bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two different doses of gluten show a dose‐dependent response of enteropathy but not of serological markers during gluten challenge in children with coeliac disease
Authors: Jansson UHG , Gudjónsdóttir AH , Ryd W , Kristiansson B 
Published: August 2010

In order to study dose‐dependency in histopathological reactions and in changes of serological markers of mucosal relapse, gluten challenge was performed with two defined amounts of gluten in 54 children with earlier enteropathy. Gluten was provided in the form of powder and the patients were randomly allotted to either 0.2 (group A, n= 27) or 0.5 (group B, n= 27) grams per kg body weight per day. At the start and after 4 wk of challenge a small intestinal biopsy was performed. Biopsy specimens were evaluated, in accordance with defined criteria, graded and summarized in an enteropathy score. Blood was sampled at the start and after 2 and 4 wk of challenge. Serum levels of anti‐gliadin antibodies (AGA) and anti‐endomysium antibodies (EmA) were measured. Within 4 wk of challenge, 24 out of 27 patients in group A and all patients in group B had relapsed. After increasing the gluten dose to 0.5 g/kg/d during the subsequent 4 wk, the three non‐relapsing patients also relapsed. Conclusion: The severity of mucosal inflammation was significantly higher for group B (p= 0.04) indicating a dose‐related severity of the enteropathy. No significant difference was found for maximum AGA level, or in the proportion of patients that converted to pathological values for AGA or EmA.
Inhalation of corticosteroids after hospital care for respiratory syncytial virus infection diminishes development of asthma in infants
Authors: Hesselmar B , Adolfsson S 
Published: August 2010

The aim of the study was to assess the effect of inhaled corticosteroids on subsequent respiratory symptoms and asthma in infants hospitalized for respiratory syncytial virus infection (RSV). The study included 188 children below 12 mo of age, hospitalized because of RSV infection. During the winter of 1994/95 only selected children (13%) were given inhaled corticosteroids following discharge from the hospital. The following winter (1995/96), almost all children (86%) were given this treatment for 6–;8 wk. Outcomes of the two different treatment regimens were compared by questionnaire 19–;24 mo after discharge. Children hospitalized and treated during the winter of 1995/96 developed asthma (12% vs. 24%) and other severe symptoms of the respiratory tract less often than infants treated the year before. The frequency of children with less severe symptoms did not differ between the two treatment periods. Conclusion: The results indicate that inhalation of corticosteroids for 6–;8 wk may reduce subsequent asthma and severe respiratory morbidity in infants hospitalized for RSV infection.
Changing panorama of cerebral palsy in Sweden. VIII. Prevalence and origin in the birth year period 1991–94
Authors: Hagberg B , Hagberg G , Beckung E , Uvebrant P 
Published: August 2010

This 8th Swedish population‐based cerebral palsy (CP) report comprises 241 children born 1991–94. The live birth prevalence was 2.12 per 1000. Excluding 7 postnatally‐derived cases, the gestational age‐specific prevalences were 86 for extremely preterm children, 60 for very preterm and 6 for moderately preterm, and 1.3 for term children per 1000. Spastic hemiplegic, diplegic and tetraplegic subtypes accounted for 33%, 44% and 6%, dyskinetic CP for 12% and simple ataxia for 4%. Neuroimaging had been performed in 90%. Probable aetiology was identified in 73% of preterm and 86% of term children. Among preterm children it was considered prenatal in 12%, peri/neonatal in 61% and unclassifiable in 27%, while it was 51%, 36% and 14% among term children. Conclusion: The live birth prevalence for CP in the birth year period 1991–94 continued to decrease slightly. Gestational age‐specific prevalences increased marginally in extremely and very preterm births, continued to decrease in moderately preterm births and decreased slightly in term births. Probable aetiology and timing of the brain insult could be revealed in 81%, birth asphyxia being the likely cause in 28% of term children.
Smoking related to plasma leptin concentration in pregnant women and their newborn infants
Authors: Helland IB , Reseland JE , Saugstad OD , Drevon CA 
Published: August 2010

Leptin, a hormone produced in adipose tissue and placenta, is potentially important in relation to energy metabolism and growth. We investigated the effect of cigarette smoking on maternal plasma leptin concentration during pregnancy, and on plasma leptin concentration and weight among infants up to 13 wk of age. Plasma leptin concentration was measured in women in week 18 (n= 203) and week 35 (n=164) of pregnancy, while cotinine (nicotine metabolite) was measured in plasma sampled from mothers in week 35 of pregnancy (n= 159). Leptin concentration was also measured in plasma from the umbilical cord (n= 133) and from 4‐wk‐old (n= 129) and 13‐wk‐old (n= 130) infants. There was no difference in plasma leptin concentration between smoking and non‐smoking mothers at 18 wk and at 35 wk of pregnancy. Plasma cotinine concentration was higher in smoking than in non‐smoking mothers, and a negative correlation between plasma cotinine and leptin concentrations was found. The leptin concentrations in umbilical cord plasma were similar, although the birthweights of newborns from smoking mothers were significantly lower than those from non‐smoking mothers. The plasma leptin concentrations were similar between the two groups also at 4 wk of age. At 13 wk of age, infants of smoking mothers had significantly higher plasma leptin concentrations than infants of non‐smoking mothers. Conclusion: Our results indicate that a lower birthweight of neonates among smoking mothers is not due to altered plasma leptin concentration.
Clinical predictors of outcome following mild and moderate neonatal encephalopathy in term newborns in Kathmandu, Nepal
Authors: Ellis M , Shrestha L , Shrestha PS , Manandhar DS , Bolam AJ , de L Costello AM 
Published: August 2010

We describe a clinical grading system for the assessment of neonatal encephalopathy developed for a large prospective study in Kathmandu. Inter‐observer variability testing of our system on 27 infants showed high agreement (kappa value 0.87). Validity for the prediction of major neuro‐developmental impairment at 1 y of age was tested using a cohort of 57 survivors of encephalopathy, all of whom were assessed using a combination of the Denver Developmental Screening Test and Bailey 2 at 1 y. We compared this with a modification of a scoring system previously validated in Cape Town. Both schemes converted a pretest probability of 31% (the prevalence of major impairment at 1 y of age in this cohort) to a post‐test probability of 55%. This showed only marginal improvement over the traditional risk marker of neurological abnormality at discharge (post‐test probability 51%). At 6 wk of age acquired microcephaly increased the probability of major impairment to 79%.Conclusions:It seems to make little difference both in practical or predictive terms whether one describes the neurological condition of the neonate using a descriptive or scoring system. The important thing is to perform repeated systematic neurological examinations on a daily basis during the neonatal period. Many clinicians will justifiably continue to use the discharge examination as the deciding factor for the need for continued neurodevelopmental surveillance.
Breastfeeding and complementary feeding practices in rural Malawi
Authors: Vaahtera M , Kulmala T , Hietanen A , Ndekha M , Cullinan T , Salin M‐L , Ashorn P 
Published: August 2010

To facilitate optimal growth of newborns, many countries have developed infant feeding recommendations, usually suggesting 4–6 mo of exclusive breastfeeding and then the gradual introduction of complementary foods. We prospectively studied the changes in infant diets and predictors of adherence to national infant feeding recommendations in a cohort of 720 newborn babies in rural Malawi, Sub‐Saharan Africa. Monthly interviews of the main guardians indicated that breastfeeding was universal for 18 mo. As most babies were given water or other supplemental foods soon after birth, the exclusive breastfeeding rates were only 19%, 8%, 2% and 0% at ages 1, 2, 3 and 4 mo, respectively. Complementary foods and family foods were introduced at median ages of 2.5 and 6.3 mo, i.e. much earlier than recommended. Better adherence to recommendations was associated with smaller number of children in the family, increased maternal education and some other socio‐economic or environmental variables. Conclusion: Exclusive breastfeeding is uncommon and complementary foods were introduced early to newborns among these rural families. Education and family planning may improve adherence to infant feeding recommendations and reduce the incidence of early childhood malnutrition in Malawi.
Correlation between level of self‐regulation in the newborn infant and developmental status at two years of age
Authors: Lundqvist‐Persson C 
Published: August 2010

The purpose of this study was to investigate whether the level of self‐regulation in the newborn baby (a) predicts later cognitive and social development, (b) correlates to duration of breastfeeding and (c) has an impact on sleeping rhythm and the infant's autonomic behaviour. The study involved 38 full‐term infants of optimal health who were assessed at an age of 3 d using a screening instrument measuring neonatal self‐regulation, low, ordinary and high. The instrument, a conditional global scale, developed on the basis of the items in the Neonatal Behavioral Assessment Scale, identifies three levels of self‐regulation. Thirty‐six of the infants participated in a follow‐up study at 2 y of age, when they were tested with Griffiths' Mental Developmental Scales and one of the parents was interviewed about length of breastfeeding, sleeping habits and the infant's autonomic behaviour. The results showed that the level of self‐regulation was correlated to 3 out of 5 variables (Personal‐Social development, Hearing & Speech and Eye & Hand Coordination) in the Griffiths test. The results also indicated differences in sleeping rhythm as well as in breastfeeding patterns between the three groups. Furthermore, the study indicated gender‐based differences in the level of neonatal self‐regulation and confirmed previous findings of gender‐based differences in achieved developmental level at 2 y of age assessed with Griffths' Mental Developmental Scales.Conclusion: The findings in this study indicate that infants with a low level of self‐regulation are at risk for poorer social and cognitive development as well as regulatory disorders.
Enterobacter sakazakii infection in the newborn
Authors: Bar‐Oz B , Preminger A , Peleg O , Block C , Arad I 
Published: August 2010

Enterobacter sakazakii, a Gram‐negative bacillus, previously known as “yellow pigmented Enterobacter cloacae,” is a rare cause of neonatal infection. We describe the detailed clinical presentation of two cases in whom E. sakazakii was isolated in our neonatal service during the course of 1 mo. These include one case of sepsis and meningitis complicated by cerebral infarction, and one case of sepsis. In addition, three cases of intestinal colonization were identified. The source of the organism was thoroughly sought and was found to be a blender in the milk kitchen that was used for preparation of the reconstituted powdered milk formula. Conclusion: Our paper adds clinical and laboratory information about the disease spectrum caused by this relatively rare organism and emphasizes the importance of a thorough search for the source of the infection.
Role of natriuretic hormones in the diagnosis of patent ductus arteriosus in newborn infants
Authors: Pesonen E 
Published: August 2010

Haemodynamically significant patent ductus arteriosus worsens respiratory distress by initiating pulmonary congestion and inactivating of surfactant. Excepting size of the ductus, several factors influence ductal flow. Conclusion: Atrial natriuretic hormones provide clinically useful data, especially in serial follow‐up of the patient.
Parents' observations of sexual behaviour in pre‐school children
Authors: Lagerberg D 
Published: August 2010

This commentary on the Larsson and Svedin study of sexual behaviour in pre‐school children, published in the present issue of Acta Paediatrica (1), centres around three questions: 1. How can normal sexual behaviour in children be distinguished from problematic behaviour? 2. What characterizes the sexual development of the normal child? 3. Can knowledge about normal and problematic sexual behaviour be used to screen for sexual abuse or to confirm cases of sexual victimization? It is recommended that the inventory used by the authors be standardized on a representative sample of Swedish children, because this would enhance its usefulness in distinguishing normal from problematic behaviour. It is further recommended that research about sexual development in children be based on person‐oriented rather than on variable‐oriented analyses. It is finally argued that knowledge about normal and problematic sexual behaviour may not contribute to more effective screening or confirmation procedures in suspicions of sexual abuse. However, knowledge about normal sexual behaviour is valuable in studies of sexual behaviour in different categories of children, e.g. in the developmentally delayed or psychosocially deprived. Conclusion: By helping to identify problematic sexual behaviour in individual children, a standardized inventory could guide professionals in detecting possible psychological problems accompanying the behaviour.
Breast odour as the only maternal stimulus elicits crawling towards the odour source
Authors: Varendi H , Porter RH 
Published: August 2010

In previous studies, newborn infants placed on their mother's chest grasped a nipple and sucked without assistance. Furthermore, neonates sucked preferentially from an untreated breast rather than the alternative breast that had been washed to eliminate its natural odour. This study investigated the influence of breast odours per se on orientated physical movement of neonates. In total, 22 babies were observed during two trials on a warming bed. In one trial, a pad carrying the mother's breast odour was placed 17 cm in front of the baby's nose; in the other trial a clean pad was used. More babies moved towards and reached the breast pad than the clean pad. Conclusion: Natural breast odours unsupported by other maternal stimuli therefore appear to be sufficient to attract and guide neonates to the odour source.
Body mass index, triceps skinfold and waist circumference in screening for adiposity in male children and adolescents
Authors: Sarría A , Moreno LA , Garcí‐LIop LA , Fleta J , Morellón MP , Bueno M 
Published: August 2010

Simple anthropometric measurements and indices are the most commonly used tools for assessing body composition. Only a few papers have examined the sensitivity and specificity of the body mass index (BMI) against total body fat percentage (TBF%) from underwater weighing in children and adolescents. The objective of the study was to evaluate the screening performance of BMI, triceps skinfold thickness and waist circumference for excess TBF%. A total of 175 healthy volunteer males, aged 7.0–16.9 y, participated in the study. TBF% was measured using underwater weighing as the reference method. Receiver operating characteristic (ROC) curves were constructed to assess the value of the three anthropometric measurements as a screening measure for total adiposity. Sensitivity and specificity were calculated at several percentile cut‐offs for BMI, triceps skinfold and waist circumference. The areas under the ROC curves were also calculated, and were 0.86 for BMI, 0.90 for triceps skinfold and 0.88 for waist circumference. The point on the ROC curve closest to 1 corresponded to the 70th percentile for BMI, to the 75th percentile for triceps skinfold, and to the 70th percentile for waist circumference. Conclusion: BMI, triceps skinfold and waist circumference predicted total fat content well in male children and adolescents.
Current diagnosis, management and morbidity in paediatric inflammatory bowel disease
Authors: Spray C , Debelle GD , Murphy MS 
Published: August 2010

In the 1970s several reports highlighted the long delay in diagnosis often experienced by children with Crohn's disease. In recent years this disorder has attracted much publicity, and many believe that the incidence has increased substantially. The aim of this investigation was to determine whether heightened awareness had shortened the interval to diagnosis, improved clinical management and reduced morbidity. A retrospective study was therefore carried out on 112 children with inflammatory bowel disease (64 Crohn's disease, 41 ulcerative colitis, 7 indeterminate colitis) referred to a paediatric gastroenterology department in the UK between 1994 and 1998. In Crohn's disease the median interval to diagnosis was 47 wk (maximum 7 y). In those without diarrhoea this was longer (66 vs 28 wk; p= 0.005). In ulcerative colitis the median interval was 20 wk (maximum 3 y). Even in severe colitis the median interval was 5.5 wk (range 3–9 wk) and 4 required urgent colectomy soon after referral. Many with unrecognized Crohn's disease had undergone inappropriate treatments, such as growth hormone or psychiatric therapy. Nineteen (17%) had undergone endoscopic investigations in adult units prior to referral. Malnutrition was equally common in Crohn's disease and ulcerative colitis (11%). Short stature was present in 19% with Crohn's disease, and 5% with ulcerative colitis, and was severe in 8% with Crohn's disease. There was a significant correlation between symptom duration and the degree of growth impairment present (rs= 0.4; p= 0.004). Conclusion: This study suggests that late diagnosis and inappropriate investigation and management are still significant problems.
Rare alpha‐1‐antitrypsin phenotypes and liver‐test abnormalities during infancy
Authors: Pittschieler K 
Published: August 2010

Over 14 y of neonatal screening 71675 dried blood samples were examined for the alpha‐1‐antitrypsin (α1‐AT) alleles by isoelectric focusing in the Province of Bozen, Northern Italy. In infants carrying abnormal phenotypes the liver enzymes alanine aminotransferase and gamma‐glutamyltransferase were determined at 2, 5 and 12 mo of age. In 17 neonates the PiMV phenotype was found, in 11 PiMF, in 11 PiMP, in 5 PiMN, in 3 PiMR, in 3 PiFZ, in 2 PiPZ and in 1 the PiMG phenotype was found. Two infants, 1 carrying the PiMV and 1 the PiFZ phenotype showed at the age of 2 and 5 mo, respectively, elevated values of the liver enzyme S‐ALAT[CE1]. Only the PiFZ and PiPZ carriers displayed low enough levels of α1‐AT of 0.78 and 0.85 g 1‐1, respectively, to be at moderately increased risk of pulmonary emphysema. Their early detection through the screening should discourage them from dangerous smoking habits. Conclusion: Only a neonatal screening based on phenotyping can detect these rare carriers early in life.
Meconium passage in extremely low birthweight infants and its relation to very early enteral nutrition
Authors: Mihatsch WA , Franz AR , Lindner W , Pohlandt F 
Published: August 2010

The aim of this study was to evaluate the correlation between the timing of the first and last meconium and feeding tolerance in the very early enteral nutrition of extremely low birthweight (ELBW) infants. Forty‐one ELBW infants were fed following a standardized protocol (day 3–14). At 48 h of age bolus gavage feeding with milk was started (12 ml kg‐1 d‐1 increments, 12 meals per day). Gastric residuals up to 2 ml or up to 3 ml were tolerated in infants with a birthweight of ± 750 g or ± 750 g, respectively. No enemas or laxatives were given during the study. The impact of the time until the passage of the first (M‐1) and last (M‐last) meconium on the feeding volume on day 14 (V14) was evaluated by linear regression analysis. Data are presented as median (range). M‐1 was 31 h (0.5–77 h), M‐last was 6d (1.4–22 d) and V14 was 99 (0–156) ml kg‐1. V14 increased with decreasing M‐last (p < 0.001) but there was no correlation between V14 and M‐1. V14 was 112 (0–156) ml kg‐1 if M‐last was shorter than 6 d and 37 (0–147) ml kg‐1 if M‐last was longer than 6 d. Conclusion: Rapid meconium evacuation appeared to be a key factor for the feeding tolerance of ELBW infants during the first 14 d of life Further studies are needed to investigate whether meconium passage can be accelerated and whether acceleration of the meconium passage will improve the early feeding tolerance in ELBW infants.
Sexual behaviour in Swedish preschool children, as observed by their parents
Authors: Larsson I , Svedin C‐G 
Published: August 2010

Issues of what constitutes normal and healthy childhood sexual behaviour have acquired new implications in the light of child sexual abuse. Increased knowledge in this area is therefore of vital importance and studies in different countries are needed. In the present study parents of 231 children aged 3–6 y were asked to answer questionnaires about their child's behaviour at home. The questionnaire consisted of four sections: demographic data, a general behaviour checklist, a sexual behaviour inventory, and attitudinal questions to the parents. The results showed that children in Sweden exhibit a wide range of sexual behaviour, most of them developmentally related. Some behaviour appeared to be very rare in a normative sample of preschool children and included behaviours usually referred to as sexualized and problematic. Reports on sexual behaviour in the children were also related to general behaviour reports, the parent's socio‐economic level, parental attitudes towards child sexuality and the openness of family habits. Conclusion: There is a need for further national studies in different settings, to help create a better understanding of what constitutes both normative and deviant sexual behaviour in children.
Reactive thrombocytosis in children with upper urinary tract infections
Authors: Garoufi A , Voutsioti K , Tsapra H , Karpathios Th , Zeis PM 
Published: August 2010

The relationship between reactive thrombocytosis and the level of urinary tract infections was studied in 48 children. Platelets were counted before, during and after treatment. Reactive thrombocytosis was noticed in 74% of children with upper and in 14% with lower urinary tract infections. A significant rise in the platelet count presented in another five children (15%) with upper urinary tract infections. Conclusion: Reactive thrombocytosis was found almost exclusively in the renal parenchymal infections, usually during the recovery phase.
High proportions of n‐6 polyunsaturated fatty acids in mature milk of mothers in Ouagadougou, Burkina Faso
Authors: Rocquelin G , Kiffer J , Tapsoba S , Bouda C 
Published: August 2010

Milk from 101 mothers living in Ouagadougou (Burkina Faso) showed a mean lipid content of 33.42 g/l and a fatty acid composition strongly related to the mothers' dietary habits: high proportions of linoleic acid (19.80%), n‐6 long‐chain polyunsaturated fatty acids (1.90%), and 8:0– 14:0 saturated fatty acids (26.94%). Conclusion: The proportions of α‐linolenic acid (0.45%) and n‐3 long‐chain polyunsaturated fatty acids (0.44%) were low. The 18:2 /18:3 and n‐6/n‐3 long‐chain polyunsaturated fatty acids ratios (53:1 and 5:1, respectively) were well above recommendations.