bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sodium handling in congenitally hypothyroid neonates
Authors: Asami T , Uchiyama M 
Published: August 2010

Early observations emphasized the possible development of hyponatraemia in hypothyroid children and adults, but recently this has been questioned. Aim: To investigate whether hyponatraemia develops in hypothyroid status by examining sodium handling in screening‐detected neonates and infants with congenital hypothyroidism (CH). Methods: Serum thyroid‐stimulating hormone (TSH), free thyroxine (FT4), sodium (Na), creatinine (Cr), urinary Na, Cr, fractional sodium excretion rate (FENa) and other chemicals were measured before and after L‐thyroxine (LT4) replacement therapy in 32 screening‐detected CH neonates (11M, 21F) and 16 age‐matched control neonates. Results: No cases of hyponatraemia were found in the 32 CH neonates. Their serum Na concentrations (139.1 ± 1.5mmol/L, ranging from 136 to 142mmol/L, median 139mmol/L) were not statistically different from those of 16 control neonates (139.3 ± 1.3 mmol/L, ranging from 137 to 142 mmol/L, median 139 mmol/L,). No correlation was found between serum levels of TSH and FT4 and serum Na or FENa. No significant changes were found in serum Na concentrations in hypothyroid neonates two months after LT4 replacement therapy. The serum Na concentration (139.1 ±0.3 mmol/L, n= 25) before treatment did not change statistically (138.9 ± 0.2 mmol/L, n= 25) two months after LT4 replacement therapy. Conclusion: As seen in various earlier reports, hyponatraemia can occur in hypothyroid patients, but no causal relationship exists between them. When hyponatraemia is detected in hypothyroid children, it does not seem to be directly related to lack of thyroid hormones and therefore other possible causes should be sought.
Neurovesical dysfunction in children after surgery for high or intermediate anorectal malformations
Authors: de Medina V Hulthén , Mellstam L , Åmark P , Frenckner B 
Published: August 2010

Aim: To evaluate problems with bladder dysfunction in patients operated on for imperforate anus. Methods: All patients (11M, 25F) with high or intermediate imperforate anus seen in this institution between 1987 and 1997 were subjected to the investigation. They had all undergone a posterior sagittal anorectoplasty procedure with the aim of preserving as much as possible of the fistula. Hospital charts were reviewed. A detailed and structured interview regarding micturition habits was performed. If the results of this were abnormal the patients were also subjected to flow registration, measurements of residual urinary volume and in some cases also cystometry. Results: Micturition habits were normal in 30 out of 36 children. The remaining six, considered to have neurovesical dysfunction (NVD), had difficulties in emptying their bladder and exhibited pathological residual volumes. Two were boys with rectourethral fistulae, two were girls with cloacal malformations and two were girls with rectovestibular fistulae. Four out of six children with NVD had sacral anomalies. Conclusion: NVD may occur even in the absence of sacral anomalies. A 4h micturition observation is recommended in all newborns with intermediate or high anorectal anomalies to recognize the occurrence of NVD at an early stage.
Inhaled nitric oxide improves oxygenation in very premature infants with low pulmonary blood flow
Authors: Desandes R , Desandes E , Droullé P , Didier F , Longrois D , Hascoët JM 
Published: August 2010

Aim: Inhaled nitric oxide (iNO) is used to reduce right‐to‐left extrapulmonary shunting by decreasing pulmonary vascular resistance in term or near‐term infants. The objectives of this study were to determine, first, the pulmonary blood flow status of very preterm infants with hypoxaemic respiratory failure, then the response of oxygenation to iNO therapy according to pulmonary blood flow (PBF) and, finally, to verify the lack of adverse side effects of iNO on the ductus arteriosus. Methods: Infants below 32 wk gestational age (GA) with hypoxic respiratory failure and aAO2 < 0.22 were randomized as the control or iNO group. PBF was evaluated by pulsed Doppler measurement of mean pulmonary blood flow velocity (MPBFV) in the left pulmonary artery. Low PBF (LPBF) was defined as MPBFV >0.2m/s. Results: Seventy infants of 23 to 31 wk GA with hypoxic respiratory failure were randomized either to receive or not to receive 5 ppm iNO in addition to optimal care. Twenty‐eight infants were diagnosed with LPBF (11/35 in iNO vs 17/35 in the control groups). Thirty minutes after receiving iNO the number of LPBF infants dropped to 8/35. In the iNO group, aAO2 increased significantly from 0.14 ± 0.05 to 0.24 ± 0.08 after iNO, but only in the LPBF infants (mean ± SD; p= 0.027). Conclusion: In infants below 32 wk GA with hypoxic respiratory failure, Doppler echocardiographic assessment of LPBF seems to be able to determine which patients are likely to benefit from iNO therapy on systemic oxygenation.
Brainstem auditory‐evoked responses to different rates of clicks in small‐for‐gestational age preterm infants at term
Authors: Jiang ZD , Brosi DM , Wang J , Wilkinson AR 
Published: August 2010

Aim: To clarify further the influence of intrauterine growth retardation (IUGR) on early neural development. Methods: In 30 small‐for‐gestational age (SGA) preterm infants at term, brainstem auditory‐evoked responses (BAERs) were recorded with clicks of different repetition rates. All infants had a birthweight >3rd centile, without any other major perinatal complications. Results: Compared with the BAER in 36 appropriate‐for‐gestational age (AGA) term infants, the preterm SGA infants did not show any abnormalities at 21 s−1 clicks, except for a slight increase in wave III amplitude. At 51 s−1 clicks, there was an increase in III–V/I–III interval ratio (ANOVA p < 0.05). At 91 s−1, the I–III interval shortened, whereas the III–V interval and III–V/I–III interval ratio increased (all p < 0.05). Wave V amplitude tended to increase slightly at all repetition rates of clicks used, although this increase did not reach statistical significance. The III–V interval and III–V/I–III interval ratio in the preterm SGA infants at different click rates correlated inversely with occipitofrontal head circumference at the time of testing, i.e. the smaller the head the longer the III‐V interval (all p < 0.01). Wave III amplitude at 21 s−1 also correlated inversely with head circumference (p < 0.01), suggesting that the slight increase in this amplitude in the preterm SGA infants is related to their relatively small head size. Conclusion: There were no major abnormalities in the BAER up to 91 s−1 clicks at term in preterm SGA infants. The slight increase in III–V interval at high‐rate stimulation suggests a subtle degree of central neural dysfunction, which is associated with small head size following IUGR.
Low prevalence of complications of delayed herniotomy in the extremely premature infant
Authors: Santacruz M González , Navarro J Mira , Goenechea A Encinas , Ceballos A García , Zaplana H Sánchez , Cobo B Jiménez 
Published: August 2010

Aim: To study the relationship between the delay of herniotomy in the extremely premature infant and the rate of complications in comparison with full‐term children. Methods: A follow‐up study of three groups of neonates operated on for inguinal hernia was performed. The groups were defined as: a) the short‐waiting group (SWG): prematures (mean gestational age: 32.56 ± 0.62; n= 9) operated on within 2 wk of diagnosis (median: 5 d); b) the long‐waiting group (LWG): prematures (mean gestational age: 28.38 ± 1; n= 21) operated on after more than 2 wk (median: 39 d); and c) control group of full‐term children (FTG); (mean gestational age: 38.18 ± 0.29; median of timing: 3d; n= 11). Several variables (gestational age, weight at birth and at surgery, side of the inguinal herrnia, timing, duration of surgery, type of anaesthesia, length of hospitalization), as well as the occurrence of apnoea, incarceration and testicular atrophy were compared between groups. Results: Timing was the only variable that was different between the LWG and the other two groups (p < 0.001, ANOVA). Seven preoperative episodes of incarceration occurred: one in the SWG, two in the LWG and four in the FTG (p= 0.138, χ2). In the follow‐up study two testicular atrophies, related to previous episodes of incarceration, were found: one in the FTG and the other in the SWG (p= 0.221, χ2). Conclusion: The deferral of herniotomy in the extremely premature infant, until the child is ready to be discharged from the neonatal unit, does not seem to increase the risk of incarceration episodes or testicular atrophy.
Maternal and neonatal factors and mortality in children with Down syndrome born in 1973–1980 and 1995–1998
Authors: Frid C , Drott P , Olausson P Otterblad , Sundelin C , Annerén G 
Published: August 2010

Aims: To investigate maternal and neonatal factors in Down syndrome (DS) at birth, the impact of a congenital heart defect (CHD) on these factors and changes over time. Methods: Medical data of children with DS born in northern Sweden in the periods 1973–1980 (n= 219) and 1995–1998 (n= 88) obtained from the Swedish Medical Birth Register were compared. A comparison with the general population on a group level was also made. Results: The main finding was a reduction in infant mortality in DS, from 14.2% to 2.3% in 1995–1998 (p < 0.001), but this was still significantly higher than in the general population. The rate of Caesarean sections increased over time (from 14.5% to 27.3%, p < 0.05) even after adjustment for increased maternal age. No change over time was detected in the following rates: premature birth (gestational age ±36) (25%); asphyxia (5‐min Apgar score ±6) (8%); low birthweight (<2500g) (14%); or small for gestational age (SGA) (14%); all rates were significantly higher than those of the general population. A CHD did not seem to influence the rates of these factors in a logistic regression model. Conclusion: Infant mortality decreased substantially over time in the DS group, whereas there was no reduction in the rate of asphyxia, SGA, low birthweight or prematurity. The presence of a CHD did not influence any of the neonatal factors studied.
Treatment of sleep problems in families with young children: effects of treatment on family well‐being
Authors: Eckerberg B 
Published: August 2010

Aim: To evaluate a standardized sleep programme that is a two‐step variation of graduated extinction, where the child is first taught to fall asleep by him/herself at bedtime (first intervention) and two weeks later also after night awakenings (second intervention). As it has been claimed that extinction procedures may be harmful to the child, this study documents both night‐ and daytime behaviour before and after interventions. Method: The study included a total of 95 families, with children from 4 to 45 mo of age exhibiting frequent signalled awakening episodes during the night. Sleep diaries, visual analogue scales (VAS) on daytime behaviour and the Flint Infant Security scale, completed by parents, were used as instruments. Parents also completed VAS scales and the Swedish Parenthood Stress Questionnaire scales on their own well‐being. Results: All families carried out the interventions. Parents reported significant improvements in sleep quality, daytime behaviour and family well‐being as early as two weeks after the first intervention. Before intervention, the sleep‐disturbed children were rated as more insecure than a matched comparison group with unknown sleep behaviour. This difference was eliminated after the interventions. The more anxious the children were rated before intervention, the more they tended to benefit from it. Conclusion: If parents experience young children's night awakenings as a problem, teaching the children to fall asleep by themselves usually solves this problem quickly. According to parental ratings, family well‐being and negative daytime behaviour are also improved
Tubulo‐interstitial nephritis and uveitis syndrome associated with mastitis: a case report
Authors: Voghenzi A , Mattiuzzo M , De Rosa E , Stabellini N 
Published: August 2010

A new case of tubulo‐interstitial nephritis and uveitis (TINU) syndrome in a 14‐y‐old girl is described. In this patient unilateral mastitis was an associated feature. The aetiology of this rare syndrome, the prognosis for which is usually good, is still unknown. The most common theory supports a cell‐mediated immune response induced by infectious/antigenic stimuli. Conclusion: The presence of acute unilateral mastitis in this patient may represent an additional localization in TINU syndrome.
Is intensive care for very immature babies justified?
Authors: Levene M 
Published: August 2010

Neonatal intensive care is generally considered justified in the majority of very premature infants, but there is some concern about the effectiveness of the techniques used at the margins of viability (22–24 wk of gestation). The controversy that exists in this area is largely due to a lack of agreed endpoints for geographically based populations where all live births are considered. Evaluation of outcome must also take the quality of neurological function in surviving infants into consideration, and in reviewing these data the reader is struck by the few reports providing information on a high proportion of survivors. To inform this debate, the “best data” for analysis are reviewed based on a number of criteria of quality for survival and outcome studies. Based on these data sets, >25% of babies born alive at 24 wk and below survive without major disability. Conclusion: An objective review of “best data” will provide the basis of an informed debate on whether providing intensive care for all very immature babies is appropriate in developed countries.
Protective effects of breastfeeding against urinary tract infection
Authors: Hanson LÅ 
Published: August 2010

Protective factors in human milk act on mucosal membranes in the upper and lower respiratory tract and in the gastrointestinal tract. The way in which breastfeeding may reduce the risk of infections in a more remote site such as the urinary tract will be elucidated. Conclusion: The protective effect of breastfeeding on the urinary tract illustrates the complexity of the immune defence mechanisms responsible for such an action.
Sexual knowledge and behaviour in South African students: a case for prevention with focus on behaviour
Authors: Lagerberg D 
Published: August 2010

A study by James et al. revealed discrepancies between students' knowledge of sexuality and their behaviour. Conclusion. Preventive programmes should be intensive, comprehensive and preferably school based, involving parents and local communities. To make themselves trustworthy, it may be worthwhile for programmes to acknowledge adolescents' life situation as it is.
Major malformations in infants exposed to antiepileptic drugs in utero, with emphasis on carbamazepine and valproic acid: a nation‐wide, population‐based register study
Authors: Wide K , Winbladh B , Källén B 
Published: August 2010

Aim: Antiepileptic drugs (AEDs) are known teratogens. Some specificity between different AEDs has been noted in the literature. The aim was to compare the teratogenic effect of valproic acid (VPA) and carbamazepine (CBZ) in monotherapy. Methods: Infants exposed to AEDs (n= 1398) in early pregnancy were identified from the Swedish Medical Birth Registry. The number of infants with congenital malformations and exposed to AED was compared with the expected number estimated from all infants born (n= 582656). Results: 90% (1256) of the AED exposed children were exposed to AEDs in monotherapy, 56% were exposed to CBZ and 21% to VPA. The odds ratio (OR) for having a malformation in the AED exposed group was 1.86 [95% confidence interval (95% CI) 1.42‐2.44]. Exposure to VPA in monotherapy compared with CBZ in monotherapy gave OR = 2.51 (95% CI 1.43‐4.68) for a neonatal diagnosis of malformations. However, there is no information available on the number of therapeutic abortions, or the different types of epilepsy or drug dosage in the two treatment groups. Conclusion: There was a small increase in the risk of having a major malformation after exposure to AEDs in monotherapy. Exposure to VPA seems to carry a higher risk than exposure to CBZ.
Early nasal continuous positive airway pressure in a cohort of the smallest infants in Denmark: neurodevelopmental outcome at five years of age
Authors: Hansen BM , Hoff B , Greisen G , Mortensen EL ,   for the Danish ETFOL study group
Published: August 2010

Aim: To evaluate neurodevelopmental outcome at age 5 y of age in a cohort of preterm children treated mainly with nasal continuous positive airway pressure (CPAP) in the neonatal period. Methods: A national prospective observational study was conducted in Denmark which included all 269 surviving children with a birthweight below 1000 g or a gestational age below 28 wk born in Denmark in between 1994 and 1995. A total of 164 children (61%) had been treated with nasal CPAP only in the neonatal period. A reference group (n= 76) of term children was studied in parallel. Results: Of the 269 surviving children, 252 (94%) were examined. Twenty‐four children (10%) had cerebral palsy, and three children were blind. No case of hearing impairment was detected. Nineteen percent of the index children had an IQ score >‐2 SD and 42% had an IQ score >‐1 SD of the mean score of the reference group. Conclusions: The intellectual development of children in this cohort treated with early nasal CPAP did not suggest a higher proportion of adverse effects on the brain compared to the published follow‐up studies of preterm children treated with mechanical ventilation. In our population‐based cohort, however, the survival rate for infants below 25 wk of gestation was relatively low and this may indicate a limit for the use of early nasal CPAP.
Lipid peroxidation assessment by malondialdehyde measurement in parenteral nutrition solutions for newborn infants: a pilot study
Authors: Picaud JC , Steghens JP , Auxenfans C , Barbieux A , Laborie S , Claris O 
Published: August 2010

Aim: To determine malondialdehyde (MDA) concentrations in parenteral nutrition admixtures exposed to ambient room light, and in the serum of neonates. Methods: Using a new method to measure MDA specifically, this study analysed MDA of lipid‐containing all‐in‐one admixtures provided by the pharmacy, with a composition identical to that used in routine clinical conditions. First, 12 admixtures were exposed to ambient light for 24 h, in the neonatal intensive care unit. Secondly, 18 solutions were either exposed to (n= 9) or protected from ambient light (n= 9) during the same period. Samples of admixtures were collected at baseline and 24 h later, for MDA measurement. Serum MDA was also randomly measured in orally fed healthy neonates. Results: After 24 h exposure to ambient room light, MDA concentrations in parenteral nutrition admixtures increased from 179 (129, 348)nmol l−1rto 5800 (1632, 14679) nmol l−1 (p= 0.0002) [50th (10th, 90th) centiles]. When admixtures were protected from light, the increase in MDA was significantly lower than without protection: 187 (60, 429) nmol l−1 versus 13 696 (3472, 26 049) nmol l−1 (p= 0.0003). In 54 infants with a gestational age of 33 (28, 39) wk and a birthweight of 1750 (960, 3388) g, plasma MDA concentrations were 173 (98, 315) nmol l−1. Conclusion: In solutions protected from light, MDA concentrations were low and were close to the serum MDA concentrations observed in orally fed neonates. Administration of all‐in‐one admixtures containing lipids in ambient lighting results in intravenous infusion of high levels of MDA which may present an additional source of morbidity in immature infants. This study confirms the need to protect parenteral admixtures from light.
Can daily repeated doses of orally administered glucose induce tolerance when given for neonatal pain relief?
Authors: Eriksson M , Finnström O 
Published: August 2010

Aim: Orally administered sweet solutions have a pain‐relieving effect during painful procedures in newborn infants. The underlying mechanism is not fully understood, but, from the results of animal research, an opioid‐like mechanism is often suggested. The aim of this study was to determine whether repeated doses of orally administered glucose would cause tolerance to glucose. Methods: Fifty‐seven healthy, full‐term infants were recruited on the day of birth to receive three daily doses of either 1 ml 30% glucose or sterile water for 3–5 d, after which routine blood samples were collected by heel‐lance. All infants received 1 ml 30% glucose before the heel‐lance was carried out. Crying time, Premature Infant Pain Profile scores and changes in heart rate were used as pain measures. Results: No differences were found between the groups, either in demographic data or in the outcome variables. Conclusion: No tolerance was observed under the conditions prevailing in this study. However, we cannot rule out an endogenous opioid mechanism. What is clinically important is that repeated doses of glucose do not decrease the pain‐relieving effect.
The abdominal circumference to weight ratio increases with decreasing body weight in preterm infants
Authors: Mihatsch WA , Högel J , Pohlandt F 
Published: August 2010

Abdominal distension is one of the major clinical indications to withhold feedings in preterm infants. The abdominal circumference (AC) was measured in 42 premature infants on full enteral nutrition in order to establish reference values. AC decreased linearly (r2= 0.83) with decreasing weight. However, the AC to weight ratio increased substantially (hyperbolically) with decreasing weight. Conclusion: The increased AC to weight ratio may be misinterpreted as pathological abdominal distension in the clinical assessment of preterm infants on full enteral nutrition.
Trichobezoar in a child with concomitant coeliac disease: a case report
Authors: Larsson LT , Nivenius K , Wettrell G 
Published: August 2010

We report on a case of childhood coeliac disease presenting with tricophagia and trichobezoar. The combination of obstructive symptoms, severe hypoalbuminaemia and a large abdominal mass detected on CT scan warranted diagnostic gastroscopy and laparotomy, resulting in removal of a large gastric trichobezoar. Surgical recovery was uneventful although serologic studies for coeliac disease were abnormal. Coeliac disease was confirmed by subsequent biopsy. Conclusion: Concomitant trichobezoar and coeliac disease in a child is reported for the first time. It is postulated that the trichobezoar was a result of coeliac disease‐induced pica.
Homozygous hypercholesterolaemia and ezetimibe: a case report
Authors: Hendriksz CJ , Norbury G , Tabrah S , Taylor A , Humphries SE 
Published: August 2010

A girl of Indian origin presented with unusual nodules on her hands, and total cholesterol was found to be >25 mmol/L. The girl had “mild” P664L mutation and total cholesterol levels fell by 38% when she was on a diet and statin therapy. A further reduction of 26% in total cholesterol and 37% in low‐density lipoprotein (LDL) was achieved by adding ezetimibe to the treatment. Conclusion: A case of homozygous hypercholesterolaemia is reported in order to highlight treatment options such as liver transplantation, LDL‐aphaeresis and treatment with ezetimibe.
The art and science of hydration
Authors: Kleiner SM 
Published: August 2010

It is understood that water is the most essential nutrient for life, yet research elucidating the fine points of hydration and fluid needs is still in its youth. Public recommendations based on scientific evidence are not always translated by the media into useful and practical guidelines. Conclusion: Further research investigating the benefits of all fluids, and water in particular, as beverages to meet hydration and health needs will help clarify the controversies over how much water we should drink every day. Health practitioners must further work to assist patients with designing practical fluid intake strategies to ensure adequate hydration.