throughout each inspiration. These modalities proportionally enhance the effect on ventilation of each respiratory effort. They rely on rather than interfere with the subject's respiratory control system. The patient controls all variables of the respiratory pattern while the ventilator works fully enslaved as a proportional amplifier. Back‐up conventional mechanical ventilation is initiated during episodes of hypo ventilation and apnoea. The clinician sets the degree of the assist during RMU/PAV in terms of “gains”. Selecting specific gains for the elastic and resistive unloading components allows the ventilator pressure waveform to be tailored to the individual degree of restrictive and obstructive pulmonary disease. This results in a reduction in the transpulmonary pressure cost of ventilation compared with conventional modes. Conclusion: Further studies on RMU/PAV are required to evaluate clinically important long‐term outcome variables in infants and to determine whether the benefits outweigh potential drawbacks and the complexity involved in these new modes of mechanical ventilation.
Different quantities and quality of fat in milk products given to young children: effects on long chain polyunsaturated fatty acids and trans fatty acids in plasma
Authors: Svahn JCE , Feldl F , Räihä NCR , Koletzko B , Axelsson IEM 
Published: August 2010

In this study we compared plasma contents of long‐chain polyunsaturated fatty acids (LC‐PUFAs) and trans fatty acids in triglycerides (TG), phospholipids (PL) and cholesterolesters (CE) in young children fed milk diets containing different amounts of linoleic (LA) and α‐linolenic acid (ALA). Because the diets differed in vitamin A and E content, plasma concentrations of vitamin A and E were also studied. Thirty‐seven 1‐y‐old children were randomly assigned to one of four feeding groups: (1) low‐fat milk (LF) (1.0 g cow's milk fat/dL); (2) standard‐fat milk (SF) (3.5 g cow's milk fat/dL); (3) partially vegetable fat milk (PVF) (3.5 g fat/dL; 50% vegetable fat from rapeseed oil, 50% milk fat); and (4) full vegetable fat milk (FVF) (3.5 g fat/dL; 100% vegetable fat from palm‐, coconut‐ and soybean oil). We found higher amounts of plasma LA in the FVF group than in the LF and SF groups (p < 0.001) and higher amounts of ALA in the PVF group than in the SF (p < 0.001 in TGs, p < 0.05 in CEs) and LF (p < 0.01 in PLs and CEs, p < 0.05 in TGs) groups. However, amounts of plasma arachidonic acid (AA) were similar between groups as well as the amounts of docosahexaenoic acid (DHA) in CEs and PLs. Total trans FAs were lower in CEs in the PVF and FVF groups than in the SF group (p < 0.05 SF vs PVF; p < 0.01 SF vs FVF). Plasma concentrations of α‐tocopherol were higher in the FVF group than in the other groups (p < 0.05 FVF vs SF, p < 0.01 FVF vs SF and PVF). Conclusion: Children consuming milk diets containing high amounts of vegetable fat present with higher plasma LA and ALA without any effects on amounts of plasma LC‐PUFA. The plasma LC‐PUFA status is not adversely affected by a low‐fat milk diet. AHA and DHA in plasma are not affected by the diets studied, presumably because 15‐mo‐old children may be able to compensate for dietary influences through endogenous LC‐PUFA metabolism.