bluuebunny/crossref_metadata_2025_split huggingface dataset:
Software and scan acquisition technique‐related discrepancies in bone mineral assessment using dual‐energy X‐ray absorptiometry in neonates
Authors: Picaud JC , Lapillonne A , Pieltain C , Reygrobellet B , Claris O , Salle BL , Rigo J 
Published: August 2010

Aim: In adults, whole‐body mineralization assessment by dual‐energy X‐ray absorptiometry can be affected by the densitometer and/or the software used. As there are no published data on neonates, the aim of this study was to evaluate the magnitude of such effects in growing preterm infants. Methods: We analysed the absorptiometry results obtained from 44 preterm infants scanned at discharge and again 6 wk later using densitometers from the same manufacturer equipped with “Pediatric” (Group A, n= 24) or with “Infant” (Group B, n= 20) packages. Results of bone mineral content assessment were compared using an unpaired f‐test and a linear regression analysis. Results: At the time of the first absorptiometry (body weight = 2119 ± 144 g, n= 44), the bone mineral content was three times lower in Group A (10 ± 3 g) than in Group B (29 ± 4 g) (p < 0.001). Subsequently, on the second absorptiometry (body weight = 4037 ± 236 g, n= 44) such significant differences in bone mineral content (A: 65 ± 19 g, B: 66 ± 9 g, p= 0.85) were no longer in evidence. The differences in bone mineral content were related to differences in analysis algorithms between the two programs, which can lead to an overestimation of bone mineral content accretion when two successive measurements are made using the “Pediatric” package. Conclusion: Considering that significant differences in bone mineral assessment may depend upon which program is used, data previously collected in low birthweight infants using the “Pediatric” package should be analysed with caution. Data obtained using the “Pediatric” and “Infant” packages are not directly comparable. Careful validation studies of future densitometers and programs are required before their use in clinical paediatric studies.
Prophylactic high‐frequency oscillatory ventilation in preterm infants
Authors: Calvert S 
Published: August 2010

The role of high‐frequency oscillatory ventilation (HFOV) for the treatment of respiratory disease in preterm infants remains uncertain. Several randomized trials, comparing HFOV and conventional ventilation (CV) have been performed and their results suggest that HFOV may reduce the incidence of chronic lung disease (CLD) in preterm infants. However, the trials have several limitations and it remains unclear whether HFOV might increase intracranial pathology in very prematurely born infants. UKOS, a large, UK‐based, multicentre trial was conducted to establish conclusively the role of prophylactic HFOV for the prevention of CLD in infants born prior to 29 wk of gestational age. Conclusion: There is still a need to fully evaluate prophylactic HFOV with particular emphasis on both short and long term respiratory and neurological outcomes.
Antimicrobial susceptibility of Haemophilus influenzae among children in Beijing, China, 1999–2000
Authors: Hu YY , Yu SJ , Liu G , Gao W , Yang YH 
Published: August 2010

A study on the nasopharyngeal carriage and antimicrobial susceptibility of Haemophilus influenza among children was conducted in Beijing Children's Hospital from April to May 2000. The study included 292 children between 1 and 60 mo of age with acute upper respiratory tract infection. Nasopharyngeal swabs from these patients were cultured, and 105 Haemophilus influenzae strains were isolated, 3 of which were type b. Antibiotic susceptibility of the strains was determined using disk diffusion and E‐tests and the results compared with those of isolates from children with pneumonia in 1999. The carriage rate of Haemophilus influenzae was 36.0% (105/292). It was found that 4.8% and 1.0% of isolates were resistant to ampicillin and cefaclor, respectively, and 5.7%, 16.2% and 77.1% were resistant to chloramphenicol, tetracycline, and sulphamethoxazole/trimethoprim, respectively. Amoxicillin/clavulanic acid, cefuroxime, ceftriaxone, azithromycin, and clarithromycin were uniformly active to all strains. Compared with the data from 1999, there was a significant increase in resistance to tetracycline (from 12.7% in 1999 to 16.2%) and sulphamethoxazole/trimethoprim (from 40.5% in 1999 to 77.1%). Conclusion: H. influenzae isolates from outpatients in Beijing Children's Hospital had low ampicillin resistance and were sensitive to amoxicillin/clavulanic acid. Sulphamethoxazole/trimethoprim resistance rates increased rapidly compared with those in the 1999 data. Further surveillance investigations are important for the choice of empiric therapy of acute respiratory tract infection.
Risk factors for invasive fungal infection in neonates
Authors: EI‐Masry FAY , Neal TJ , Subhedar NV 
Published: August 2010

Invasive fungal infection is an uncommon, but increasing cause of morbidity and mortality in neonates. There are few controlled studies defining risk factors for the development of fungal infection in a contemporary neonatal population. This retrospective case‐control study was undertaken to investigate antenatal, demographic and postnatal variables that may be potentially important in the development of fungal infection. Two gestation‐matched controls were identified for each index case. Information about perinatal and demographic variables, as well as important neonatal outcomes, was obtained from case notes. Microbiological data collected included the presence of fungal colonization, and organisms responsible for invasive fungal infection. Over a 5‐y period, 24 infants with invasive fungal infection and 48 controls were identified. Candida albicans was the organism identified in 75% of cases of fungal septicaemia, and in all cases complicated by fungal meningitis. Preceding fungal colonization, pulmonary haemorrhage and intrauterine growth restriction were factors significantly and independently associated with invasive fungal infection. Fifty‐four percent of infants with invasive fungal infection died, and 82% of survivors developed chronic lung disease. Conclusion: Some new and potentially important risk factors for the development of invasive fungal infection in a contemporary population of infants admitted to a neonatal intensive care were identified.
Elevated S100B protein as an early indicator of intracranial haemorrhage in infants subjected to extracorporeal membrane oxygenation
Authors: Gazzolo D , Masetti P , Meli M , Gratzfeld D , Michetti F 
Published: August 2010

The aim of this investigation was to verify whether plasma S100B could be a useful tool in identifying which infants subjected to extracorporeal membrane oxygenation (ECMO) might develop intracranial haemorrhage (ICH). A case‐control study of eight infants who developed ICH during ECMO was conducted. Plasma samples collected daily after ECMO insertion were assessed for S100B and compared with those obtained from eight infants supported by ECMO who did not develop ICH. Cerebral ultrasound and Doppler velocimetry waveform patterns in the middle cerebral artery (MCA PI) were also recorded at the same time as blood sampling. S100B blood concentrations were significantly higher in the group of infants with ICH 72 h before any signs of haemorrhage could be detected by ultrasound (ICH: 2.91 ± 0.91 μg/L vs. control: 0.53 ± 0.15 μg/L), reaching their peak at day 6, when cerebral ultrasound scan patterns were suggestive of intracranial haemorrhage (ICH: 3.50 ± 1.03 μg/L vs. control: 0.66 ± 0.27 μg/L) (p < 0.05, for both). The highest S100B levels were observed in the three ICH infants who expired during the ECMO procedure (3.43 μg/L, 4.0 μg/L, 4.12 μg/L, respectively). MCA PI values in the ICH group were also significantly higher, but only 24 h before any ultrasound pattern of bleeding was detected (ICH: 2.31 ± 0.22 vs control: 1.81 ± 0.24) (p < 0.05). Conclusion: This study suggests that blood S100B measurement could be a promising tool for the identification of infants at risk of ICH when imaging assessment and clinical symptoms of haemorrhage might still be silent.
Lumbar bone mineral density in normal subjects aged 3–6 years: a prospective study
Authors: Arikoski P , Komulainen J , Voutilainen R , Kröger L , Kröger H 
Published: August 2010

Longitudinal studies on bone mineral density (BMD) accrual in young children are scarce. The purpose of the present study was to evaluate prospectively the development of spinal BMD in healthy Finnish children aged 3–6 y by dual‐energy x‐ray absorptiometry (DXA). Lumbar spine (L2‐L4) areal BMD (g/cm2) was measured by DXA (Lunar DPX) in 20 children (10M, 10F) aged 3.3‐6.9 y (median 4.8 y) at baseline and after a median follow‐up of 1.0 y (range 0.8‐1.1 y). Apparent volumetric BMD (BMDvol, g/cm3) was calculated to minimize the effect of bone size on BMD in growing spine. At baseline, lumbar areal and volumetric BMDs (mean ± SD) for males were 0.623 ± 0.087 g/cm2 and 0.270 ± 0.034 g/cm3, respectively, and for females 0.620 ± 0.082 g/cm2 and 0.254 ± 0.035 g/cm3, respectively. During the median follow‐up of 1 y, lumbar areal and volumetric BMDs (mean ± SD) increased in males by 4.7 ± 2.7% (p < 0.01) and 3.5 ± 3.5% (p < 0.05), respectively, and in females by 7.2 ± 5.3% (p < 0.01) and 3.1 ± 3.1% (p < 0.05), respectively. No statistically significant difference in the BMD values was observed between the sexes. Conclusion: A significant increase in both areal and apparent volumetric BMD was observed in children aged 3–6 y during a follow‐up of 1 y. The increase in volumetric BMD indicated that there was a real accrual of BMD in growing spine measured by DXA. The present study provides prospective data on BMD accrual in young children for the evaluation of bone mass development in early childhood.
Randomized controlled study of digestive enzyme activity following trophic feeding
Authors: McClure RJ , Newell SJ 
Published: August 2010

A randomized, controlled, prospective study of 80 preterm infants of birthweight less than 1750 g requiring ventilatory support was performed. While ventilatory support was required group TF (39 infants) received trophic feeding (0.5–1 ml h−1) along with parenteral nutrition, whereas group C (41 infants) received parenteral nutrition alone. When ventilatory support was no longer required milk feeds were started in group C and then increased in both groups until full milk feeds were established. The ratio of lactase to sucrase activity (L:S ratio) was measured in aspirated proximal intestinal fluid on 3 occasions: immediately after ventilatory support was withdrawn (TO), 7 days later (T7) and 14 days later (T14). On the same 3 occasions faecal chymotrypsin activity was measured. The mean difference (95% confidence interval) L:S ratio was significantly higher in group TF at both T0 and T14, 1.8 (0.03, 3.57) and 0.78 (0.2,1.35) U l−1, respectively. There was no significant difference in faecal chymotrypsin concentration. Conclusion: Trophic feeding alters relative intestinal disaccharidase activity, probably by inducing lactase production, but has no effect on pancreatic chymotrypsin activity.
Idiopathic intracranial hypertension presenting as hemiplegic migraine
Authors: Stanley TV 
Published: August 2010

A 14‐y‐old girl presented with a 2 h history of left hemiplegia preceded by mild left‐sided sensory disturbance. She had experienced migraines for several years and there was a strong family history of migraine, including hemiplegic migraine in one of her sisters. Her hemiplegia and headache responded to sumatriptan but her headache and vomiting subsequently returned. She was found to have intracranial hypertension and developed papilloedema and paracentral scotomas. Further history revealed she had been taking minocycline for acne. Conclusion: An association between hemiplegic migraine and pseudotumour cerebri has not previously been reported. There may be a case for examining patients with pseudotumour cerebri for the calcium channel mutation (CACNA1A).
Erythropoietin and hypoxia inducible factor‐1 expression in the mid‐trimester human fetus
Authors: Ohls RK 
Published: August 2010

Aim: Infants born prematurely lack a normal response to anemia and fail to increase erythropoietin (Epo) production despite an apparent need for improved tissue oxygenation. This anemia may involve a deficiency in the fetal and premature kidney to produce Epo. To evaluate fetal Epo production, Epo and hypoxia inducible factor‐1 (HIF) mRNA expression was measured in the mid‐trimester human fetus. Methods: Fetal liver and kidney samples were obtained at 11–22 wk of gestation. RNA was isolated and reverse transcribed from snap‐frozen specimens. Epo and HIF cDNA concentrations were determined using real‐time polymerase chain reaction (PRISM). Epo cDNA concentrations were standardized to HIF concentrations present in each sample. Results: HIF concentrations remained constant during gestation in kidney and liver samples. Epo cDNA concentrations in kidney did not change from 12 to 22 wk (8.4 ± 3.4 fg Epo pg−1 HIF cDNA, 4.8 ± 1.4, 2.6 ± 0.4, and 4.2 ± 1.8 at 11–14, 15–16, 17–19, and 20–22 wk of gestation, respectively), while Epo cDNA concentrations in liver increased with gestation (74.5 ± 31.9 fg pg−1 HIF, 23.8 ± 6.5, 96.4 ± 19.2 and 276.1 ± 28.5 at 12–14, 15–16, 17–19 and 20–22 wk of gestation, respectively, p± 0.05, 20–22 wk of gestation liver samples vs all other gestations). Concentrations were 5–20‐fold higher in liver than in kidney in each gestational group (p± 0.01, liver vs kidney). Conclusion: HIF concentrations did not change with gestation in liver or kidney. The human fetal kidney produced approximately 5% of the total Epo mRNA measured during the second trimester. It remains to be determined how Epo production by these tissues is affected by premature birth.
Enzyme replacement therapy: from concept to clinical practice
Authors: Sly WS 
Published: August 2010

In the early 1960s, the first lysosomal storage disease was identified. Since then over 40 such diseases have been reported. The common feature is that enzyme deficiency leads to accumulation of undegraded macromolecules and lysosomal engorgement, resulting in organ dysfunction. Enzyme replacement therapy (ERT) is being developed for many of these disorders. The present paper summarizes the history of the development of ERT, with particular reference to the mucopolysaccharidoses, and specifically, to mucopolysaccharidosis type VII (MPS VII). The rarity of MPS VII has meant that ERT is not yet available for the small number of affected patients, although the study of MPS VII and murine models of the disease have played an important part in the development of treatment for related disorders, including Gaucher disease. Conclusion: Much progress has been made in our understanding of lysosomal storage diseases over the past 40 years. This has led to the development of effective ERT for some of the more common storage diseases, such as Fabry disease and Gaucher disease. Treatment is still awaited, however, for many of the other rare disorders in this area, such as MPS VII.
Randomized controlled study of the effects of different durations of light exposure on weight gain by preterm infants in a neonatal intensive care unit
Authors: Boo N‐Y , Chee S‐C , Rohana Jaafar 
Published: August 2010

A randomized controlled study was carried out on 96 preterm infants (>37 wk) with birthweight less than 2000 g admitted to a neonatal intensive care unit. The aim was to compare the weight gain between preterm infants exposed to 12 h cyclical lighting (intensity of light: 78.4 ± 24.7 lux, mean ± SD) and those exposed to a continuously dim environment (5.9 ± 1.9 lux). The exclusion criteria were infants with major congenital malformations or who needed continuous lighting for treatment procedure and care. From day 7 of life until discharge, 50 infants were randomized to receive 12 h cyclical lighting and 46 infants to a continuously dim environment. There was no significant difference in the mean birthweight (12 h lighting vs continuously dim: 1482 vs 1465 g, p= 0.8), mean gestational age (31.6 vs 31.4 wk, p= 0.6), median duration of hospital stay (28.5 vs 28.5 d, p= 0.8), mean age to regain birthweight (13.0 vs 12.9 d, p= 0.3), mean weight gained by day 14 (27.6 vs 36.2 g, p= 1.0), median weight gain per day (11.9 vs 12.2 g, p= 0.9) or median body weight on discharge (1800 vs 1800g, p= 0.4) between the two groups of infants. Conclusion: Exposing preterm infants to either 12 h cyclical lighting or continuously dim environment did not have any significant effect on their weight gain during the neonatal period.
Nitric oxide treatment and acute pulmonary inflammatory response in very premature infants with intractable respiratory failure shortly after birth
Authors: Aikio O , Saarela T , Pokela ML , Hallman M 
Published: August 2010

Aim: Premature infants with respiratory failure and early‐onset pneumonia have low inducible nitric oxide synthase (NOS2) and no evidence of nitric oxide (NO) toxicity. However, inhalation of NO may not be indicated in sepsis because excessive NO generation has been reported. This prospective study was designed to test the hypothesis that inhaled NO is effective in a select group of small premature infants and that the responsiveness to NO is associated with low NOS2 enzyme. Methods: 246 very low birthweight infants (birthweight <1500 g, VLBW) were screened for severe, intractable respiratory failure (oxygenation index >40, arterial‐alveolar ratio for oxygen tension <0.10) that does not respond to two doses of surfactant within 5 h from birth. Infants with severe cardiac failure or a bleeding disorder were excluded. Five of the nine eligible cases received inhaled NO. They all had prolonged rupture of foetal membranes, early‐onset pneumonia and persistent pulmonary hypertension. Results: All five responded strikingly, survived and appeared normal in follow‐up. Airway specimens during the first day of life revealed very low NOS2, interleukin‐1β and surfactant protein A, compared with VLBW infants who had no acute infection despite histological chorioamnionitis. In early‐onset pneumonia, NOS2 and other inflammatory mediators increased first during the recovery 1–2 d after birth. Conclusion: VLBW infants with progressive respiratory failure and infection at birth have deficient pulmonary NOS2 and cytokine response. After surfactant therapy, these infants responded strikingly to inhaled NO. An acute pulmonary inflammatory response may contribute to respiratory adaptation in early‐onset pneumonia.
A nocturnal enuresis service for a deprived inner city
Authors: Tappin DM , Clarke L , Ross LM , Bell M ,   the Glasgow School Nurse Enuresis Team
Published: August 2010

Aim: Glasgow is a city where 80% of the most deprived children in Scotland live within 20% of the overall population. Of 168 000 children in Glasgow, an estimated 5000 aged 5–15 y have primary nocturnal enuresis. The aim of this study was to establish a nocturnal enuresis service for Glasgow. Methods: Needs assessment was performed and the incident cases were documented at school entry healthcare appraisal, at the age of 5 y. A cohort of these children was followed up at 8 y of age and symptom resolution was no better than natural remission. Parents, general practitioners, clinical medical officers and a hospital paediatrician were interviewed face‐to‐face about their need for a service. Results: Ten of 11 general practitioners expressed a need for a specialist service. Ten school nurse‐led local nocturnal enuresis clinics were established. Accommodation, funding, default and managing alarms were major problems. School nurses enjoyed extra training and quickly became skilled therapists. Two research projects highlighted that most children at first attendance did not believe they could ever be dry, which predicted outcome. Deprived families, once motivated, could successfully undertake complex behavioural therapies. Conclusion: A comprehensive nocturnal enuresis service begins when children stop using night nappies at the age of 3–4 y. Appropriate waterproof mattress, duvet and pillow coverings should be advocated until 5 y, when desmopressin may be helpful. For continued wetting at the age of 7 y, a local service should be led by a team of well‐trained nurses using enuretic alarms.
Kikuchi‐Fujimoto disease: a rare but important cause of lymphadenopathy
Authors: Payne JH , Evans M , Gerrard MP 
Published: August 2010

Cervical lymphadenopathy is a common problem in children. Kikuchi‐Fujimoto disease (histiocytic necrotizing lymphadenitis) is a rare condition that causes persistent lymphadenopathy and has a characteristic histological appearance. Kikuchi‐Fujimoto disease is well recognized in Japan, where it was first described, but descriptions in the paediatric literature are sparse. Paediatricians may therefore be unaware of this rare but important condition. The case is described of a 14‐y‐old girl suffering from fatigue, weight loss, night sweats and lymphadenopathy. The predominance of systemic symptoms prompted an extensive investigation. The diagnosis of Kikuchi‐Fujimoto disease was made after direct histological examination of a lymph node biopsy. The case illustrates the clinical features of this little‐known condition and highlights the potential confusion with other diagnoses. The pathological features are discussed and the literature reviewed. Conclusion: Kikuchi‐Fujimoto disease should be considered in cases of persistent lymphadenopathy. An early biopsy can be instrumental in preventing unnecessary investigations and potentially harmful treatments.
Posterior ocular malformations in children: somatic, neuroradiological and cognitive aspects
Authors: Fahnehjelm K Teär , Wide K , Flodmark O , Ek U , Hellström A 
Published: August 2010

Aim: To investigate associated neurological, endocrinological and cognitive dysfunctions in children with visual impairment caused by optic nerve hypoplasia or optic nerve/fundus coloboma and/or microphthalmus. Methods: Forty children born between 1990 and 1998 were assessed by neurological examination, re‐evaluation of neuroradiological investigations, review of medical records and examination of cognitive levels. Results: Neurological dysfunctions (epilepsy and/or motor impairment) were found in 13/28 children with optic nerve hypoplasia and in 3/12 children with coloboma/microphthalmus. The optic pathways were thin in 22/24, an abnormal posterior pituitary gland and/or thin infundibulum was found in 16/22 and absence of septum pellucidum in 14/27 children with optic nerve hypoplasia. Other types of cerebral abnormalities occurred in 9/26 children. Among children with coloboma/microphthalmus, the optic pathways were thin in 4/8 children but none had pituitary or cerebral midline abnormalities. Sixteen children with optic nerve hypoplasia were receiving hormone substitution but none of the children with coloboma/microphthalmus. Thirteen of the 16 children with optic nerve hypoplasia and with an abnormal pituitary region had endocrinological deficiencies. Mental retardation was found in 9/24 of the children with optic nerve hypoplasia and in 5/10 of the children with coloboma/microphthalmus. Conclusion: Endocrinological, neurological and neuroradiological defects seem more common in children with optic nerve hypoplasia than in children with coloboma. A pituitary region that appears abnormal in magnetic resonance imaging seems to predict endocrinological deficits in children with optic nerve hypoplasia.