bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recurrent abdominal and flank pain in children with idiopathic hypercalciuria
Authors: Vachvanichsanong P , Malagon M , Moore ES 
Published: August 2010

Objective: To evaluate the role of idiopathic hypercalciuria (IH) as a cause of recurrent abdominal pain (RAP) in children. Patients and methods: We retrospectively reviewed the medical records of 124 children referred for various complaints who had 24‐h urine calcium excretion greater than 2mg/kg/d or random urine calcium‐creatinine ratio greater than 0.18mg/mg. Results: Fifty‐two children with various clinical complaints had RAP or flank pain. These comprised of 22 males and 30 females, 9 mo to 15.9 y of age, mean 6.7 3.5 y. A family history of urolithiasis was present in 50% of all the children. Only 6 of the 52 children with abdominal pain had renal stones. In addition to abdominal pain, 27 children had hematuria and 10 had urinary incontinence. Mild metabolic acidosis was present in three children, parathyroid hormone activity elevated in two and serum vitamin D activity was increased in nine. All children were treated with increased fluid intake and a reduction in dietary sodium and oxalate and some required treatment with thiazide and antispasmodics. Forty‐five cases responded to treatment, 5 failed to improve from therapy, and 2, which were not followed up as patients, were not available. Conclusion: We describe 52 children with RAP or back pain due to IH and recommend that IH be considered in the differential diagnosis of RAP in childhood.
Cholesterol dynamics in the foetal and neonatal brain as reflected by circulatory levels of 24S‐hydroxycholesterol
Authors: Lütjohann D , Björkhem I , Locatelli S , Dame C , Schmolling J , Bergmann K von , Fahnenstich H 
Published: August 2010

Oxysterols, particularly those hydroxylated in the steroid side‐chain, are formed from cholesterol by specific cytochrome P450 enzymes and may facilitate elimination of cholesterol from extrahepatic sources. In humans, the greatest portion of circulating 24S‐hydroxycholesterol (24S‐OH‐Chol) is derived from the brain and the absolute concentration depends on age. In the present study, concentrations of 24S‐OH‐Chol and for comparison 27‐OH‐Chol were determined by a highly sensitive isotope dilution method using gas chromatography‐mass spectrometry in serum samples from normal preterm and term neonates and those with Rhesus haemolytic disease, taken serially for diagnostic purposes. Serum concentrations of cholesterol, 24S‐OH‐Chol and 27‐OH‐Chol were similar in venous versus arterial cord blood of 6 term neonates. Serum concentrations of 24S‐OH‐Chol and 27‐OH‐Chol in 12 small for gestational age (SGA) preterm neonates were significantly lower than those in 12 appropriate for gestational age (AGA) preterm neonates (p< 0.001), and also lower than those in 12 SGA (p< 0.001) and 12 AGA term neonates (p< 0.05). Serum cholesterol was significantly higher in preterm than in term neonates (p< 0.001). 24S‐OH‐Chol serially determined in 8 infants with Rhesus haemolytic disease increased 5‐6‐fold during the first 3 mo after birth (from 42 ± 20 ng ml−1to 227 ± 71 ng ml−1). 27‐OH‐Chol increased simultaneously from 30 ± 14 ng m ml−1to 100 ± 39 ng m ml−1.Conclusion: Serum concentrations of 24S‐OH‐Chol increased 5‐6‐fold after birth. This could be an indication of normal cholesterol metabolism in the developing neonatal brain.
Hyperinsulinism in syndromal disorders
Authors: Meissner T , Rabl W , Mohnike K , Scholl S , Santer R , Mayatepek E 
Published: August 2010

Analysis of a German database comprising a total of 54 patients with neonatal manifestations of persistent hyperinsulinism revealed 5 patients in whom hyperinsulinism was associated with additional clinical symptoms, suggesting an underlying syndromal disorder. Three of the patients presented with a similar yet unknown clinical entity characterized by severe psychomotor retardation, chronic pulmonary disease, hypothyroidism and congenital heart defects. A fourth patient was affected by severe congenital central hypoventilation syndrome. The fifth patient presented with Beckwith‐Wiedemann syndrome, with unusually severe and persistent hyperinsulinism requiring subtotal pancreatectomy.Conclusion: Our results indicate that, in addition to the well‐known biochemical pathways, more complex pathophysiological mechanisms can result in persistent hyperinsulinism that presents clinically with a disease involving multiple organs.
Insulin‐like growth factor‐I and insulin‐like growth factor‐binding protein‐3 in cystic fibrosis: a positive effect of antibiotic therapy and hyperalimentation
Authors: Lebl J , Zahradníková M , Bartošová J , Zemková D , Pechová M , Vávrová V 
Published: August 2010

Patients with cystic fibrosis (CF) are underweight and growth retarded. This study tested the link between serum insulin‐like growth factor‐I (IGF‐I) and insulin‐like growth factor‐binding protein‐3 (IGFBP‐3) levels and body height, nutritional status, pulmonary function tests and activity of inflammation in 92 subjects with CF (age 2.1–18.8 y). It also analysed the effect of short‐term antibiotic treatment and hyperalimentation on IGF‐I and IGFBP‐3 levels in 33 subjects (age 3.6–33.7 y) on 41 occasions. Both IGF‐I (‐1.19 ±0.17 SD) and IGFBP‐3 levels (‐0.66 ±0.12 SD; both p 0.0001 vs 0) were decreased in cross‐sectional measurements. Their standardized values were inversely proportional to age (IGF‐I: r= ‐0.23, p= 0.03; IGFBP‐3: r= ‐0.29, p= 0.005) and positively correlated with SDS of height (IGF‐I: r= 0.40, p 0.0001; IGFBP‐3: r= 0.36, p= 0.0005) and of mid‐arm circumference (IGF‐I: r= 0.39, p= 0.0001; IGFBP‐3: r= 0.38, p= 0.0002), and with pulmonary function tests. After a short‐term course of intensive antibiotic therapy and hyperalimentation, IGF‐I normalized (from ‐0.66 ± 0.20 to 0.00 ± 0.25 SD; pľ 0 0001) and IGFBP‐3 increased (from ‐0.78 ± 0.15 to ‐0.53 ± 0.16 SD; p= 0.002). IGFBP‐3 correlated inversely with erythrocyte sedimentation rate (r= ‐0.40, p= 0.01).Conclusion: The levels of IGF‐I and IGFBP‐3 are markedly decreased in patients with CF and tend to normalise after a short course of antibiotic treatment and hyperalimentation.
Transcutaneous bilirubinometry in preterm infants
Authors: Knüpfer M , Pulzer F , Braun L , Heilmann A , Robel‐Tillig E , Vogtmann C 
Published: August 2010

The aim of this study was to evaluate the accuracy and safety of transcutaneous bilirubinometry in preterm infants using the new bilirubin analyser BiliCheck±. The study included 145 preterm children (23–36 wk gestation). Capillary blood sampling for determination of serum bilirubin (BS) was combined with transcutaneous bilirubin measurement (BTc) every morning until the sixth postnatal day and related to several clinical data (phototherapy (PT), infection signs, breathing disturbances, skin bleeding, etc.). Overall bilirubin concentration ranged from 17 to 371 μmol/l, and from 21 to 325 μmol/l for BS and BTc, respectively. Mean values obtained by BTc were significantly higher than BS values. The correlation coefficient between BS and BTc was r= 0.64 for the whole group, and r= 0.73 in infants without PT. As demonstrated by multiple regression analysis, BS‐BTc correlations were related only to gestational age (beta ‐0.32) and breathing disturbances (beta 0.29), indicating that the lower the gestational age and the more seriously ill the baby, the higher the incoherence between BS and BTc.Conclusion: BiliCheck±provides a convenient, non‐invasive possibility for bilirubin estimation in preterm infants. However, there are limitations: the method gives reliable results only in newborns older than 30 wk gestation, without PT and artificial ventilation.
Brainstem size and function at term age in relation to later neurosensory disability in high‐risk, preterm infants
Authors: Valkama AM , Tolonen EU , Kerttula LI , Püaukö ELE , Vainionpää LK , Koivisto ME 
Published: August 2010

The aim of this study was to measure brainstem size on magnetic resonance imaging (MRI) scans of high‐risk, preterm infants, to assess brainstem function by brainstem auditory‐evoked potentials (BAEP) and to determine the predictive value of these measures for the neurosensory outcome. A total of 51 preterm infants (gestational age <34 wk, birthweight <1500 g) underwent examinations at term age; neuromotor outcome and hearing were followed up until a corrected age of 18 mo. Fourteen (27%) infants had neurosensory disability. Those with a later neurosensory disability had a significantly smaller brain stem than those with a normal outcome. The preterm infants had significantly longer peak latency (L) V and interpeak latency (IPL) III–V than the full‐term control infants. Most of the preterm infants with severe cerebral palsy or hearing loss had abnormal BAEP. Sensitivity of morphometric dimensions for predicting neurosensory disability was only 20–31%, but specificity was 97–100%. Abnormal L I and IPL III–V in BAEP predicted disability with a sensitivity of 93% and a specificity of 57–59%.Conclusion: We conclude that adverse events during the perinatal period may lead to morpho‐functional changes in the brain stem in high‐risk, preterm infants, and it seems that functional changes are accurate in predicting neurosensory disability in such patients.
Duration of breastfeeding and associated factors in Western and Eastern Germany
Authors: Dulon M , Kersting M , Schach S 
Published: August 2010

Ten years after the German political reunification, specific lifestyle habits still vary between the former Western (FRG) and Eastern (GDR) sectors of Germany. We have analysed data from the first nationwide SuSe Study on breastfeeding 1997–1998 (n= 1593 healthy, term German infants) stratified in a Western (80.3%) and Eastern (19.7%) subgroup. In the Eastern subgroup, breastfeeding was higher for the first 2 wk but decreased more rapidly thereafter. The adjusted relative risk (odds ratios, OR) for short‐term breastfeeding was strongly associated (OR >2) with maternal age, supplementary feeding, single parent status, maternal educational status, breastfeeding problems and partner's attitude towards breastfeeding. In the multivariate model, not the geographical location where the mother grew up but the different distribution of risk factors was associated with short‐term breastfeeding. Moreover, mothers from both the Western and Eastern sectors mentioned different reasons for giving up breastfeeding.Conclusion: More breastfeeding promotion is necessary for women from the former GDR.
Selective screening for neonatal galactosemia: an alternative approach
Authors: Shah V , Friedman S , Moore AM , Platt BA , Feigenbaum ASJ 
Published: August 2010

No universal consensus exists for population‐based neonatal screening for galactosemia. In our institution, selective screening for classical galactosemia is carried out on infants under 2 wk of age and those with symptoms suggestive of this disorder. Eighteen cases were diagnosed from 25099 tests done; 17 were symptomatic at the time of diagnosis.Conclusion: We suggest that improved clinical vigilance and selective screening would identify most infants with severe galactosemia as early as a population‐based program.
Selenium status, kwashiorkor and congestive heart failure
Authors: Manary MJ , MacPherson GD , McArdle F , Jackson MJ , Hart CA 
Published: August 2010

Selenium deficiency is associated with congestive heart failure (CHF) in geographic areas where dietary selenium intake is low and in individuals receiving total parenteral nutrition. Among 66 children with kwashiorkor (including marasmic‐kwashiorkor), those who developed CHF had lower serum selenium concentrations than those who did not (32.9 ±8.3 vs 41.1 ± 11.9 Lig/L, meaniSD, p= 0.03). This association was independent of serum albumin and selenium status was not associated with severity of symptoms, anthropometric indices or HIV infection.Conclusion: This association raises the possibility that selenium may contribute to CHF in kwashiorkor.
Fifteen year trends in water intake in German children and adolescents: Results of the DONALD Study
Authors: Sichert‐Hellert W , Kersting M , Manz F 
Published: August 2010

Water intake was evaluated and time trends in water intake and beverage consumption were assessed on the basis of 3 d weighed dietary records (n= 3736) of 2‐13‐y‐old males (n= 354) and females (n= 379) enrolled in the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study, 1985–1999). Total water intake increased with age from 1114 g d−1 in the 2‐3‐y‐olds to 1363 g d−1 in the 4‐8‐y‐olds and further to 1801 g d−1 (1676 g d−1) in the 9‐13‐y‐old boys (girls); 33–38% came from food, 49–55% from beverages and 12–13% from oxidation. Total water intake per body weight decreased with age from 77.5 gkg−1 (boys and girls) to 48.9 and 42.6 gkg−1 in boys and girls, respectively. Milk (9–17%) and mineral water (12–15%) were the most important source of total water intake. In the 15 y period a significant increase in total water intake (+1.7 to +3.2 g Mr−1 y1) in all three age groups irrespective of sex was found. The increase of total water intake was mainly due to an increase in beverage consumption (+0.32 to +0.47% y−1). This study offers a differentiated insight into water intake and patterns of beverage consumption in German children and adolescents. Conclusion: The comparison of these data with other surveys points to a low total water intake, especially a low tap water intake, in German children and adolescents and underlines cultural influences on food and drinking habits.
Early feeding resistance: A possible consequence of neonatal oro‐oesophageal dyskinesia
Authors: Abadie V , André A , Zaouche A , Thouvenin B , Baujat G , Schmitz J 
Published: August 2010

Paediatricians frequently find early feeding disorders in neonates and infants that result in poor weight gain and which sometimes have no clear organic basis. For many years, we have observed infants with unexplained poor feeding skills and excessive regurgitation, and since 1992 we have prospectively performed oesophageal manometry in infants hospitalized for retarded growth and “unexplained” feeding disorders. From the group of infants hospitalized for growth failure in the General Paediatric Unit of Necker‐Enfants Malades Hospital from 1992 to 1997, we identified 16 children (3%) with abnormal feeding behaviour who had an abnormal oesophageal manometry. The manometric data of these children were compared with those of a group of 16 age‐matched children who underwent oesophageal manometry for other reasons, and served as controls. The affected children had precocious feeding skills disorders: prolonged bottle‐feeding (75%), bottle refusal (75%), unexplained crying (63%) and excessive regurgitation (94%). Half of them had mild anatomical facial consequences of their poor foetal sucking, and mild pharyngolaryngeal hypotonia, which could not be considered as malformations. Apart from these disorders, their clinical status was normal. At inclusion, their oesophageal manometry was abnormal, showing in 70% of cases specific anomalies: lower oesophageal sphincter hypertonia and/or partial failure to relax, and giant waves of oesophagus body. Their course was good and their feeding difficulties decreased around the end of the first year, with the acquisition of normal voluntary mastication. Conclusion: We suggest that the early feeding resistance of this group of children could be | related to an organic and transient neonatal oro‐oesophageal dyskinesia.
Serum bilirubin levels at 72 hours by selected characteristics in breastfed and formula‐fed term infants delivered by cesarean section
Authors: Hintz SR , Gaylord TD , Oh W , Fanaroff AA , Mele L , Stevenson DK ,   NICHD, Neonatal Research Network
Published: August 2010

The present multicenter study analysed the relative impact of maternal and infant factors on serum bilirubin levels at 72 ± 12 h in exclusively breastfed vs formula‐fed term infants. End‐tidal carbon monoxide levels corrected for ambient air (ETCOc), an index of bilirubin production, were measured in exclusively breastfed (B = 66) or formula‐fed (F = 210) term infants at 2–8 h of age. Inclusion criteria included cesarean section to ensure a 3 d hospitalization, birthweight ±2500 g, gestational age ±37 wk and absence of any illness. The ETCOc for B infants and F infants did not differ significantly (1.3 ± 0.7 ppm vs 1.3 ± 0.8 ppm). The serum bilirubin level at 72 ± 12 h was significantly higher in B infants than in F infants (8.5 ± 3.4mg dl−1 vs 6.7 ± 3.4 mg d l−1, p < 0.001), as was the percentage weight loss from birthweight. Serum bilirubin levels were significantly higher in infants who were male, who did not have meconium‐stained amniotic fluid, and in those whose mothers were insulin‐dependent diabetics or hypertensive. There was no difference between groups in the need for phototherapy or exchange transfusion. Conclusion: Although higher bilirubin levels were observed in group B at 72 ± 12 h compared with group F, this finding was not of clinical or therapeutic consequence in this study. The lack of difference in ETCOc between the groups may be a factor of the timing of ETCOc measurement in this study, or may suggest that early increased bilirubin production is not a significant contributor to jaundice observed in exclusively breastfed infants.
Transcutaneous‐PO2 monitoring for detection of exercise‐induced right‐to‐left shunts in children with congenital heart defects: A case report
Authors: Holmgren D , Redfors S , Solymar L 
Published: August 2010

A 2‐y‐old boy with scimitar syndrome underwent surgery involving the redirection of partial anomalous pulmonary venous return to the left atrium. Heart catheterization after the operation did not reveal any significant intra‐cardiac shunts. An exercise test performed at the age of 10 y revealed a reduction in working capacity. At the age of 12 y, the patient became unconscious and experienced seizures during heavy physical exercise. EEG and Holter ECG examinations were normal. In a second exercise test, a fall in transcutaneous PO2 was demonstrated at the start of the test. A new heart catheterization revealed communication between the inferior vena cava and the left atrium owing to a misplaced patch. No right‐to‐left shunt was found at rest, probably as a result of drainage of the inferior vena cava to the superior vena cava by the azygous vein. An exercise test after re‐operation revealed normal conditions. Conclusion: Haemodynamic studies during heart catheterization in children are usually performed at rest. This could result in exercise‐induced right‐to‐left‐shunts being overlooked. The use of PtcO2 monitoring during exercise tests is a non‐invasive means of exposing these shunts.
Integration of vitamin A supplementation with the Expanded Programme on Immunization: lack of impact on morbidity or infant growth
Authors: Semba RD , Munasir Z , Akib A , Melikian G , Permaesih D , Muherdiyantiningsih D , Marituti S , Muhilal S. 
Published: August 2010

Vitamin A deficiency is associated with increased morbidity and mortality from diarrheal disease, measles, and malaria. It has been proposed that vitamin A supplementation could be linked with childhood immunization programs to improve child health. We conducted a randomized, double‐blind, placebo‐controlled clinical trial to evaluate the impact of linking vitamin A supplementation with the Expanded Programme on Immunization on morbidity and child growth. In West Java, Indonesia, 467 six‐week‐old infants were randomized to receive 7.5 mg retinol equivalent (RE), 15 mg RE, or placebo with childhood immunization contacts at 6, 10, and 14 wks and 9 mo of age. Child growth was assessed through anthropometry, and morbidity histories were obtained. Vitamin A supplementation had no apparent impact upon linear or ponderal growth or infectious disease morbidity in the first 15 mo of age when integrated with the Expanded Programme on Immunization. Conclusion: Although improving vitamin A nutriture is of general importance in reducing diarrheal and measles morbidity and mortality in developing countries, this clinical trial showed no apparent benefit of vitamin A capsules for infant health when given through childhood immunization programs.
Pancreatic beta‐cell stimulation tests in transient and persistent congenital hyperinsulinism
Authors: Christesen HBT , Feilberg‐Jørgensen N , Jacobsen Brock 
Published: August 2010

In congenital hyperinsulinism (HI), the in vivo pancreatic β‐cell function is poorly described. Among 14 neonates with severe hyperinsulinaemic hypoglycaemia, 2 patients had very prolonged or persistent hypoglycaemia and mutation in the sulphonylurea receptor SUR1 gene. Patient 1 had transient HI and was treated medically for 3.5 mo before clinical remission was seen. He had initially very high basal and stimulated C‐peptide and insulin levels, followed by a state of normal preprandial values, but blunted β‐cell glucose sensitivity, before complete β‐cell normalization occurred. A single, paternal SUR1 mutation, G1382S, was found suggesting focal type HI. Patient 2 had persistent HI and underwent 3 pancreas resections up to the age of 2 y, 7 mo, followed by a state of mild diabetes. On biopsy, diffuse‐type β‐cell hypertrophy was seen. The β‐cell response to glucose and glucagon stimulation was blunted before, as well as after, pancreas resections. Compound heterozygosity for the SUR1 mutations 3992–3c to g and N188S was found. Conclusion: Transient, possibly focal, HI with paternal SUR1 mutation was associated with a gradual, but complete normalization of the in vivoβ‐cell function; in the diffuse type HI, a blunted β‐cell response to glucose and glucagon stimulation persisted. In vivoβ‐cell stimulation tests may contribute to the characterization of the HI subtypes.
Muscle power in “high‐risk” preterm infants at 12 and 24 weeks corrected age: a measure for early detection
Authors: Samsom JF , de Groot L , Hopkins B 
Published: August 2010

A group of 72 “high‐risk” preterm infants was studied at the corrected ages of 12 and 24 wk. Only infants with a high risk for developmental deviance with gestational ages below 32 wk and/or birthweights of less than 1500 g were included in the study. In addition, the infants were categorized according to their medical history, as confirmed by the “Neonatal Medical Index” (NMI I to V), with category I describing infants with few medical problems and V characterizing those with the most serious complications. In this study we included only “high‐risk” infants as categorized in NMI III to V, since infants with a “low risk” have been described earlier. Apart from the standard paediatric follow‐up, an age‐adequate neurological assessment was made, with special emphasis on the relationship between active and passive muscle power. When development is optimal, these two components of muscle power should be in balance in order to create a stable posture and fluent motility. We compared muscle power at the corrected ages of 12 and 24 wk to determine whether the method employed to assess muscle power could enhance early detection of deviant development. At 12 wk of age, only 5 infants showed overall optimal muscle power, while at 24 wk this figure had increased to 27. Significantly more infants in NMI III had optimal outcomes at 24 wk of age. When muscle power in the different parts of the body was studied separately at 24 wk, outcomes in shoulders and trunk still showed significant discrepancies in all NMI groups. At this age, fewer asymmetries were found compared to outcomes at 12 wk. Conclusion: Our method of assessing muscle power is useful in detecting preterm infants at risk for pathological development.