bluuebunny/crossref_metadata_2025_split huggingface dataset:
A single intramuscular dose of ceftriaxone changes nasopharyngeal bacterial flora in children with acute otitis media
Authors: Heikkinen T , Saeed KA , McCormick DP , Baldwin C , Reisner BS , Chonmaitree T 
Published: August 2010

The increasing prevalence of drug‐resistant bacteria is attributed to the extensive use of antibiotics, which causes selective pressure on the nasopharyngeal bacterial flora. Shortened courses of antibiotics have been proposed to decrease the development of resistant strains. We determined the effect of a single intramuscular dose of ceftriaxone (50 mg/kg) on the nasopharyngeal bacterial flora in 167 children (median age 13 mo) with acute otitis media. Nasopharyngeal samples for bacterial culture were obtained before and 5 d after treatment with ceftriaxone. Before treatment, Moraxella catarrhalis was isolated in 99 (59%) children, Streptococcus pneumoniae in 87 (52%), and Haemophilus influenzae in 53 (32%). After treatment, M. catarrhalis was found in 62 (37%) children, which constitutes a 37% decrease in the colonization rate by this pathogen (p < 0.001). S. pneumoniae was isolated in 50 (30%; 43% decrease) and H. influenzae in 17 (10%; 68% decrease) children after treatment (p < 0.001 for both). Before treatment, 60% of pneumococcal isolates were sensitive to penicillin, 26% were of intermediate susceptibility, and 14% were penicillin‐resistant. Eradication of S. pneumoniae occurred mainly in children with penicillin‐sensitive isolates. As a consequence, only 24% of pneumococcal isolates that remained after treatment were sensitive to penicillin, 59% were penicillin‐intermediate, and 16% were penicillin‐resistant.A single dose of ceftriaxone resulted in significant changes in the nasopharyngeal bacterial flora, increasing the relative prevalence of pneumococcal strains with decreased susceptibility to penicillin.
Prophylaxis of patent ductus arteriosus with ibuprofen in preterm infants
Authors: Dani C , Bertini G , Reali MF , Murru P , Fabris C , Vangi V , Rubaltelli FF 
Published: August 2010

The aim of our study was to evaluate whether the prophylactic use of ibuprofen would reduce the incidence of significant patent ductus arteriosus (PDA) and to confirm the effectiveness of ibuprofen as rescue treatment in closing PDA. Eighty preterm infants with gestational age less than 34 wk with infant respiratory distress syndrome (iRDS) were randomized to receive intravenous ibuprofen lysine (10 mg/kg, followed by 5 mg/kg after 24 and 48 h) either within 24 h of life (group A) or after echocardiographic diagnosis of PDA (group B). To evaluate the severity of RDS in each patient, we calculated the initial and highest values of Oxygenation Index (O.I. =mean airway pressure × FiO2 × 100 / PaO2) and Ventilatory Index (V.I. = O.I. × mechanical respiratory rate). Other studied variables were ventilatory support, renal function, biochemical and haematological profiles, frequency of bronchopulmonary dysplasia (BPD), intraventricular haemorrhage (IVH), necrotizing enterocolitis (NEC) and retinopathy of prematurity (ROP). On the 3rd day of life, 8% (3/40) of patients of group A and 53% of patients (21/40) of group B (p < 0.0001) developed a significant PDA. Between patients of group B who presented PDA at 3 d of life 90% (19/21) had a closure of ductus arteriosus after ibuprofen treatment. Initial and highest values of O.I. and V.I. were similar in both groups A and B. No significant differences between the groups were observed in regard to respiratory support, renal function and frequency of BPD, IVH, NEC and ROP. Ibuprofen was not associated with adverse effects. Conclusion: Prophylactic treatment with ibuprofen reduces PDA occurrence in preterm infants with iRDS at 3 d of life in comparison with rescue treatment, but both modes are effective in closing the ductus without significant adverse effects.
Dextran reduces surfactant inhibition by meconium
Authors: Tashiro K , Kobayashi T , Robertson B 
Published: August 2010

We have previously shown that an addition of dextran to surfactant increases resistance to inactivation by albumin. The present study was designed to investigate whether dextran has a protective effect against inactivation of surfactant by meconium. The dynamic surface properties of various mixtures of modified natural surfactant (Curosurf, meconium and dextran were evaluated with the pulsating bubble technique. In the absence of meconium, an addition of dextran at 10 mg ml1 significantly shortened the surface adsorption time of Curosurf suspended in normal saline at a concentration of 5 mg m‐1 from 1.6 ± 1.3 (mean ± SD) sec to 0.4 ± 0.4 sec (p < 0.05). Meconium at 5mgm‐1 increased the mean minimum surface tension (γmin) after 3 min of pulsation from 2.1 mN m‐1 to 24 mN m‐1 (p < 0.05). An addition of dextran at 5 and 10 mg m‐1 to the meconium‐surfactant mixture significantly reduced the γmin to 6.4 ± 4.5 mN m‐1 and 2.6 ± 5.6 mN m‐1, respectively (p < 0.05 vs dextran 0mgml‐1). Meconium also increased the maximum surface tension (γmax) of Curosurf from about 33 mN m‐1 to 53 mN m‐1. An addition of dextran at 5 and 10 mg ml‐1 to the meconium‐surfactant mixture reduced the γmax to 41 and 39 mN m‐1, respectively (p < 0.05 vs dextran 0mgml‐1). There were significant negative correlations between dextran concentration and both γmin and γmax.We conclude that dextran reduces surfactant inhibition by meconium in a dose‐dependent manner.
Insulin‐like growth factor binding protein‐1 as glucose regulator in adolescent boys with type 1 diabetes
Authors: Zachrisson I , Dahlquist G , Wallensteen M , Brismar K 
Published: August 2010

The aim of the present study was to investigate whether the diurnal variability of B‐Glucose is dependent on GH, IGF‐I and IGFBP‐I levels, apart from insulin, and if there is any difference between Tanner stages 3 and 5. Five boys in Tanner stage 3 and 6 boys in stage 5 with type 1 diabetes were included. Blood was continuously collected from a cubital vein for 24 h. S‐Insulin, S‐GH, S‐IGF‐I and S‐IGFBP‐1 were analysed. B‐Glucose was analysed hourly at bedside. One week before and 1 wk after the 24‐h study period the participants performed self‐monitoring of blood glucose (SMBG) during normal physiologic conditions. In the 24‐h profile of B‐Glucose, insulin, IGFBP‐I and GH, we found a significant positive correlation between B‐Glucose and log IGFBP‐1 (r=0.5, p= 0.005) and an inverse correlation to insulin (r=‐0.5, p= 0.004) but no correlation to logGH (r=‐0.04, p= 0.831). In multiple regression analysis, B‐Glucose was still significantly correlated to log IGFBP‐1, when adjusting for insulin and GH, in Tanner stage 5. We found a difference between Tanner stages 3 and 5 in the variability of B‐Glucose over a longer period during normal daily activity (p= 0.02), but not over the 24‐h study period. Conclusion: We have demonstrated in type 1 diabetes adolescent boys a relationship between simultaneously measured blood‐glucose and IGFBP‐1 levels independent of the insulin and GH levels, suggesting that the free fraction of IGF‐I influences the glucose metabolism.
Middle ear effusion IL‐6 concentration in bacterial and non‐bacterial acute otitis media
Authors: Barzilai A , Dekel B , Dagan R , Leibovit E 
Published: August 2010

Background: The pathogenesis of acute otitis media is complex and multifactorial. It is characterized by inflammation of the middle ear with an infiltration of leukocytes, macrophages and mast cells. The resulting effusion contains a large amount of inflammatory mediators, among which are cytokines. Objectives: To test the role of IL‐6 in the inflammatory process associated with acute otitis media. Methods: We analyzed 20 middle ear fluid (MEF) sample pairs, obtained by aspiration before initiating antibiotic therapy (day 1) and during treatment (days 4–3, for the presence of IL‐6. IL‐6 concentrations were assayed with an ELISA kit (detection limit 5 pg/ml) and were correlated with bacterial etiology and bacterial eradication from the middle ear. Results: IL‐6 was detected in all middle ear effusions analyzed. We found decreased IL‐6 concentrations in culture negative MEF compared to culture positive MEF on both days 1 and 4–5 (day 1, 1752.20 ± 1001.31 pg/ml vs 1216.20 ± 1015.44 pg/ml, p= 0.19; days 4–5, 1049.36 ± 472.40 pg/ml vs 800.33 ± 676.00 pg/ml, p= 0.23); however, differences did not achieve statistical significance. Overall, a marked and significant decrease in IL‐6 concentration occurred following 72–96 h of antibiotic therapy (1618.15 ± 1004.88 pg/ml vs 936.85 ± 581.05 pg/ml, p= 0.04). While MEF IL‐6 concentrations decreased in ears where bacteria persisted (1468.20 ± 858.48 pg/ml vs 1044.80 ± 514.16 pg/ml, p= 0.167) or were eradicated (2320.20 ± 866.16 pg/ml vs 767.40 ± 522.88 pg/ml, p= 0.029), a more prominent decline was demonstrated in the latter. Conclusions: These results strongly suggest the involvement of IL‐6 in the ongoing inflammatory process in both bacterial and non‐bacterial acute otitis media. Resolution of inflammation in the middle ear, especially where bacteria were eradicated, is reflected by low IL‐6 levels.
Growth hormone in short children: beyond medicine?
Authors: Bolt LLE , Mul D 
Published: August 2010

The indications for growth hormone (GH) treatment in non‐GH‐deficient short children are in debate, with some arguing that this treatment does not belong solely in the medical domain. We describe three different approaches to the issue, and argue that neither a disease‐oriented nor client‐oriented approach is sufficient. Both lead to withdrawal of medical interventions or to an undesirable application. Conclusion: An approach focusing on suffering as an indication for treatment of short stature is the most appropriate. The challenge is to develop proper tools by which to evaluate suffering and the efficacy of GH treatment in these children in order to relieve or prevent suffering.
Chlamydia pneumoniae in children undergoing adenoidectomy
Authors: Normann E , Gnarpe J , Nääs J , Gnarpe H , Karlsson MG , Wettergren B 
Published: August 2010

Chlamydia pneumoniae is a common respiratory pathogen which is often found in paediatric populations. Little is known about the true colonization rate and the localization of the bacteria in the respiratory tract. In this study, immunohistochemistry was used to examine adenoids from 69 children undergoing elective adenoidectomy. Throat swabs for polymerase chain reaction (PCR) and blood samples for serology were also obtained. Chlamydia pneumoniae was demonstrated in the adenoids by immunohistochemistry in 68 of the children. Five children (7%) had a positive C. pneumoniae PCR test from throat swabs and 14 children (20%) had detectable antibodies by the microimmunofluorescence technique. Conclusion: The results suggest that C pneumoniae is a common finding in the adenoids of children undergoing adenoidectomy. Whether or not C pneumoniae plays a pathogenic role in this patient population could not be determined from the data obtained in this investigation.
Comparison of handling and acceptability of two spacer devices in young children with asthma
Authors: Brand PLP , van der Baan‐Slootweg OH , Heynens JWCM , Vries TW de , Versteegh FGA , Vreuls RCFM , den Ouden WJ , Smit FJ 
Published: August 2010

This study compared parents' preference for two spacer devices, NebuChamber® and Babyhaler® for the treatment of young children with asthma. In this open, cross‐over study 141 patients (aged 5–57 mo) who used inhaled steroids via a spacer device were randomized to budesonide via NebuChamber or beclomethasone dipropionate via Babyhaler. Both treatments were given by the parents twice daily for 2 wk. At the final visit parents completed a questionnaire on preference in general and for a given set of features. Acceptability and handling were scored in a diary. Diary scores on acceptability by the child and handling of both spacer devices were comparable. In the preference questionnaire, 68% of parents preferred NebuChamber [95% confidence interval (CI) 60–76] and 25% Babyhaler (95% CI 18–33). The preference was independent of the type of spacer used before the study and was also apparent in the different features: acceptability by child, carrying around, cleaning, close fitting of face mask, assembling and disassembling, damage resistance and size. These differences were statistically significant for all features, except for acceptability by the child. Conclusion: Two‐thirds of parents prefer NebuChamber over Babyhaler for the treatment of their young asthmatic children.
Comparison of EMLA cream versus placebo in children receiving distraction therapy for venepuncture
Authors: Lal MK , McClelland J , Phillips J , Taub NA , Beattie RM 
Published: August 2010

Eutectic mixture of local anaesthetics (EMLA) cream is used routinely as a local anaesthetic prior to venepuncture in children. Despite this, however, a significant proportion of children will still be distressed. Cognitive‐behavioural interventions, such as distraction by breathing and blowing exercises, have been used and found to be helpful as alternative coping strategies. There is, however, a paucity of data regarding effectiveness. We have evaluated the efficacy of distraction therapy as a coping strategy before and during venepuncture, and in these children evaluated the need for EMLA using a prospective, randomized, double‐blind, placebo‐controlled clinical trial. Twenty‐eight children attending for venepuncture were recruited, median age 6 y (range 4–8 y), and randomly allocated to receive either EMLA or a placebo cream. All were given distraction therapy prior to and during the procedure by a play specialist. Venepuncture was carried out by one investigator. A modified pediatric pain assessment chart was used for objective pain score at the end of the procedure. After one exclusion, the treatment group (17 children) and the placebo group (10 children) were similar: median age of 6 and 7 y (range 4–8), median baseline and postprocedure heart rate and oxygen saturation. The median (interquartile range) for total pain score in the treatment group was 1 (0 to 4.5) and in the control group 1 (0 to 2.3). There was no significant difference in pain score between the two groups (Mann‐Whitney test, p= 0.7). The 95% confidence interval for the difference in pain score was 1.0 to +3.0. Conclusions: The low pain score in both groups suggests the effectiveness of distraction therapy, although factors such as skill of the operator and previous experience of the patient group are of relevance. There was no significant difference in the pain score between the EMLA and placebo groups, suggesting that in this age group if carefully selected children receive distraction during venepuncture EMLA may not be necessary.
Connections between parental eating attitudes and children's meagre eating: questionnaire findings
Authors: Saarilehto S , Keskinen S , Lapinleimu H , Helenius H , Simell O 
Published: August 2010

This study investigated whether young children's problematic, meagre eating is associated with the eating habits and attitudes of the parents. The subjects, 397 children, their mothers (n= 397) and fathers (n= 375) participated in a prospective atherosclerosis risk‐factor intervention trial. The parents evaluated their own eating behaviour in questionnaires when their child was 13 mo old. The children's eating problems were recorded by the mothers when the child was 13 mo old, and by both parents when the child was 5 y old. At both ages, the weight and height of the children were measured. Problematic or maladaptive eating habits of the children were found to be connected to those of their parents. The mother's poor ability to enjoy eating, high tendency to snack and low tendency to eat only when hungry, as well as the father's difficulty in maintaining ideal weight significantly predicted persistent problems of meagre eating in their children. Conclusion: The study suggests that the eating habits and attitudes of parents may be reflected in the eating behaviour of young children.
Cord blood endothelin‐1 and perinatal asphyxia
Authors: Laforgia N , Difonzo I , Altomare M , Mautone A 
Published: August 2010

Discordant data have been reported on endothelin‐1 (ET‐1), a potent endothelium‐derived vasoconstriction peptide, during the neonatal period, and elevated levels have been found in various neonatal diseases. This study evaluated ET‐1 in the cord blood of 74 neonates of different gestational age, birthweight, mode of delivery and 5′‐Apgar score. Conclusion: Higher ET‐1 levels were found in neonates born by emergency caesarean section, and in newborns with low 5′‐Apgar score, suggesting that ET‐1 could be a marker of perinatal asphyxia.
Incarcerated inguinal hernia in premature babies‐ a report of two cases
Authors: Coren ME , Madden NP , Haddad M , Lissauer TJ 
Published: August 2010

We highlight the morbidity of incarcerated inguinal hernia in very low birthweight (VLBW) infants by presenting a report of two cases. Our aim is to raise the question of the optimal timing of surgery when this common problem presents on the neonatal unit. In each of our cases the hernia was diagnosed but surgery was delayed, as per normal policy on the unit, pending growth of the baby and improvement in respiratory status. Both babies suffered significant morbidity when the hernias subsequently became acutely incarcerated. Conclusion: In conclusion, we question whether the widespread practice of delayed surgery for inguinal hernia in VLBW infants should be reconsidered.
Lactic dehydrogenase isoenzymes in cerebrospinal fluid associated with hydrocephalus
Authors: Nussinovitch M , Volovitz B , Finkelstein Y , Amir J , Harel D 
Published: August 2010

Various neurological disorders are associated with specific changes in the level of total lactic dehydrogenase and concentrations of its isoenzymes in the cerebrospinal fluid. We describe the lactic dehydrogenase isoenzyme values in children with hydrocephalus. Cerebrospinal fluid samples collected from 10 patients (2 to 16 mo) with hydrocephalus were analysed for total lactic dehydrogenase activity and lactic dehydrogenase isoenzymes. Findings were compared with those in samples from 15 paediatric patients, with normal results. Mean total lactic dehydrogenase activity in the cerebrospinal fluid was significantly higher in the patients with hydrocephalus (101 ± 23.11 U/L) than in the controls (33.53 ± 5.75 U/L) (p < 0.001). In the control samples, lactic dehydrogenase‐1 was the main fraction, followed by lactic dehydrogenase‐2 and 3; only small concentrations of lactic dehydrogenase‐4 and lactic dehydrogenase‐5 were detected. By contrast, patients with hydrocephalus had lower concentrations of the lactic dehydrogenase‐1 fraction and higher lactic dehydrogenase‐2 and lactic dehydrogenase‐3 concentrations, the differences between these results and those in the control group being statistically significant (p < 0.001). The values for lactic dehydrogenase‐4 and lactic dehydrogenase‐5 were similar in both groups. Conclusion: Findings should be considered together with computed tomography/magnetic resonance imaging and ultrasound scans. The cerebrospinal fluid lactic dehydrogenase profile may prove to be an important predictor of cerebral injury, obstructive hydrocephalus and long‐term neurodevelopmental problems.
Comparison of brainstem auditory evoked responses recorded at different presentation rates of clicks in term neonates after asphyxia
Authors: Jiang ZD , Brosi DM , Wilkinson AR 
Published: August 2010

This study examined whether high presentation rates of clicks while recording brainstem auditory evoked responses (BAER) can improve the detection of central auditory impairment in asphyxiated neonates using the BAER. The BAER was analysed at different presentation rates of clicks within the first week after birth in 38 term neonates who suffered perinatal asphyxia. At the routinely used 21 s−1 clicks all BAER wave latencies increased significantly (ANOVA, p < 0.05‐0.01). After excluding five neonates who had a significantly elevated BAER threshold, only wave V latency increased slightly (p < 0.05). The interpeak intervals of I–V and III–V also increased slightly (both p < 0.05). Similar results were found at 51 s−1 clicks. As the clicks were increased to 91 s−1, the III–V interval increased more significantly (p < 0.01) and the III–V/I–III interval ratio also increased significantly (p < 0.01). In particular, wave V amplitude reduced more significantly than that in normal term controls (p < 0.01). Compared with values in the controls, wave V amplitude reduced by 4.5%, 12.2% and 24.7% at 21, 51 and 91 s−1 clicks, respectively. Conclusion: Although a moderate increase in the rate (e.g. 51 s−1) while recording the BAER did not improve the detection of hypoxic‐ischaemic auditory impairment, a significant increase (e.g. 91 s−1) did, which mainly indicates an abnormal reduction in wave V amplitude.
Low‐density lipoprotein apheresis in a patient aged 3.5 years
Authors: Stefanutti C , Giacomo S Di , Vivenzio A , Colloridi V , Bosco G , Berni A , Rabbone I , Cerutti F , Bertolini S 
Published: August 2010

A 3.5 y‐old girl carrying a severe mutation of the LDL‐receptor gene known as “FH Pavia”, affected by homozygous familial hypercholesterolemia (FH), and at high risk of developing coronary artery atherosclerosis was treated with selective dextran sulphate cellulose (DSC) column low‐density lipoprotein apheresis (LDL‐a). This is the youngest patient ever treated with LDL‐a. Plasma total cholesterol (982 mg/dl) and LDL‐cholesterol (939mg/dl) (T‐Chol, LDL‐Chol) levels at baseline showed a transient decrease: –13.4%, and –16.8%, respectively, after 9 mo of combined treatment with a diet, cholestyramine (max. 12g/d) and atorvastatin (max. 30mg/d). However, the drugs were discontinued because of intolerance and an increase in aminotransferases and creatine phosphokinase in the plasma. Moreover, after 9 mo of this therapy, the mean plasma T‐Chol and LDL‐Chol levels were still high (930 mg/dl and 869.5 mg/dl, respectively). Therefore, 9 consecutive treatments with LDL‐a were carried out every 15 d (plasma volumes treated: 1000–1700 ml). Mean plasma T‐Chol, LDL‐Chol, triglycerides (TG), and Lp(a) decreased significantly: –75.5%, –77.2%, –67.5% and −50.8%, respectively. HDL‐cholesterol (HDL‐Chol) concentration was considerably decreased immediately after apheresis because of haemodilution (X: −45.1%). Conclusion: LDL‐a treatment improved the plasma apo B 100‐containing lipoproteins–LDL, Lp(a)‐profile in a homozygote with a severe inherited disorder in which coronary artery atherosclerosis frequently has its clinical onset before 10 y of age. At the time of this report, no significant side effects had been observed.
Small bowel capsule biopsy in children: parents' opinions on children's discomfort
Authors: Högberg L , Nordwall M , Stenhammar L 
Published: August 2010

This questionnaire study asked the parents of 62 children undergoing small bowel capsule biopsy for their reactions to the discomfort experienced by their children. The children were randomized to receive sedation with midazolam either intravenously or intranasally. With regard to the biopsy procedure the parents of 94% of the children had no objections. The parents of 3% of the children found the biopsy very unpleasant and another 3% suggested that the biopsy should be performed under general anaesthesia. The proportion of parents with negative reactions to the biopsy procedure did not differ significantly between the intravenously and intranasally sedated children. With regard to the sedation given, the parents of 79% of the children did not think that their children were in any discomfort at all. Ten percent of the children had obvious signs of nasal discomfort using the intranasal administration. In the remaining 11% of the children the parents reported various symptoms.Conclusion: The vast majority of parents of children undergoing small bowel capsule biopsy found the procedure satisfactory providing that the sedative medication was given intravenously rather than intranasally.