bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of invasive childhood pneumococcal infections in Greece
Authors: Syriopoulou V , Daikos GL , Soulis K , Michos A , Alexandrou H , Pavlopoulou I , Pagali A , Hadjichristodoulou C , Theodoridou M 
Published: August 2010

A retrospective study was conducted to identify the epidemiologic characteristics of invasive pneumococcal infections among children <14y of age in our geographic region. During a 5‐y period, from 1995 to 1999, 590 cases of invasive pneumococcal infection were identified in Aghia Sophia Children's Hospital, Athens, Greece. The male to female ratio was 1.4:1 and 64% of patients were younger than 5 y of age. The overall annual incidence rate was estimated as 44/ 100000 children <14y of age, whereas the incidence rate for children <5y of age was 100/ 100000. The most common types of infections were pneumonia (472 cases; 133 definite and 339 probable), bacteraemia without focus (79 cases), and meningitis (33 cases). A seasonal variation of invasive pneumococcal infections was noted, with two peaks‐one during spring and the other during autumn. Only two cases with meningitis died and one developed permanent neurological sequelae, representing a case‐fatality rate for meningitis of 6%. Serogroups 14, 19, 6, 18, 23, 4 and 9 were the most prevalent, comprising 77% of 92 serotyped isolates. Conclusion: Invasive pneumococcal infections cause considerable morbidity in the paediatric population in the Athens metropolitan area. Sixty‐six percent of the serotypes causing invasive pneumococcal disease in our region are included in the 7‐valent conjugate vaccine.
Streptococcus pneumoniae in children in Spain: 1990–1999
Authors: Fenoll A , Jado I , Vicioso D , Berrón S , Yuste JE , Casal J 
Published: August 2010

This study analyses the serogroups/types (SGTs) and resistance to penicillin and erythromycin of 3921 strains isolated from 1990 to 1999 in children aged 0–14 y in Spanish hospitals of all the autonomous communities. Based on the age of the children, strains have been divided into five groups: 0–6 mo, <6–1 y, <1–2y, <2–5 y and 5 y. While only eight SGTs were responsible for 80% of the infections in children from 6 mo to 2 y of age, this number increased to 11 and 16 for the groups 2–5 y and <5–14 y, respectively. SGTs 6, 14 and 19 were prevalent in blood and otic exudates. SGTs 1, 4, 5, 12 and 18 were more frequent in invasive disease but serotype 3 was clearly associated with otitis. Serotypes 1 and 5 were quite significant in children of over 2 y of age, and this should be taken into account in future vaccine formulations. Conclusion: Although high, the rate of penicillin resistance in the paediatric population has remained stable in recent years. Conversely, erythromycin resistance is still increasing in our country. Coverage by the 7‐valent vaccine was 78 and 81% for blood and otic isolates, respectively. These coverage levels would be increased by 9% and 3% if 9‐valent (plus 1 + 5 serotypes) were used and by an additional 2.6% and 7.6% using the 11‐valent (plus 3 + 7) formulation.
A study of breathing pattern and ventilation in newborn infants and adult subjects
Authors: Al‐Hathlol K , Idiong N , Hussain A , Kwiatkowski K , Alvaro RE , Weintraub Z , Cates DB , Rigatto H 
Published: August 2010

Experimentally modified breathing pattern in human subjects, by varying the inspired gas mixture or administering different neuromodulators, has been studied extensively in the past, yet unmodified breathing has not. Moreover, most data refer to infants during sleep and adults during wakefulness. We studied the baseline breathing pattern of preterm infants [n= 10; GA 30 (27–34) wk (median, range)]; term infants [n= 10; GA 40 (39–41) wk)], and adult subjects [n= 10; age 31 (17–48) y)] during quiet sleep. A flow‐through system was used to measure ventilation. We found: (i) instantaneous ventilation was 0.273 ± 0.006, 0.200 ± 0.003, and 0.135 ± 0.002 Lmin‐1.kg‐1 in preterm, term infants, and adult subjects; the coefficients of variation were 39%, 25%, and 14% (p <0.01). The greater coefficient of variation in neonates compared to adults related to increased variability in Vt (39% and 25% in preterm and term infants vs 14% in adults; p < 0.01) and f (39% and 22% vs 9%; p < 0.01). The major determinant of frequency in preterm infants was Te (81% variability), Ti varying less (25% variability); (ii) VT/Ti decreased and Ti/Ttot increased with age; (iii) the higher breath‐to‐breath variability in preterm infants was associated with larger changes in alveolar PCO2 and a larger variability in O2 saturation than later in life.We conclude: (i) the high breath‐to‐breath variability in frequency in preterm infants closely relates to variation in Te; (ii) decreased effective inspiratory timing (Ti/Ttot) in preterm infants compared with adults likely reflects their high pulmonary impedance; and (iii) greater breath‐to‐breath variability in ventilation in neonates with large variations in alveolar PCO2 and O2 saturation remains when compared with values in the sleeping adult. We speculate that high variability in Te early in life represents an effort to maintain lung volume through increased post‐inspiratory diaphragmatic activity and increased upper airway resistance in an attempt to avoid collapse due to poor chest wall recoil.
A multicenter collaborative study on the risk factors of cardiac sequelae due to Kawasaki disease: a one‐year follow‐up study
Authors: Oki I , Tanihara S , Ojima T , Nakamura Y , Yanagawa H 
Published: August 2010

Objective: To measure the prevalence of cardiac sequelae 1 y after the onset of Kawasaki disease and determine the risk factors associated with these cardiac sequelae. Material and methods: 1594 patients who initially visited one of the 87 target hospitals in 1996 for Kawasaki disease participated. Selection of the target hospitals was based on a nationwide survey. The patients were followed‐up and information concerning cardiac sequelae occurring within 1 y of onset was obtained by mail survey. Results: The prevalence of cardiac sequelae 1 mo after onset was 10.2% and decreased to 4.2% in 1 y. The prevalence was higher among males than females and higher in patients less than 1 y and 5 ys or older than in 1–4 year‐olds. Of the patients with cardiac sequelae at 1 mo, the sequelae disappeared in 60.7% after 1 y. Analysis revealed low serum albumin as a risk factor related to the occurrence of cardiac sequelae 1 y after onset. Of the 1594 patients, 10 had giant anuerysms and 3 had a fatal outcome. Conclusions: Approximately 60% of cardiac sequelae due to Kawasaki disease that developed within 1 mo after onset disappeared in 1 y. The odds ratio was significantly higher among patients with a low serum albumin level 1 y after onset.
Insulin‐like growth factor binding protein‐3 proteolysis and growth of athyreotic infants in the first weeks of life
Authors: Zamboni G , Antoniazzi F , Tatò L 
Published: August 2010

To gain a better understanding of the growth of athyreotic newborns in the first weeks of life, we evaluated auxological parameters and determined the serum levels of growth hormone (GH), insulin‐like growth factor I (IGF‐I) and free IGF‐I, and IGF‐binding protein‐3 (IGFBP‐3) in 15 hypothyroid infants (10 females) at a mean age of 25 d of life, immediately before the beginning of L‐thyroxine therapy, and at 3 and 6 mo of life. Fourteen normal infants (9 females) of the same age were studied as controls. IGFBP‐3 proteolytic activity was evaluated in 8 patients and in 8 controls at 25 d and 6 mo of life. There was no significant difference concerning weight and length between the patients and controls at birth, 25 d, 3 and 6 mo of life. The blood GH, IGF‐I and IGFBP‐3 levels were significantly lower in patients at diagnosis than in controls of the same age (p < 0.01 for all parameters), as well as IGFBP‐3 studied by Western blotting. At diagnosis, the patients’free IGF‐I level was within the control range, but the free IGF‐I percentage of total IGF‐I was higher than in the controls (p, < 0.01). IGFBP‐3 proteolytic activity was found to be greater in the patients (p < 0.01). At 6 mo of life, after therapy, none of these parameters was different from those of the controls. Conclusion: Increased IGFBP‐3 proteolytic activity in our patients at diagnosis, favouring IGF‐I bioavailability, could account for normal free IGF‐I levels and in turn for their normal growth pattern during the first weeks of life and before the start of treatment.
Anti‐endotoxin antibodies in human milk: correlation with infection of the newborn
Authors: Feist N , Berger D , Speer CP 
Published: August 2010

A longitudinal study was performed to investigate the content of human colostrum and milk of antibodies against endotoxins of Escherichia coli, Pseudomonas aeruginosa and Salmonella minnesota during the first 6 mo of lactation. The influence of the gestational age of the newborn and the prevalence of a systemic infection in the child on maternal antibody production were observed. Colostrum of mothers of term infants who had shown signs of systemic infection contained higher antibody concentrations compared to colostrum of mothers of healthy newborns. After the first week post partum, no difference in the milk's antibody content could be observed between these two groups. Antibody titres rose from 2 wk to 6 mo post partum (p < 0.001). Milk of mothers of preterm infants with signs of systemic infection contained higher antibody titres than milk of mothers of preterm infants without infection throughout the observation period. This difference reached statistical significance 3 wk after delivery (p < 0.05). The corrected endotoxin antibody levels against all tested antigens in milk of mothers of preterm infants with infection 6 mo post partum were 6 ± 3.5 times as high as 2 wk post partum. Conclusions: Breast milk contains anti‐endotoxin antibodies. The particularly high levels of anti‐endotoxin antibodies in cases of neonatal infection may present a special maternal protection for premature infants.
Serum cortisol concentrations in ill preterm infants less than 30 weeks gestational age
Authors: Heckmann M , Wudy SA , Haack D , Pohlandt F 
Published: August 2010

Adrenal insufficiency is suspected in some ill preterm infants. The aim of this prospective study was to compare serum cortisol concentrations during the first 2 wk of life of well preterm infants (group A) less than 30 wk of gestational age with the cortisol concentrations of ill preterm infants whose arterial hypotension—a potential sign of adrenal insufficiency—had been treated with catecholamine (group B), and the cortisol concentrations of ill preterm infants who had not been so treated (group C). Cortisol concentrations did not differ significantly between group A (240 nmol/l, 58–659; n= 46) (median, minimum‐maximum) and group C (268 nmo/l, 58–1007; n= 25). Group B had a double‐peaked distribution of cortisol. Two subgroups were formed by taking the highest cortisol level of group A as a threshold: group B1 (110 nmol/1, 41–378; n= 20) and group B2 (1200 nmol/l, 764–1482; n = 8). The cortisol concentrations of group B1 were significantly lower (p= 0.00097) compared to the cortisol concentrations of the well preterm infants (group A). The seventy of illness, which was quantified by two scoring systems, differed significantly among the groups (p < 0.003 for all comparisons) with the following sequence: A < C < B, but not between B1 and B2, as clinical variables were not different between the subgroups.In conclusion, when clinical signs of adrenal insufficiency, such as severe arterial hypotension, were not found in ill preterm infants, serum cortisol concentrations were not different from those of well preterm infants. Seventy‐one percent of preterm infants with catecholamine‐treated arterial hypotension had significantly lower cortisol concentrations, which may reflect adrenal insufficiency, but no differences in the seventy of illness were found between infants with high and low cortisol levels.
Mucosal pathology of the foregut associated with food allergy and recurrent abdominal pains in children
Authors: Kokkonen J , Ruuska T , Karttunen TJ , Niinimäki A 
Published: August 2010

To determine whether children with recurrent abdominal pain (RAP) include an excess of children with food allergy (FA), this study examined a consecutive series of 84 children (43M, 41F, mean age 7.9 y, range 1.6–15 y) referred during 1 y to 2 university hospitals. In addition to a clinical examination, the patients underwent gastroduodenoscopy with three biopsy specimens, skin‐prick and patch tests, and comprehensive laboratory tests for atopic allergy. Based on an open elimination‐challenge test, a total of 28 (33%) subjects were diagnosed for FA. In the whole material, specific endoscopic abnormalities were found in 38 (45%) subjects: oesophagitis in 17, gastric erosions in 8, lymphonodular duodenitis in 12 and erosive duodenitis in 5. FA showed a close relationship with duodenal lesions, but no significant association with oesophagitis and gastritis. The histological findings were mild, although some alterations could be observed in up to 66 (79%) subjects, equally often in patients with and without FA. None showed villous atrophy or severe infiltration of eosinophilic or mononuclear cells. Slightly increased densities of eosinophilic cells were significantly associated with endoscopic findings, especially oesophagitis. At least one positive skin‐prick test with food allergens was found in 11 subjects and a positive patch test in 21 subjects, but neither showed an association with the endoscopic or histological findings, or even with clinical FA.Conclusion:Since the children with FA showed significantly more often concomitant mucosal pathology of the foregut than those without FA, FA may be considered one of the major factors underlying RAP. The report suggests the trial of an elimination diet in cases with RAP if lymphonodular hyperplasia or duodenitis is seen on gastroduodenoscopy.
Maternal cannabis use in the sudden death syndrome
Authors: Scragg RKR , Mitchell EA , Ford RPK , Thompson JMD , Taylor BJ , Stewart AW 
Published: August 2010

The smoking of cannabis and tobacco is common in many countries. In contrast to tobacco, which is an established risk factor for the sudden infant death syndrome (SIDS), nothing is known about cannabis and its effects on SIDS risk. We analysed data collected in a nation‐wide case control study in New Zealand (393 cases, 1592 controls) to determine if there is any association between maternal cannabis use and SIDS risk. Adjusting for ethnicity and maternal tobacco use, the SIDS odds ratio for > weekly maternal cannabis use since the infant's birth was 2.23 (95% CI = 1.39, 3.57) comparedto non‐users; and the multivariate odds ratio was 1.55 (95% CI = 0.87, 2.75).We conclude that frequent maternal cannabis use may be a weak risk factor for SIDS, but this finding requires further research.
Intra‐amniotic endotoxin accelerates lung maturation in fetal rabbits
Authors: Bry Kristina , Lappalainen Urpo 
Published: August 2010

The hypothesis that endotoxin in amniotic fluid accelerates fetal lung maturation was tested. On day 25 of gestation, LPS (5 μg/fetus) was injected intra‐amniotically into one uterine horn of eight New Zealand white rabbits, whereas the contralateral amniotic sacs were injected with saline vehicle. The fetuses were delivered 48 h after LPS administration and their lungs were studied. One dam went into premature labor prior to the 48 h time point and was excluded from the study. Mean white cell counts in amniotic fluid and bronchoalveolar lavage fluid from LPS‐treated fetuses were increased 3.2‐fold (p= 0.04) and 9.9‐fold (p= 0.04), respectively. Fetal weights and lung weights were not affected by LPS. Surfactant protein SP‐A and SP‐B mRNA expressions in LPS‐treated fetuses were increased 2.3‐fold (p= 0.03) and 1.4‐fold (p= 0.04), respectively. Static lung compliance was increased in animals treated with LPS (p= 0.001). Lungs from LPS‐treated animals had better aeration than those of controls. Mean volume of inflation‐fixed lungs of LPS‐treated fetuses was 1.7 times greater than that of controls (p= 0.03). Conclusion: Intra‐uterine exposure to LPS increases surfactant protein expression and improves lung stability and aeration in preterm animals.
Aetiological factors in neonatal cholestasis
Authors: Fischler B , Papadogiannakis N , Nemeth A 
Published: August 2010

The aim of the study was to investigate factors of possible importance for the aetiology of neonatal cholestasis. The medical records of 85 cholestatic infants were retrospectively reviewed. The most common diagnoses were extrahepatic biliary atresia (n= 30 patients), α1‐antitrypsin deficiency (n= 11) and progressive familial intrahepatic cholestasis (n= 11). The mothers of the patients with biliary atresia had a higher mean age and were more commonly treated for gestational diabetes than the mothers of patients with intrahepatic neonatal cholestasis. The morbidity and mortality in the siblings of patients with biliary atresia were also greater than expected. There was a seasonal variation of the birth months in the biliary atresia group, possibly indicating an association to viral infections. Signs of ongoing cytomegalovirus infection were more common in both the extrahepatic and the intrahepatic group. Conclusions: Progressive familial intrahepatic cholestasis may be a more common cause of neonatal cholestasis in Sweden than reported elsewhere. A maternal vulnerability, of genetic or other origin, is suggested in the aetiology of biliary atresia. The true pathogenetic importance of cytomegalovirus infection in patients with neonatal cholestasis of different origins remains to be established.
Importance of insulin content in infant diet: suggestion for a new infant formula
Authors: Shehadeh N , Gelertner L , Blazer S , Perlman R , Solovachik L , Etzioni A 
Published: August 2010

Oral insulin promotes intestinal maturation and may prevent diabetes in animal models. The aim of this study was to evaluate the concentration of insulin in human milk and in different infant formulas. Our results show that the concentration of insulin in human milk is significantly higher (60.23 ± 41.05 μU/ml mean ± SD) compared with cow's milk (16.32 + 5.98 μU/ml mean ± SD) and that insulin is hardly detectable in infant formulas.We propose the addition of human insulin to infant formula to match its composition more closely to human milk.
Hydrolysed protein accelerates the gastrointestinal transport of formula in preterm infants
Authors: Mihatsch WA , Högel J , Pohlandt F 
Published: August 2010

Vomiting, large gastric residuals and abdominal distension are common in very immature infants on formula feeding. The present trial investigated whether a protein hydrolysate formula reduces the gastrointestinal transit time in preterm infants. Fifteen preterm infants (median gestational age 29 (24–32) wk, birthweight 1241 (660–1900) g, postnatal age 18 (5–54) d) on full enteral feeds (>150 ml/kg*d) were enrolled. It was hypothesized that the gastrointestinal transit time is at least 2 h shorter when protein hydrolysate formula is fed compared with standard preterm formula. In a randomized cross‐over design study, each formula was fed for 5 d. On days 4 and 9 the gastrointestinal transit time was estimated using carmine red. The protein hydrolysate formula had a markedly shorter gastrointestinal transit time (9.8 h) than the standard formula (19 h) (p= 0.0022, two‐sided Mann‐Whitney U test). Conclusion: The hydrolysate protein formula accelerated gastrointestinal transit of milk and stools, but whether hydrolysate formulas enable a more rapid establishment of full enteral feeding in preterm infants needs to be investigated.
Limiting light‐induced lipid peroxidation and vitamin loss in infant parenteral nutrition by adding multivitamin preparations to Intralipid
Authors: Silvers KM , Sluis KB , Darlow BA , McGill F , Stocker R , Winterbourn CC 
Published: August 2010

Parenteral lipids are susceptible to light‐induced peroxidation, particularly under phototherapy. Ascorbic acid is protective. The aim of this study was to investigate whether dark delivery tubing and/or coadministration of multivitamin preparations could prevent peroxidation of Intralipid without undue vitamin loss. In experiments carried out on the benchtop, lipid peroxidation occurred in ambient light and was more extensive under phototherapy. Dark tubing decreased peroxide formation, but only by about 65%. In simulated clinical conditions in which solutions were pumped through standard clear or dark minibore plastic tubing, Intralipid accumulated lipid peroxides as measured by the FOX assay (280 μM) or as triglyceride hydroperoxides (52 μM). Multivitamin preparations (MVIP or Soluvit/Vitlipid) inhibited peroxide formation almost completely, and were fully protective when used with dark tubing. There was loss of riboflavin (65% from Soluvit and 35% from MVIP) in clear tubing but this was decreased to 18% and 11%, respectively, in dark tubing. Ascorbate loss was 20% (MVIP) and 50% (Soluvit) and only slightly less in dark tubing. Ascorbate loss was also seen in the absence of Intralipid and is due to riboflavin‐induced photo‐oxidation. Conclusion: Multivitamin preparations protect Intralipid against light‐induced formation of lipid hydroperoxides, and administering multivitamins with Intralipid via dark delivery tubing provides a practical way of preventing peroxidation of the lipid while limiting vitamin loss. This procedure should be considered for routine use as well as with phototherapy.
The balance of the autonomic nervous system is normal in colicky infants
Authors: Kirjavainen J , Jahnukainen T , Huhtala V , Lehtonen L , Kirjavainen T , Korvenranta H , Mikola H 
Published: August 2010

Excessively crying, hard‐to‐soothe infants are described as colicky. The self‐limiting course of infantile colic during early infancy suggests an etiology of transient developmental dysmaturation. It has been proposed that emotional characteristics such as temperament and self‐soothing ability are correlated with the balance of the autonomic nervous system. Heart rate variability (HRV) analysis was used for evaluating the balance of the autonomic nervous system in colicky and control infants during and after the colicky period. HRV analysis was carried out on 12 colicky infants and 14 control infants at the age of 2 mo, and repeated on 10 colicky and 11 normal infants at the age of 7 mo. Measurements were performed during polygraphically confirmed slow‐wave sleep (sleep stages 3 and 4). Three HRV frequency bands were defined, including a high (0.2–1.0 Hz), middle (0.12–0.2 Hz) and low (0.025–0.12 Hz) frequency variability. There were no differences between the study groups in any of the three HRV frequency bands analyzed. The high frequency variability increased significantly with age in both study groups (p= 0.009). Conclusion: The findings suggest that imbalance between the parasympathetic and the sympathetic nervous system is not associated with infantile colic and that, in accordance with previous findings, control of HRV shifts in a parasympathetic direction with increasing age during the first year of life.
Antenatal magnesium sulphate exposure is associated with prolonged parathyroid hormone suppression in preterm neonates
Authors: Rantonen T , Kääpä P , Jalonen J , Ekblad U , Peltola O , Välimäki I , Kero P 
Published: August 2010

The effects of maternal magnesium sulphate treatment on neonatal mineral status and parathyroid hormone secretory response were studied in 8 exposed and 27 control preterm infants during the first 2 wk of life. Antenatal magnesium sulphate resulted in hypermagnesaemia during the first 3–7 d of life without affecting other serum mineral concentrations. Conclusion: Early hypermagnesaemia was associated with hypercalciuria during the first 3 d and parathyroid hormone suppression up to the age of 2 wk in the exposed infants.