bluuebunny/crossref_metadata_2025_split huggingface dataset:
Idiopathic gastric rupture in a 3‐month‐old girl
Authors: Shimizu T , Horiuchi T , Hirooka S , Yonekura T , Tamai H 
Published: August 2010

This case reports on idiopathic gastric rupture in a 3‐mo‐old girl who had frequent episodes of vomiting and abdominal distension the day before admission to the clinic. Metabolic acidosis was detected and rotavirus antigen was identified in the stools. Abdominal X‐rays and CT scans revealed free air and fluid in the abdominal cavity, leading to a diagnosis of gastrointestinal perforation. During surgery, idiopathic gastric rupture was detected and treated. The postoperative course was uneventful. Conclusion: Idiopathic gastric rupture is extremely rare in childhood beyond the neonatal period. Early diagnosis and surgery are mandatory if children with this condition are to be saved.
Why do we help a micropreemie to live?
Authors: Takahashi S , Endo A , Minato M 
Published: August 2010

Helping a “micropreemie” to live by aggressive interventions may sometimes seem unnatural. However, utilitarian assessment of benefits derived from lifesaving efforts for a micropreemie is considered inappropriate. The goal in treating premature infants has advanced from fetal salvage to achieving “intact survival”, which represents a new therapeutic target. In this way, the record for lifesaving in extremely low‐birthweight infants is continually being broken. Why do we help a micropreemie to live? Moral and ethical emotions are the underlying reasons for the aggressive care devoted to premature infants, including micropreemies. Such human feelings might even be considered the purpose of life. Human emotion is the impetus for aggressive efforts to improve the survival prospects of premature infants. The beautiful and delicate nature of a newborn is compelling. The high‐order emotion of empathy for another's misfortune is also important. Most human emotions are related to an awareness of death, and micropreemies are near death. In Oriental thought, a human being is a growing product of nature. Forces of nature and changes in a living being follow nature's rules. First and foremost, an individual life is part of the long chain of existence beginning before the self and continuing beyond it. An immature human being, even a newborn, is simultaneously a complete entity and part of nature's long chain of being, which has a wholeness of its own that affirms a micropreemie's right to life. A fetus is a member of human society in the sense that there is an overall reverence for life as a quality that lives on. Conclusion: The limit that bioethics must not exceed is the sanctity of life. We believe that the birth of a micropreemie is an important and serious event. We profoundly wish that a micropreemie might live and thrive, because we on earth must live with the continual presence and imminence of death.
Psychosocial distress during pregnancy and the risk of infantile colic: a follow‐up study
Authors: Søndergaard C , Olsen J , Friis‐Haschè E , Dirdal M , Thrane N , Sørensen H Toft 
Published: August 2010

Aim: To examine the association between psychosocial exposures during pregnancy and the risk of infantile colic. Methods: The study included 378 infants and was conducted as a substudy of the Danish National Birth Cohort from 1997 to 1999, with prenatal data collected twice during pregnancy. A diary with a record for postpartum weeks 4–8 was used to quantify the amount of the infants' crying and fussing. Results: The cumulative incidence proportion of infantile colic was 8.2%. A threefold increased risk of infantile colic (OR = 3.7; 95% CI: 1.1–13.2) was found for mothers who reported distress during pregnancy. Close to a twofold increased risk of IC was found for the women who scored higher than 8 on the psychological distress scale (adjusted OR = 1.9; 95% CI: 0.5–7.2). Conclusion: The results indicate that general distress during pregnancy influences the risk of infantile colic. Whether or not this relationship is causal requires further investigations.
Seven‐year review of paediatric bacteraemias diagnosed in a Spanish university hospital
Authors: López A Pérez , Giménez M , Rodrigo C , Alonso A , Prat C , Ausina V 
Published: August 2010

This study analysed the clinical and bacteriological patterns of paediatric bacteraemia in a university hospital, by a review of 213 episodes over a period of 7 y. Streptococcus pneumoniae was the most frequent aetiological agent after the neonatal period and Streptococcus agalactiae in neonatal sepsis. Almost half of pneumococci and meningococci were penicillin non‐susceptible. Four neonatal deaths attributed to bacteraemia were recorded. Conclusion: Streptococcus pneumoniae is the leading cause of community‐acquired bacteraemia. Mortality due to bacteraemia in children without underlying conditions is rare.
Partial trisomy 22 resulting from rearrangements between chromosomes 11/22 and 16/22: a report of two cases
Authors: Werding N , Holland H , Hueckel D , Froster UG , Häusler HJ , Kiess W 
Published: August 2010

Two male infants with partial trisomy 22 resulting from a rearrangement between chromosomes 11/22 and 16/22 were admitted to the Children's Hospital of the University of Leipzig within the space of two months. The characteristic phenotype of the infants is described and compared with the data on liveborn infants with trisomy 22, as reported in the literature. One of the infants reported here showed a prenatally detected hygroma colli. To the best of our knowledge this is the first description of a hygroma colli in this chromosomal disorder. Conclusion: Infants with trisomy 22 can present with variable phenotypes. It is important to bear the phenotype of chromosome 22 infants in mind.
Does circadian variation in risk factors for sudden infant death syndrome (SIDS) suggest there are two (or more) SIDS subtypes?
Authors: Mitchell EA , Williams SM 
Published: August 2010

Sudden infant death syndrome (SIDS) is known to occur more frequently at night. In two studies it has now been shown that a prone sleep position is more strongly associated with SIDS occurring during the day, whereas night‐time deaths are more strongly associated with maternal smoking and illness. Conclusion: This variation, although unexplained, does suggest at least two SIDS subtypes: one related to sleep position and possibly a thermal mechanism, and one related to an uncontrolled inflammatory response to infection predominantly occurring at night. In addition, there are probably other mechanisms that do not show a circadian variation.
Children and statins
Authors: Tonstad S 
Published: August 2010

Use of statins is increasing among children with familial hypercholesterolaemia who previously have had to take unpalatable resins. In a selected group with no controls, children taking statins had similar scores for quality of life and anxiety as normative scores. The question that remains is how to improve dietary and disease information. Conclusion: Children with familial hypercholesterolaemia who are taking statins have no reduction in quality of life or increase in anxiety.
Oesophageal pH monitoring in children: how is it perceived by the parents and does the technique change feeding and daily activity?
Authors: Arana A , Hauser B , Hegar B , Kaufman L , Vandenplas Y 
Published: August 2010

Aim: To determine whether oesophageal pH monitoring in infants induces changes in daily activity and feeding, and with the help of a questionnaire to evaluate how parents perceive pH monitoring. Methods: The parents of 100 children, consecutively referred for oesophageal pH monitoring, were asked by one of the authors (A.A.) to respond to a standardized questionnaire immediately after the end of the procedure. Twenty questions were asked, concerning five topics: feeding (4 questions), activity (6 questions), perception of the parents (6 questions), accuracy of the provided information (3 questions), and previous experience with oesophageal pH‐metry (1 question). For statistical analysis, every variable was qualified as “no change” and “change” for feeding and activity, as “positive” or “negative” regarding the perception of the test, and as “sufficient” or “insufficient” regarding the information provided. The answers to the questions were also analysed according to the result of the oesophageal pH monitoring (normal vs abnormal), and according to whether or not there was previous experience of oesophageal pH‐metry in a first degree relative. Results: Changes in feeding occurred in 28% of cases and changes in activity in 30%, but did not differ according to the oesophageal pH‐metry result. Equally, the perception of the parents regarding the test (37% negative), the acceptability of a second pH‐metry test (refusal in 52%) and previous experience with oesophageal pH‐metry (positive in 25%) were not influenced by the result of the pH monitoring. Parents of infants with abnormal oesophageal pH monitoring were more frequently dissatisfied with the information about the nature of the test provided before the test and also the results than parents of infants with normal results (52% vs 19%, respectively; p < 0.05). Conclusion: According to the perception of the parents, pH monitoring induces changes in feeding and activity in 28% and 30%%, respectively; 63% of the parents considered pH monitoring to be well tolerated. Parents of infants with abnormal pH monitoring results need more attention.
Pubertal growth and development in cystic fibrosis: a retrospective review
Authors: Aswani N , Taylor CJ , McGaw J , Pickering M , Rigby AS 
Published: August 2010

Aim: Normal growth patterns are seen throughout the first decade in children with cystic fibrosis (CF). Growth in the second decade is, however, less satisfactory and may reflect pubertal delay. This study was performed to assess the extent of pubertal delay, to examine factors that influence the timing and magnitude of the pubertal growth spurt, and to establish whether the final height for most CF patients differed significantly from the normal population. Methods: Thirty subjects (16 male) attending a single centre were studied. Peak height velocity (PHV), final height and ages when achieved were compared with population norms. Outcome data were correlated with disease severity using Shwachman and Chrispin‐Norman scores and forced expiratory volume in 1 s. Results: PHV was significantly later in both genders in this CF population compared with Tanner and Whitehouse standards: boys 14.6 y (95% confidence interval (95% CI) 12.4–16.8, p < 0.01) and girls 12.6 y (95% CI 10.5–14.7, p < 0.01). Mean PHV was also lower in both genders (boys 7.7 cm y−1 and girls 6.4 cm y−1, both p < 0.001). However, final heights did not differ significantly from Freeman standards (height standard deviation scores: males–1.2, females–0.1); 52% of final heights equalled or exceeded the mid‐parental centile. Conclusion: CF patients showed suboptimal PHVs with a later pubertal growth spurt influenced by disease severity, but eventually achieved a normal final height.
Improved final height in Turner's syndrome following growth‐promoting treatment at a single centre
Authors: Gault EJ , Paterson WF , Young D , Donaldson MDC 
Published: August 2010

Aims: To examine the final height (FH) outcome of girls with Turner's syndrome (TS) treated at a single Scottish centre (Glasgow group), to compare it with an earlier national analysis (Scottish group) and to suggest reasons for any change. Methods: Retrospective growth and treatment data for 29 Glasgow patients were compared with those of 26 Scottish patients. Results: Age at GH start (mean ± SD) was 10.1 ± 2.6 vs 12.1 ± 1.7 y (p < 0.01) in the Glasgow versus Scottish groups, with overall duration of treatment 6.2 ± 2.4 vs 3.7 ± 1.1 y (p < 0.001) and years of GH treatment before pubertal induction 2.7 ± 2.8 vs 0.3 ± 0.8 y (p < 0.001), respectively. Pubertal induction was at a similar age: 12.7 ± 1.8 vs 12.8 ± 1.8 y (ns). FH was 151.1 ± 4.6 cm in the Glasgow group compared with 142.6 ± 5.6 cm in the Scottish group (p < 0.001), with FH ‐projected adult height (PAH) 5.7 ± 4.6 cm vs 0.6 ± 3.6 cm (p < 0.001), respectively. Univariate analysis of the Glasgow group's FH – PAH with a number of growth and treatment variables identified no statistically significant relationships. Conclusion: This group's improved FH and FH – PAH, relative to an earlier sample, are attributed to the introduction of GH treatment from a younger age and for longer, overall and before pubertal induction. In addition, the authors believe that compliance with treatment has been enhanced by this single centre's dedicated Turner clinic and the efforts of its established “growth team”. These data demonstrate that a favourable FH can be achieved using a safe and financially viable dose of GH, while inducing puberty at a “normal” age.
Identifying children at risk for language impairment: screening of communication at 18 months
Authors: Bruce B , Kornfalt R , Radeborg K , Hansson K , Nettelbladt U 
Published: August 2010

Aim: To investigate the possibility of identifying children at risk for language impairment based on a new screening instrument to assess communication and language skills at 18 mo of age. Methods: At 18 mo, 58 children were assessed with a screening instrument for communication and language consisting of a professional assessment and a parents' questionnaire. Students of speech and language pathology, well trained in child language assessment, carried out the professional assessment, which was based on observations of play behaviour, interaction and expressive and receptive language skills. Of the 58 children, 43 attended a follow‐up assessment of language skills at 54 mo of age. Results: Nine children were considered to be at risk for language impairment at 18 mo and 10 children were evaluated as being at risk at 54 mo. A significant positive correlation was found between the professional evaluations at 18 mo and the language tests at 54 mo. Verbal comprehension and pretend play correlated significantly with the results on the language tests. Conclusion: A professional screening of communication and language at 18 mo of age is worthwhile for predicting problems in language development. The results further show that language comprehension and pretend play rather than expressive skills should be emphasized.
Pregnancy and childbirth‐related factors associated with recurrent antibiotic use in infants
Authors: Louhi‐Pirkanniemi KA , Rautava PT , Aromaa M , Ojanlatva AT , Mertsola J , Helenius H , Sillanpää ML 
Published: August 2010

Aim: To determine the reasons for the possible overuse of antibiotics by investigating whether family‐related medical, behavioural, emotional, and social risk factors during the mother's pregnancy and childbirth are associated with subsequent recurrent antibiotic therapy of infants. Methods: Subject selection was based on stratified randomized cluster sampling. A total of 1443 women (91%) and their spouses expecting their first child gave informed consent to participate and 1287 infants were born. The parents of 817/1025 infants (80%) reported the number of courses of antibiotic therapy the child had Received at the ages of 9 and 18 mo. The outcome measure was the number of courses of antibiotic therapy (none/1–5/= 6) given during the first 18 mo of life. The explanatory variables included family‐related factors during the pregnancy and immediately after childbirth. Results: In the final multivariate stepwise analysis, parents' long‐term illnesses were associated with recurrent antibiotic medication. Conclusions: Parents with long‐term illnesses need special guidance and support from the beginning of the mother's pregnancy in order to minimize the subsequent risk for recurrent antibiotic therapy of their infants. Preventive healthcare workers should be aware of the effects of these factors on parental guidance.
Coronary arteries in fetal life: physiology, malformations and the “heart‐sparing effect”
Authors: Chaoui R 
Published: August 2010

The present knowledge of coronary arteries in prenatal diagnosis is reviewed with a focus on three aspects: the physiology and visualization of coronary flow, malformations involving the coronary arteries, and the “heart‐sparing effect”. Visualization of coronary arteries in a healthy human fetus is possible in real‐time and colour Doppler during the last 10wk of gestation when ultrasound conditions are excellent. Visualization at an earlier gestational age (up to 13 wk) is feasible mainly in association with malformations and impending hypoxia. The main coronary malformations that can be visualized in utero are the ventriculo‐coronary communications in fetuses with pulmonary atresia. In the last few years, interest has been focused on the “heart‐sparing effect”, defined as the increased perfusion of the coronary arteries in fetuses with severe growth restriction and abnormal Doppler velocimetry in the peripheral vessels. Increased perfusion detectable with colour and pulsed Doppler is a late sign of fetal compromise in hypoxaemia. It confirms animal experiments that have demonstrated dilatory reserves of the fetal coronary arteries under chronic hypoxaemia. The outcome of 21 fetuses showing the “heart‐sparing effect” before 32 wk gestation was poor: nine fetuses died in utero and two after birth, the median weight at birth was 630 g.In summary, our knowledge of the coronary arteries in the fetus is based on the diagnostic means used in prenatal diagnosis. New information in this field may also contribute to a better understanding of coronary heart disease later in life.
Coronary flow and flow reserve in children
Authors: Óskarsson G 
Published: August 2010

Aortic blood pressure affects coronary blood flow, but within the normal physiological blood pressure range coronary blood flow is constant. The coronary flow is pulsatile, being maximal in the early diastole. There is a smaller systolic flow component. The low systolic pressure in the right ventricle favours systolic flow. The proportion of systolic flow is greater in the right than in the left coronary artery. Heart diseases in children cause several haemodynamic and functional changes that are likely to affect myocardial perfusion. Newborns with severe valvular aortic stenosis may have a retrograde systolic flow in the left coronary artery. Children with dilated cardiomyopathy have a reduced coronary flow related to myocardial mass. Coronary flow reserve (CFR) is defined as the ratio of maximal coronary blood flow, as induced by reactive hyperaemia or administration of vasodilators, divided by resting flow. Coronary flow can normally increase 2.5–4‐fold. CFR is reduced if basal flow is increased due to myocardial hypertrophy, strain or hypoxaemia. Very low CFR values measured with positron emission tomography are reported in neonates with surgically treated congenital heart disease. Measurement of coronary flow velocity with the intracoronary Doppler guide wire may be regarded as a reference or “gold standard” in the evaluation of coronary flow velocity and CFR. Conclusions: Coronary flow and CFR in children is a largely unexploited field, and has vast potential for future research.
Magnetic resonance measurement of coronary blood flow
Authors: Sakuma H , Higgins CB 
Published: August 2010

Magnetic resonance (MR) flow measurement in the coronary artery can be achieved with either a breath‐hold acquisition or a respiration‐triggered acquisition. MR measurements of cardiac output are significantly depressed during breath‐holding at deep inspiration, but the advantage is that the breath‐hold method requires less scan time. Blood flow in the coronary sinus reflects the global myocardial blood flow because it represents approximately 96% of the total myocardial blood flow of the left ventricle (LV). If blood flow in the coronary sinus is measured with phase‐contrast cine magnetic resonance imaging (MRI) and LV myocardial mass is measured with cine MRI, both the total myocardial blood flow and the average coronary blood flow per gram of myocardial mass can be quantified. Coronary flow reserve with volumetric MR flow measurement is measured to be within 4.2–5.0‐fold. The noninvasive MR measurement of coronary flow reserve has been shown to be useful in identifying the functional significance of stenoses in the left anterior descending artery. The sensitivity and specificity of MR coronary flow velocity reserve for identifying stenosis of 70% or greater in the left main or left anterior descending artery were 100% and 83%, respectively. The MR quantification of total coronary blood flow and coronary blood flow per gram of myocardial mass seems to be an ideal method for evaluating coronary hemodynamics and may be useful in evaluating endothelial dysfunction of the coronary circulation.SummaryRecent advances in fast MRI sequences have considerably extended the capabilities of cardiac MRI in the functional assessment of coronary blood flow and flow reserve. The MR measurement of coronary flow reserve can be used to identify restenosis of the left main and left anterior descending coronary arteries after percutaneous interventions in clinical patients. Further refinements in MR pulse sequences, including the use of phase‐contrast echo‐planar or spiral MR methods, may make it possible to quantify blood flow volume and flow reserve more accurately in all major branches of the coronary arteries.The MR measurement of blood flow through the coronary sinus allows a noninvasive assessment of global coronary hemodynamics. Because the coronary sinus is larger than the native coronary arteries, the errors in blood flow quantification associated with the limited spatial and temporal resolution of current phase‐contrast MR sequences are substantially smaller. The MR quantification of total coronary blood flow and coronary blood flow per gram of myocardium during stress and at rest seems to be an ideal method for evaluating coronary hemodynamics in diffuse myocardial diseases of the heart, such as hypertensive heart diseases and cardiomyopathies, and may be useful in evaluating endothelial dysfunction of the coronary circulation, which develops in the earliest stages of atherosclerotic disease and may precede obstruction of the epicardial coronary arteries.
Orphaned and vulnerable to infection, undernutrition and early death: increasing threats to infants and children
Authors: Gracey M 
Published: August 2010

Infants and young children in Guinea‐Bissau who were made motherless had much higher mortality rates than a control group of subjects. Child mortality was higher in rural than urban children and was highest under 2 y of age and within 6 mo of their mothers' deaths. The authors of this study, which appears elsewhere in this issue, suggest that premature weaning may contribute to this excess mortality. Conclusion: There are many causes of maternal mortality that can lead to motherlessness among infants and children, particularly in developing countries. Multifaceted approaches to the care of these children are needed to lessen their excessive mortality. Paediatricians have a potentially very important role in preventing this burden of childhood ill‐health and deaths.