bluuebunny/crossref_metadata_2025_split huggingface dataset:
Septicaemia and meningitis in neonates and during early infancy in the Göteborg area of Sweden
Authors: Persson E , Trollfors B , Brandberg L Lind , Tessin I 
Published: August 2010

In a retrospective study of neonatal septicaemia and meningitis carried out in 1987–1996 in the Göteborg area of Sweden, 305 cases during the first 28 d of life were found. The incidence was 3.7/1000 live births, which was higher than that found in a study from 1975 to 1986 in the same area, 2.8/1000 live births. The most common pathogens were group B streptococci, aerobic Gram‐negative rods, Staphylococcus aureus and enterococci. The cases were approximately equally divided between very early, early and late onset infections. The case‐fatality rate was lower in the present study (9%) than that in the previous study (15%). The case‐fatality rate varied between 23% in neonates with a gestational age of ≤29 wk and 3% in full‐term neonates. Eighty‐three very late onset infections occurred between days 28 and 120 after birth, corresponding to an incidence of 1.0/1000 live births. Of those, 47 occurred in preterm neonates. The most common organisms were aerobic Gram‐negative rods. Coagulase‐negative staphylococci (CoNS) were studied separately. This organism was isolated in 60 and 32 cases during the first 28 d of life and between days 28 and 120, respectively, in neonates fulfilling the criteria of the Yale‐New Haven Hospital for infections caused by commensal species. The incidence rates of CoNS infections were 0.7 and 0.4/1000 live births, respectively. Conclusion: The incidence of neonatal infections increased and the case‐fatality rate decreased in the Göteborg area compared to the findings of a previous study. Very late onset infections should be added to the total burden of neonatal infections. CoNS are important pathogens but their role is difficult to determine since they are both pathogens and contaminants of cultures from blood and cerebrospinal fluid.
Decreased interleukin‐10 in tracheal aspirates from preterm infants developing chronic lung disease
Authors: Oei J , Lui K , Wang H , Henry R 
Published: August 2010

The inability to balance pulmonary injury with healing may predispose preterm infants to chronic lung disease (CLD). It is postulated that the production of interleukin (IL)‐10, an anti‐inflammatory cytokine, is gestationally influenced and that CLD‐prone infants may have a reduced ability to produce IL‐10. Methods: Tracheal fluid (TF) was collected at least twice weekly from 48 mechanically ventilated infants within the first 7 d of life while intubated. Results: A total of 87 TF specimens were obtained. None of the 11 CLD infants (24‐31 wk of gestation) had TF IL‐10 levels above 4 pg/ml (0/20 TF specimens), while 14 (70%) of the 20 non‐CLD preterm infants (27–36 wk of gestation) had IL‐10 levels above 5 pg/ml in one or more of their TF specimens (18/48 TF specimens, p < 0.001). Only the 5 term infants who were ventilated for severe lung disease had raised IL‐10 levels (17 infants, 5/19 TF specimens). IL‐10 levels, if detected, (range 6‐938 pg/ml) tended to be higher with increasing gestation (Spearman's rho coefficient = 0.43; p= 0.003). TF IL‐10 detection was not associated with hyaline membrane disease, antenatal steroids or influenced by TF sample volume. Overall IL‐8 levels were wide ranging but towards the end of week 1 the levels were significantly higher in CLD infants (CLD: median 34 184 ng/ml, preterm non‐CLD: median 699 ng/ml, p < 0.001, term: 2961 ng/ml, p= 0.028). Conclusion: A gestationally influenced low IL‐10 may predispose preterm infants to persistent pulmonary inflammation of CLD.
Comparative outcome study between triplet and singleton preterm newborns
Authors: Maayan‐Metzger A , Naor N , Sirota L 
Published: August 2010

Aim: To evaluate the outcome of triplet versus singleton preterm newborns. Methods: The study population included 64 sets of preterm triplet (gestational age 25‐34 wk) and 64 singleton controls. Data on prenatal and perinatal findings, neonatal complications, duration of hospitalization, and neonatal mortality were collected by chart review. Results: Mothers of triplets were more likely to receive prenatal tocolytic treatment and more antenatal steroids for foetal lung maturation, and to be delivered by caesarean section. No differences were found between the groups in perinatal parameters (cord pH, Apgar score, respiratory support after birth), respiratory parameters (severity of acute and chronic lung disease, use and duration of oxygen treatment and assisted ventilation), or neonatal complications (patent ductus arteriosus, intraventricular haemorrhage, periventricular leukomalacia, necrotizing enterocolitis, retinopathy of prematurity, meningitis, sepsis and jaundice). This was also true for duration of hospitalization and neonatal mortality. No differences were recorded by birth order among the triplets for any of these parameters. Conclusion: The study indicates that good prenatal care can lead to a good outcome for preterm triplets, close to that of preterm singleton infants. Families and physicians should consider this information when foetal reduction is offered.
Epidemiology of invasive Streptococcus pneumoniae infections in children in an area of Barcelona, Spain
Authors: Pineda V , Fontanals D , Larramona H , Domingo M , Anton J , Segura F 
Published: August 2010

Aim: Streptococcus pneumoniae is the most common cause of bacteraemia, pneumonia, sinusitis and acute otitis media. With the advent of conjugate vaccines, there is now the possibility of preventing disease caused by this organism. However, little is known about the epidemiology of invasive pneumococcal disease in children in Spain. The aim of this study was to determine the incidence and the clinical and microbiologic characteristics of invasive pneumococcal disease in Sabadell, an industrial area in the province of Barcelona, Spain. Methods: From January 1990 to December 2000, the case records of children with pneumococcal invasive disease at Sabadell Hospital were retrospectively (1990–1996) reviewed and prospectively (1997–2000) collected. The hospital serves a population of 61 143 children under 15 y of age, 18 073 children under 4y of age and 7300 children under 2 y of age. Results: A total of 112 children (54% under 24 mo of age and 93% under 6 y of age) with invasive pneumococcal disease were diagnosed during a period of 11 y. The incidence of invasive pneumococcal disease was 76 per 100000 for children aged 0 to 24 mo, 45 for children aged 0–48 mo and 16.6 for children aged 0‐14 y. Occult bacteraemia was the most common manifestation of invasive pneumococcal disease (66 cases), pneumonia was the second form (34 cases) and meningitis (10 cases) and arthritis (2 cases) were the other clinical manifestations. Of the 105 strains tested, 8.6% were highly penicillin resistant, 37.1% were intermediately penicillin resistant, 16.2% were intermediately cefotaxime resistant and 32.4% were erythromycin resistant. Pneumococci of serogroups 6, 14, 18, 19, 1, 5, 4, 9, 23 and 33 were the most frequently isolated groups (92%) but only 6, 9, 14, 19 and 23 were resistant to penicillin, cefotaxime, or erythromycin. Conclusions. In this study the incidence of invasive pneumococcal disease was found to be greater than that reported elsewhere in Spain and Europe. Penicillin resistance levels are high but the trend towards increasing penicillin resistance may have ended over the past few years. The currently licensed seven‐valent (7‐V) pneumococcal conjugate vaccine would cover 78% of cases of invasive pneumococcal in children aged 0–14 y, 80% in children aged 0–24 mo and 100% of cases of penicillin‐ or cefotaxime‐resistant invasive pneumococcal disease.
Origins of reactive airways disease in early life: do viral infections play a role?
Authors: Piedimonte G 
Published: August 2010

There is mounting evidence suggesting that infection with respiratory syncytial virus (RSV) in early life increases the risk of developing reactive airway disease (RAD) later in childhood. A recent prospective study demonstrated that children hospitalized with RSV bronchiolitis in infancy face a significantly increased risk of recurrent wheezing and allergy at least until the age of 7 y that is independent of hereditary factors. Proposed mechanisms for this link include immune dysregulation, in which RSV‐specific IgE or an imbalance between T‐lymphocyte‐dependent immune pathways may be involved, and abnormal neural control, in which the non‐adrenergic, non‐cholinergic pathways are altered by RSV infection. More recent studies suggest that immune and neural mechanisms may be linked and that post‐RSV airway inflammation may be explained, at least in part, on the basis of these neuroimmune interactions. Conclusion: Passive immunoprophylaxis may protect against persistent viral‐induced inflammation of the respiratory tract, long‐term changes in pulmonary function and increased frequency of RAD episodes.
Nature and extent of gastric lesions in symptomatic Chilean children with Helicobacter prylori‐associated gastritis
Authors: Guiraldes E , Peña A , Duarte I , Triviño X , Schultz M , Larraín F , Espinosa MN , Harris P 
Published: August 2010

Chile has one of the highest rates of gastric cancer in the world and most children and adolescents in the country are colonized by Helicobacter pylori. This study assessed the nature and extent of the gastric lesions in 73 consecutive patients aged 5‐17 y, referred for upper gastrointestinal endoscopy. Their H. pylori‐associated gastric pathology was characterized and these data were compared with their sociodemographic status. Endoscopic assessment was normal in 43 patients while in 30 there was a variety of mucosal lesions. Sixty patients (83%) had histological chronic gastritis of the antrum and in 45 (63%) the lesions also involved the gastric corpus; 90% of patients with chronic gastritis were colonized by H. pylori. Although most of these patients had epithelial erosions and dedifferentiation of the pit epithelium, atrophy and metaplasia were not found. Patients' socioeconomic status was inversely correlated with their rate of colonization by H. pylori (p < 0.005), the frequency of gastric lesions on endoscopy (p < 0.01) and the frequency of involvement of antral and corpus mucosa by chronic gastritis (p < 0.002). This latter feature was positively correlated with age (p < 0.001). Conclusion: This study shows a high frequency of extensive lesions of H. pylori‐associated chronic gastritis in young Chilean patients. This histological picture is consistent with the hypothesis of a H. pylori‐associated progressive gastric pathology which may represent a major factor in the high local rate of gastric cancer.
Faecal calprotectin levels in infants with infantile colic, healthy infants, children with inflammatory bowel disease, children with recurrent abdominal pain and healthy children
Authors: Olafsdottir E , Aksnes L , Fluge G , Berstad A 
Published: August 2010

This study investigated faecal calprotectin concentration, a measure of intestinal inflammation, in infants and children with abdominal pain. Faecal calprotectin was measured by an enzyme‐linked immunosorbent assay kit in spot stool samples in 76 infants with typical infantile colic, 7 infants with transient lactose intolerance and 27 healthy infants. All infants were 2‐10 wk of age. In addition, 19 children with recurrent abdominal pain (RAP; mean age 11.5 y), 17 with inflammatory bowel disease (IBD; mean age 11.1 y; 10 had Crohn's disease and 7 ulcerative colitis) and 24 healthy children (mean age 5.3 y) were studied. In infants with infantile colic the mean faecal calprotectin concentration was not different from that in healthy infants (278 ± 105 vs 277 ± 109 mg kg−1, p= 0.97) or in infants with transient lactose intolerance (300.3 ± 124 mg kg−1, p= 0.60). The calprotectin level was similar in boys and girls and fell significantly with age (p = 0.04). Children with IBD had faecal calprotectin levels (293 ± 218 mgkg−1) much higher than healthy children (40 ± 28 mg kg−1, p < 0.0001) and children with RAP without identified organic disease (18 ± 24 mg kg−1, p < 0.0001). Conclusion: Faecal calprotectin may differentiate between functional abdominal pain and IBD in school‐aged children. In young infants high faecal calprotectin levels are normal.
Cardiovascular responses to submaximal treadmill running in 11 to 13 year olds
Authors: Armstrong N , Welsman JR 
Published: August 2010

The influence of age, sex, maturity, body size and body fatness on cardiac output (Q) and stroke volume (SV) during treadmill running at 2.22 m·s−1 was examined longitudinally. Mass, stature, triceps and subscapular skinfold thickness, and oxygen uptake (VO2) were recorded and Q was estimated using the CO2 rebreathing technique on each of three annual measurement occasions. Maturity was assessed using the indices for pubic hair described by Tanner. At the onset, subjects were 11.3 (0.4) y of age and data were available from a total of 274 Q determinations with equal numbers from boys and girls. Age‐, sex‐ and maturity‐associated changes in Q and SV adjusted for differences in body size and fatness were examined using multilevel regression modelling within an allometric framework. Changes in Q in both sexes were essentially in direct proportion to body surface area but, even with anthropometric variables controlled for, girls demonstrated a lower SV than boys, which was compensated for by a higher heart rate (HR) at each observation. Conclusion: At a given level of submaximal exercise over the age range 11–13 y Q is directly related to body size in both sexes. With body size and fatness controlled for, boys have greater SVs than girls when exercising at the same absolute VO2, Q and treadmill running speed. Age and maturation do not exert independent effects on either Q or SV.
Geographic variations in possible risk factors for severe cardiac malformations
Authors: Cedergren M , Selbing A , Kaällén B 
Published: August 2010

The aim of this study was to investigate various putative risk factors in a county in Sweden, described as having a 28% increased prevalence of cardiovascular malformations, and to compare them with the risk factors in two reference counties. Women giving birth in the studied counties differed in age and parity distribution, smoking, and educational level but these differences could not explain the increased risk of cardiovascular malformations in the county, since after stratification for these variables, the risk estimate did not change substantially. A number of potential risk factors were studied in a case/control design: spontaneous abortions, involuntary childlessness, maternal disease, body mass index, medical drug use, alcohol use, parental employment, paternal age, and urban/rural residency. No single factor could be attributed to the increased rate, with the exception of living in a rural district. Nearly all risk factors, however, were stronger in the county studied than those in the reference counties (0.02 > p > 0.01). Conclusion: The only single putative risk factor that could have contributed to the increased risk for cardiac defects described in the county studied was maternal residency in a rural district. Notably, nearly all potential risk factors studied were stronger in the county studied compared with those in the reference area. A conceivable explanation is that one or more unidentified factors related to rural residency could potentiate prevalent and weak teratogenic risk factors for cardiac defects.
Sidestream end‐tidal capnometry as related to infant's position and maturation
Authors: Kugelman A , Bilker A , Bader D , Cohen A , Tirosh E 
Published: August 2010

The objective of this study was to investigate the effect of body position on sidestream, end‐tidal carbon dioxide (EtCO2) wave measurements in maturing infants. Sidestream EtCO2 wave patterns were analysed longitudinally in 20 preterm infants (born at ≪ 32 wk) at 32–37 wk gestation, and in 39 full‐term controls. Capnography measurements included maximal EtCO2, inspired CO2 and frequency of apnoea events (<3 s) in the supine, supine with inclination, side and prone positions. Apnoea frequency decreased during maturation, and was less prevalent in the prone than in the supine and side positions in preterm as well as in term infants (p > 0.05). No clinically significant apnoea episodes were found in our cohort. EtCO2 in term infants was lower than that in preterm infants (p > 0.05) and was not affected by sleep position in the most premature (>33 wk) and in term infants (<36 wk). EtCO2 was higher in the prone position than in supine or side positions in infants between 33 and 35 wk gestation (p > 0.01). Conclusion: Short apnoeic episodes decrease during maturation, and are less prevalent in the prone position in maturing infants (32–37 wk). Only modest changes in EtCO2 were recorded in the different positions during maturation.
Oral versus rectal midazolam as a pre‐anaesthetic sedative in children receiving dental treatment under general anaesthesia
Authors: Jensen B , Matsson L 
Published: August 2010

Dental treatment in children who are too young or too apprehensive to cooperate is often performed under sedation. In Sweden, the tradition has been to administer sedatives rectally in small children, but oral liquid sedation is now increasingly used. Aim: To compare the sedative effects of oral and rectal administration of midazolam in children undergoing dental treatment under general anaesthesia and to assess acceptance of sedative administration, acceptance of application of the facemask, and amnesia. Methods: Fifty children aged 2–7 y were randomly allocated to receive either liquid oral or rectal sedation, with 25 children in each group. Results: The sedative effect of rectal administration was higher, but not statistically significantly, than that of oral administration (p= 0.07). No significant differences in acceptance of sedative administration, acceptance of mask application or amnesia were found between the groups. Conclusion: Both the oral and the rectal routes can in most cases be appropriate. However, the better sedative effect of rectal administration of midazolam makes it a more favourable route in pre‐cooperative and non‐compliant children.
Treatment of sleep problems in families with small children: is written information enough?
Authors: Eckerberg B 
Published: August 2010

The aim of this study was to evaluate a standardized sleep programme, i.e. a two‐step variation of graduated extinction, where the child is first taught to fall asleep by him/herself at bedtime (first intervention) and 2 wk later also after night wakings (second intervention). The outcome after consultations with a therapist followed by telephone support during both interventions was compared with the outcome after giving written information only during the first intervention and therapist support during the second. A total of 67 families with infants exhibiting spontaneous awakening and crying episodes during the night were randomly assigned to either programme. There were no significant differences in terms of outcome between the two groups. In both groups the number of registered night wakings decreased immediately following the first intervention. At registration, at 1 mo and 3 mo later, all parents, with the exception of one couple at the 3‐mo follow‐up, reported that the sleep problem had improved. Conclusion: If parents experience their infant's night awakenings as a problem, teaching their infant to fall asleep by him/herself usually solves this problem quickly. Written information is in most cases sufficient to help parents introduce the new evening routines.
Association of cytokine responses with disease severity in infants with respiratory syncytial virus infection
Authors: Chen ZM , Mao JH , Du LZ , Tang YM 
Published: August 2010

Aim: To explore the relationship between cytokine responses and severity of respiratory syncytial virus (RSV) infection in infants. Methods: Intracellular interleukin‐4 (IL‐4) and interferon‐γ (IFN‐γ) expression in peripheral blood CD3+ and CD8+ lymphocytes was measured by four‐colour flow cytometry. Serum IL‐12, IL‐4 and IFN‐γ levels were also determined by enzyme‐linked immunosorbent assay. Results: The frequency of IL‐4 and IFN‐γ expression in CD3+CD8‐ cells was the same in RSV‐infected, non‐RSV‐infected and control infants and in those with RSV bronchiolitis or RSV pneumonia, indicating that no Th2 predominance exists in the acute phase of RSV infection and RSV bronchiolitis. Furthermore, RSV‐infected infants had a more frequent IFN‐γ expression in CD3+CD8+ cells than controls, and they also showed a much lower serum IL‐4/IFN‐γ ratio because of decreased IL‐4 and elevated IFN‐γ, the latter being most prominent in RSV bronchiolitis. The serum IL‐12 level in RSV‐infected infants was the same as in control infants, while those with non‐RSV infections had a much higher level. Serum IL‐12, IFN‐γ and frequency of IFN‐γ expression in CD3+CD8+ cells in mild RSV infection were much higher than in controls, while no difference existed between severe cases and controls. Conclusion: Type 2 cytokine predominance was not found in the acute phase of RSV infection and RSV bronchiolitis, but both were accompanied by enhanced production of IFN‐γ and a much higher serum IFN‐γ level than in healthy controls, especially in those with RSV bronchiolitis, suggesting a role in causing airway obstruction. IFN‐γ and IL‐12 may also play a protective role in RSV infections by diminishing viral replication, and high levels of IL‐12 and IFN‐γ may be associated with lessening of the severity of infection.
Psychological functioning in boys of short stature: effects of different levels of growth hormone secretion
Authors: Erling A , Wiklund I , Wikland K Albertsson 
Published: August 2010

Aim: To examine the relationship between growth hormone (GH) and psychological functioning, especially self‐perception and well‐being, in 60 prepubertal boys of short stature with a wide range of GH levels. Methods: A comparison was made of the well‐being and self‐perception of children with GH insufficiency, children with idiopathic short stature (ISS), a normative sample and healthy boys with normal stature. Results: Children with GH insufficiency had a more negative perception of their own physical appearance than the normative sample. They perceived themselves as more alert but also more inhibited than both the children with ISS and the healthy boys with normal stature. In comparison with the healthy boys with normal stature they perceived themselves as having more stability. The parents of the boys with GH insufficiency also perceived their children as being more stable compared with how the parents of boys with ISS perceived their children. To elucidate the effects of GH on psychological functioning a multiple regression analysis was performed. Conclusion: The lower the levels of GH the more inhibited were the boys of short stature, as perceived both by themselves and by their parents. The boys with GH insufficiency had a more negative perception of their physical appearance than the normative sample.