bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post‐discharge nutrition of the very low‐birthweight infant: interim results of the multicentric GAMMA study
Authors: Agosti M , Vegni C , Calciolari G , Marini A ,   the Investigators of the “GAMMA” Study Group
Published: August 2010

This report presents the interim results up to 12 mo corrected age (c.a.) of a multicentric, prospective, controlled study on very low‐birthweight infants, randomized at 40 wk post‐conception in two different groups of formula feeding: 80 Kcal/dL (group A) vs 70 Kcal/dL (group B) up to 55 wk of postconceptional age. Subsequently, all the babies were fed with a follow‐on formula, with the introduction of solid foods at 6 mo c.a. Weight, length, head circumference and neurological conditions with psychomotor development (evaluated by the Griffiths’Developmental Scale) were measured at regular intervals and all of these parameters were satisfactory in both groups. For growth, in group A there was a greater increase in weight in boys at 55 wk and at 6 mo c.a., and small for gestational age (SGA) babies had a greater increase in length at 1 y of age, while head circumference caught up on growth from week 40 to week 55. Measured by the Griffiths’Developmental Scale, the SGA group fed 80 Kcal/dL had a better score at 6 mo; similarly boys fed 80 Kcal/dL had a better score at 6 and at 9 mo. Conclusion: Nutrition of very low birthweight infants post‐discharge could have an influence on physical growth and on neurodevelopmental outcome. This interim report needs to be confirmed at the end of the study.
Troponins in children and neonates
Authors: Adamcová M 
Published: August 2010

Cardiac troponin T and cardiac troponin I—the biochemical markers of myocardial injury—are characterized by high specificity and sensitivity in comparison with other markers used in the past. Conclusion: Troponins have been studied in a wide range of clinical settings. Some of them are unique to paediatric care, but many questions, mainly concerning laboratory limitations and data interpretation in paediatrics, are still open to debate.
Trans fatty acids in human milk in Poland and their association with breastfeeding mothers’diets
Authors: Mojska H , Socha P , Socha J , Soplińska E , Jaroszewska‐Balicka W , Szponar L 
Published: August 2010

Aim: To determine the content of trans fatty acids in human milk in relation to breastfeeding mothers’diet. Methods: Samples of milk were collected from 100 breastfeeding mothers and 7‐d dietary records and anthropometry from 69 mothers were obtained. Results: The following total trans fatty acids contents (median (lower‐upper quartile); % wt/wt) in milk samples were determined: 1) data for Spring: colostrum—1.37 (1.00–2.00), mature milk at 5–6 wk of lactation—2.59 (1.49–3.34) and at 9–10 wk of lactation—2.36 (1.55–3.92); 2) data for Autumn: colostrum—1.80 (1.42–2.48), mature milk at 5–6 wk of lactation—2.41 (1.79–4.31) and at 9–10wk of lactation—2.77 (1.53–4.18). The major sources of trans fatty acids in mothers’diets were bakery products, confectionery and snacks. Mothers who had high level of trans isomers in their milk consumed significantly higher amounts of these products.Conclusions: Bakery products, confectionery and snacks are a major source of trans fatty acids in maternal diet in Poland. The levels of trans fatty acids in human milk may reflect the current diet of the mother as well as the diet consumed early in pregnancy.
Anogenital human papillomavirus in non‐abused preschool children
Authors: Myhre AK , Dalen A , Berntzen K , Bratlid D 
Published: August 2010

Aim: To estimate the prevalence of human papillomavirus (HPV) in anogenital samples from children selected for non‐abuse. Methods: A letter of invitation was sent to 2731 girls and 1042 boys, all of them aged 5 or 6 y. Inclusion was based on self‐selection, whereby parents who did not suspect any occurrence of sexual abuse of their child gave informed consent to participate. Several mechanisms were undertaken to exclude abused children. A complete examination was done of each child, including anogenital examination with a colposcope and microbiological sampling from the genitals and anus. Polymerase chain reaction (PCR) using primers MY09 and MY11 was used to identify HPV, and sequencing was done on each positive amplicon. Results: PCR was performed on 325 adequate specimens from 211 children enrolled. Seven samples from 5 girls were HPV‐positive, making 2/161 (1.2%) of the anal and 5/164 (3.0%) of the genital specimens positive. HPV was not detected in any of the boys. In four girls strong associations with HPV 6 genotypes were found, while one girl probably had a mixed infection with HPV 6 and 16. Three girls (1.8%) had clinically detectable anogenital warts. Conclusion: Since our results are comparable with a prevalence reported from allegedly abused children, and higher rates have been reported from the oral cavity in healthy children, we find detection of HPV unreliable as an indicator of sexual abuse in 5–6‐y‐old children. The rate of anogenital warts found in our study is comparable with a rate reported in abused children.
Genital anatomy in non‐abused preschool girls
Authors: Myhre AK , Berntzen K , Bratlid D 
Published: August 2010

Aim: To describe the normal variations in genital anatomy in preschool girls selected for non‐abuse. Methods: A total of 2731 girls aged 5 or 6 y were invited to take part in the study; 195 girls were recruited. Inclusion was based on self‐selection, whereby parents who did not suspect any occurrence of sexual abuse of their children gave informed consent to participate. Several steps were taken to exclude abused girls and girls with previous accidental genital injuries. The genital examination, using a colposcope and a camera, was performed in supine position using a separation and traction technique, and in the prone knee‐chest position. Results: A number of genital anatomical features and hymenal measurements were described and found consistent with previous studies. An important finding was outward folding of the posterior hymenal rim in many girls, a feature that could be difficult to distinguish from attenuation of the posterior hymen. A gaping hymenal orifice, previously suggested to be a supportive sign of sexual abuse, was fairly frequently found and significantly associated with a large horizontal hymenal diameter. Conclusion: To distinguish between girls with outward folding of the posterior hymen and those with attenuated hymens, we recommend the use of the saline irrigation method. Even though normative hymenal measurement data now exist from a reasonable number of girls, these measurements should be used with caution in sexual abuse evaluations.
Evaluation of screening procedures for congenital cataracts*
Authors: Magnusson G , Jakobsson P , Kugelberg U , Lundvall A , Maly E , Tornqvist K , Abrahamsson M , Andreasson B , Borres MP , Broberger U , Hellström‐Westas L , Kornfält R , Nelson N , Sjöstrand J , Thiringer K 
Published: August 2010

Aim: To evaluate the efficacy of two different Swedish screening procedures for early detection of congenital cataracts in comparison with no screening. Methods: Children born between January 1992 and December 1998 in Swedish regions with an established eye‐screening routine procedure, diagnosed with congenital cataract, and operated on before 1 y of age, were included in a retrospective study. Age at referral and age at time of the operation were compared between regions using different screening procedures: screening in the maternity wards (Region 1), at the well‐baby clinics (Region 2) and one region without any screening (Region 3). Results: Seventy‐two children were included in the study. Concerning early diagnosis and surgery, Region 1 differed significantly from Regions 2 and 3, which were more similar and were combined for further analysis. The difference in detected cases was greatest at 21 d of age (55% vs 18%; p < 0.001), but persisted even at 100 d of age (78% vs 64%; p < 0.02). Region 1 screening resulted in more and earlier cases detected than the other two regions (22 vs 15 per 100000 births). In 72% of all cases, surgery was performed in response to referrals from either the maternity wards (36%), or the well‐baby clinics (36%). However, half of the cases from the well‐baby clinics were detected too late, i.e. at >100d. Conclusion: Eye screening in the maternity ward is preferable to well‐baby clinic screening and to no screening at all, since it leads to early detection. Screening should also be performed routinely at well‐baby clinics within the period when successful treatment is possible.
Body mass index for Saudi children with Down's syndrome
Authors: Husain M Al 
Published: August 2010

Aim: Children with Down's syndrome (DS) have a higher prevalence of obesity than children without DS. This study aimed to assess the prevalence of overweight/obesity and to establish reference body mass index (BMI) percentile curves for Saudi children with uncomplicated DS below the age of 5 y. Methods: BMI was measured prospectively in 785 children with DS and compared with 989 Saudi children without DS. Both groups were compared with the international cut‐off point figures for age and gender. Results: Obesity was not a prominent features in Saudi children with DS and their mean BMI curves were linear to the international cut‐off points for BMI, indicating a clear tendency for overweight. BMI reference percentile curves were constructed. Conclusion: Reference curves for BMI worked out in this study, taken in conjunction with those for height and weight, will be useful in monitoring the size and shape of Saudi children with DS up to the age of 5 y.
Early nasal continuous positive airway pressure for preterm neonates: the need for randomized trials
Authors: Lundstrøm KE 
Published: August 2010

The use of early nasal continuous positive airway pressure (nCPAP) as prophylaxis and treatment for respiratory distress syndrome in preterm neonates, with or without prophylactic surfactant, is becoming increasingly popular. However, the justification for this is limited to comparisons between centres and comparisons of historical controls. Conclusion: Randomized trials and appropriate evaluation of the nCPAP technique are needed.
Body size and early growth in appropriate‐ and large‐for‐gestational‐age infants
Authors: Sun M , Schutz Y , Grezzani A , Clementi M , Gaudino R , Maffeis C 
Published: August 2010

Aims: To study weight, length, body composition, sleeping energy expenditure (SEE), and respiratory quotient (RQ) at birth and at 5 mo of age in both adequate‐for‐gestational‐age (AGA) and large‐for‐gestational‐age (LGA) subjects; to compare the changes in body weight and body composition adjusting for gender, age, SEE, RQ and several maternal factors; to investigate the contribution of initial SEE and RQ to changes in body weight and body composition. Methods: Sixty‐nine neonates were recruited among term infants in the University Hospital of Verona, Italy. Forty‐nine subjects participated until follow‐up. At birth and follow‐up, weight and length were measured and arm‐fat area and arm‐muscle area were calculated from triceps and subscapular skinfolds. SEE and RQ were measured by indirect calorimetry. Results: At birth, weight, length, arm‐muscle and arm‐fat areas were significantly higher in LGA subjects than in AGA subjects. Weight status, SEE and RQ at birth did not explain the relative weight change after adjusting for gestational weight, placental weight, age at follow‐up and gender. Arm‐fat area and weight/length ratio at birth were negatively associated with relative changes in body weight after adjusting for the above variables (p < 0.05). Conclusion: Early growth from birth to 5 mo of life is significantly affected by body size and adiposity at birth. Fatter newborns had a slower growth rate than thinner newborns.
Efficacy of Helicobacter pylori eradication on platelet recovery in children with chronic idiopathic thrombocytopenic purpura
Authors: Jaing T‐H , Yang C‐P , Hung I‐J , Chiu C‐H , Chang K‐W 
Published: August 2010

Aim: Little is known about the influence of environmental factors on the epidemiology of idiopathic thrombocytopenic purpura (ITP). The role of Helicobacter pylori infection in relation to the development and/or persistence of ITP in infected patients remains controversial. Therapy used for eradicating H. pylori has led to a rise in platelet counts in a significant number of adult patients, but few paediatric studies have been undertaken to evaluate such treatment. The aim of this prospective study was to determine the prevalence of H. pylori and to evaluate whether H. pylori eradication can induce chronic ITP regression in children. Methods: To investigate new, non‐invasive techniques for diagnosis of H. pylori infection, an enzyme immunoassay for H. pylori antigens in faeces (HpSA) was evaluated. Patient eligibility criteria included isolated thrombocytopenia (±50 ± 109 L−1) for more than 6 months without any identifiable cause and either normal or increased marrow megakaryocytes. H. pylori status was monitored before eradication and 4, 12, and 24 mo, after the end of treatment using Premier Platinum HpSA. Results: In this study we evaluated 22 chronic ITP patients, 9 of whom were infected with H. pylori. Using repeated HpSA testing, we demonstrated for eradication of H. pylori after treatment in all infected patients. Five of the nine patients had increased platelet counts that persisted throughout the follow‐up period. Conclusion: These results should stimulate additional research into the involvement of H. pylori infection in chronic ITP in childhood. This approach may offer an accepted algorithm at least for some of these patients.
Decreased immune response to hepatitis B eight years after routine vaccination in Israel
Authors: Gold Y , Somech R , Mandel D , Peled Y , Reif S 
Published: August 2010

Background and Aim: Although immunization of infants against hepatitis B virus (HBV) is the most effective way to prevent infection, duration of the afforded protection is unknown. Titers of anti‐HBV antibodies decline with time, especially during the first few years after vaccination. Anti‐HBV antibody levels were measured in the serum of vaccinated children in order to determine the duration of the response afforded by the primary course of HBV vaccine. Methods: The immunity derived from the HBV vaccine was assessed by measuring antibody levels in 122 healthy children who were vaccinated in a routine vaccination program in Israel. Results: Ninety‐four children (77.1%) had detectable antibodies levels (HBsAb titer >10mIU/ml): 59 (48.4%) of the children had high antibodies levels (HBsAb titer MOO mIU/ml). Twenty‐eight children (22.9%) had undetectable antibodies levels (HBsAb titer <10mIU/ml). When the children were divided into three groups according to the time elapsed since vaccination, it was found that the antibody levels declined with time (p < 0.009). Most of the children with undetectable antibody levels belonged to the 5 to 8‐y post‐vaccination group (36.1% vs 20% and 14.6% for the 2.5 to 5‐y and 1 to 2.5‐y groups, respectively, p < 0.01). The mean HBsAb declined in relation to the length of time post‐vaccination (226.9 ± 248.2 mIU/ml for 1–2.5 y post‐vaccination, 199.0 ± 235.7 mIU/ml for 2.5‐5 y and 90.4 ± 138.5 for 5–8 y, p < 0.05). No correlation was found between HBsAb titers and gestational age, birthweight and parental origin, although females generated higher mean antibody levels than males (207.3 ± 217 mIU/ml vs 141.9 ± 218.9 mIU/ml, p < 0.05). Conclusion: Our data demonstrate a steady decline in anti‐HBV titers over time after routine vaccination against HBV in Israel. The most significant decline occurred 5–8 y post‐vaccination.
Hand, foot and mouth disease in Singapore: a comparison of fatal and non‐fatal cases
Authors: Chong C‐Y , Chan K‐P , Shah VA , Ng WYM , Lau G , Teo TE‐S , Lai S‐H , Ling A‐E 
Published: August 2010

Aim: An epidemic of hand, foot and mouth disease (HFMD) occurred in Singapore between September and November 2000. During the epidemic, there were four HFMD‐related deaths and after the epidemic, another three HFMD‐related deaths. This study sought to determine the risk factors predictive of death from HFMD disease. Methods: The risk factors for fatal HFMD were determined by comparing clinical and laboratory findings between fatal cases (n= 7) and non‐fatal controls (n= 131) admitted between September 2000 and April 2001. Enterovirus 71 positive fatal cases (n= 4) and non‐fatal controls (n= 63) were also compared. Results: In total, 138 HFMD cases with a mean age of 32 mo were studied. The majority of fatal cases died from interstitial pneumonitis, of whom three also had brainstem encephalitis. Of the 131 non‐fatal cases, 3 had concomitant infections (respiratory syncytial virus bronchiolitis, right‐sided pneumonia, Haemo‐philus influenzae type b meningitis), 2 had aseptic meningitis, and 1 each had transient drowsiness, intravenous immunoglobulin‐related complications and transverse myelitis. By multivariate logistic regression analysis, atypical physical findings (p= 0.0006), raised total white cell count (p= 0.0128), vomiting (p= 0.0116) and absence of mouth ulcers (p= 0.043) were predictive of a fatal course. Although previous epidemics have described neurogenic pulmonary oedema as the main cause of death, the fatal cases in this study died mainly from interstitial pneumonitis alone or with myocarditis or encephalitis. Conclusion: Although HFMD is generally a benign disease, risk factors such as vomiting, absence of mouth ulcers, atypical presentation and raised total white cell count should alert the physician of a fatal course of illness.
Microbiological factors associated with neonatal necrotizing enterocolitis: protective effect of early antibiotic treatment
Authors: Krediet TG , van Lelyveld N , Vijlbrief DC , Brouwers HAA , Kramer WLM , Fleer A , Gerards LJ 
Published: August 2010

Aim: The incidence of necrotizing enterocolitis (NEC) strongly increased in an neonatal intensive care unit (NICU) in 1997 and 1998 compared with previous years, which coincided with increased incidence of nosocomial sepsis. Specific risk factors related to this NICU and a possible relationship between NEC and nosocomial sepsis were studied retrospectively, including all patients with NEC since 1990 and matched controls. Methods: Clinical and bacteriological data from the period before the development of NEC and a similar period for the controls were collected retrospectively and corrected for birthweight and gestational age. Statistical analysis was performed by a stepwise regression model. Results: Data of 104 neonates with NEC and matched controls were analysed. The median day of onset of NEC was 12 d (range 1–63 d). Significant risk factors for NEC were: insertion of a peripheral artery catheter [odds ratio (OR) 2.3, 95% confidence interval (95% CI) 1.3‐3.9] and a central venous catheter (OR 5.6, 95% CI 3.1‐10.1), colonization with Klebsiella sp. (OR 3.4, 95% CI 1.5‐7.5) and Escherichia coli (OR 2.1, 95% CI 1.CM1.5), and the occurrence of sepsis, in particular due to coagulase‐negative staphylococci (OR 2.6, 95% CI 1.4‐5.1). The risk for NEC was decreased after the early use (<48h after birth) of amoxicillin‐clavulanate and gentamicin (OR 0.3, 95% CI 0.2‐0.6). Conclusion: Insertion of central venous and peripheral arterial catheters is positively associated with NEC, as is colonization with the Gram‐negative bacilli Klebsiella and E. coli and the occurrence of sepsis, particularly due to coagulase‐negative staphylococci. Early treatment with amoxicillin‐clavulanate and gentamicin is negatively associated with NEC and may be protective against NEC.
Clinical and pathological characteristics of cystic lesions of extrahepatic bile duct in neonates
Authors: Jiexiong F , Minju L , Hongfeng T , Weizhong G , Shaoyong Y 
Published: August 2010

Aim: To investigate the differences in clinical and pathological manifestations between biliary atresia with extrahepatic biliary cyst and choledochal cyst in neonates. Methods: Symptoms and clinical signs in 5 neonates with biliary atresia with extrahepatic biliary cyst (4 of type I and 1 of type III) and 17 neonates with choledochal cyst were recorded. The levels of serum alkaline phosphatase, bilirubin, direct bilirubin, transaminase, gamma‐glutamyl transpeptidase were analysed. Width and length of gallbladder and choledochal cyst were measured on B‐mode ultrasound before surgery. Intrahepatic or extrahepatic biliary ducts were visualized with intraoperative cholangiography. The pathologic features in specimens of the liver were studied with light‐ and electron transmission microscopy. Results: All malformations occurred more commonly in girls, and obstructive jaundice was the main manifestation in both groups. Laboratory tests showed similar results for all patients in this study. With regard to pathological features, no significant difference was seen in either light microscopy or transmission electron microscopy, but it was shown with ultrasound that the length and width of the cysts and the gallbladder in neonates with biliary atresia were all shorter than the measurements in patients with choledochal cyst. The intrahepatic bile ducts could not be visualized on intraoperative cholangiography in type III biliary atresia. Deformation of the biliary ducts within the liver and stricture of the portal bile duct were the predominant features in type I biliary atresia, while the bile duct within the liver was normal or dilated in neonates with choledochal cyst. Conclusions: Cystic lesions of the extrahepatic bile duct might be a common manifestation of biliary atresia and choledochal cyst. Intraoperative cholangiography is a precise and effective technique in the differential diagnosis of those lesions and helps decide on the most rational method of treatment.
Safety in road crossing of children with cerebral palsy
Authors: te Velde AF , Savelsbergh GJP , Barela JA , van der Kamp J 
Published: August 2010

Aim: Children with cerebral palsy (CP) are regularly confronted with physical constraints during locomotion. Because abnormalities in motor control are often related to perceptual deficits, the aim of this study was to find out whether children with CP were able to walk across a road as safely as their non‐handicapped peers. Method: Ten children with CP and 10 non‐handicapped children aged 4–14 y were asked to cross a simulated road if they felt the situation was safe. Results: With respect to safety and accuracy of crossings, the behaviour of children with CP was comparable with that of non‐handicapped children. However, a closer examination of children's individual crossing behaviour showed considerable differences within the CP group. In contrast to children with damage to the left hemisphere, children with damage to the right hemisphere made unsafe decisions and did not compensate for them by increasing walking speed. Conclusion: The differences in unsafe behaviour and in the ability to compensate for it within the group of children with CP might be related to damage to specific regions of the brain that are involved in the processing of spatial or temporal information.