bluuebunny/crossref_metadata_2025_split huggingface dataset:
Onset of puberty at eight years of age in girls determines a specific tempo of puberty but does not affect adult height
Authors: Llop‐Viñolas D , Vizmanos B , Monasterolo R Closa , Subías J Escribano , Fernández‐Ballart JD , Martí‐Henneberg C 
Published: August 2010

Aims: To analyse the effect of early puberty (onset between 7.5 and 8.5 y) on pubertal growth and adult height in girls, and the implications of this effect for the age limit for normal onset of puberty. Methods: Longitudinal study in Reus (Spain) of 32 girls with early puberty until they reached adult height. Data from these girls were compared with longitudinal data from girls (116) from the same population with normal onset at 10 (n= 37), 11 (n= 47), 12 (n= 19) and 13 (n= 13) y. We analysed height, target height, adult height, pubertal height increase, duration of pubertal growth, age at menarche and time to menarche. Results: The adult height of girls with early puberty (160.9 ± 5.4 cm) was similar to that of girls with onset at later ages (p= not significant). In these girls, puberty lasted 5.4 ± 0.7 y and the mean growth during puberty was 31.1 ± 3.5 cm. As the age of onset of puberty increases, the duration of puberty and mean growth during puberty progressively decreased (p < 0.001). Girls with early puberty reached menarche at a mean age of 10.9 ± 1.0 y, 3.2 ± 0.9 y after onset of puberty, and this time span was greater than in the other groups. Conclusion: Girls with onset of puberty at 8 y show all the compensatory phenomena related to height at onset, pubertal duration and height increase during puberty. These phenomena cause their adult height to be similar to that of girls who begin puberty at the age of 10 to 13 y.
Adaptation of reaching movements in children and young adults with myelomeningocele
Authors: Norrlin S , Rösblad B 
Published: August 2010

Aim: To investigate the ability to adapt reaching movements to new visuomotor gain conditions in subjects with myelomeningocele (MMC) and subjects without disabilities. In addition, differences in movement error within the MMC group were investigated. Methods: Thirty subjects with myelomeningocele, 9–19 y, and 30 subjects without disabilities were included in the study. Data were collected with a digitizing tablet linked to a computer. The subjects made reaching movements towards three targets at different distances displayed on the computer screen, and movements were carried out under two different gain conditions—a base condition and an altered condition. Adaptation was quantified from the extent error and expressed in percentage of the target distances. For statistical analysis, ANOVA and t‐tests were used. Results: Under the base condition, no statistically significant difference between the groups was found, but after the first gain change, the MMC group evinced larger percentage error compared to the control group (p= 0.005). Analysis showed that the subjects in the MMC group did not fully adapt their movements under the altered condition after several trials of practice, but in the control group movements were rapidly adapted to the new gain. Subjects with early and severe symptoms of brainstem dysfunction showed a dramatic increase in error variability under the altered condition, while subjects who had shunt‐treated hydrocephalus did not have larger percentage error compared to the others. Conclusion: Motor adaptation of reaching movements was impaired in subjects with MMC, but short‐term motor learning did also occur in the MMC group.
Reduced case fatality among hospitalized children during a war in Guinea‐Bissau: a lesson in equity
Authors: Sodemann M , Veirum J , Biai S , Nielsen J , Bale C , Jakobsen M Skytte , Gustafson P , Aaby P 
Published: August 2010

Background: During a recent armed conflict in Guinea‐Bissau, we observed a marked decline in the case fatality among hospitalized children at the only paediatric department in the country. Aim: To analyse the causes behind the observed fall in case fatality. Material: All children hospitalized at the only paediatric department in the capital of Guinea‐Bissau. The war cohort comprised all children hospitalized during the war, which lasted from June 1998 to May 1999, and the peace cohort comprised all children hospitalized in the year preceding the war. As part of a longitudinal community study, we also registered all children being hospitalized from the Bandim Health Project's study area, including routinely collected information on socio‐economic background factors. Methods: The war cohort was compared with the peace cohort in terms of determinants for hospital case fatality. Through information in the community register, we examined post‐hospital mortality in the 2 wk after discharge as well as socio‐economic differences in recruitment during the war. Hospital case fatality was estimated by odds ratios and compared by multiple logistic regression. Community mortality risk was estimated by deaths per person years. Results: The case fatality among children aged 0–14 y fell during the war (age‐adjusted OR = 0.58; 95%CI: 0.50–0.68). There was a uniform reduction in case fatality among children hospitalized less than 7 d, while we observed no decline among children hospitalized longer. There were more children per bed during the war and mean hospitalization time was shorter, and post‐discharge mortality also fell (mortality ratio (MR) = 0.57; 95%CI: 0.40–0.83). Adjustment for socio‐economic con‐founders in recruitment during the war period made no difference to the estimated decline in case fatality. The decline in case fatality at the hospital was not explained by a general decline in mortality. Compared with the preceding year, the mortality ratio was 1.34 (1.20–1.51) in the Bandim Health Project's study area during the war. Adjusted for age, the decline in case fatality at the hospital was most marked for disadvantaged groups. For example, the general reduction in case fatality was 42% (95%CI: 11–63); however, children of mothers without any schooling experienced a reduction of 73% (95%CI: 27–90%), whereas the reduction was only 33% (95%CI: 14–61%) for children of mothers with school education. Conclusion: The decline in case fatality could be explained neither by a general decline in childhood mortality nor by changes in recruitment or discharge policy. The decline was therefore most likely due to improved treatment as a result of better availability of drugs funded by humanitarian aid and the presence of dedicated staff, which was offered relief food as compensation. Interventions improving case management may have a proportionately larger effect for poor families.
Clinical and morphological features of paediatric myelodysplastic syndromes: a review of 34 cases
Authors: Polychronopoulou S , Panagiotou JP , Kossiva L , Mavrou A , Anagnostou D , Haidas S 
Published: August 2010

Background: The clinical and morphological spectrum of myelodysplastic syndromes (MDS) during childhood has not yet been completely documented. We herein present the clinical features and morphological data from peripheral blood (PB), bone marrow aspirates (BMA) and bone marrow biopsies (BMB) of a series of paediatric MDS patients, with particular emphasis on their specific morphological characteristics and their diverse underlying genetic background. Patients and methods: Thirty‐four patients with MDS (median age 8.45 y) were consecutively diagnosed and treated during a period of 15 y (1988–2002). Diagnosis was based on clinical manifestations, morphology of PB, BMA and BMB, and cytogenetic analysis of BM cells. Clonogenic methyl‐cellulose cell cultures were performed in 23/34 patients. Patients were categorized into group A [26 primary/de novo MDS, i.e. refractory anaemia (RA) 18, RA with excess of blasts (RAEB) 2, RAEB in transformation (RAEB‐t) 6] and group B (8 secondary MDS, i.e. RA 4, RAEB 1, RAEB‐t 3). Treatment options varied according to protocols active during the period of the study and the availability of a suitable BM donor. Survival probabilities were estimated using the Kaplan‐Meier method. Results: Dysplastic features of the erythroid, myeloid and megakaryocytic lineage were detected at BMA in 85%, 50% and 90% of the patients, respectively, while decreased cellularity was found at BMB in 21/34 patients (60%). RA patients of group A presented at BMB significant hypocellularity (14/18) as a prominent finding due to decrease of the myeloid (13/18 patients) and/or the megakaryocytic (14/18 patients) lineage. Hypocellularity in RA was accompanied by dysplasia of the erythroid (17/18 patients) and megakaryocytic (16/18 patients) lineage, the presence of abnormal localization of immature precursors (ALIP, 8/18 patients), fibrosis (5/18) and stromal changes (11/18). Chromosomal aberrations were revealed in 17/34 patients, of which monosomy 7 was present in seven. Cell cultures demonstrated abnormal myeloid and/or erythroid in vitro clonal growth pattern in all the examined patients. An associated disorder or inherited disease, was identified in 14/26 patients (54%) with primary MDS. Cumulative survival of group A patients was 44.2% (RA 66.6%, RAEB/RAEBt 14.6%; p= 0.001), and of the whole group 42.4%, at 14 y.Conclusions: Hypocellularity of significant degree is a constant and prominent feature among paediatric MDS, especially those with RA. A large variety of associated disorders underlies the clinical appearance of paediatric MDS, reflecting their marked heterogeneity. RA represents the prominent subtype during childhood (69% in this study), and it appears to have the best prognosis, while prognosis of RAEB/RAEBt remains extremely poor.
Effect of BCG vaccine on tuberculin skin tests in 7–11‐year‐old children
Authors: Bozaykut A , Atay E , Sevim H , Atay Z , Ceran O 
Published: August 2010

Aim: To determine the effect of Bacillus Calmette Guerin (BCG) vaccination on tuberculin skin test responses in 7–11‐year‐old children, and also to clarify whether the number of vaccinations and the time interval between vaccination and tuberculin skin test have an effect on the test responses. Method: 1200 primary school children were evaluated for the presence and number of BCG scars. They were then given 5 TU PPD‐S intra‐dermally. Seventy‐two hours after the application of tests, PPD indurations were measured. Results: Mean indurations were 3.7 ± 3.9, 6.5 ± 5.4 and 9.2 ± 7.1 mm in children with no scar, one scar and two scars, respectively. No statistical difference was found between mean induration of children with one scar and those with two scars.Conclusion: The effect of the number of BCG vaccinations and the time interval between vaccination and tuberculin skin test application on tuberculin skin test responses was statistically insignificant.
Influence of anthropometric parameters on the body composition measured by bioelectrical impedance analysis or DXA in children
Authors: Leppik A , Jürimäe T , Jürimäe J 
Published: August 2010

Aim: To investigate the influence of anthropometric measures (skinfold thicknesses, girths, lengths and breadths/lengths) on (1) the whole body impedance and impedance index and (2) the body fat mass measured by means of DXA in children. Methods: Nine skinfolds, 13 girths, eight lengths and eight breadths/lengths were measured in 26 boys and 27 girls, 11–12 y of age. The somatotype components—endomorphy, mesomorphy and ectomorphy—were assessed according to the method of Carter and Heath. Body impedance at 50 kHz was measured (Multiscan 5000, Bodystat Ltd, UK) and impedance index (height2/impedance) was calculated. Four body components—total body fat mass and separate hands, legs and trunk fat mass—were determined using DXA. Results: Skinfold thicknesses did not influence body impedance or impedance index according to stepwise multiple regression analysis. Impedance index was influenced more by the girth measures than was body impedance. The leg length measures highly influenced the impedance index (50–81%, R2± 100). Different breadth/length parameters influenced body impedance and body impedance index (21–49%). Mesomorphy influenced body impedance only in boys (35%). Body fat mass measured by DXA was highly dependent on the measured skinfold thicknesses (59–92%). The influence of lengths and breadths/lengths on the total fat mass was significant (25–49%). Endomorphy characterized total fat mass as 86% and 52% in boys and girls, respectively.Conclusion: Variation in anthropometry highly determined the variance observed in impedance in children, and the girths were the best predictors of impedance. Selected skinfold thicknesses highly predicted fat mass measured by DXA for total body, trunk, arms and legs.
Using radioligand‐binding assays to measure tissue transglutaminase autoantibodies in young children
Authors: Agardh D , Carlsson A , Lynch K , Axelsson I , Lernmark Å , Ivarsson S‐A 
Published: August 2010

Aim: To measure autoantibodies against tissue transglutaminase (tTG) in young children prospectively screened for coeliac disease (CD). Methods: In total, 652 children aged 2.9 (2.5–4.2) y were analysed for IgA‐tTG and IgG‐tTG with radioligand‐binding assays and IgA endomysial antibodies (EMA) by indirect immunofluorescence. Antibody‐positive children were retested after 1.2 (range 0.2–1.9) y. Intestinal biopsy was performed on children with persistently high antibody levels. Results: In total, 3.2% (95% CI: 1.9–4.6%) of the 652 children were positive for at least one antibody at baseline: 2.5% (95% CI: 1.3–3.7%) for IgA‐tTG, 1.7% (95% CI: 0.7–2.7%) for IgG‐tTG and 2.9% (95% CI: 1.6–4.2%) for IgA‐EMA, respectively. Ten children were positive for all three antibodies, five for both IgA‐tTG and EMA, four for EMA only, one for IgA‐tTG and another for IgG‐tTG. IgA‐EMA titres correlated with IgA‐tTG levels (r= 0.73, p= 0.0003). At follow‐up, seven of 20 children remained positive for all three antibodies, three for IgA‐tTG only, one for both IgA‐tTG and EMA, one for IgA‐tTG and IgG‐tTG, and the remaining child refused further participation. Three biopsies showed villous atrophy, two increased intraepithelial lymphocytes and two normal findings. Biopsy was not performed in four children with low or declining tTG antibody levels at follow‐up and in one child who declined. CD was evident in 0.5% (95% CI: 0.0–1.0%) (3/652).Conclusion: This study revealed a high number of young children positive for tTG antibodies as well as EMA, but the majority showed declining levels in both antibodies over time. We suggest using radioligand‐binding assays for quantitative measurement of tTG antibodies when change in antibody levels is studied in young children.
Relation of serum leptin and insulin‐like growth factor‐1 levels to intima‐media thickness and functions of common carotid artery in children and adolescents with type 1 diabetes
Authors: Atabek ME , Kurtoglu S , Demir F , Baykara M 
Published: August 2010

Background and aim: Leptin and insulin‐like growth factor‐1 (IGF‐1) have been suggested to be involved in the pathogenesis of atherosclerosis. The aim of this study was to evaluate the relationship between serum leptin, IGF‐1 and intima‐media thickness (IMT) and functions of common carotid artery (CCA) in children and adolescent patients with type 1 diabetes. Material and methods: Serum leptin and IGF‐1 levels were measured in 45 diabetic patients (23 girls and 22 boys). Age, diabetes duration as well as major cardiovascular risk factors, including anthropometric and metabolic parameters, were matched between girls and boys. The relation of serum leptin and IGF‐1 levels to CCA structure and functions were measured by ultrasonography as IMT, cross‐sectional compliance (CSC), cross‐sectional distensibility (CSD), diastolic wall stress (DWS) and incremental elastic modulus (IEM). Results: Serum leptin levels of diabetic girls were higher than those in the boys (21.8 ± 14.5 μg/1 vs 8.9 ± 10.6 μ.g/1, p= 0.002). However, the difference for serum IGF‐1 levels was not significant between diabetic girls and boys (240.7 ± 96.8 μg/ml vs 234.7 ± 93.2 ng/ml; p < 0.05). In all subjects, leptin levels were correlated with CSC (p= 0.04), CSD (p= 0.04) and IEM (p= 0.01), and IGF‐I levels were only correlated with CSC (p= 0.01). Leptin did not show any correlation with ultrasonographic measurements in both girls and boys separately. IGF‐1 was correlated with CSC (p= 0.001), CSD (p= 0.002) and IEM (p > 0.001) in boys but not in girls. In a multivariate regression model, IGF‐1 emerged as independent correlates for mean CSD and IEM in boys but not in girls.Conclusion: Serum leptin and IGF‐1 levels in children and adolescent patients with type 1 diabetes are associated with functions of common carotid artery, and the association of IGF‐1 levels is influenced by sex.
Effects of intralipid infusion on blood viscosity and other haemorheological parameters in neonates and children
Authors: Kessler U , Poeschl J , Raz D , Linderkamp O , Bauer J 
Published: August 2010

Aim: To study acute haemorheological effects of intralipid in preterm and full‐term neonates and children. Circulatory complications of intralipid infusion, such as increases in pulmonary and peripheral flow resistance, have been associated with impaired blood rheology. Methods: During total parenteral nutrition, 10 preterm infants, 10 full‐term neonates and 10 children received an initial dose of intralipid as continuous infusion (0.6 g/kg) over 4 h. Additionally, blood of 10 healthy preterm infants, 10 full‐term neonates and 10 adults was incubated with intralipid. Whole blood and plasma viscosity (capillary viscometer), red blood cell (RBC) deformability (rheoscope) and RBC aggregation (Myrenne aggregometer) were measured before and after intralipid infusion and before and after in vitro incubation of blood with intralipid. Results: During intralipid infusion, plasma triglyceride levels increased from 0.13 ± 0.27 to 2.16 ± 0.68g/l in the preterm infants, from 0.14 ± 0.21 to 1.64 ± 0.54g/l in the full‐term neonates and from 0.65 ± 0.31 to 2.26 ± 0.60 g/l in the children. Whole blood viscosity decreased by about 10% after intralipid in all three groups due to similar decreases in haematocrit. RBC aggregation decreased by about 20% after intralipid infusion. Plasma proteins, plasma viscosity and RBC deformation were not affected by intralipid. In vitro incubation of blood with intralipid resulted in a marked reduction of RBC aggregation that was related to the intralipid concentration. At intralipid concentrations of 4 and 8 mg/ml, no RBC aggregation was noted in preterm and full‐term neonates. In adults, RBC aggregation decreased by 50%.Conclusions: Previously described deleterious effects of intralipid on circulation can not be explained by changes in haemorheological properties.
Characteristics and outcome of long‐stay patients in a paediatric intensive care unit: a case‐control study
Authors: van der Heide PhA , Hassing MBF , Gemke RJBJ 
Published: August 2010

Aim: To identify differences in baseline characteristics and outcome between long‐stay and other patients admitted to a paediatric intensive care unit with the same diagnosis. Methods: Over a period of 6 y, data of paediatric intensive care unit patients with a length of stay of 30 or more days (long‐stay patients) and aged 1 to 18 y were retrospectively collected. Long‐stay patients were matched with the next patient who was admitted to the paediatric intensive care unit with the same diagnosis. Evaluated characteristics on admission included: age, sex, presence of chronic morbidity, functional status, Pediatric Risk of Mortality score, presence of multiple organ system failure and complications during admission. Outcome (survival and functional status) was assessed 2.5 to 8.5 y after admission. Results: Of 19 long‐stay patients identified, 15 could be matched with a control patient admitted with the same diagnosis. No significant difference in baseline characteristics was found between long‐stay patients and the matched controls. The mean number of complications per long‐stay patient was 2.9, compared to 1.2 per control patient (p= 0.02). Infection accounted for half of the complications. Mortality rate in long‐stay patients was not higher than in the matched controls (36.8 vs 26.7%, p= 0.54). Paediatric intensive care unit stay did not change functional status in either long‐stay patients or controls.Conclusion: Long‐stay patients in the paediatric intensive care unit had more complications, but baseline characteristics, mortality and functional outcome were not different from a control group admitted with the same diagnosis.
Short‐term outcome after active perinatal management at 23—25 weeks of gestation. A study from two Swedish tertiary care centres. Part 2: infant survival
Authors: Serenius F , Ewald U , Farooqi A , Holmgren P‐Å , Håkansson S , Sedin G 
Published: August 2010

Aim: To determine neonatal survival rates based on both foetal (stillborn) and neonatal deaths among infants delivered at 23–25 wk, and to identify maternal and neonatal factors associated with survival. Methods: The medical records of 224 infants who were delivered in two tertiary care centres in 1992–1998 were reviewed retrospectively. At these centres, policies of active perinatal and neonatal management were universally applied. Data were analysed by gestational age groups and considered in three time periods. Logistic regression models were used to identify factors associated with survival. Results: The rate of foetal death was 5%. Of infants born alive, 63% survived to discharge. Survival rates including foetal deaths in the denominator at 23, 24 and 25 wk were 37%, 61% and 74%, respectively, and survival rates excluding foetal deaths were 43%, 63% and 77%, respectively. Of infants born with 1‐min Apgar scores of 0–1, 43% survived. In the total cohort, survival rates including foetal deaths in the denominator increased from 52% in time period 1 to 61% in time period 2 and 74% in time period 3 (p > 0.02). On multivariate logistic regression analysis, higher birthweight (OR: 1.91 per 100 g increment; 95% CI: 1.45–2.52), female gender (OR: 3.33; 95% CI: 1.65–6.75), administration of antenatal steroids (OR: 2.95; 95% CI: 1.46–5.98) and intrauterine referral from a peripheral hospital (OR: 2.35; 95% CI: 1.18–4.68) were associated with survival. Apgar score ± 3 at 1 min (OR: 0.46; 95% CI: 0.22–0.95) was associated with decreased survival. The use of antenatal steroids was protective at 23–24 wk (OR: 5.2; 95% CI: 2.0–13.7), but not at 25 wk.Conclusions: Active perinatal management that included universal initiation of neonatal intensive care virtually eliminated intrapartum stillbirths and delivery room deaths, and resulted in survival rates that compare favourably with those of recent studies. However, the policies of active care postponed death in non‐survivors. Individual variations in outcome in relation to the infant's condition at birth as reflected by the Apgar scores preclude the making of treatment decisions in the delivery room.