bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of tilting on cerebral haemodynamics in preterm infants with periventricular leucencephalomalacia
Authors: Pichler G , Urlesberger B , Schmölzer G , Müller W 
Published: August 2010

Aim: Measurement of cerebral haemodynamics to detect impaired cerebral blood flow and impaired cerebral autoregulation might make prevention of brain lesions and especially periventricular leucencephalomalacia (PVL) achievable. Methods: Changes in cerebral blood volume (CBV) and the cerebral haemoglobin oxygenation index (cHbD) following tilting up and down in 10 preterm infants with PVL and 25 preterm infants without PVL, measured by near infrared spectroscopy (NIRS), were analysed. Tilting manoeuvres were recorded with a polysomnographic system in combination with NIRS. CBV and cHbD of the baseline phase (1 min before tilting) were compared with data from the post‐tilting phase (1 min after tilting). Results: Changes in CBV and cHbD after tilting were significantly pronounced in infants with PVL compared with infants without PVL. CBV decreased in infants with PVL, by ‐0.099 ± 0.081 ml 100 g−1 brain (mean ± SD) after tilting up, and increased by 0.106 ± 0.104 ml 100 g−1 brain after tilting down. CBV decreased in infants without PVL, by –0.041 ± 0.068 ml 100 g−1 brain after tilting up, and increased by 0.020 ± 0.096 ml 100 g−1 brain after tilting down. cHbD showed similar changes after tilting. Conclusion: Changes in CBV and cHbD after tilting were pronounced in preterm infants with PVL and this may indicate reduced cerebral autoregulatory capacity.
Invited commentary to supplement hot topics in neonatology
Authors: Ives NK 
Published: August 2010

The very interesting and varied collection of papers from the UK Hot Topics meeting held at Egham, Surrey, UK on 27 September 2002 (chaired by Professor Anne Greenough of King's College Hospital, London and sponsored by Abbott Laboratories Limited) has been reviewed. Conclusion: The scientific value and clinical implications for neonatal intensive care of the papers presented reflect the status of a meeting that has grown to be head and shoulders above comparable UK neonatology gatherings.
Coagulase‐negative staphylococcal sepsis as a predictor of bronchopulmonary dysplasia
Authors: Liljedahl M , Bodin L , Schollin J 
Published: August 2010

Aim: To determine whether sepsis caused by coagulase‐negative staphylococci (CoNS) is a risk factor for developing bronchopulmonary dysplasia (BPD) in premature newborns. Methods: All newborns born at ±30 wk of gestation at Örebro University Hospital during 1994–2001 with clinical sepsis caused by CoNS (group A, n= 22) or by other bacteria (group B, n= 17) were included and compared with premature newborns without sepsis (group C, n= 53). Clinical sepsis was defined as a positive blood culture (monoculture) plus clinical symptoms and laboratory findings. BPD was defined as treatment with oxygen >21% for at least 28 d. Results: The incidence of BPD differed between the three groups, as follows: CoNS sepsis (A) 64%, other sepsis (B) 41% and control (C) 24%. The difference between the control group and the sepsis groups was highly significant (p= 0.006). In a univariate model the crude estimates of relative risk (RR) for occurrence of BPD increased with presence of sepsis and particularly with presence of sepsis with CoNS (A: RR 2.6, 95% CI 1.5–4.6, p= 0.001; B: RR 1.7, CI 0.8–3.5, p= 0.17). When regression was performed with two additional predictive variables in multivariate models including sepsis, gestational age and mechanical ventilation (group A: RR 1.5, CI 1.1–2.0, p= 0.004; group B: RR 0.9, CI 0.6–1.4, p= 0.67), the estimates were lower. Conclusion: The relative risk for BPD is significantly increased in premature newborns with sepsis caused by CoNS compared with those with sepsis caused by other bacteria and compared with premature newborns with no sepsis.
Congenital chylothorax: lymphopenia and high risk of neonatal infections
Authors: Wasmuth‐Pietzuch A , Hansmann M , Bartmann P , Heep A 
Published: August 2010

Aim: To describe the clinical course of patients with congenital chylothorax focusing on infectious complications. Congenital chylothorax is a common manifestation of non‐immune hydrops fetalis (NIHF). The drainage of chyle leads to loss of cellular and plasmatic factors that influence the patient's immune response and increase the risk of infections. Methods: In a retrospective analysis of 24 preterm infants with NIHF treated between 1998 and 2002, congenital chylothorax was diagnosed in 7 patients. Results: All 7 patients were treated conservatively with pleural drainage over a median period of 22 d (range 10–36 d). Lymphopenia was found in all patients (median of minimal lymphocyte counts 285/μl, range 80–770). The nadir was on day 5 (2‐6 d). Lymphopenia lasted for 12 d median (range 4–39 d) and was significantly correlated with the duration of lymph drainage (p= 0.001). Cell‐surface analysis of peripheral blood lymphocytes was performed in two patients. Both patients had a decreased number of total T cells. Four out of seven (57%) patients developed nosocomial infections. This incidence of nosocomial infections in patients with congenital chylothorax is about three times higher than that in other neonatal patients. None of the children suffered from fungal or viral infection. Although there was a very high incidence of infections, no correlation between lymphopenia and the occurrence of infections could be shown. Conclusion: Drainage of congenital chylothorax results in the loss of lymphocytes and bears a high risk of infections.
The Greek family system when a child has diabetes mellitus type 1
Authors: Tsamparli A , Kounenou K 
Published: August 2010

Aim: To depict the characteristic ways that families who have a child suffering from diabetes and face difficulties with metabolic control function. In addition, to reveal the ways that this functioning is related to metabolic control problems. Methods: Qualitative methods were used, including an in‐depth interview and observation of 30 Greek families having one child suffering from diabetes mellitus type 1 and facing difficulties with metabolic control. An average of 10 meetings were conducted with each family, including separate meetings with each individual family member, the parental couple and the family as a whole. Methods were based on thematic categories provided by the model of the “psychosomatic family”. Results: The presence of the disease and the requirements of the treatment regimen seemed to be associated with certain family characteristics: enmeshed relationships, ambiguous roles and rules, break down of hierarchy, coalition between mother and patient, absence of father's involvement and “infantilization” of the suffering child. Also in such families, healthy siblings are assigned parental roles and, finally, the families present signs of social exclusion. Conclusion: The study provides important findings concerning the psychological characteristics of the families under study. The present ways of functioning are associated with the difficulties families face when coping with the treatment regimen.
High prevalence of cagA and vacA seropositivity in asymptomatic Bangladeshi children with Helicobacter pylori infection
Authors: Sarker SA , Nahar S , Rahman M , Bardhan PK , Nair GB , Beglinger C , Gyr N 
Published: August 2010

Aim: To evaluate the prevalence of antibodies against two major markers of virulence of Helicobacter pylori—cytotoxin‐associated gene A (cagA) and the vacuolating cytotoxin gene (vacA)—among children in a peri‐urban community of Bangladesh, and to evaluate Western blot (WB) assay for detection of H. pylori infection diagnosed by 13C urea breath test (UBT) in such children. Methods: One hundred and eighty‐two children aged 18–60 mo, of the peri‐urban community of Dhaka, were screened for H. pylori infection using UBT, and the serum samples were analysed for antibody against cagA and vacA by Western blot. Results: The overall prevalence of H. pylori infection by 13C‐urea breath test was 80%. The seroprevalence of cagA with or without vacA, vacA with and without cagA, and both cagA and vacA were 82%, 82% and 81%, respectively. Among children with a positive UBT, 95% were seropositive for both cagA and vacA, indicating that the products of these genes are frequently co‐expressed in H. pylori infection in this community. The sensitivity, specificity, positive and negative predictive value of the Western blot test for H. pylori infections, compared to UBT, were 94%, 68%, 92% and 76%, respectively. Conclusion: Compared to UBT, Western blot test is reliable for the detection of H. pylori infection. The high seroprevalence of cagA‐ and vacA‐positive virulent H. pylori strains in an asymptomatic paediatric population indicate that such strains are common in this population and may cause characteristic H. pylori infection in Bangladesh.
Appropriate prophylaxis with restrictive palivizumab regimen in preterm children in Sweden
Authors: Navér L , Eriksson M , Ewald U , Linde A , Lindroth M , Schollin J 
Published: August 2010

Aim: Palivizumab (Synagis®) was registered in Sweden in 1999 for prophylaxis against respiratory syncytial virus (RSV) in premature infants. The high costs and the limited knowledge of the efficacy of this substance have led to debate about how and when it should be used. National guidelines for the use of palivizumab in Sweden were constructed in the year 2000. The aim of this study was to evaluate the guidelines. Methods: A nation‐wide prospective study was conducted during the two RSV seasons of the years 2000–2002. The paediatric departments in Sweden reported the use of palivizumab, the indication for its use, and the number of infants born preterm before 36 wk of gestation and less than 2 y old who were admitted to hospital for RSV infection. Results: During the two seasons, 218 (3.8%) children who were born before 36 wk of gestation, and 97 (5.4%) who were born before 33 wk, were hospitalized because of RSV infection. Five children were treated with mechanical ventilation. No death caused by RSV was reported. A total of 390 children were treated with palivizumab, and 16 (4.1%) of those who received prophylactic treatment were admitted to hospital with RSV infection. Conclusion: We consider the comparatively restrictive Swedish recommendations to be safe and recommend that palivizumab should also be used very restrictively in the future. In our opinion, palivizumab in preterm children could be recommended only for those with chronic lung disease younger than 1 y of age, and with active treatment for their disease.
Milk consumption during pregnancy and infant birthweight
Authors: Ludvigsson JF , Ludvigsson J 
Published: August 2010

Aim: To examine the risk of low birthweight (>2500 g, LBW), intrauterine growth retardation (IUGR) and preterm birth (gestational age >37wk) in relation to milk intake. Methods: Observational study in southeast Sweden. Questionnaires were used to collect data on milk consumption during pregnancy and infant birthweight from mother‐infant pairs during a 2‐y period as part of the ABIS (All Babies in Southeast Sweden) study. Data on IUGR were obtained through the Swedish medical birth registry. Results: Adjusting for confounders, low milk intake during pregnancy was associated with an increased risk of IUGR (p= 0.019; n= 12880). LBW (p= 0.191) and preterm birth (p= 0.921) were not associated with milk intake during pregnancy. Conclusion: This study indicates that low milk intake in the pregnant mother may be associated with IUGR of the newborn. We cannot exclude the possibility that the correlation found between milk consumption and intrauterine growth may be due to undetected confounders. Hence, further research is needed to evaluate the relationship between low milk intake, birthweight and risk of IUGR.
Effects of maternal cigarette smoking and cocaine use in pregnancy on fetal response to vibroacoustic stimulation and habituation
Authors: Gingras JL , Mitchell EA , Grattan KJ , Stewart AW 
Published: August 2010

Background: Cigarette smoking and cocaine use in pregnancy are common in the US and both are risk factors for sudden infant death syndrome (SIDS). Although the cause of SIDS is not known, one postulated mechanism involves abnormalities of arousal and arousal regulation. Cigarette smoking and cocaine use may cause deficits of arousal. Many believe arousal deficits occur prenatally.Aims: The aim of this study was to assess the effects of cigarette smoke and cocaine exposure during pregnancy on measures of fetal arousal and arousal competency: 1) the fetal response to vibroacoustic stimulation (VAS) and 2) habituation to VAS.Hypothesis: Maternal cigarette smoking and cocaine use in pregnancy are associated with altered arousal and arousal regulation in the fetus.Methods: Three groups of mother‐fetal dyads were enrolled: 1) cigarette smokers (n= 54), 2) cocaine users (n= 30), and 3) controls (n= 60). One hundred eight fetuses were tested at 29–31 wk gestation, 119 at 32–35 wk, and 118 at 36+ wk. The fetal response to VAS was assessed using real‐time ultrasound and a paradigm of arousal responsiveness. Responders were tested with repeated VAS to assess habituation. Also, the quality of fetal reactivity to repeated stimuli was assessed as a measure of arousal and arousal regulation competence (Behavioral Reactivity Scale).Results: The control group had a larger proportion of fetuses who were too active to initiate testing (“too active to test”) (p= 0.013); the proportion of fetuses too active to test decreased with increasing gestational age. The majority of the fetuses who could be tested responded to the initial VAS, and there were no group differences. The proportion of fetuses that habituated and the rate of habituation did not differ between the groups. Behavioral reactivity did not differ between groups.Conclusions: The original hypotheses were not confirmed. However, the chosen assessment paradigms may have lacked sensitivity. The proportion of fetuses that were “too active to test” decreased with gestational age. The control group had a larger proportion of fetuses that were “too active to test” compared with the exposure groups. We speculate that these findings indicate that prenatal exposure to these neuroteratogens may have produced an acceleration of the behavioral response to vibroacoustic stimulation.
Indoor exposures and recurrent wheezing in infants: a study in the BAMSE cohort
Authors: Emenius G , Svartengren M , Korsgaard J , Nordvall L , Pershagen G , Wickman M 
Published: August 2010

Aim: The aim of this study was to examine the relationship between indoor exposures and the home environment, and the development of recurrent wheezing during infancy. Methods: A birth cohort, comprising 4089 children, was followed. Information on exposures was obtained shortly after birth, and episodes of wheezing were recorded when the infants were 1 and 2 y of age. In a nested case‐control study, 181 infants were enrolled, who had three or more reported episodes of wheezing after 3 mo of age combined with either use of inhaled steroids or symptoms of bronchial hyper‐reactivity, and 359 age‐matched controls. Home inspections were performed during the winter following enrolment, and indoor conditions were measured. Results: Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated. The OR for recurrent infant wheezing associated with signs of dampness reported prospectively by parents was 1.4 (0.9–2.2), and the OR for observed signs of dampness at home inspections was 1.6 (1.0–2.5). A trend was found in the risk of recurrent wheezing in relation to the number of indicators of dampness: OR 1.3 (0.8–2.2) for one sign of dampness and OR 2.7 (1.3–5.4) for three or more signs of dampness. Newly painted surfaces in the child's bedroom was associated with an increased OR for recurrent wheezing: 1.7 (1.3–2.6). Conclusion: Indicators of dampness, as well as recently repainted interior surfaces, appear to be associated with recurrent infant wheezing, with a strengthened effect of combined indoor exposures.
Aicardi‐Goutières syndrome: clinical and neuroradiological findings of 10 new cases
Authors: Abdel‐Salam GMH , Zaki MS , Lebon P , Meguid NA 
Published: August 2010

Aim: To describe the clinical and neuroimaging findings in new cases with Aicardi‐Goutières syndrome (AGS) from Egypt. Methods: Ten patients with progressive encephalopathy, bilateral calcification of the basal ganglia and spastic quadriplegia were described. Feeding difficulties, irritability, unexplained episodic fever and acrocyanosis were also observed. They were diagnosed as AGS after excluding possible non‐genetic causes (especially TORCH) and because of the high interferon‐α (IFN‐α) level in cerebrospinal fluid (CSF) in two children who underwent this specific investigation. Results: Six patients had postnatal microcephaly. Putamen was by far the most common site of calcification (nine cases) inside the basal ganglia. Calcifications were extended to the white matter, periventricular and cerebellum in three cases. Brain atrophy and/or white matter demyelination were evident in most of the cases. Further, hypogenesis of corpus callosum was detected in two cases; one of them had in addition cerebellar hypoplasia, atrial septal defect (ASD) and horseshoe kidney. To the best of our knowledge, the association of these congenital abnormalities has not been reported before in AGS. Eight families were consanguineous. Conclusion: This paper presents variability in both age of onset, clinical picture and neuroimaging findings even in the same family, comprising new congenital abnormalities associated with AGS and subsequently expanding the spectrum of heterogeneity. The observation of familial cases and both affected males and females emphasized the major role of the single gene inheritance.
Children younger than 4 years and their substance‐dependent mothers in the child welfare clinic
Authors: Savonlahti E , Pajulo M , Helenius H , Korvenranta H , Piha J 
Published: August 2010

Aim: To explore the prevalence of substance dependency among mothers of small children and to evaluate the value of a routine‐style maternal report on social support, child's somatic health history and child caregiving experiences to differentiate the substance‐dependent group from the non‐dependent group. Methods: Mothers (n= 413) of children less than 4 y in the child welfare clinics filled in the Substance Abuse Subtle Screening Inventory (SASSI, Miller 1985) and questionnaires concerning social support, somatic history of the child, difficulties in social environment and in caring for the child. Results: The prevalence of substance dependency was 5.8%. The maternal perceptions of the child's somatic history could not differentiate the dependent from the non‐dependent group, while the child caregiving difficulties were more often present in the group of substance‐dependent mothers. The combined group of substance dependency and substance use was significantly associated with low social support and difficulties in social environment. Conclusions: The prevalence of substance dependency among mothers of small children is considerable and significantly associated with child caregiving difficulties and low social support, while the perceptions on the somatic health of the child did not differentiate the dependent from the non‐dependent group. This suggests the value of considering the maternal experiences in caring for the child and well‐being of the mother during check‐ups in the child welfare clinic in order to identify the mother‐child pairs at risk.
A genetic reason for male excess in infant respiratory mortality?
Authors: Finnström Orvar 
Published: August 2010

Male infants have a 50% higher risk of death from respiratory diseases and a number of congenital heart diseases that can lead to cerebral hypoxia. The most important of these diseases are infant respiratory distress syndrome and sudden infant death syndrome. Conclusion: The mechanism behind the excess peri‐mortality rate in male infants is not known. A genetic factor leading to reduced tolerance to hypoxia is possible.
Reduced gains in fat and fat‐free mass, and elevated leptin levels in children and adolescents with cystic fibrosis
Authors: Ahmed ML , Ong KK , Thomson AH , Dunger DB 
Published: August 2010

Aim: Bodyweight is an important prognostic indicator in children with cystic fibrosis (CF), but the relationships between body composition and clinical outcomes are less clear. We have investigated the role of leptin (a potential satiety factor) and changes in body composition, height and weight with respect to age and clinical outcome. Methods: 143 children (77 boys) with CF and a median age (range) of 5.99 (2.27–17.98) y were followed with annual measurements of height, weight, skinfolds, forced expiratory volume (FEV1), Shwachman score assessment and fasting blood sample. Our control group comprised 40 children (20 boys, 20 girls) aged 8.6–10.2 y at recruitment who were participating in a longitudinal study of growth and puberty. Results: SD scores for height, weight and BMI decreased with age; fat and fat‐free mass was lower in both sexes compared to controls. Shwachman score decreased with age in both sexes and was related to fat‐free mass in girls, and to both fat‐free and fat mass in boys. FEV1 decreased with age only in boys and was related to fat‐free mass. Leptin levels by age and by fat mass were higher in CF children compared to controls. Conclusion: Despite improvements in management, contemporary children with CF still gain less body fat and fat‐free mass and are shorter than controls. The higher leptin levels we observed may be due to stimulatory effects of inflammatory cytokines and we postulate that they may contribute to the anorexia, poor weight gain and growth of these children.
Prevalence of germline mutations in the TSH receptor gene as a cause of juvenile thyrotoxicosis
Authors: Lavard L , Jacobsen B Brock , Perrild H , Vassart G , Parma J 
Published: August 2010

Aim: To ascertain the prevalence of germline mutations in the TSH receptor gene as a cause of juvenile thyrotoxicosis (JT) in non‐autoimmune patients. TSH receptor gene mutations are not seen in autoimmune‐active patients. Methods: In a nationwide study on JT, 123 patients were re‐examined 10 y (range 4 to 21 y) after diagnosis. Two patients with toxic adenoma were excluded. In 25 patients, no TPO, TG or TSH‐R antibodies were found. In 17 patients, DNA material was available for TSH receptor gene analysis. The entire TSH receptor gene was sequenced in five patients. TSH receptor “hot spots” for mutations in exon 9 and 10 were sequenced in the remaining 12 patients. Results: A TSH receptor gene germline mutation was identified in only one patient of a total number of 121 patients with JT, of which 17 patients were presumed to have non‐autoimmune JT by the lack of thyroid autoantibodies. Conclusion: In Denmark the prevalence of germline mutations in the TSH receptor gene is one in 121 patients with JT (0.8%; 95% CI: 0.02–4.6%) and one in 17 patients with presumed non‐autoimmune JT (6%; 95% CI: 5.88% (0.15–28.69)).