bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blood pressure in the neonate: Three non‐invasive oscillometric pressure monitors compared with invasively measured blood pressure
Authors: Dannevig Ingrid , Dale Helen Caroline , Liestøl Knut , Lindemann Rolf 
Published: August 2010

Abstract Aim: To compare blood pressure in neonates obtained from three different oscillometer blood pressure monitors (Dinamap™, Criticare™, Hewlett‐Packard™) with arterial blood pressure (Hewlett‐Packard™ invasive unit). Study design: A total of 32 randomized, non‐invasive blood pressure series, each consisting of three measurements from each monitor, were obtained from 20 neonates (birthweight 531–4660 g). Each measurement was compared with the invasive pressure. Results: Two factors appear to have a systematic effect on the difference between oscillometric and invasive pressure (the measurement deviance): the size of the infant, e.g., the arm circumference, and the monitor system. For small infants, the non‐invasively measured value tends to be too high. The deviance is partly reversed for larger infants (dependency on size significant for mean and diastolic pressure, p < 0.001). The difference between monitor systems is clearly significant (p < 0.001). Hewlett‐Packard™ gives the lowest pressure values for all pressures. Thus, Criticare™ and Dinamap™ tended to show values too high in the smallest infants, while Hewlett‐Packard™ tended to give values too low in larger infants. Birthweight, present weight and arm circumference affected measurement deviance approximately equally strongly, while factors such as the infant's sex, need of breath support and umbilical or radial arterial line were non‐significant. Conclusions: Blood pressure should preferably be measured invasively in severely ill neonates and preterm infants, being aware of pitfalls with measurements using different oscillometer monitors and the size/arm circumference of the infant.
Comparison of sucking patterns at introduction of oral feeding and at term in Israeli and American preterm infants
Authors: Bromiker Ruben , Arad Ilan , Loughran Bernardette , Netzer Dvorah , Kaplan Michael , Medoff‐Cooper Barbara 
Published: August 2010

Abstract Background: It has been hypothesized that early initiation of oral feeding in premature infants may enhance the maturation of sucking patterns. Aim: To compare preterm infant sucking characteristics in urban level III neonatal care units in the USA and Israel. The two hospitals have different practices regarding the introduction of oral feeding. Methods: Infants were assessed at 34–35 wk postconceptional age (PCA) and at term. Sucking parameters were assessed with the Kron's Nutritive Sucking Apparatus. Results: 70 infants (38 Americans and 32 Israelis) participated in the study. Oral feedings were initiated earlier (32.6±4.3 vs 34.5±1.8 wk PCA, p<0.01) and full oral feedings were reached earlier (35.4±2.8 vs 36.5±2.5 wk PCA, p<0.05) in the USA infants. American preterm infants produced significantly more sucks (p<0.001), had a higher suck rate (p<0.001), more sucks per burst (p<0.05), and a shorter interburst width (p<0.01) at 34 wk PCA than Israeli infants. At term, American infants produced significant more sucks (p<0.001), higher suck rate (p<0.001), shorter intersuck width (p<0.001), and a shorter interburst width (p<0.05) than the Israeli infants of the same PCA. Conclusion: Different practices in the care of preterm infants, such as postconceptional age at introduction of oral feeding, may play a role in the development of feeding and feeding organization at term.
VWF‐cleaving protease (ADAMTS13) in premature infants
Authors: Hellström‐Westas Lena , Ley David , Berg Ann‐Cathrine , Kristoffersson Ann‐Charlotte , Holmberg Lars 
Published: August 2010

Abstract Background: Patients with thrombotic thrombocytopenic purpura (TTP) are deficient in von Willebrand factor (VWF)‐cleaving protease, called ADAMTS13, and are prone to develop abnormal intravascular platelet aggregation leading to focal cerebral ischaemia. We speculated that low levels of ADAMTS13 are present in premature infants. This might result in platelet aggregation with subsequent ischaemia, vessel rupture and haemorrhage, and thus contribute to intraventricular haemorrhage and periventricular leucomalacia (IVH and PVL). Patients and methods: Nine preterm infants with gestational ages 23.7 to 30.9 (median 25.7) wk, and 10 healthy term control infants with gestational ages 36.9 to 39 (median 37.9) wk were included. Blood was sampled from the umbilical cord at delivery, and levels of ADAMTS13, VWF antigen and VWF collagen binding activity were analysed. Results: The mean ADAMTS13 level in preterm infants was lower than in the term infants, but the difference between the groups was not statistically significant. However, in the preterm group there was a positive correlation between ADAMTS13 and both gestational age (r=0.70, p=0.035) and birthweight (r=0.83, p=0.005). Three preterm infants had ADAMTS13 of 18–20%. One of these developed a germinal matrix haemorrhage and PVL, and this infant had the lowest measured ADAMTS13 of all. The levels of VWF antigen and VWF collagen binding activity were higher in the preterm infants. Conclusion: This pilot study showed that preterm infants have low levels of ADAMTS13. Enzyme substitution may be a therapeutic option if an association with IVH or PVL can be confirmed in larger patient groups.
A randomized controlled trial of an asthma clinical pathway for children in general practice
Authors: Mitchell Ed A , Didsbury PB , Kruithof N , Robinson E , Milmine M , Barry M , Newman J 
Published: August 2010

Abstract Aims: To evaluate the effect of the implementation of an asthma clinical pathway on asthma in children in general practice. Methods: A randomized, controlled trial involving 270 general practitioners. One group of general practitioners implemented the asthma clinical pathway for children (intervention group) and the control group continued with their usual asthma medical care management. The main outcome measures were admissions to hospital for asthma and attendance at the Children's Emergency Department. Compliance with the guidelines was assessed by examining asthma drug prescriptions. Results: Admissions to hospital for asthma dropped 40% in the intervention group, by 33% in the control group and by 22% in general practitioners not participating in the trial. The differences between the intervention and control and between the intervention and non‐participating general practitioners were not statistically significant. The decrease in attendance at the Children's Emergency Department decreased by 25%, 30% and 19%, respectively, but this was not statistically significant. There was a significant decrease in prescriptions for oral relievers, dry powder relievers in the under 6s, mast cell stabilizers and methylxanthines in both control and intervention groups. However, only for oral relievers was there a significant difference between the intervention group and control, with the decrease larger in the intervention group (p<0.001). Conclusions: Admissions to hospital for asthma decreased, as did attendance at the Children's Emergency Department. Prescriptions for asthma medication changed in the direction anticipated with compliance with the asthma clinical pathway. However, we found no evidence within the study that implementation of the asthma clinical pathway by general practitioners resulted in lower morbidity than those general practitioners who did not implement the pathway. Possible explanations are that these general practitioners were already providing care according to the recommendations of the pathway, or that there was contamination of the control group by the intervention, or that the guidelines, although based on currently accepted recommendations, are ineffective.
Non‐progressive congenital ataxia with cerebellar hypoplasia in three families
Authors: Yapici Z , Eraksoy M 
Published: August 2010

Abstract Aim: Non‐progressive ataxias with cerebellar hypoplasia are a rarely seen heterogeneous group of hereditary cerebellar ataxias. Method: Three sib pairs from three different families with this entity have been reviewed, and differential diagnosis has been discussed. Results: In two of the families, the parents were consanguineous. Walking was delayed in all the children. Truncal and extremity ataxia were then noticed. Ataxia was severe in one child, moderate in two children, and mild in the remaining three. Neurological examination revealed horizontal, horizonto‐rotatory and/or vertical nystagmus, variable degrees of mental retardation, and pyramidal signs besides truncal and extremity ataxia. In all the cases, cerebellar hemisphere and vermis hypoplasia were detected in MRI. During the follow‐up period, a gradual clinical improvement was achieved in all the children. Conclusion: Inheritance should be considered as autosomal recessive in some of the non‐progressive ataxic syndromes. Congenital non‐progressive ataxias are still being investigated due to the rarity of large pedigrees for genetic studies. If further information on the aetiopathogenesis and clinical progression of childhood ataxias associated with cerebellar hypoplasia is to be acquired, a combined evaluation of metabolic screening, long‐term follow‐up and radiological analyses is essential.
Tackling childhood obesity: Diet, physical activity or lifestyle change?
Authors: Poskitt Elizabeth ME 
Published: August 2010

AbstractTHe present day, almost worldwise, fattening of children is widely attributed to both excessive energy intake and reduced physical activity. However, treatments which only focus on reducing energy intakes and increasing energy expenditures rarely show long‐term success. The family attitudes and environments which contribute to energy imbalance and the development of obesity are virtually unchanged by many treatment programmes. We need to learn more about the nuture of those children who retain normal fatness although eveloped by obesity‐promoting environments.
Interdisciplinary and prospective studies necessary to increase insight into developmental language disorders
Authors: Lacerda Francisco , Ors Marianne 
Published: August 2010

AbstractThe study of developmental language disorders is discussed from an interdisciplinary perspective. it is argued that retrospective studies have provided valuable information on developmental language disorders that needs to be integrated into a theoretical model capable of capturing the basic mechanisms of language development. Conclusion: It is concluded that interdisciplinary and prospective studies and theoretical work are necessary to increase insight into developmental language disorders.
Influence of smoking on metallothionein level and other proteins binding essential metals in human milk
Authors: Milnerowicz Halina , Chmarek Monika 
Published: August 2010

Abstract Aim: To assess the influence of smoking on the level of total protein, metallothionein (MT), albumin and lactoferrin in human breast milk. Methods: Samples of whole milk and supernatants of milk after centrifugation at 10 000×g and 105 000×g were analysed. Cadmium was determined by graphite furnace atomic absorption spectrometry (GFAAS). The concentration measurements employed the following methods: total protein by Lowry, albumin by colorimetry, cotinine and lactoferrin by ELISA tests, metallothionein by 109Cd/haemoglobin assay. Results: The assessment of tobacco smoke exposure was based on concentrations of cotinine in breast milk (197±98 ng/ml in smokers and 23±11 ng/ml in non‐smokers; p0.001) and serum (179±87 ng/ml and 32±19 ng/ml, respectively; p0.001). The level of cadmium was four times higher in the milk of smoking women than in non‐smokers. The concentration of total protein was lower in smoking (37.3±10.6 mg/ml) than in non‐smoking mothers (51.8±13.8 mg/ml; p0.02). No significant differences between albumin and lactoferrin concentrations were observed. The level of metallothionein was over twice as low in smokers (5.1±1.9 μg/ml) than in non‐smokers (13.4±3.0 μg/ml; p0.001), and an inverse correlation between MT level and cadmium concentration (r=−0.86; p=0.001) was noticed. Conclusions: The breast milk of smoking mothers might be of lower nutritive value. The amount of MT transported by milk to the mammary gland is smaller in smokers than in non‐smokers, which may prove to be advantageous to an infant because of the higher toxicity of the Cd–MT complex than that of inorganic Cd salts.
Excluding hepatitis C virus (HCV) infection by serology in young infants of HCV‐infected mothers
Authors: England Kirsty , Pembrey Lucy , Tovo Pier‐Angelo , Newell Marie‐Louise 
Published: August 2010

Abstract Aim: To identify the age at which HCV infection can be accurately excluded by serology in young children born to HCV‐infected mothers and to determine an appropriate schedule of antibody testing, most informative to clinical practice. Methods: Children born to HCV‐infected mothers were followed in centres of the European Paediatric HCV Network. Turnbull survival analysis techniques were used to estimate the age at which HCV‐uninfected children will lose maternally acquired HCV antibodies. Factors associated with age at antibody loss were assessed in logistic regression. Results: In 1104 children followed from birth and later confirmed to be HCV uninfected, an estimated 57% will have lost passively acquired HCV antibodies before 6 mo of age and an estimated 95% by 12 mo. Maternal HCV viraemia antenatally was associated with later, and maternal HIV–HCV co‐infection with earlier loss of antibody. Actual antibody testing of uninfected children at 12 mo identified 82% of those tested to be anti‐HCV negative. Conclusions: Serological confirmation of HCV uninfection remains necessary given the uncertainty in the specificity of virological tests. These results suggest that, in most children, HCV infection can be ruled out with serological testing at an earlier age than previously thought, and that nearly all children born to HCV‐infected mothers will have lost passively acquired maternal antibodies by 1 y of age. Antibody loss was significantly later among children born to HCV viraemic mothers. The earlier loss of HCV antibodies in children born to HIV co‐infected mothers may be due to HIV treatment.
Comorbidity in severe developmental language disorders: Neuropediatric and psychological considerations
Authors: Rejnö‐Habte Selassie Gunilla , Jennische Margareta , Kyllerman Mårten , Viggedal Gerd , Hartelius Lena 
Published: August 2010

AbstractAim:To explore possible patterns of comorbidity in children with severe developmental language disorders (DLD).Methods:A retrospective investigation of the clinical records of 28 children relating to oral motor and language problems, psychological profiles, medical history and EEG findings.Results:36% of all the children had pure expressive language problems, 64% had combined expressive‐receptive language problems and 57% had additional oral motor problems. Girls predominated in expressive‐receptive problems, while boys predominated in oral motor problems. Children with expressive‐receptive disorders were over‐represented at the lower end of normal full‐scale IQ (p=0.015). Lower verbal than non‐verbal IQ levels were almost as common as equal levels, but a lower non‐verbal IQ than verbal IQ was also found. Pre/perinatal problems were found in 21%, and heredity for developmental language problems or dyslexia in 39%. There was a higher proportion of attention and motor problems, EEG abnormalities, and epileptic syndromes than in the general population (p<0.001).Conclusion:In severe DLD, both pure expressive and mixed expressive‐receptive problems are found, and oral motor problems are common. Gender differences regarding symptoms are present. Receptive language ability is associated with the full‐scale IQ level. A high proportion of EEG abnormalities and epilepsy is found. There is a complex pattern of comorbidity between speech‐language symptoms, psychological characteristics, heredity and EEG findings.
Psychosocial adjustment in Swedish children with upper‐limb reduction deficiency and a myoelectric prosthetic hand
Authors: Hermansson L , Eliasson AC , Engström I 
Published: August 2010

Abstract Aim: To study psychosocial adjustment and mental health in children with upper‐limb reduction deficiency and a myoelectric prosthetic hand. Methods: Sixty‐two parents of children aged 8 to 18 y old answered a questionnaire concerning competence and behaviour/emotional problems in their children. Of the 62 children, 37 adolescents aged 11 to 18 y old answered questionnaires concerning competence, problems and mood state. The results were compared with Swedish normative data. The children were divided into five groups based on degree of myoelectric prosthetic use. Results: Children with upper‐limb reduction deficiency and a myoelectric prosthetic hand showed social competence and behaviour/emotional problems similar to Swedish standardized norms. However, withdrawn behaviour was significantly higher in all children, social competence was significantly lower in girls, and social activities were significantly lower in older children with upper‐limb reduction deficiency. There was a significant difference between prosthetic use groups. Non‐users had significantly more delinquent behaviour problems than full‐time users. There was an interaction between gender and prosthetic use in their affect on competence and behaviour/emotional problems, yielding two contrasting patterns. Conclusion: Children with upper‐limb reduction deficiency and a myoelectric prosthetic hand are as well adjusted psychosocially as their able‐bodied peers. There are indications, however, of social stigmata related to the deficiency, which have to be considered differently in boys and girls.
Test performance and self‐esteem in relation to experienced stress in Swedish sixth and ninth graders—saliva cortisol levels and psychological reactions to demands
Authors: Lindahl Mats , Theorell Töres , Lindblad Frank 
Published: August 2010

Abstract Aims: To study relations between test performance, academic self‐esteem, self‐reported stress and saliva cortisol levels in students exposed to test demands at school. Methods: 46 randomly selected 6th and 9th graders voluntarily participated in an experimental school test concerning reading and mathematics skills. Cortisol saliva samples were collected at awakening, 30 min later, before test and after test. Perceived stress was registered with a visual analogue scale (VAS). A standardized self‐rating questionnaire for measuring self‐esteem was administered together with questions about school stress and psychological reactions when exposed to stress during a test. Results: Experienced stress during the school test was correlated to low test performance and to low self‐rated evaluation of self‐esteem as well as to an increase of saliva cortisol levels during the test. There were also correlations between certain psychological reactions to demands and different cortisol measures. Children who reported that they applied the procedure “I say to myself: I can solve this task” in a school test situation had a lower morning increase of saliva cortisol. Reported use of the procedure “I get worried and will have problems solving other tasks too”—when referring to a school test situation—was correlated to an increase in cortisol levels during the test situation. Conclusion: Test performance, academic self‐esteem, perceived stress and reactions of the hypothalamus‐pituitary‐adrenal axis (HPA axis) are highly intertwined. Furthermore, certain school stress psychological reactions to performance demands seem to be related to different cortisol reactions.
Is orofacial granulomatosis in children a feature of Crohn's disease?
Authors: Khouri JM , Bohane TD , Day AS 
Published: August 2010

AbstractOrofacial granulomatosis is a term generally used to describe lip swelling secondary to an underlying granulomatous inflammatory process. Granulomatous cheilitis is the histopathological description of such inflammation occurring in the lips and surrounding tissues. Melkersson‐Rosenthal syndrome (a triad of orofacial swelling, facial paralysis and a fissured tongue) is one manifestation of orofacial granulomatosis, which more commonly presents as granulomatous cheilitis alone. Oral Crohn's disease also belongs to the entity of orofacial granulomatosis. Most reported cases of orofacial granulomatosis have been in adults and some in adolescents. We present six children presenting with orofacial granulomatosis at an early age (range 5–8 y) whose course points towards the development of Crohn's disease. Conclusion: Orofacial granulomatosis in the paediatric population may be an initial manifestation of Crohn's disease and so careful surveillance is recommended.
Positive expiratory pressure (PEP) treatment in children with multiple severe disabilities
Authors: Lagerkvist Anna‐Lena , Sten Gunilla , Westerberg Barbro , Ericsson‐Sagsjö Anne , Bjure Jan 
Published: August 2010

Abstract Background: Children with multiple severe disabilities cannot be spontaneously physically active and therefore lack the ventilatory stimulation of physical activity. They often produce large quantities of airway mucus, which they have difficulty to evacuate on their own. The accumulation of mucus may lead to respiratory insufficiency. Aim: To investigate whether chest physiotherapy with positive expiratory pressure (PEP) could improve the blood oxygen tension (PO2) and/or decrease carbon dioxide tension (PCO2) in severely disabled children with airway mucus accumulation. Methods: Eighteen disabled children (mean age 7.5 y, SD 4.3, range 1.7–17.8 y) participated in the study. Transcutaneous (tc) PO2, tcPCO2 and respiratory rate (RR) were recorded before and after PEP treatment. The reproducibility of the effect of the treatment was tested by repeating the recordings. Results: The mean tcPO2 increased 1.0 kPa (range −0.2 to 3.4 kPa) immediately after PEP treatment (p=0.0001). No significant changes in tcPCO2 or RR were noted. The reproducibility of the effect of PEP treatment was good, with a significant increase in tcPO2 at all retests. All children accepted the treatment well. Conclusion: PEP increases blood oxygen tension immediately after treatment in severely disabled children with airway mucus accumulation. Long‐term effects remain to be proven.
Are influences during pregnancy associated with wheezing phenotypes during the first decade of life?
Authors: Kurukulaaratchy Ramesh J , Waterhouse Linda , Matthews Sharon M , Arshad Sayed H 
Published: August 2010

Abstract Aim: Recently, attention has focused on possible early life origins for asthma. We sought to identify whether factors present during pregnancy were associated with development of childhood wheezing phenotypes. Methods: A whole population birth cohort (n=1456) on the Isle of Wight, UK, was followed through to age 10 y. Where possible, information regarding environmental exposures and events during pregnancy was obtained from the maternity records (n=1238). Children were seen at ages 1, 2, 4 and 10 y, and wheezing symptoms were used to define wheezing phenotypes in the first decade (n=1034). Results: Risk of early‐onsetpersistent wheeze (onset in the first 4 y, still present at age 10) was increased by environmental tobacco smoke exposure in pregnancy (OR=2.44; 95% CI: 1.37–4.34) plus maternal asthma (3.57; 1.84–6.94), but reduced by cat ownership (0.30; 0.13–0.62). Early transient wheeze (onset in the first 4 y, but not present at age 10) was increased by environmental tobacco smoke exposure (1.58; 1.02–2.45), male gender (1.68; 1.09–2.60) and low birthweight (3.65; 1.27–10.52). No environmental factors in pregnancy were associated with late‐onset persistent wheeze (onset after age 4 y, still present at 10 y). Conclusion: In addition to genetics, maternal exposures during pregnancy show association with childhood and especially early‐life wheezing phenotypes.