bluuebunny/crossref_metadata_2025_split huggingface dataset:
Concentrations of IL‐10 in preterm human milk and in milk from mothers of infants with necrotizing enterocolitis
Authors: Fituch CC , Palkowetz KH , Goldman AS , Schanler RJ 
Published: August 2010

Background: Despite the protective effects of human milk against necrotizing enterocolitis, the incidence is highest in the extremely premature infant, and only minimally decreased with feeding human milk. This suggests that certain protective agents may be lower in milk from mothers delivering extremely premature infants. The anti‐inflammatory cytokine IL‐10 was one possibility. Aim: We hypothesized that low concentrations of IL‐10 in preterm milk contribute to the development of necrotizing enterocolitis in extremely premature infants. Methods: IL‐10 in human milk collected at weeks 1, 2, and 4 postpartum was measured by ELISA in mothers of infants born extremely premature at 23–27 wk gestation (group EP), premature at 32–36 wk gestation (group P), and term at 38–42 wk gestation (group T). Single milk samples were collected from a separate group of mothers whose infants developed necrotizing enterocolitis. Results: There were no significant differences in concentrations of milk IL‐10 among groups EP, P, or T. Concentrations of IL‐10 declined as lactation progressed (p > 0.001). IL‐10 in milk was frequently undetected in all groups, but even more so in the milk of the group of women whose infants had necrotizing enterocolitis (86%) than in groups EP (40%) and P (27%) (p > 0.01). Conclusion: IL‐10 was present in preterm milk from most women, and the concentrations in preterm and term milk were not significantly different. A paucity of IL‐10 in human milk was found in certain mothers in each group, especially in those whose infants developed necrotizing enterocolitis.
Migrant children—a challenge for European paediatricians
Authors: Hjern A , Bouvier P 
Published: August 2010

Each year, tens of thousands of children seek asylum in Europe. Irregular immigration, family reunification programmes and labour migrants contribute additional large populations to the migrant scene in Europe. Paediatricians struggle to find solutions to their needs of health and medical care within different societal and political contexts on a common platform of children's rights and medical ethics. Conclusions: Migrant children have important health and protection needs. Paediatricians can improve the health and well‐being of migrant children by assuring access to paediatric healthcare regardless of the child's legal status. Paediatricians can play an important role in advocating for migrant children in their local community, through concerted activities of national paediatric societies, and through the international paediatric community. National paediatric societies need to put migrant children high on their agenda in discussions with policy and decision makers. Initiatives are needed to create platforms within the international paediatric community where practical strategies to the multitude of issues touched upon by migrant children can be exchanged and international advocacy organized.
Antipsychotic medication and marked hyperprolactinaemia: iatros or true prolactinoma?
Authors: Koves IH , Jarman FC , Cameron FJ 
Published: August 2010

Aim: To demonstrate that hyperprolactinaemia and/or prolactinoma occur in association with antipsychotic medication use. Methods: Three case studies of patients with markedly elevated serum prolactin level (<132 μg/1); either antipsychotic medication induced or as a consequence of a prolactinoma. Conclusion: The management and investigation of children with markedly elevated serum prolactin levels remains poorly defined. In our case series, two patients were found to have prolactinomas. We suggest that paediatric patients with serum prolactin level above 50 μg/1 in males and 70 μg/1 in females, regardless of any antipsychotic medication use, receive magnetic resonance imaging to exclude prolactinoma.
Poly chlorinated biphenyls in colostral milk and visual function at 12 months of life
Authors: Riva E , Grandi F , Massetto N , Radaelli G , Giovannini M , Zetterström R , Agostoni C 
Published: August 2010

Background and aims: Environmental contaminants such as persistent organic chlorines and heavy metals, which are supplied to the foetus by transplacental transfer and to breastfed infants by the milk, may impair cognitive functions. Long‐chain polyunsaturated fatty acids, which are known to enhance development during foetal life and early infancy, may counteract the toxic effect of environmental contaminants. In this study, we have investigated whether polychlorinated biphenyls (PCBs) impair early development of vision, and whether such impairment can be modulated by essential long‐chain polyunsaturated fatty acids. Material: Healthy term infants born in Milan and its surroundings, and who were exclusively breastfed for at least 4 mo, were prospectively examined up to the age of 12 mo. Methods: Samples from colostrums, the first 2d after delivery, and of mature breast‐milk after 1 and 3 mo were collected. The samples were analyzed for PCB 105, 118, 138, 153, 156 and 180 and for DDT and DDE. In all infants, the plasma levels of the long‐chain polyunsaturated fatty acids (LC‐PUFAs), C18:2 n‐6, C18:3 n‐3, C20:4 n‐6, C20:5 n‐3 and C22:6 n‐3 were analysed within the first three postnatal days. The PCB levels in colostral milk, as well as of LC‐PUFAs in plasma, were considered to mirror perinatal supply. Visual function was evaluated by P100 with latency evoked potentials (VEPs) at 12 mo of age. Statistical analysis was based on simple and partial correlation coefficients (p > 0.05). Results: On bivariate analysis, wave latency VEP at 15 min was significantly related to the colostral levels of DDT, DDE and all examined PCBs except PCB 105 (with correlation coefficient r= 0.401 to 0.618), whereas P100 wave latency VEP at 60 min was related to DDT (r= 0.513) and PCB 180 (r= 0.504). Infant plasma levels of C22:6 n‐3 were inversely associated with P100 wave latency at 60 min (r=‐0.418) and at 1 Hz‐2 J (r=‐0.466). After controlling for C22:6 n‐3, the partial correlation coefficient of P100 wave latency VEP at 15 min to the colostral level of PCB 180 was 0.403 (p= 0.07).Conclusion: Within the population of this study, a weak relation was found between impaired visual function at 12 mo of age of healthy infants and the levels of PCBs, DDT and DDE in colostral milk. The effect of impairment was no longer evident after controlling for the plasma level of LC‐PUFAs as found in the infant a few days after birth.
Effect of activators and the phosphodiesterase inhibitors Pentoxifylline and Enoximone on the deformability of neutrophils in neonates and adults
Authors: Ruef P , Poeschl JMB , Simon C , Altfelder F , Craciun E , Linderkamp O 
Published: August 2010

Background: Stimulated polymorphonuclear leukocytes (PMN) are extremely rigid compared to resting PMN. They may obstruct narrow vessels and contribute to ischaemic organ injury. Deformability is a prerequisite for both active and passive movement in the microcirculation. Aim: The investigation was designed to study whether stimulators and inhibitors of stimulation show different effects on deformability of neonatal and adult PMN. Methods: Deformability of PMN was assessed by complete aspiration of a PMN into a micropipette with an internal diameter of 5 μm. Blood samples from 20 neonates and 20 adults were studied before and after stimulation with N‐formyl‐methionyl‐leucyl‐phenylalanine (fMLP), interleukin‐8 (IL‐8) or tumour necrosis factor‐α (TNF‐α). Moreover, effects of the phosphodiesterase inhibitors Pentoxifylline (PTX) and Enoximone on the deformability of stimulated PMN were investigated. Results: fMLP, IL‐8 and TNF‐α significantly delayed aspiration times of PMN in relation to the concentrations of the stimulators. The addition of PTX or Enoximone to stimulated PMN increased the deformability up to 60% depending on the concentration of the inhibitors. No significant differences in the aspiration times were found between neonatal and adult PMN at any of the experimental conditions after activation with the three stimulators and treatment with the two inhibitors. Conclusion: Neonatal and adult PMN show similar reduction of passive deformability when stimulated with either fMLP, IL‐8 or TNF‐α compared to resting PMN and a similar improvement of deformability in response to PTX or Enoximone.
Clinicians' perspective on quality of life assessment in paediatric clinical practice
Authors: Baars RM , van der Pal SM , Koopman HM , Wit JM 
Published: August 2010

Aim: This study was undertaken to investigate paediatric clinicians' views on and use of quality of life (QoL) assessment in clinical practice. Methods: A survey was conducted among members of the Dutch Paediatric Association via e‐mail. Results: Over half of the 303 respondents (57%) believed that it was possible to use QoL questionnaires in clinical practice. The majority indicated that assessing QoL was beneficial and that it was especially necessary to assess QoL in children with a chronic disease (82%). Although only a minority (17%) currently used QoL questionnaires, most respondents would want to use QoL questionnaires in the future (76%). Obstacles that prevent the use of QoL questionnaires are the extra time needed for assessment, the unavailability of standardized questionnaires and insufficient knowledge about QoL. Conclusion: This survey shows that paediatric clinicians are positive towards QoL assessment, but that certain obstacles prevent the use of questionnaires. Thus, to facilitate future use, QoL questionnaires need to be developed from the perspective of the paediatrician. This means that they need to be developed for clinical use and brought to the attention of the paediatric health care community, demonstrating their validity to child health care.
Prediction of academic and behavioural limitations in school‐age survivors of bacterial meningitis
Authors: Koomen I , Grobbee DE , Roord JJ , Jennekens‐Schinkel A , van der Lei HDW , Kraak MAC , van Furth AM 
Published: August 2010

Aim: To develop a prediction rule to identify postmeningitic children at high risk of academic and behavioural limitations. Methods: 182 children (mean age 10 y; range 5–14) were selected from a cohort of 674 school‐age survivors of bacterial meningitis. These children had neither meningitis with “complex onset”, nor prior cognitive or behavioural problems, nor severe disease sequelae. On average, 7 y after the meningitis, they were evaluated using an “Academic Achievement Test”, and their parents filled in the “Child Behaviour Checklist”. By reviewing the medical records, potential risk factors for academic and/or behavioural limitations were collected. Independent predictors were identified using multivariate logistic regression analysis, leading to the formulation of a prediction rule. Results: The cumulative incidence of academic and/or behavioural limitations among children who survived bacterial meningitis without severe disease sequelae was 32%. The prediction rule was based on nine independent risk factors: gender, birthweight, educational level of the father, S. pneumoniae, cerebrospinal fluid leukocyte count, delay between admission and start of antibiotics, dexamethasone use, seizures treated with anticonvulsive therapy, and prolonged fever. When 10 was taken as a cut‐off point for the risk score computed using this rule, 76% of the children with limitations could be identified, while 38% of the children in the cohort were selected as at risk for these limitations. Conclusion: With a prediction rule based on nine risk factors, postmeningitic children at high risk of developing academic and/or behavioural limitations could be identified. Additional research is required to further validate this prediction rule. In the future, a careful follow‐up of high risk children may enhance early detection and treatment of these limitations.
Intractable congenital chylous ascites
Authors: te Pas AB , vd Ven K , Stokkel MPM , Walther FJ 
Published: August 2010

A male newborn presented with congenital chylous ascites, the treatment of which is difficult and complicated due to persistent loss of chyle. The primary therapeutic goal is to reduce the lymph flow and to allow the leakage to heal naturally. Usually, conservative management—enteric rest with total parental feeding or an enteral diet with medium‐chain triglycerides—can achieve this. A new treatment option is the use of octeotride, a somatostatin analogue. Both therapies failed in our patient, and surgical ligation of the leaking lymphatic duct was successful. Conclusion: The success of the surgical treatment depends on localizing the leaking lymphatic duct. Lymphatic imaging with lymphoscintigraphy and pre‐operative administration of lipophilic dye can assist the surgeon.
Illness and exposure to negative life experiences in adolescence: two sides of the same coin? A study of 15‐year‐olds in Oslo, Norway
Authors: Haavet OR , Straand J , Saugstad OD , Grünfeld B 
Published: August 2010

Aim: To investigate associations between negative life experiences and common illnesses among adolescents. Methods: Cross‐sectional questionnaire study carried out at all lower secondary schools (10 grade) in Oslo, Norway, during 2000 and 2001 (n= 8316 pupils). Different negative life experiences and illnesses were addressed. Results: The participation rate was 88%. Among reported negative life experiences last year were a pressure felt to succeed (62%), death of a close person (26%), exposure to physical violence (22%), bullying at school (15%) and sexual violation (4%). A large number of the pupils had some chronic illness: hay fever (38%), eczema (29%) and asthma (13%). Reported illnesses the previous 12 month were: headache (56%), painful neck or shoulders (35%), sore throat at least three times (15%), lower respiratory tract infection (9%) and mental problems for which help was sought (7%). During the week prior to the survey, 26% of all girls had symptoms of a depressive disorder, while this applied to 10% of all boys. Fifty‐three percent of the boys (29% of the girls) who had depressive symptoms had been exposed to physical violence. Sexually violated boys had a high probability for seeking help for mental problems (OR = 4.9) and for frequent episodes of sore throat (OR = 2.5). Corresponding odds ratios for girls were 1.7 and 2.5, respectively. Conclusion: Common illnesses in adolescence are significantly associated with negative life experiences. In clinical encounters with adolescents not only should the presenting complaints be addressed, but also other common illnesses and relevant background factors such as negative life events.
Immunogenicity and safety of a virosomal hepatitis A vaccine (Epaxal®) in healthy toddlers and children in Chile
Authors: Riedemann S , Reinhardt G , Ibarra H , Frösner GG 
Published: August 2010

In this open study, 20 toddlers and 80 schoolchildren received an intramuscular dose of Epaxal® and a booster dose 12 mo later to assess the efficacy and safety of this aluminium‐free, virosomal hepatitis A vaccine. Four weeks after primary vaccination, 94% of toddlers and 99% of schoolchildren had seroconverted, and all toddlers and 94% of schoolchildren remained seroprotected for 12 mo. Conclusion: After vaccination with Epaxal® and booster, all subjects were seroprotected. Epaxal® was very well tolerated by both age groups.
Lower leg growth suppression caused by inhaled glucocorticoids is not accompanied by reduced thickness of the cutis or subcutis
Authors: Schou AJ , Plomgaard AM , Thomsen K , Wolthers OD 
Published: August 2010

Background: Exogenous glucocorticoids suppress short‐term lower leg growth in children as assessed by knemometry. The knemometric measurements, however, may be confounded by reductions in the thickness of the cutis and subcutis over the knee. Aim: To assess whether inhaled glucocorticoid‐induced suppression of short‐term growth is accompanied by changes in the thickness of the cutis and subcutis. Methods: The study was a randomized, controlled, crossover trial with 1 wk treatment, run‐in and washout periods. Active treatment was inhaled budesonide 200 μg twice daily. Short‐term growth was assessed by knemometry, and the thickness of the cutis and subcutis over the knee, on the volar forearm and abdomen was measured by 20 MHz B‐mode ultrasound. Material: Nineteen children with asthma aged 7 to 13 y. Results: Lower leg growth was significantly reduced during budesonide treatment (0.27 mm/wk) compared to the treatment‐free period (0.54 mm/wk) (p= 0.02, 95%: –0.50 to –0.05). Variations in the thickness of the cutis were seen during budesonide treatment (mean ± SEM): –0.01 ± 0.03 mm over the knee, –0.02 ± 0.02 mm on the forearm and 0.01 ± 0.02 mm on the abdomen. The variations in the total thickness of the cutis and subcutis were –0.05 ± 0.12 mm, 0.06 ±0.12 mm and –0.06 ± 0.10 mm during budesonide treatment. The variations in thickness of the cutis or subcutis were not statistically different during budesonide treatment and the treatment free period in any anatomical location. Conclusions: Short‐term lower leg growth suppression induced by inhaled glucocorticoids is not confounded by variations in thickness of cutis or subcutis. The present observations further establishes knemometry as a reliable tool for assessment of the risk of growth suppression of inhaled glucocorticoids in children with asthma.
Ultrasound bone measurements in pre‐adolescent girls: interaction between ethnicity and lifestyle factors
Authors: Micklesfield LK , Zielonka EA , Charlton KE , Katzenellenbogen L , Harkins J , Lambert EV 
Published: August 2010

Aim: We obtained calcaneal ultrasound measurements in 198 girls between 7.5 and 11.7 y of age, representing ethnic groups (black [n= 80], white [n= 41], mixed ancestral origin [n= 77]) in South Africa. Methods: Anthropometry was assessed. Demographics, physical activity, habitual dietary calcium intake and pubertal development were quantified by questionnaires. Broadband ultrasound attenuation (BUA) and speed of sound (SOS) of the left calcaneus were measured. Girls in Tanner breast stage 5 and/or those menstruating were excluded from analysis. Results: Black girls were lighter than white girls (31.4 ± 7.8 vs 34.8 ± 7.5 kg; p < 0.05), and shorter than girls of mixed ancestral origin (1.29 ± 0.08 vs 1.34 ± 0.07 m; p < 0.001) and white girls (1.35 ± 0.07 m; p < 0.001), after adjusting for age. Reported calcium intake scores were higher in black than white girls (21.6 ± 11.1 vs 16.1 ± 8.4; p < 0.01). Total peak bone strain score (TPBSS) was higher in white compared to black girls (6.8 ± 4.8 vs 5.0 ± 4.7; p < 0.05), while walking energy expenditure (MET h/wk) was higher in black girls compared to the other groups (p < 0.001). BUA and SOS were higher in the black girls (59.6 ± 13.7 dB/MHz; 1575.1 ± 22.6 m/s; p < 0.001) and girls of mixed ancestral origin (59.0 ± 12.5 dB/MHz; 1567.8 ± 26.1 m/s; p < 0.01) than in the white girls (50.4 ± 8.7 dB/MHz; 1552.1 ± 19.5 m/s). Co‐varying for age and weight did not affect these results. Walking energy expenditure (r= 0.20) and calcium score (r= 0.17) were correlated (p < 0.05) with SOS for the whole group.Conclusion: Ultrasound parameters were lower in the white compared to the black girls, who consumed more calcium on average, but who were lighter, shorter and performed less impact activity. This suggests that interactions between ethnicity and lifestyle factors determine bone quality in premenarcheal girls.
Is there any role for protein hydrolysates to premature newborns?
Authors: Foucard T. 
Published: August 2010

AbstractThe use of hydrolysed cow's milk formula seems to increase beyond what is recommended based on evidence regarding allergy‐preventive effect. Infants born preterm are sometimes given such formulas without proven effect. Conclusion: If the use of hydrolysed cow's milk formula is based on allergy‐preventive aspects, evidence‐based recommendations should be followed.
Long‐chain polyunsaturated fatty acids and neurological developmental outcome at 18 months in healthy term infants
Authors: Bouwstra H. , Dijck‐Brouwer D. A. J. , Boehm G. , Boersma E. R. , Muskiet F. A. J. , Hadders‐Algra M. 
Published: August 2010

Abstract Aim: Previously, we found a beneficial effect of 2 mo supplementation of infant formula with long‐chain polyunsaturated fatty acids (LC‐PUFA) on neurological condition at 3 mo in healthy term infants. The aim of the present follow‐up study was to evaluate whether the effect on neurological condition persists until 18 mo. Methods: A prospective, double‐blind, randomized control study was conducted. Three groups were formed: a control (CF; n=169), an LC‐PUFA‐supplemented (LF; n=146) and a breastfed (BF; n=159) group. Information on potential confounders was collected at enrolment. At the age of 18 mo, neurodevelopmental condition was assessed by the age‐specific neurological examination of Hempel and the Bayley scales. The Hempel assessment resulted in a clinical neurological diagnosis, a total optimality score and a score on the fluency of motility. The Bayley scales resulted in mental and psychomotor developmental indices. Attrition at 18 mo was 5.5% and non‐selective. Multivariate regression analyses were carried out to evaluate the effect of type of feeding while adjusting for confounders. Results: None of the children had developed cerebral palsy and 23 (CF: n=8; LF: n=10; BF: n=5) showed minor neurological dysfunction. The groups did not show statistically significant differences in clinical neurological condition, neurological optimality score, fluency score, and the psychomotor and mental development indices. Multivariate analysis confirmed that there was no effect of type of feeding on neurological condition. Conclusion: This study indicates that the beneficial neurodevelopmental effect of 2 mo LC‐PUFA supplementation in healthy term infants can not be detected at the age of 18 mo.
Cytomegalovirus transmission to extremely low‐birthweight infants through breast milk
Authors: Doctor S. , Friedman S. , Dunn M. S. , Asztalos E. V. , Wylie L. , Mazzulli T. , Vearncombe M. , O'brien K. 
Published: August 2010

Abstract Aim: To determine the incidence, timing and clinical significance of acquired postnatal cytomegalovirus (CMV) in extremely low‐birthweight (ELBW) infants. Methods: Prospective, longitudinal surveillance study. ELBW infants were recruited in the first week of life. Maternal blood was tested for CMV‐specific IgG antibodies. Weekly urine samples were obtained from infants for CMV culture and rapid antigen testing. Data were collected regarding clinical course and breast milk intake. Results: Of 181 eligible infants, 119 infants, born to 101 mothers, were enrolled. Eighty of the 101 mothers had their serum checked for CMV status. Seventy percent of those tested were seropositive for CMV. Of the 65 infants born to seropositive mothers, 94% received breast milk during their hospital stay. Complete urine collection was obtained in 92 infants. CMV was cultured from the urine of only four infants, all of whom were born to seropositive mothers. Only one of these four infants was symptomatic. The range at which CMV was first detected was between 48 and 72 postnatal days of age. Conclusions: Despite a very high CMV seropositivity rate in mothers of ELBW infants, and the previously reported high rate of CMV excretion into breast milk, the incidence of postnatal CMV transmission was extremely low in our study.