bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of cytokines (interleukin‐1β, 6, 8, tumour necrosis factor‐α, and soluble receptor of interleukin‐2) and C‐reactive protein in the diagnosis of neonatal sepsis
Authors: Reyes C Santana , García‐Muñoz F , Reyes D , González G , Dominguez C , Domenech E 
Published: August 2010

Aim: To investigate whether the serum levels of interleukin‐1β, 6, 8, tumour necrosis factor‐α and the soluble receptor of IL‐2 are useful in the diagnosis of neonatal sepsis, and whether their diagnostic power is increased when in combination with classical markers such as C‐reactive protein and white blood cell count. Methods: Blood samples were collected at admission from 40 neonates with suspected infection. Patients were included in different groups according to the bacteriological and laboratory results: Group I consisted of 20 newborns with positive blood cultures and other biological tests suggestive of infection. Group II included 20 neonates with negative blood cultures and biological tests not suggestive of infection. The control group included 20 healthy neonates with no clinical or biological data of infection. Results: Mean values of C‐reactive protein were significantly higher in Group I. No differences were found between the groups for white blood cell count, with the exception of the presence of leucocytosis in Group II. Levels of interleukin‐1β, 6, 8, tumour necrosis factor‐α, soluble receptor of interleukin‐2, and C‐reactive protein were significantly higher in infected neonates than in the control groups. Detection sensitivity and specificity were 80 and 92% for C‐reactive protein, 60 and 87% for interleukin‐1β, 61 and 80% for interleukin‐6, 62 and 96% for interleukin‐8, 54 and 92% for tumour necrosis factor‐α and 63 and 94% for soluble receptor of interleukin‐2. The discriminant analysis showed that the best combination for sepsis diagnosis was C‐reactive protein + interleukin‐8 + soluble receptor of interleukin‐2, with a sensitivity of 85% and a specificity of 97.1%. Conclusion: Our study suggests that no individual test can on its own identify infected neonates, and that although the combination of C‐reactive protein, interleukin‐8 and the soluble receptor of interleukin‐2 exhibits a high specificity, its sensitivity is limited.
Prevalence and dimensions of sexual orientation in Swiss adolescents: a cross‐sectional survey of 16 to 20‐year‐old students
Authors: Narring F , Huwiler SM Stronski , Michaud P‐A 
Published: August 2010

Aim: Sexual orientation plays an important part in building identity during adolescence. The aim of this study was to describe patterns of sexual orientation, including sexual attraction, fantasies, affiliations and behaviour.Methods: The study was based on the analysis of data from computerized self‐administered questionnaires of a Swiss national survey on the sexual life of 16 to 20‐year‐old adolescents (n= 2075 girls and 2208 boys.).Results: Overall, 95.0% of girls and 96.2% of boys described themselves as predominantly heterosexual; 1.4% of girls and 1.7% of boys as predominantly homosexual or bisexual; and 2.8% of teenagers (girls: 3.6%; boys: 2.1%) were “unsure” of their sexual orientation. The reported prevalence of homosexual attraction (girls: 2.0%; boys: 2.9%) exceeded homosexual fantasies (girls: 0.4%; boys: 0.5%) and affiliations (girls: 0.3%; boys: 0.5%). Among the 4205 respondents, 31 girls (1.5% of girls) and 56 boys (2.5% of boys) reported sexual behaviour (experience or penetrative intercourse) with a person of the same sex. Among 1.5% of girls and 2.5% of boys who reported sexual behaviour with a person of the same sex, 65% of boys and 80% of girls nevertheless considered themselves as heterosexual.Conclusion: For a comprehensive understanding of sexual orientation in adolescence a differentiated look at dimensions of sexual orientation is indispensable. This applies to clinical settings, public health and research.
Urinary effects of morphine in preterm infants
Authors: Bengtsson B‐OS , Wootton‐Gorges SL , Poulain FR , Sherman MP 
Published: August 2010

Aim: To describe the association between morphine administration in preterm infants, hydronephrosis, and renal dysfunction. Methods: The findings were based on serial ultrasound examinations and blood studies. Results: Two preterm infants had bladder distension and hydronephrosis after they received intravenous morphine for analgesia. Morphine was used at a low dose. Each patient had a normal urine output and normal serum creatinine before the signs and symptoms of urinary retention were observed. Within 24 h of morphine administration, each infant concurrently developed oliguria and elevation of the serum creatinine. Cessation of morphine and urinary drainage resulted in rapid and complete resolution of the hydronephrosis and the elevated creatinine. Conclusion: Morphine, even at low dosages, can be associated with hydronephrosis in hospitalized preterm infants.
Lung lavage using high‐frequency jet ventilation in rabbits with meconium aspiration
Authors: Sevecova D , Calkovska A , Drgova A , Javorka M , Petraskova M , Javorka K 
Published: August 2010

Aim: To determine the efficacy of the expulsion effect of high‐frequency jet ventilation (HFJV) on meconium clearance from the airways in comparison with conventional suctioning in adult rabbits with meconium aspiration. Methods: Experiments were carried out on tracheotomized, anaesthetized and paralysed adult rabbits. A suspension of human meconium in saline (25mg ml−1, 4 ml kg−1) was instilled into the tracheal cannula. When respiratory failure developed, saline lavage (10ml kg−1 in 3 portions) was performed during conventional ventilation or by means of the inpulsion and expulsion regime of HFJV. Animals were further ventilated for 2 h with either conventional ventilation or HFJV. Results: There was no significant difference between groups in the amount of meconium recovered by lavage. Compared to conventional ventilation, the application of HFJV enhanced the elimination of carbon dioxide, increased lung compliance and diminished right‐to‐left shunts after 30 min of ventilatory treatment. Oxygenation also improved during HFJV, although this was not a consistent finding during the ventilation period. Conclusion: HFJV improved gas exchange, lung compliance and reduced right‐to‐left pulmonary shunts, but saline lung lavage by HFJV was not found to be more efficient than lavage during conventional ventilation in rabbits with meconium aspiration.
Skin‐to‐skin contact may reduce negative consequences of “the stress of being born”: a study on temperature in newborn infants, subjected to different ward routines in St. Petersburg
Authors: Bystrova K , Widström A‐M , Matthiesen A‐S , Ransjö‐Arvidson A‐B , Welles‐Nyström B , Wassberg C , Vorontsov I , Uvnäs‐Moberg K 
Published: August 2010

Aim: To evaluate how different delivery‐ward routines influence temperature in newborn infants. Methods: A total of 176 newborn mother‐infant pairs were included in a randomized study. The babies were kept skin‐to‐skin on the mother's chest (Skin‐to‐skin group), held in their mother's arms, being either swaddled or clothed (Mother's arms group), or kept in a cot in the nursery, being either swaddled or clothed (Nursery group). Temperature was measured in the axilla, on the thigh, back and foot at 15‐min intervals at from 30 to 120 min after birth. Results: During this time period the axilla, back and thigh temperatures rose significantly in all the treatment groups. The foot temperature displayed a significant fall in the babies in the Nursery group and this decrease was greatest in the swaddled babies. In contrast, foot temperature rose in the babies in the Mother's arms group and in particular in babies in the Skin‐to‐skin group. Foot temperature remained high in the Skin‐to‐skin group, whereas the low temperature observed in the Nursery group gradually increased and two days after birth the difference was no longer significant. Conclusion: The results show that delivery‐ward routines influence skin temperature in infants in the postnatal period. Allowing mother and baby the ward routine of skin‐to‐skin contact after birth may be a “natural way” of reversing stress‐related effects on circulation induced during labour.
Implementation of a nation‐wide automated auditory brainstem response hearing screening programme in neonatal intensive care units
Authors: van Straaten HLM , Hille ETM , Kok JH , Verkerk PH ,   the Dutch NICU Neonatal Hearing Screening Working Group
Published: August 2010

Aim: As part of a future national neonatal hearing screening programme in the Netherlands, automated auditory brainstem response (AABR) hearing screening was implemented in seven neonatal intensive care units (NICUs). The objective was to evaluate key outcomes of this programme: participation rate, first stage success rate, pass/referral rates, rescreening compliance, diagnostic referral rates, age of first diagnostic evaluation and prevalence of congenital hearing loss (CHL). Methods: This prospective cohort study collected data on 2513 survivors. NICU graduates with one or more risk factors according to the Joint Committee on Infant Hearing were included in a two‐stage AABR hearing screening programme. Conventional ABR was used to establish a diagnosis of CHL. Results: A total of 2513 newborns enrolled in the programme with a median gestational age of 31.6 (range 24–43) wk and a median birthweight of 1450 (range 510–4820) g. In 25 (1%) cases parents refused screening. Four out of 2513 newborns were initially lost; 2484 newborns have been tested initially. A final 98% participation rate (2465/2513) was obtained for the whole programme. After a median postmenstrual age at the first test of 33.7 (range 27–54) wk, a pass rate of 2284/2484 (92%) resulted at the first stage. The rescreening compliance after the first test was 92% (184/200). A referral rate for diagnostic ABR of 3.1% (77/2484) resulted. Of the 77 referrals 14 (18.2%) had normal screening thresholds, 15 (19.5%) had unilateral CHL and 48 (62.3%) had bilateral CHL. The prevalence of unilateral CHL was 0.6% (15/2484) and of bilateral CHL 1.9% (48/2484). Conclusion: A financially supported two‐stage AABR hearing screening programme can be successfully incorporated in NICU centres and detects a high prevalence of CHL in NICU graduates. Neonatal hearing screening should be part of standard clinical practice in all NICU infants.
In‐hospital mortality of newborn infants born before 33 weeks of gestation depends on the initial level of neonatal care: the EPIPAGE study
Authors: Empana JP , Subtil D , Truffert P 
Published: August 2010

Aim: To determine the relation between the level of initial neonatal care and in‐hospital mortality of infants born before 33 wk of gestation in the era of surfactant therapy. Methods: A 1 y prospective population‐based survey was conducted in the north of France, as part of the EPIPAGE (Epidemiologie des Petits Ages Gestationnels) survey. Perinatal data were recorded for 585 very premature newborns transferred to a neonatal intensive care unit in 1997. The relation between the level of the neonatal unit that provided care for the first consecutive 48 h and in‐hospital mortality was assessed by multivariate logistic regression, and adjusted for perinatal data and initial disease severity, estimated by the Clinical Risk Index for Babies (CRIB). Results: The average gestational age (mean ± SD) was 31.6 ± 0.62 wk in level I, 30.7 ± 0.21 in level II, 29.9 ± 0.13 in non‐teaching level III, and 29.0 ± 0.15 in the level III teaching unit (p < 0.0001). The mean in‐hospital mortality rate was 8.4% and did not differ by level of care (ptrend= 0.17). After adjustment for perinatal data and CRIB, however, with the teaching unit as the reference, the risk of death was significantly higher in level I–II units [adjusted odds ratio (ORa) = 7.9, 95% confidence interval (95% CI) 2.2–29.1], but not in the non‐teaching level III units (ORa = 0.8, 95% CI 0.3–2.1). Conclusion: In‐hospital mortality in non‐teaching level III units was similar to that in a teaching unit, but significantly higher in level I‐level II units. Neonatal care of newborns delivered before 33 wk of gestation should initially occur in level III units.
Gender differences in outcome after neonatal intensive care: speech and language skills are less influenced in boys than in girls at 6.5 years
Authors: Jennische M , Sedin G 
Published: August 2010

Aim: To study language development at age 6.5 y in 230 children who had required neonatal intensive care (NIC) and 71 full‐term neonatally healthy control children, all born in 1986–1989, with a focus on comparison between genders. Methods: Eight aspects of spontaneous speech, 3 fine motor functions, 10 linguistic areas, Peabody Picture Vocabulary Test, and digit recall (ITPA) were assessed. Results: Achievements for gender and gestational age groups were analysed (group I, 23–31 wk; subgroup IA, 23–27 wk; IB, 28–31 wk; group II, 32–36 wk; group III, >36 wk), with children with congenital malformations as a separate group. As a group, at 6.5 y NIC girls had more developed spontaneous speech than NIC boys, and performed better than NIC boys in some linguistic areas. NIC girls of group I had lower results than control girls in spontaneous speech aspects such as speech motor function, interaction and motivation, and in many areas of linguistic skills. In contrast, NIC boys of group I had higher results than control boys in auditory memory, and only regarding information and speech motor function in spontaneous speech were their results lower. Analysis of results of matched pairs of group I NIC girls versus control girls and group I NIC boys versus control boys revealed even more marked differences between NIC girls and their matched controls than between NIC boys and their matched controls. Conclusion: Language development in extremely or very preterm NIC boys seems to be less influenced than that in NIC girls by the need for and administration of NIC. The neonatal factors associated with low scores in girls are different from those in boys.
Strabismus in infants of opiate‐dependent mothers
Authors: Gill AC , Oei J , Lewis NL , Younan N , Kennedy I , Lui K 
Published: August 2010

Aim: At a follow‐up clinic for infants of opiate‐dependent mothers it was noted that more infants than expected developed strabismus. This study aimed to assess the prevalence of strabismus and the need for active strabismus surveillance in this population. Methods: Consecutive infants of opiate‐dependent mothers born over an 18 mo period were recalled for ophthalmological assessment by an ophthalmologist and orthoptist. Those unable to attend were surveyed by telephone using a questionnaire. Results: 49 (69%) of the 71 eligible infants were recalled at a mean age of 21 mo (range 6–39); 29 had a full ophthalmological examination and the remaining 20 completed the questionnaire only. Seven (14%) of the 49 recalled infants had strabismus on examination; 4 needed glasses or patching. A further seven (14%) had a history of intermittent strabismus but declined formal examination. Another child had significant hypermetropia without strabismus. The mean age at which strabismus was observed was 8.3 mo (range birth to 19 mo). The presence of strabismus was not significantly influenced by conditions at birth, maternal drug doses, family history or need for or duration of abstinence treatment. Conclusion: The rate of strabismus in infants of opiate‐dependent mothers was at least 10 times that in the general population. As attendance at follow‐up is often poor, paediatricians should be aware of the association to encourage opportunistic assessment and ophthalmological surveillance of this population.
Congenital rickets due to maternal vitamin D deficiency in a sunny island of Greece
Authors: Anatoliotaki M , Tsilimigaki A , Tsekoura Th , Schinaki A , Stefanaki S , Nikolaidou P 
Published: August 2010

A full‐term male infant presented with clinical and biochemical findings consistent with the diagnosis of congenital rickets: weak muscle tone, craniotabes, episodes of tremor, hypocalcaemia, elevated serum alkaline phosphatase, secondary hyperparathyroidism, decreased 25‐hydroxyvitamin D and normal 1,25‐dihydroxyvitamin D serum levels. The mother's history and biochemical findings suggested nutritional vitamin D deficiency. Treatment with calcium and vitamin D resulted in the disappearance of clinical findings of rickets, normalization of the baby's biochemical profile and normal growth. It is surprising that this case occurred in an affluent setting, in the Mediterranean island of Crete, with an abundance of sunlight throughout the year. Conclusion: We report this case in order to emphasize the continuing occurrence of congenital rickets even in populations not considered at risk for hypovitaminosis D. A high index of suspicion is required for prompt diagnosis and treatment, thus preventing complications.
Congenital tuberculous lymphadenitis in a preterm infant in Greece
Authors: Hatzistamatiou Z , Kaleyias J , Ikonomidou U , Papathoma E , Prifti E , Kostalos C 
Published: August 2010

Congenital tuberculosis is a rare disease. The risk of tuberculosis in pregnancy has increased owing to recent changes in the epidemiology of the disease, which have led to an increased risk of congenital tuberculosis. We present a case report on a 6‐d‐old premature infant with tuberculous lymphadenitis. Smears of the lymphatic tissue contained acid‐fast bacilli, and cultures were positive for Mycobacterium tuberculosis hominis. Polymerase chain reaction (PCR) assay of the suppurative material of the lymph node was positive for M. tuberculosis. Twenty days before onset of labour, the mother developed miliary tuberculosis and meningitis. Conclusion: The atypical clinical manifestations of congenital tuberculosis and the devastating consequences in the absence of early therapy signify the importance of early diagnosis and treatment during the neonatal period. PCR assay is a useful technique for prompt diagnosis in neonates with clinically suspected infection.
Intra‐rachidian disorders: two unusual cases of recurrent abdominal pain in children
Authors: Rebouissoux L , Ramirez del Villar S , Brun M , Fayon M , Lamireau T 
Published: August 2010

Recurrent abdominal pain (RAP) is generally thought to be of psychological origin but organic aetiologies are increasingly being identified. The cases of two children with vertebral disorders revealed by recurrent abdominal pain are reported. A 14‐y‐old girl presented with RAP associated with scoliosis, due to a T8‐T9 intra‐dural extra‐medullary tumour. A 7‐y‐old girl who suffered from nocturnal RAP located in the right iliac fossa for 1 y had decreased muscular strength, pyramidal signs, and a 10° Lassègue sign in the right lower limb, revealing a vascular malformation extending from T12 to L2. Conclusion: Atypical pain and associated neurological signs or scoliosis must raise the possibility of intra‐rachidian disorders. Magnetic resonance examination will then precisely state the location and nature of the pathological process, avoiding excessive delay in therapeutic management.
Acute inflammatory demyelinating polyradiculoneuropathy associated with perforin‐deficient familial haemophagocytic lymphohistiocytosis
Authors: Del Giudice E , Savoldi G , Notarangelo LD , Di Benedetto L , Manganelli F , Bruzzese E , Romano A , Santoro L 
Published: August 2010

This study reports the first paediatric case of acute inflammatory demyelinating polyradiculoneuropathy (AIDP) associated with a fatal haemophagocytic lymphohistiocytosis (HLH). The patient developed progressive weakness of the lower limbs in the context of a picture of infectious mononucleosis and Epstein‐Barr virus (EBV) infection. After an apparent improvement, a fulminant hepatic failure and pancytopenia ensued, leading to death. Molecular genetic studies documented a compound heterozygosity for two mutations in the perforin (PRF1) gene as the background defect for a familial haemophagocytic lymphohistiocytosis (FHL). Conclusion: In this patient EBV infection triggered both AIDP and FHL. The latter condition was due to PRF1 deficiency. Two novel mutations in the PRF1 gene were concomitantly present in the patient. The first caused an amino acid change, while the second introduced a stop codon in the sequence which resulted in a truncated protein.
Low back pain in Flemish adolescents and the role of perceived social support and effect on the perception of back pain
Authors: Staes F , Stappaerts K , Lesaffre E , Vertommen H 
Published: August 2010

Aim: To document the prevalence of low back pain (LBP) in Flemish adolescents and to recognize the association between perceived social support and affect and medical consultation and reduction of activities. Methods: The study comprised 620 adolescents. A questionnaire was used to elicit the characteristics of LBP. Perceived social support and affect were investigated using the Personal Resource Questionnaire (PRQ) and the Positive Affect Negative Affect Scale (PANAS), respectively. Comparisons were made between adolescents with LBP and adolescents without LBP. Within the LBP group, answers from adolescents appealing for medical advice were compared with those who did not seek advice. Another comparison was done between adolescents who reduced their activities and those who did not. Descriptive statistics, the median test for two samples, a ‐χ2 test or Fisher's exact probability test and logistic regression analysis were used for data analysis. Results: Month prevalence of LBP was 24.7%. Thirteen adolescents visited a physician or received treatment, pain severity being the sole factor associated with the decision. Fifteen adolescents reduced their sports activities and 11 reduced or stopped other leisure activities. Pain severity and negative affect were the main associated factors. Conclusion: The results of the present study encourage further research on the role of pain perception and the influence of psychosocial factors on back pain in adolescents.