bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of a language‐screening programme for 2.5‐year‐olds at Child Health Centres in Sweden
Authors: Mattsson C Miniscalco , Mårild S , Pehrsson NG 
Published: August 2010

A population‐based language‐screening programme started in the western part of Sweden (South Bohuslän) in 1991, with the aim of identifying developmental language disability in 2.5‐y‐old children. The programme was evaluated during 1998 in an experimental study. A group of 105 2.5‐y‐old children was recruited from 24 separate Child Health Centres. A sample of 25 children with a positive screening result was selected. For each of the 25 children, 1–4 controls, i.e. children with a negative screening result, were selected. The results were reclassified blindly by three speech and language therapists and used as a gold standard. Positive and negative predictive values were estimated to be 0.52 (95% confidence interval 0.31–0.72) and 0.96 (95% confidence interval 0.89–0.99), respectively. Baye's theorem was used to calculate the sensitivity (0.69) and the specificity (0.93) of the screening. A method of calculating the sensitivity and specificity of the test method by means of three samples was demonstrated. Conclusion: The data confirm that it is possible to identify reliably children with developmental language disability at 2.5 y of age through the screening programme.
Anticholinergic treatment improves glycaemic control in adolescent girls with insulin‐dependent diabetes mellitus
Authors: Halldin MU , Aman J , Brismar K , Jones I , Tuvemo T , Gustafsson J 
Published: August 2010

Metabolic control often deteriorates during puberty in girls with insulin‐dependent diabetes. It is well accepted that there is an abnormality in the growth hormone (GH)‐insulin‐like growth factor‐I (IGF‐I) axis in these girls, resulting in reduced IGF‐I levels and elevated GH. As GH antagonizes insulin, attempts have previously been made to reduce excess GH secretion through anticholinergic treatment. However, most of these studies have been performed on adult patients. The aim of the present study was to evaluate the effects of 12 wk of oral anticholinergic treatment with Pirenzepine, 100 mg twice daily, in 16 adolescent girls with diabetes. Serum samples of IGF‐I, glycated haemoglobin and fasting IGF‐binding protein 1 were analysed at initiation and after 3, 8 and 12 wk of Pirenzepine therapy. Nocturnal urinary GH excretion was also examined. Glycated haemoglobin declined significantly after 3 wk of Pirenzepine therapy (9.8 ± 0.18 vs 9.2 ± 0.17; p < 0.001) and was still improved at the end of the study. Unexpectedly, nocturnal urinary GH excretion did not change. Serum IGF‐I continuously increased during the study, while IGF‐binding protein 1 levels were not significantly altered. Conclusion: Anticholinergic treatment with Pirenzepine improves glycaemic control in adolescent girls with diabetes. Although nocturnal urinary GH excretion was unchanged there may still be changes in pituitary GH secretion to explain the improvement. Effects of Pirenzepine on gastrointestinal motility can represent other possible mechanisms behind the improved metabolic control.
Comparison of airway pressure and airflow triggering systems using a single type of neonatal ventilator
Authors: Dimitriou G , Greenough A , Cherian S 
Published: August 2010

The performances of two triggering systems using a single neonatal ventilator type (SLE) were compared. Eight infants, gestational age 27–30 wk, were each recorded during two 1‐h periods of patient‐triggered ventilation (PTVs), one with airway pressure and one with airflow triggering. The airflow trigger had a shorter trigger delay (p < 0.02), higher sensitivity (p < 0.02) and lower asynchrony rate (p < 0.02). Conclusion: In immature infants with mild respiratory distress syndrome using the SLE ventilator with inflation times of 0.3 to 0.36 sec, airflow triggering is more appropriate than airway pressure triggering.
Introduction of solids and formula to breastfed infants: a longitudinal prospective study in Uppsala, Sweden
Authors: Hörnell A , Hofvander Y , Kylberg E 
Published: August 2010

The introduction of solids and formula was studied among 506 breastfed infants in Uppsala, Sweden, based on daily recordings during the first year. The mothers had previously breastfed at least 1 infant for at least 4 mo. Thirty‐four per cent of the infants were introduced to solids before the age of 4 mo (4–6 mo is recommended in Sweden). Accustoming the infants to solids was a lengthy process. Life‐table analyses showed a median duration of 28 d from the first introduction of solids to consumption of >10 ml daily, and 46 d before the infants ate 100 ml of solids in 1 d for the first time. These durations were longer the younger the infant was at the introduction of solids. Thirty‐two per cent of infants given formula consumed 100 ml the first time it was given, and 49% did so within 1 wk, regardless of infant age.Conclusion: Parents and healthcare personnel need to be aware that accustoming breastfed infants to solid food is a lengthy process, and that there is a strong age effect on this duration. It is also important to consider what consequences the (usually) more abrupt introduction of formula might have on breastfeeding.
Morning versus evening administration of estradiol to girls with Turner syndrome receiving growth hormone: impact on growth hormone and metabolism. A randomized placebo‐controlled crossover study
Authors: Naeraa RW , Gravholt CH , Kastrup KW , Svenstrup B , Christiansen JS 
Published: August 2010

Timing of 17β‐estradiol (E2) administration in relation to that of GH could influence the “first pass effect” of E2 on hepatic IGF‐I secretion. In order to test this hypothesis, a randomized double‐blind placebo‐controlled crossover study was conducted. Nine Turner girls (12.8–20.0 y) were treated for 2 mo periods with GH 0.1 IU/kg/d sc at bedtime, and oral E2 6–11 μg/kg/d in the morning and placebo in the evening in one 2‐mo period and vice versa in the other period. After each period, 24‐h blood sampling was performed. IGF‐I and mean 24‐h integrated GH were comparable. However, the IGF‐I/IGFBP‐3 ratio was higher (p= 0.05) and insulin levels were lower after evening administration of E2 (24 h: p= 0.03). During an oral glucose tolerance test in the morning, glucagon and insulin were lower following evening E2 administration (ANOVA: glucagon, p= 0.03; insulin, p= 0.04), as well as insulin resistance tended to be lower (p= 0.09). Conclusion: The timing of oral E2 supplementation modulates the IGF‐I/IGFBP‐3 ratio, insulin and glucagon levels in Turner syndrome during GH treatment. Evening administration of oral estrogen together with evening injections of GH may be preferable.
Pre‐school children with developmental co‐ordination disorder: self‐perceived competence and group motor skill intervention
Authors: Pless M , Carlsson M , Sundelin C , Persson K 
Published: August 2010

Objective: To investigate self‐perceived competence in 5‐ to 6‐y‐old children with developmental co‐ordination disorder. Subjects and methods: Scores in two scales of self‐perceived competence were compared between a study group of children with developmental co‐ordination disorder (n= 37) and a reference group (n= 60). In addition, effects of group motor skill intervention were evaluated by comparing scores in study group children randomly allocated to an intervention (n= 17) and a control subgroup (n= 20). The intervention subgroup received intervention once weekly for 10 wkConclusions: Pre‐school children with developmental co‐ordination disorder are similar to peers of the same age regarding self‐perception of their own competence in areas concerning school, peer relations and motor skills. The change in score in the perceived motor competence scale was significantly greater in the intervention than in the control subgroup, suggesting that the intervention increased individual awareness of motor competence.
Development and behaviour of seven‐year‐old triplets
Authors: Garel M , Salobir C , Lelong N , Blondel B 
Published: August 2010

The aim of this study was to assess the development and behaviour of 7‐y‐old triplets, who were followed from delivery to 7 y of age. The McCarthy Scales of Children's Abilities (MSCA) and Achenbach's Child Behaviour Checklist (CBCL) were used to assess and compare development and behaviour in the triplets and in a control group of singletons. The sample included 33 sets of triplets and 33 singletons, all 7‐y‐olds, and comparable for sex and fathers' social class. The triplets' scores on the MSCA were all within normal range. Although their mean scores for all subtests were below those of singletons, they did not differ significantly. The mean CBCL scores, based on mothers' reports, indicated that the triplets had significantly fewer behavioural problems than the controls. In half the triplet sets, one child stood out as having more behavioural problems than the others. Conclusion: Further assessments of the development of triplets are needed; these should be based on larger study samples and should use information from teachers and external observers as well as mothers.
Microcephalus, medulloblastoma and excessive toxicity from chemotherapy: an unusual presentation of Fanconi anaemia
Authors: Ruud E , Wesenberg F 
Published: August 2010

Fanconi anaemia is a genetically and phenotypically heterogeneous disorder with different forms of clinical presentation. In this case the patient had suffered from microcephalus and delayed motor development from birth, but extensive investigation did not disclose any aetiology. At 3.5 y she developed a cerebellar medulloblastoma which was treated with surgery and chemotherapy. Following chemotherapy with alkylating agents she suffered from severe bone marrow aplasia which caused life‐threatening infections, feeding problems and impaired kidney function. Fanconi anaemia was suspected, but it took 2 mo before the chromosome fragility test came out positive. From the moment diagnosis of Fanconi anaemia was made, no further active treatment was given. The patient's condition improved for some time, but she relapsed and died exactly 1 y after the first diagnosis of brain tumour. Conclusion: Fanconi anaemia must always be suspected in patients who experience excessive toxicity from chemotherapy regardless of the type of malignancy and congenital malformations.
Hepatic technetium‐99m‐mebrofenin iminodiacetate scans and serum γ‐glutamyl transpeptidase levels interpreted in series to differentiate between extrahepatic biliary atresia and neonatal hepatitis
Authors: Arora NK , Kohli R , Gupta DK , Bal CS , Gupta AK , Gupta SD 
Published: August 2010

Hepatic technetium‐99m‐mebrofenin iminodiacetate (99mTc‐mebrofenin IDA) scans and serum γ‐glutamyl transpeptidase (GGTP) have high sensitivity for extrahepatic biliary atresia (EHBA). This study was based on the hypothesis that the interpretation of results of 99mTc‐mebrofenin IDA scans and serum GGTP levels in series would result in a reduction of the false positivity observed with these tests individually. The aetiology of neonatal cholestasis in 132 study patients was: 25% (33/132) EHBA, 45.5% (60/132) neonatal hepatitis (NH) with an identifiable cause and 19.7% (26/132) idiopathic NH. Of the various clinical, biochemical and imaging parameters that were significantly different between patient groups, sensitivity for EHBA was: serum GGTP ≥ 150 IU 1−1(100%), 99mTc‐mebrofenin IDA scans (100%), pale stools (82.8%) and total serum bilirubin ≥ 12mg d1−1 (66%). However, specificity ranged from 48.5 to 79%. Of the 63 patients who had non‐excreting IDA scans, operative cholangiograms could be avoided on the basis of a specific aetiological diagnosis of NH, made concurrently, in only 9 infants. The rest (54) underwent operative cholangiograms; 21 (39%) of these had patent biliary trees and therefore underwent the procedure unnecessarily. If serum GGTP (<150 IU 1−1) had been used as a screen after IDA scanning in these 54 patients, operative cholangiograms could have been avoided in another 12 patients and thereafter only 9/42 (21%) of the operative cholangiograms would have been considered unnecessary. Conclusion: A diagnostic algorithm is proposed wherein serum GGTP level (at a cut‐off level that maintains 100% sensitivity for EHBA) is used in series with non‐excreting 99mTc‐mebrofenin IDA scans (for patients with no specific aetiological label). This strategy reduces the false positivity of individual tests.
Incidence and predictors of atopic dermatitis in an open birth cohort in Sisimiut, Greenland
Authors: Tamsmark TH , Koch A , Melbye M , Mùlbak K 
Published: August 2010

The frequency of atopic dermatitis (AD) is unknown among children in Greenland. To determine the incidence of AD and to identify risk factors for onset of AD within the first 2 y of life among Greenlandic children an open cohort of 143 children aged 0–2 y in Sisimiut, West Greenland, was followed for a median of 335 d. The children were visited on a weekly basis, where clinical examinations revealed any cases of AD. In total, 24 of the 143 children developed AD. The incidence rate of AD was 177 cases per 1000 child years at risk, corresponding to a cumulative risk of 16% per year. Maternal history of AD [hazard ratio (HR) 2.6, 95% confidence interval (CI) 1.03–6.57], high social class of the family (HR 6.18, CI 2.19–17.41) and living in a detached house compared with living in a terraced house or an apartment (HR 2.81, CI 1.16–6.28) were associated with increased risks of AD. In a multivariate model these risk factors all remained significant. Conclusion: The findings confirm that AD represents a health problem among Greenlandic infants and that the pattern of predictive risk factors associated with the development of AD is comparable to that found in northern European countries.
Reluctance to continue breastfeeding in The Netherlands
Authors: Bulk‐Bunschoten AMW , van Bodegom S , Reerink JD , Jong PCM Pasker‐de , de Groot CJ 
Published: August 2010

A prospective cohort study of breastfeeding practice (0–4 mo) was carried out in well‐baby clinics. The cohort included 4438 newborns brought to a clinic for the first time between 1 April and 1 July 1998. The odds ratios of demographic and gestational variables connected with the start and duration of breastfeeding were measured. The frequency of the reasons why breastfeeding was interrupted was determined. At birth 71% of the infants included in this study were exclusively breastfed. After 4 mo the percentage had dropped to 21%. Breast milk was replaced directly by formula (23%) or by a mixture of breast milk and formula (77%). Exclusive breastfeeding was given irrespective of the mother's cultural background. Higher education appeared to be the most decisive factor for the initiation of exclusive breastfeeding; higher parity was found to be the most decisive factor for continuation. In 46% of cases the infant's health and behaviour caused mothers to stop exclusive breastfeeding; in 38% the reasons were mother related; in 17% both mother‐ and infant‐related motives were mentioned. Conclusion: Mothers' perception of hunger and crying colics were the main infant‐related reasons for cessation of breastfeeding, whereas physical problems, return to work, doubt about the sufficiency of breast milk and the feeling of being restricted by breastfeeding were the main mother‐related reasons. The decision to abandon exclusive breastfeeding was made primarily by mothers (71%). In The Netherlands more babies are breastfed at birth than was the case 10 y ago, but the duration of the breastfeeding period has become shorter.
Cause‐specific stillbirth and neonatal death in Sweden: a catchment area‐based analysis
Authors: Serenius F , Winbo I , Dahlquist G , Källén B 
Published: August 2010

A register‐based study of the impact of obstetric and neonatal care on stillbirth and neonatal death rate was performed on all births in Sweden in 1983–1995. Each birth was assigned to a primary delivery hospital where the mother with a term singleton pregnancy was most likely to have been delivered (not possible for 25% of the deliveries), and the catchment areas of each hospital were classified according to the level of care of that hospital. Only small differences in total mortality existed between the different levels of care of the primary hospital: areas served by primary hospitals with obstetric service and resources for neonatal intensive care including continuous positive airway pressure but without facilities for ventilator treatment for prolonged periods showed a 7% excess risk of stillbirth or neonatal death. Conclusion: In areas with the lowest level of care of the primary delivery hospitals (with no or only basic neonatal care) the total mortality was not increased, indicating that the referral system works well. When the analysis was repeated for specific causes of death, more marked differences were noted, especially for death due to obstetric complications where the death risk increased with decreasing level of care of the primary delivery hospital. Even though no marked differences in total mortality were seen, a further reduction can be obtained by increasing referral for some specific conditions.
Association of a mutation in the β3‐adrenergic receptor gene with obesity and response to dietary intervention in Chinese children
Authors: Xinli W , Xiaomei T , Meihua P , Song L 
Published: August 2010

This study aimed to determine whether the Trp64Arg mutation in the β3‐adrenergic receptor (β3‐adr) gene is related to childhood obesity and the response to dietary intervention for obesity. The study included 311 healthy children aged 8‐11 y selected at random from 4 primary schools in Beijing. Fasting insulin and lipids were measured and anthropometry was carried out for all samples. The mutation of the β3‐adr gene was determined by polymerase chain reaction‐restriction fragment length polymorphism analysis. Forty‐seven obese children were selected and divided into two groups. One group received dietary intervention (36 subjects); the other served as the control group (11 subjects). After 3 mo of dietary intervention, anthropometry was carried out again in 47 obese children. The frequency of the mutated allele was similar in 73 overweight and 238 normal‐weight children (0.18 and 0.17, respectively). Adjusted for age and sex, there was no significant difference in body mass index (BMI) and the levels of fasting lipids and insulin between those with and without the mutation of the 311 children. However, after 3 mo of dietary intervention, increases in weight and BMI were significantly lower in obese children without the mutation than in the control group (2.41 ± 0.56 vs 4.43 ± 0.70, p < 0.05; 0.48 ± 0.24 vs 1.55 ± 0.35, p < 0.05, respectively), but the changes in weight and BMI in obese children with the mutation were similar to the results in the controls (4.32 ± 0.69 vs 4.43 ± 0.70; 1.47 ± 0.32 vs 1.55 ± 0.35). Conclusion: The Trp64Arg mutation of the β3‐adr gene may predict the result of dietary intervention in obese children to some extent, but it was not a major factor affecting weight in Chinese children.
High prevalence of coeliac disease in Danish children with type I diabetes mellitus
Authors: Hansen D , Bennedbæk FN , Hansen LK , Høier‐Madsen M , Hegedüs L , Jacobsen BB , Husby S 
Published: August 2010

The purpose of this population‐based study was to determine the prevalence of coeliac disease (CD) in 106 Danish children (age 2‐18 y) with type I diabetes mellitus compared with 106 age‐and sex‐matched healthy controls. Serum samples were analysed for immunoglobulin A (IgA) and IgG gliadin antibodies by enzyme‐linked immunosorbent assay (ELISA), for IgA endomysium antibodies (EMA) by immunofluorescence and for IgA tissue transglutaminase antibodies (tTGA) by ELISA. None of the controls had EMA or tTGA. Two diabetics previously diagnosed with CD were antibody negative on a gluten‐free diet. Ten diabetics had both EMA and tTGA. Intestinal biopsy was performed in nine of them. All biopsies showed a histological picture of partial or total villous atrophy confirming the diagnosis of CD. Diabetics with CD were significantly younger (p= 0.026), had an earlier onset of diabetes (p= 0.005), had a lower height standard deviation score (p= 0.019) and more often had thyroid antibodies (p= 0.040) compared with diabetics without CD. Conclusion: A high prevalence of CD of 10.4% (95% confidence interval 4.6–16.2%) was found in young Danish diabetics. Early onset of diabetes may predispose to CD. Routine serological screening for CD may be valuable in patients with type I diabetes mellitus.
Decreased lung function associated with perinatal exposure to Dutch background levels of dioxins
Authors: ten Tusscher GW , de Weerdt J , Roos CM , Griffioen RW , De Jongh FH , Westra M , van der Slikke JW , Oosting J , Olie K , Koppe JG 
Published: August 2010

Perinatal exposure to Dutch background dioxin levels is rather high. Studies of calamities have shown that dioxins negatively influence the respiratory system. It was hypothesized that perinatal exposure to background dioxin levels leads to lung suboptimality, probably through developmental interference. This study aimed to assess lung function in relation to perinatal dioxin exposure. Spirometry was performed in 41 healthy children (aged 7‐12 y, mean 8.2 y) with known perinatal dioxin exposure. The ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC ratio) was determined. A complete medical history was taken. The prenatal exposure ranged from 8.74 to 88.8 (mean 34.6) ng TEQ dioxin kg fat−1, measured in breast milk. The postnatal exposure ranged from 4.34 to 384.51 (mean 75.4) ng TEQ dioxin. Twelve children had to be excluded. A significant decrease in lung function in relation to both prenatal (p= 0.045) and postnatal (p= 0.0002) dioxin exposure was seen in the 29 non‐excluded children. A clinical association between chest congestion and perinatal dioxin exposure was seen. Conclusion: Perinatal background dioxin exposure may be inversely associated with the FEV1/FVC ratio.
Vaccination rate and age of premature infants weighing <1500 g: a pilot study in north‐western Switzerland
Authors: Tillmann BU , Tillmann H‐C , Nars PW , Weber P 
Published: August 2010

In Switzerland, there are no special vaccination recommendations for premature and low‐birthweight infants with respect to a particular target vaccination age. Incomplete and delayed vaccination bears the inherent risk of preventable infections. Therefore, the vaccination rate and age of 60 premature infants in north‐western Switzerland born in 1994/95 were investigated in a retrospective case‐control study. For this group of patients these are the first data ever available for this region. At the age of 4–5 y, the vaccination rates for polio and diphtheria, tetanus, pertussis (DTP acellular) as well as Haemophilus influenzae b (Hib) were similar in both preterm and full‐term infants. In both groups, the fourth dose of vaccine against DTP, Hib and polio was far less frequently administered than the first three. The vaccination age in preterm infants for most vaccinations was significantly higher than in age‐matched full‐term controls. This was particularly obvious for the first dose of vaccine against polio and DTP. In preterm infants, the median age (5th; 95th percentile) at the date of the first polio vaccination was 131 (89; 270) d and 82 (60; 182) in full‐term controls (p < 0.00001). The age difference was even larger for the first DTP vaccination (62 d, p < 0.00001). The main reasons for delayed vaccination may include insufficient information given to parents as well as prolonged hospitalization. Conclusion: Vaccination of preterm infants should be discussed in every discharge communication, with emphasis on vaccine administration at the appropriate chronological age.