bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bodily pain, sleep problems and mental distress in schoolchildren
Authors: Bruusgaard D , Smedbråten BK , Natvig B 
Published: August 2010

It has been suggested that childhood pain could be the beginning of a career with chronic disabling pain. Bodily pain is frequent in children. We examined the association between self‐reported bodily pain, mental distress and sleep problems in schoolchildren to test the following hypotheses: (i) that self‐reported bodily pain is associated with mental distress and sleep problems, (ii) that the association is dependent on the localization of pain, and (iii) that the association increases with number of painful areas. Eighty‐six percent of the pupils (569) in the 4th form (mean age 10.5 y), 7th form (mean age 13.5 y) and 9th form (mean age 15.5 y) from all the schools in a local community answered a questionnaire about self‐esteem, body‐image, physical activity and bodily pain. We found a strong association between the reporting of pain, mental distress and sleep problems. Pain in the knees was the only problem reported more frequently by boys than by girls, and knee pain did not show the same association with mental distress and sleep problems as pain from other regions.Conclusions: A possible cause‐effect relationship between pain, mental distress and sleep problems is discussed, and the possibility that all the complaints are the simultaneous signs of a multisymptom syndrome is introduced.
A future for neonatal α1‐antitrypsin screening?*
Authors: Sveger T , Thelin T 
Published: August 2010

A WHO expert group recommends neonatal screening for α1‐antitrypsin deficiency (α1ATD). Homozygous α1ATD PiZZ occurs in 1 in 5000 of the U.S. Caucasian population and up to 1 in 500 individuals of the European population, with a large regional variation. It is a risk factor that predisposes mainly to liver disease in early infancy and emphysema in early adulthood. Most importantly, smoking decreases the duration of the asymptomatic phase and life expectancy by 10‐20 y. The Swedish α1AT screening programme and subsequent information and advice prevented the majority of adolescents from starting to smoke. The involved parents and α1ATD adolescents retrospectively recommended neonatal screening. Potential advantages of neonatal α1AT screening are: early diagnosis and treatment of neonatal liver disease, optimal treatment of fever and bacterial infections theoretically preventing liver cell damage, genetic advice and information about the consequences of passive and active smoking. Potential advantages of postponing screening until age 11‐12 y are: identification of α1ATD close to the age when smoking may start, and possibility for the child to take part in the screening decision. Disadvantages of α1AT screening are: psychosocial reactions–the mother probably being most vulnerable in the neonatal period–and discrimination by insurance companies and employers.Important uncertainties are: lack of knowledge concerning participation in a voluntary α1AT screening, psychosocial reactions and the efficacy of anti‐smoking advice if the information is given to school‐age children and families. Thus the question whether and when to screen for α1ATD is still the topic of lively debate.
New reference for the age at childhood onset of growth and secular trend in the timing of puberty in Swedish
Authors: Liu YX , Wikland K Albertsson , Karlberg J 
Published: August 2010

The objectives of the present work were to present a new reference for the age at childhood onset of growth and to investigate the secular trend in the timing of puberty in a community‐based normal population in Sweden. A total of 2432 children with longitudinal length/height data from birth to adulthood were used to determine the two measures by visual inspection of the measured attained length/height and the change in growth velocity displayed on a computer‐generated infancy‐childhood‐puberty (ICP) based growth chart. The series represents a sample of normal full‐term children born around 1974 in Göteborg, Sweden. We found about 10% of children were delayed (>12 mo of age) in the childhood onset of growth based on the previous reported normal range, i.e. 14% in boys and 8% in girls. Distribution of the age at childhood onset of growth was skewed. The medians were 10 and 9 mo for boys and girls, respectively. After natural logarithmic transformation, the mean and standard deviation (SD) were 2.29 (anti‐log 9.9 mo) and 0.226 for boys, 2.23 (anti‐log 9.3 mo) and 0.220 for girls, respectively. The 95% normal ranges were 6.3‐15.4 and 6.0‐14.3 for boys and girls, respectively. The distribution of the timing of PHV was close to the normal distribution. The mean values were 13.5 y for boys and 11.6 y for girls with 1 y SD for both sexes.Conclusion: A downward secular trend in the onset of puberty was clearly shown in the population. The age at childhood onset of growth did not correlate with the timing of puberty (r=−0.01 and 0.05, p > 0.7 and 0.1 in boys and girls, respectively). Normal ranges of the age at childhood onset of growth are in need of revise, as this study indicates. The new reference presented here could be a reliable indicator in further studies.
Effect of growth hormone therapy on feeding problems and food intake in children with growth disorders
Authors: Blissett J , Harris G , Kirk J 
Published: August 2010

To assess the effect of therapeutic doses of growth hormone (GH) on the feeding problems, food intake, body fat and mealtime interactions of children with growth disorders, an age‐matched group of 46 children with Turner syndrome (TS) or Silver Russell syndrome (SRS) was examined using questionnaire measures and direct observation. The children's body fat was measured using bio‐electrical impedance analysis and skinfold thickness measurements. Children receiving GH consumed significantly more energy, protein, fat and carbohydrate than did the children who were not receiving GH, independent of the extent of the child's feeding problems. Children receiving GH had less body fat than did children who were not receiving GH. Children who were not receiving GH distracted their parents from the mealtime significantly more often and received more negative prompting and coaxing from their parents to eat than did children who were receiving GH. This study provides evidence to support the theory that appetite and intake is determined in part by growth and growth potential. Feeding problems seen in children with growth disorders are partly due to parental attempts to impose control over their child's intake, when their child consumes less than the parent believes to be adequate.Conclusion: GH has a significant impact on both the food intake and parent‐child interaction at mealtimes of children with SRS and TS.
Serum total magnesium and ionized calcium concentrations in asphyxiated term newborn infants with hypoxic‐ischaemic encephalopathy
Authors: Ilves P , Kiisk M , Soopõld T , Talvik T 
Published: August 2010

Total magnesium, ionized calcium, potassium and sodium concentrations in mixed umbilical cord blood and venous blood serum at a median (min.‐max.) age of 33 h (24‐48 h) were assessed colorimetrically in 46 asphyxiated and 35 healthy term infants. Asphyxiated infants without any signs or with signs of mild hypoxic‐ischaemic encephalopathy (HIE) had significantly higher, and infants with severe HIE lower umbilical cord blood serum total magnesium (mean (95%CI) 0.81 (0.75‐0.87) mmol/l and 0.64 (0.47‐0.87) mmol/l, respectively, p < 0.05) compared with the control group (0.72 (0.69‐0.76) mmol/l). An increase in serum total magnesium in spite of normalized acid‐base status in asphyxiated infants suffering from severe HIE compared with the control group infants was found by the second day of life (0.97 (0.87‐1.07) mmol/l and 0.86 (0.81‐0.9) mmol/l, respectively, p < 0.05). At the age of 24‐48 h hypermagnesaemia (>2 SD) was discovered in 36%, hyponatremia (<2 SD) in 38%, and hypocalcaemia (<2 SD) in 23% of asphyxiated infants. Derangements (>2 SD) in at least two electrolytes by the second day of life were significantly associated with poor outcome.Conclusions: Magnesium, calcium and sodium derangements are a frequent finding in asphyxiated infants, and these abnormalities are significantly associated with poor outcome. For a better outcome prediction, the routine determination of magnesium in addition to other electrolytes in asphyxiated infants is recommended.
Birthweight and social deprivation: influences on serum lipids and fibrinogen
Authors: Morley R , Harland PSEG , Law CM , Lucas A 
Published: August 2010

Epidemiological studies have shown that adults with low birthweight have a higher risk of cardiovascular disease and some others have shown that they have a less favourable serum lipid and lipoprotein profile. If cholesterol metabolism were programmed in utero, we would expect to see an influence of birthweight on blood lipids in children. In 422 children aged 11‐15 y in Middlesborough, Cleveland, UK, we investigated the association between birthweight and serum lipids and plasma fibrinogen. We also investigated the influence of childhood social deprivation, measured using the Townsend deprivation index, on these measures.Conclusions: We found a significant inverse association between birthweight and serum triglyceride level, but not with other serum lipid levels. From a regression model we estimate that triglyceride rose by 1.1 mmoll−1 kg−1 fall in birthweight after adjustment for sex, current age and weight. Findings were similar in boys and girls separately. This could contribute to the observed inverse association between birthweight and cardiovascular mortality. Social deprivation was associated with higher fibrinogen, but not lipid levels. Our data highlight the importance of considering influences throughout the life course on adult disease.
Visual analogue scale for the perceived influence of exertion and movements/positions on low back problems in surveys of adolescents
Authors: Staes F , Stappaerts K , Vertommen H , Nuyens G 
Published: August 2010

The test‐retest reproducibility of visual analogue scales for the perceived influence of exertion and movements/positions on low back problems in adolescents was investigated. The study was performed on 61 adolescents with low back problems. Item completion, median score, interquartile range and weighted kappa were calculated. Results showed that visual analogue scales produce repeatable information for all items tested (weighted kappa: 0.59‐0.83), except for the influence of pulling materials on back problems (0.45).Conclusion: The results of this study suggest that adolescents, aged 16‐18‐y, can reproduce their visual analogue scores.
Longitudinal changes in 11‐13‐year‐olds' physical activity
Authors: Armstrong N , Welsman JR , Kirby BJ 
Published: August 2010

The influence of age, sex, maturity, body mass and body fatness on the physical activity (PA) of 11‐13‐y‐olds was examined longitudinally. Body mass, triceps and subscapular skinfold thickness and pubic hair were recorded and 3‐d continuous heart rate (HR) monitoring was used to estimate PA on each annual measurement occasion. At the onset, subjects were 11.0 (0.4)‐y‐old and data were available on 202, 143 and 160 subjects in years 1 to 3, respectively with an almost equal sex distribution. Multilevel regression modelling examined age‐, sex‐ and maturity‐related changes in time spent with HR above 139 (moderate activity) and 159 (vigorous activity) bpm. Sustained (10 or 20 min) periods of moderate or vigorous activity were not characteristic of PA patterns. Both PA measures declined with age, with a consistent sex difference reflecting the lower PA levels of girls. Body mass and fatness were not significant explanatory variables, but an additional decrement in activity was evident in late maturity.Conclusion: Few children experience extended bouts of PA, and from 11‐13 y, PA decreases, with more girls than boys becoming inactive. The data emphasize the importance of promoting active lifestyles during youth.
Evaluation of oral hypo‐osmolar glucose‐based and rice‐based oral rehydration solutions in the treatment of cholera in children
Authors: Dutta D , Bhattacharya MK , Deb AK , Sarkar D , Chatterjee A , Biswas AB , Chatterjee K , Nair GB , Bhattacharya SK 
Published: August 2010

In a randomized controlled clinical trial, the efficacy of a low‐sodium low‐glucose oral rehydration solution (ORS) and a low‐sodium rice‐based ORS was compared with standard WHO glucose ORS in the treatment of severe cholera in children aged 2‐10 y. In total, 120 children were evaluated for the study, of whom 58 patients were positive for Vibrio cholerae and were included in the study. Of these 58 cases, 19 received rice‐based hypo‐osmolar ORS, 20 received WHO‐ORS and 19 received glucose‐based hypo‐osmolar ORS. The clinical characteristics (age, preadmission duration of diarrhoea, frequency of stool before admission, incidence of vomiting, body weight and volume of initial fluid requirement) were comparable in the three treatment groups. All patients received tetracycline in a dose of 50 mg/kg/d of body weight in 4 divided doses for 3 d.Conclusions: Patients who received rice‐based hypo‐osmolar ORS had subsequently reduced (p < 0.05) stool output, ORS consumption and diarrhoea duration than the patients who received either WHO‐ORS or glucose‐based hypo‐osmolar ORS.
Cerebrospinal fluid concentrations of α‐melanocyte‐stimulating hormone in bacterial and aseptic meningitis
Authors: Ichiyama T , Nishikawa M , Hayashi T , Hayashi S , Ryozawa M , Furukawa S 
Published: August 2010

α‐Melanocyte‐stimulating hormone (α‐MSH) has potent anti‐inflammatory effects in several experimental models of inflammation. It inhibits both the actions and production of proinflammatory cytokines and neutrophil migration. We investigated whether α‐MSH in cerebrospinal fluid (CSF) increases during the acute stage in patients with bacterial and aseptic meningitis by measuring α‐MSH in CSF via radioimmunoassay. The α‐MSH concentrations in CSF from the children with bacterial meningitis who survived (n= 8), those with aseptic meningitis (n= 16), and the control subjects (n= 23) were all below the detection limit. However, CSF α‐MSH was elevated in four of the five children with bacterial meningitis who had neurological sequelae. We speculate that elevated a‐MSH levels in CSF during acute bacterial meningitis reflect negative feedback in response to severe inflammation associated with neurological sequelae induced by proinflammatory cytokines.Conclusion: CSF α‐MSH is elevated in children with severe bacterial meningitis who had neurological sequelae.
Characterization of the developmental stages of sucking in preterm infants during bottle feeding
Authors: Lau C , Alagugurusamy R , Schanler RJ , Smith EO , Shulman RJ 
Published: August 2010

It is acknowledged that the difficulty many preterm infants have in feeding orally results from their immature sucking skills. However, little is known regarding the development of sucking in these infants. The aim of this study was to demonstrate that the bottle‐feeding performance of preterm infants is positively correlated with the developmental stage of their sucking. Infants' oral‐motor skills were followed longitudinally using a special nipple/bottle system which monitored the suction and expression/compression component of sucking. The maturational process was rated into five primary stages based on the presence/absence of suction and the rhythmicity of the two components of sucking, suction and expression/compression. This five‐point scale was used to characterize the developmental stage of sucking of each infant. Outcomes of feeding performance consisted of overall transfer (percent total volume transfered/volume to be taken) and rate of transfer (ml/min). Assessments were conducted when infants were taking 1‐2, 3‐5 and 6‐8 oral feedings per day. Significant positive correlations were observed between the five stages of sucking and postmenstrual age, the defined feeding outcomes, and the number of daily oral feedings. Overall transfer and rate of transfer were enhanced when infants reached the more mature stages of sucking.We have demonstrated that oral feeding performance improves as infants' sucking skills mature. In addition, we propose that the present five‐point sucking scale may be used to assess the developmental stages of sucking of preterm infants. Such knowledge would facilitate the management of oral feeding in these infants.
Pyelectasis and hydronephrosis in the newborn and infant
Authors: Fanos V , Agostiniani R , Cataldi L 
Published: August 2010

The aim of this review is to describe the present status of prenatally diagnosed pyelectasis and hydronephrosis. Ultrasonographic definitions are presented, along with guidelines for the management of urinary tract dilatations. Isolated pyelectasis without caliceal involvement rarely constitutes a pathological situation and does not require any particular diagnostic or therapeutic measures. Obstructive dilatation is characterized by an obstacle to normal urinary flow situated at any level in the urinary tract, with consequent stagnation of urine and dilatation upstream of the obstruction. If the obstruction is not correctly treated it can cause a progressive deterioration of renal function. The presence of ureterectasia plays a crucial role in the diagnostic algorithm and a micturitional cystourethrography is necessary to look for a vesicoureteric reflux (VUR). The significance of urinary tract dilatation is discussed in detail. Conclusion: In newborns with pyelectasis or hydronephrosis the paediatrician's goal should be to strike the right balance between excessive medical intervention and sufficient intervention for the diagnosis of potentially dangerous conditions.
Lipid profiles in Polish adolescents from high‐ and low‐risk families: tracking unfavourable lipid levels over a one‐year period
Authors: Malecka‐Tendera E , Lewin‐Kowalik J , Wazowski R , Piskorska D , Klimek K 
Published: August 2010

In a country with a high cardiovascular mortality rate, lipid profiles were studied in 929 adolescents (440 from affected and 489 from non‐affected families for cardiovascular disease and hypercholesterolaemia). In 334 children with elevated or borderline total cholesterol level, lipid profiles were re‐measured after a 1‐y period. In boys from affected families, in contrast to boys from non‐affected families, significantly higher total cholesterol levels (4.36 ± 0.81 vs 4.19 ± 0.78mmol/L, p < 0.05) and LDL‐C level (2.1 ± 0.72 vs 1.89 ± 0.79 mmol/L, p < 0.05) and significantly lower HDL‐cholesterol levels (1.81 ± 0.34 vs 1.93 ± 0.38 mmol/L, p < 0.05) were found. The odds ratio for being in the most unfavourable decile for LDL‐cholesterol was significantly higher for girls from affected families (2.17, p = 0.02). A relatively high HDL‐C level as well as a favourable TC/HDL‐C ratio was demonstrated in all groups, being lowest in boys from affected families. A significant correlation was found between baseline lipids and their values re‐measured after 1 y.It is concluded that (1) adolescents with a positive family history are at increased risk for unfavourable lipid profile, (2) adolescents with elevated total cholesterol and LDL‐cholesterol levels remain hypercholesterolaemic after a 1‐y period and are therefore candidates for further biochemical and clinical monitoring, and (3) children with elevated total cholesterol may not be at high risk for cardiovascular disease owing to the favourable TC/HDL‐C ratio. The study results do not indicate that general cholesterol screening in Polish adolescents is necessary, as the proportion of children with elevated LDL‐cholesterol is relatively low.
Time course of severe respiratory syncytial virus infection in mechanically ventilated infants
Authors: Tasker RC , Gordon I , Kiff K 
Published: August 2010

The time course of intensive care for severe respiratory syncytial virus (RSV) lower respiratory tract illness may be predicted by the severity of gas exchange during the first 48 h of mechanical ventilation. To test this hypothesis, two studies were undertaken in RSV‐positive mechanically ventilated patients who did not have chronic lung disease, congenital heart disease or immunodeficiency. First, a retrospective criteria‐generating review of 45 infants was carried out. In these infants, more severe lower airway disease, as demonstrated by four‐quadrant consolidation on chest X‐ray, was associated with‘best’alveolar arterial oxygen gradients (AaDO2, torr) and mean airway pressure (MAP, cm H2O) values as follows: first 24 h, AaDO2 > 400 and MAP > 10 (positive and negative predictive values 100% and 97%, respectively); second 24 h, AaDO2 300 and MAP > 10 (positive and negative predictive values 91% and 100%, respectively). The second study, a prospective, hypothesis‐testing, analysis of length‐of‐stay in 44 infants stratified according to the above AaDO2 and MAP criteria demonstrated that the duration of intensive care was longer in the severe group: median (interquartile range in days) 17 (15‐39) vs 7 (4‐8) (p < 0.01).We suggest that, in mechanically ventilated infants with RSV, the time course of intensive care is predictable based on early clinical features and respiratory parameters. Therefore reports on the effectiveness of special therapies using intensive care stay as a measure of outcome should be interpreted with respect to these observations before drawing conclusions about efficacy.
Nutritional factors affecting serum phenylalanine concentration during pregnancy for identical twin mothers with phenylketonuria
Authors: Fox C , Marquis J , Kipp DE 
Published: August 2010

The effect of energy, protein, fat, and phenylalanine on serum phenylalanine concentrations during pregnancy for a set of identical twins with phenylketonuria (PKU) was examined. Blood samples were collected one to two times per week. The subjects completed a 3‐d food record prior to each blood collection. The effect of the factors on serum phenylalanine levels was evaluated statistically using time‐series analysis. Dietary intakes of the nutrients evaluated were similar for the subjects. For one subject, there were highly significant effects of energy, protein, and fat on serum phenylalanine levels. In contrast, these nutrients had no significant effect on serum phenylalanine for the other subject. Dietary phenylalanine had no significant effect on serum phenylalanine for either twin.Conclusions: There was no effect of phenylalanine intake and no consistent effect of energy, protein, or fat on serum phenylalanine. Other dietary or environmental factors or a combination of factors may impact serum phenylalanine levels of pregnant women with PKU.
Aminophylline influences cerebral hyperperfusion after severe birth hypoxia
Authors: Robel‐Tillig E , Vogtmann C 
Published: August 2010

Doppler sonographic investigations have presented cerebral hyperperfusion in neonates after severe asphyxia. Neonates with disturbed cerebral blood flow velocity (CBFV) tend to have poor outcomes. The purpose of this clinical study was to examine the influence of aminophylline on cerebral hyperperfusion. An intravenous bolus of 4 mg/kg aminophylline was given to nine neonates with Doppler sonographic signs of cerebral hyperperfusion. CBFV was determined before, 5 min, 60min and 120 min after aminophylline administration and on the following day. After aminophylline the mean systolic (56.5 vs. 41.6 cm/s) and end diastolic (21.0 vs. 12.3 cm/s) blood flow velocity decreased and the mean pulsatility index (0.83 vs. 1.1) increased significantly. Repeated measurements showed a decrease in blood flow velocities and an increase in pulsatility index on the following days. Heart rate, mean arterial blood pressure and pCO2 were not significantly changed.We conclude that aminophylline influences cerebral hyperperfusion in neonates with disturbed autoregulation.