bluuebunny/crossref_metadata_2025_split huggingface dataset:
High prevalence of stress hyperglycaemia in children with febrile seizures and traumatic injuries
Authors: Valerio G , Franzese A , Carlin E , Pecile P , Perini R , Tenore A. 
Published: August 2010

Although hyperglycaemia is relatively frequent in the course of severe illnesses and may be looked upon as the possible result of an uncoordinated insulin response to the increased glucose that the body may need during periods of stress, it is generally agreed that it does not constitute a prediabetic condition. Numerous studies have aimed to explain the pathophysiology of this occurrence but none has looked at which conditions are more prone to develop stress hyperglycaemia (SH). Therefore, the aim of this study was to evaluate the main clinical conditions that may be associated with SH in children. A total of 1199 children was studied: 833 children (439 M, 394 F, mean age 5.2 ± 4.5 y) admitted for an acute illness or injury constituted the stress‐exposed group, while 366 children (222 M, 144 F, mean age 6.2 ± 4.6 y) admitted for elective minor surgery represented the stress‐unexposed group and were considered as the control group. SH was defined as plasma glucose concentrations ≥8.3 mmol I−1 during an acute illness. Stress‐exposed patients had significantly higher glycaemic levels than controls (5.6 ≥1.4 vs 4.7 ≤0.7 mmol I−1; p < 0.0001). SH was found in 41 (4.9%) stress‐exposed patients and in none of the controls. SH was significantly more prevalent in children affected by febrile seizures (12.9%) or traumatic injuries (11.7%; p < 0.008 and p < 0.02, respectively, vs other diagnoses). A significant correlation was found between glycaemia and systolic pressure (r=0.1; p < 0.01), white cell count (r= 0.12; p < 0.0003) and body temperature (r= 0.16; p < 0.0001). SH was more frequent in patients with body temperature >39°C (14%) than in those with a temperature <39°C (4%; p < 0.0008). SH was more prevalent in clinical conditions of fever associated with seizures or pain (12.9% and 12.5%, respectively) than fever alone (4.4%). After a mean period of 3.5 ± 0.6 y of follow‐up none of the hyperglycaemic patients had developed diabetes mellitus. Conclusion: Traumatic injuries, febrile seizures or conditions in which an elevated body temperature may be found are frequently associated with SH in children. In the presence of these conditions specific studies directed towards unmasking a prediabetic state may be unnecessary.
Association between urinary tract infection, renal damage and birth size
Authors: Hellström M , Hessel H , Jacobsson B , Jodal U , Niklasson A , Wennerström M , Hellström A 
Published: August 2010

The aim of this study was to investigate whether birth size is associated with permanent renal damage in children with urinary tract infection (UTI). A cohort of 1221 children under 16 y of age was diagnosed with their first symptomatic UTI between 1970 and 1979. Of these, 74 had urographic renal scarring in childhood and 57 were re‐examined as adults. The birth files of 48 of these patients (35F, 13M) were available, and birthweight and birthlength in relation to gestational age were analysed and compared with a Swedish reference population. Children who had renal damage without vesicoureteric reflux were significantly smaller at birth (median weight, ‐0.76 SDS) compared with both children who had renal damage and reflux (median weight, ‐0.01 SDS) and the reference population. Conclusion: The demonstration of low birthweight among children with UTI and renal damage but no reflux suggests that low birthweight may be a risk factor for the development of renal damage.
Do normal leucocyte count and C‐reactive protein value exclude acute appendicitis in children?
Authors: Grönroos JM 
Published: August 2010

The present study aimed to determine the role of leucocyte count and C‐reactive protein (CRP) measurements in the diagnosis of acute appendicitis in children. In particular, children with acute appendicitis but normal leucocyte count and CRP level were sought. The present study protocol was identical to those used in earlier studies on adult patients with suspected acute appendicitis. The mean preoperative leucocyte count and CRP value in 100 consecutive children with an uninflamed appendix at appendicectomy (group A) and in 100 consecutive patients with acute appendicitis (group B) were calculated. The numbers of patients with (i) both values normal, (ii) only leucocyte count raised, (iii) only CRP level raised, and (iv) both values raised were calculated in both groups A and B. Leucocyte count effectively (p < 0.001) separated children with uninflamed appendix (mean ± SEM 10.2 ± 0.4 ± 109 1−1) from those with acute appendicitis (15.0 ± 0.4 ± 109 1−1), but the CRP value was of no use in this respect (p= 0.866; 31 ± 4mg 1−1 and 30 ± 4mg 1−1). The most conspicuous finding was that in children with acute appendicitis, both values were normal in 7 out of 100 patients. Conclusion: Contrary to adult patients, normal leucocyte count and CRP value do not effectively exclude acute appendicitis in children.
Early oral behaviour in preterm infants during breastfeeding: an electromyographic study
Authors: Nyqvist K Hedberg , Färnstrand C , Eeg‐Olofsson K Edebol , Ewald U 
Published: August 2010

The objectives were to increase the understanding of the characteristics of oral behaviour during breastfeeding in preterm infants and to validate direct observations of infant sucking. Twenty‐six infants were investigated once by simultaneous observation and surface electromyography (EMG) at 32.1–37.1 postmenstrual weeks. The orbicularis oris muscle was used for data analysis, as it provided the most distinct registrations. High correlation coefficients were observed with respect to classifications of EMG data by two raters on the number of sucks per burst (r= 0.97) and duration of sucking bursts (r= 0.99). The agreement between direct observations of sucking and EMG data was high. The median for mean number of sucks per burst was 8 (range 2–33) and for longest burst 28 (5–96) sucks. Sucks with low and very high intensity constituted a median of 14 (1–94)% and 25 (0–87)% of all sucks. The range in mean sucking frequency was 1.0–1.8 sucks s‐1. Suck duration ranged from 0.6 to 1.1 s. There was a considerable variation between infants in the extent of mouthing. No association with maturational level appeared for any of the components in oral behaviour. Conclusion: EMG data provided evidence of early sucking competence in preterm infants during breastfeeding, with wide individual variations. Surface EMG and direct observation are recommended as valid methods in the evaluation of breastfeeding behaviour in preterm infants.
Lower limb and back pain in Guillain‐Barré syndrome and associated contrast enhancement in MRI of the cauda equina
Authors: Wilmshurst JM , Thomas NH , Robinson RO , Bingham JB , Pohl KRE 
Published: August 2010

This study assesses the frequency of lower limb and back pain in children with Guillain‐Barré syndrome and reviews the magnetic resonance imaging results of those undergoing spinal imaging. Over an 8‐y period, nine children presented with various combinations of severe back pain, leg pains, impairment of gait and bladder dysfunction. Guillain‐Barré syndrome was confirmed on clinical examination and peripheral electrophysiology (n= 8). Magnetic resonance imaging in four patients, following contrast injection, showed enhancement of the cauda equine and, additionally, of the cervical nerve roots in one of the patients. A further patient, who was not scanned with contrast, had abnormal thickening of the lumbar roots. Carbamazepine and steroids were effectively used for analgesia in three cases. All the patients recovered. Conclusion: Guillain‐Barré syndrome should be considered in the differential diagnosis of children presenting with back and/or leg pain. Early diagnosis ensures prompt monitoring for autonomic dysfunction and respiratory compromise.
Acid steatocrit: a reliable screening tool for steatorrhea
Authors: Van den Neucker AM , Kerkvliet EM , Theunissen PMVM , Forget P‐Ph 
Published: August 2010

This study compared the acid steatocrit (AS) results of healthy children with those of sick children with and without gastrointestinal involvement. Stool samples of 166 children were investigated, comprising 50 healthy children, 26 asthma patients, and 90 patients with gastrointestinal problems divided into 34 treated cystic fibrosis (CF) patients with exocrine pancreatic insufficiency, 16 untreated coeliac disease (CD) patients and 40 patients with various gastrointestinal problems. The median values (5th–95th percentile) of AS results were 3.3% (0.0–21%) for healthy children, 4.5% (1.8–22.5%) for asthma patients, 24.7% (2.6–68.2%) for treated CF patients with exocrine pancreatic insufficiency, 19.8% (3–77.7%) for untreated CD patients and 5.5% (1.8–29%) for patients with various gastrointestinal diseases.Conclusion: The AS results of treated CF patients with exocrine pancreatic insufficiency and untreated CD patients were similar and significantly higher than those of healthy children and asthma patients. AS can be considered to be a reliable tool in screening for steatorrhoea in paediatric patients.
Effect of enteral nutrition on antioxidant enzyme systems and inflammation in paediatric Crohn's disease
Authors: Phylactos AC , Fasoula IN , Arnaud‐Battandier F , Walker‐Smith JA , Fell JM 
Published: August 2010

Crohn's disease is characterized by chronic inflammation of the gastrointestinal mucosa, which can be successfully treated with enteral nutrition. In this study, the activities of the antioxidant metalloenzymes copper/zinc‐superoxide dismutase (Cu/Zn‐SOD) and selenium‐glutathione peroxidase (Se‐GPx) were determined in erythrocyte lysates from children with Crohn's disease. Both enzymes exhibited significantly lower activities relative to healthy control subjects: 1.55 ±0.33 vs 2.13 ±0.75 SOD Umg‐1 protein (p < 0.025) for Cu/Zn‐SOD, and 61.9 ±17.7 vs 93.6 ±28.7 mUmg‐1 protein (p<0.01) for Se‐GPx. Treatment of patients with a specific polymeric diet, CT3211, for a period of 8 wk did not significantly alter the activities of the enzymes. In contrast, clinically, enteral nutritional therapy induced a remission in 13/14 children, and a significant fall in both median serum C‐reactive protein and mean serum tumour necrosis factor‐a levels.Conclusion: The results imply that the anti‐inflammatory action of enteral nutrition in Crohn's disease is caused by a mechanism other than restitution of these antioxidant enzymes.
Growth hormone treatment in children with Noonan's syndrome: four year results of a partly controlled trial
Authors: Noordam C , van der Burgt I , Sengers RCA , de Waal HA Delemarre‐van , Otten BJ 
Published: August 2010

The aim of the study was to evaluate the effect of continuous and discontinuous growth hormone treatment in Noonan's syndrome (NS) on linear growth and bone maturation. Thirty‐seven children with NS aged between 5.4 and 17.5 y were treated with growth hormone (GH) in a dose of 0.15 IUkg−1 per day; 23 of these children were randomly assigned to one of 2 groups in a 3 y partly controlled prospective multicentre study. Group A (n= 8) immediately started GH treatment and after 2 y discontinued GH treatment for 1 y; group B (n= 15) served as a control group during the first year and started GH treatment after 1 y. After the 3 y study period, 17 out of the 23 children continued GH treatment. An additional 14 children (group C) were treated according to the same protocol, but without discontinuation of GH treatment. The effect of GH treatment for up to 3 y was evaluated in terms of gain in height standard deviation score H‐SDS) for calendar age and for bone age. Gain in H‐SDS over the first year was significantly higher in the GH treatment group (+0.5) than in the non‐treated group (+0.0); mean bone maturation was significantly faster in the GH treatment group (1.2 vs 0.5 y/y) Discontinuation in group A in the third study year resulted in catch‐down growth (mean Δ H‐SDS ‐0.2). Over 3 y of GH treatment, mean AH‐SDS for calendar age was not significantly different between discontinuous (A: +0.8) and continuous treatment (B: +0.8; C: +1.2). Mean gain in H‐SDS for bone age in the 3 groups (+0.2, 0.0, +0.3) was minimal after 3 y of GH treatment.Conclusion: This study confirmed the gain in H‐SDS CA in Noonan's syndrome during long‐term GH treatment. However, the accelerating effect of GH on bone maturation seemed to compromise the final height prognosis.
Effect of short‐term antenatal dexamethasone administration on type I collagen synthesis and degradation in preterm infants at birth
Authors: Saarela T , Risteli J , Kauppila A , Koivisto Maila 
Published: August 2010

To assess the effects of antenatal corticoid administration on foetal collagen metabolism, cord serum concentrations of the aminoterminal propeptide and carboxyterminal telopeptide of type I procollagen (PINP and ICTP), which reflect rates of type I collagen synthesis and degradation, respectively, were measured in 67 consecutive preterm infants with gestational ages ranging from 24 to 32 wk. The samples were divided into three groups, depending on the administration and timing of antenatal corticosteroid treatment for enhancement of foetal lung maturity: cases in which the mothers had received a full 2‐dose administration of dexamethasone on consecutive days 1 to 6 d before delivery (n= 23; Complete‐Dexa), those who had received only a single dose of dexamethasone less than 24 h before delivery (n=17; Partial‐Dexa) and those who had not received any antenatal steroids (n= 27; No‐Dexa). Infants in the Complete‐Dexa group had significantly lower median PINP levels than those in the No‐Dexa group (3326 vs 4028 ug/l; p = 0.036); the median PINP level in the Partial‐Dexa group (3999 ug/l) was close to that of the No‐Dexa group. No significant differences in ICTP concentrations were seen between the groups.Conclusion: A significant suppression of foetal collagen synthesis but not degradation was found to be associated with antenatal dexamethasone administration. This should be taken into consideration, e.g. when assessing whether to administer repeated or single courses of corticosteroids antenatally in high‐risk pregnancies.
Impact of smoking on the duration of breastfeeding in mothers with insulin‐dependent diabetes mellitus
Authors: Knudsen A , Pedersen H , Klebe JG 
Published: August 2010

The effect of smoking on breastfeeding was studied in 252 mothers with insulin‐dependent diabetes mellitus (IDDM) giving birth in the period 1985–1995 and of whom 31% were classified as White group B, 16% group C, 37% group D and 16% group F or R. As part of a centralized regimen a detailed smoking history was taken during pregnancy Forty‐six percent were smokers. In 1997, a questionnaire was sent out asking for information on the duration of breastfeeding. The response rate was 87%. The duration of breastfeeding was significantly longer in the non‐smoking group (p= 0.004). Fifty‐five percent of non‐smokers versus 33% of smokers were still breastfeeding 4 mo after birth. A strong dose‐response relationship was established (p= 0.009). Cox multiple regression analysis showed a significantly negative influence of smoking (p= 0.01) and of hospitalization of the infants during the first year of life (p= 0.02) and a significantly positive influence of maternal age (p= 0.02) and birthweight (p= 0.03) on the length of breastfeeding. The breastfeeding curves for non‐smokers and smokers were mainly divergent in the first month after birth, suggesting that the effect of smoking on breastfeeding is mainly exerted during that period.Conclusion: Smoking exerted a strong, negative, dose‐dependent influence on breastfeeding duration in mothers with IDDM. Given the hazards of smoking, the advantages of breastfeeding and the possible link between being breastfed and later development of diabetes mellitus, these results should be taken into consideration when counselling pregnant women with IDDM about smoking.
Information and socioeconomic factors associated with early breastfeeding practices in rural and urban Morogoro, Tanzania
Authors: Shirima R , Gebre‐Medhin M , Greiner T 
Published: August 2010

A cross‐sectional study was undertaken in a rural and an urban area in Tanzania with the aim of identifying factors related to early infant feeding practices. The study included 320 mothers from each area with infants below 7 mo of age. A significant proportion of both rural and urban mothers had erroneous beliefs about infant feeding practices. None of the socioeconomic, demographic or biological variables studied were associated with feeding practices. Urban residence was positively associated with the duration of exclusive but not predominant breastfeeding. Better knowledge about specific breastfeeding issues was positively associated with the duration of both exclusive and predominant breastfeeding. Ownership of a radio was positively associated with both exclusive and predominant breastfeeding in the rural area. Although both rural and urban mothers had a high antenatal clinic attendance rate, 65% of the rural and 14% of the urban mothers delivered at home. Urban mothers informed about breastfeeding at the antenatal clinic had better feeding practices.Conclusion:We hypothesize that exclusive breastfeeding is not a traditionally recognized practice and thus its duration is mainly associated with information and knowledge about breastfeeding. This suggests that information programmes to provide knowledge, beginning at antenatal visits, may reduce premature complementation, though additional support may also be required.
Arterial air embolism after venous air infusion in newborn piglets
Authors: Juvik E , Solligård E , Brubakk A‐O , Brubakk A‐M 
Published: August 2010

In the newborn period, decreased right atrial pressure results in functional closure of the foramen ovale (FO). The objective of this study was to investigate whether air bubbles infused in the vena cava will pass through the FO into the arterial circulation in a newborn animal. Since air tends to rise to the highest point in a fluid, the study also investigated whether the animal's position could influence arterialization of air. Twelve 1‐3‐d‐old piglets were anaesthetized and mechanically ventilated, and had catheters placed in the vena cava for infusion of air, in the aorta for blood gas and blood pressure measurements, and in the pulmonary artery for pressure measurements. After stabilization, 0.05 ml kg1 per minute of air was infused for 25 min followed by a 3 h observation period. Six piglets were placed in the left, and six in the right lateral recumbent position. Air bubbles in the left atrium or ventricle was monitored by echocardiography. Ultrasound Doppler probes were placed on both carotid arteries for detection of air embolism. Gas bubbles were detected in the left ventricle within 45 s of air infusion in 11 of 12 piglets. Eight piglets had air bubbles in the carotid arteries. Mean pulmonary arterial pressure (PAP) increased significantly after 1 min of air infusion, whereas mean systemic arterial pressure remained unchanged. When arterial air embolism occurred, PAP had not increased significantly. The time to reach maximum PAP with the animals in the left recumbent position was significantly shorter than in the right. Conclusion: This study shows that venous gas bubbles enter the arterial circulation through the FO in newborn piglets and that body position may influence the haemodynamic effect of these bubbles.
Defecation problems in children with Hirschsprung's disease: a prospective controlled study of a multidisciplinary behavioural treatment
Authors: van Kuyk EM , Brugman‐Boezeman ATM , Wissink‐Essink M , Oerlemans HM , Severijnen RSVM , Bleijenberg G 
Published: August 2010

Constipation, faecal incontinence, soiling and difficult toilet training remain significant problems in children with Hirschsprung's disease after corrective surgery. Chronic defecation problems can have various negative implications. At the University Medical Centre Nijmegen, a multidisciplinary behavioural treatment was developed to treat defecation problems. In this paper, a prospective controlled study is presented concerning the effect of this treatment upon children suffering from chronic defecation problems following corrective surgery for Hirschsprung's disease. The effect of treatment was studied in 27 children (21M, 6F, mean age 5.2 y, range 2–11 y). Fourteen children were allocated to the experimental treatment group. The 13 children allocated to the waiting‐list control group were also treated following a waiting period of 6 mo. On all outcome variables, children in the experimental treatment group had significantly better results after treatment than children in the waiting‐list control group after the waiting period. No effect of age upon treatment was found. The effect of treatment remained significant on all outcome variables at a mean follow‐up of 7 mo after the end of treatment. Conclusion: Multidisciplinary behavioural treatment is successful in decreasing chronic defecation problems in children with Hirschsprung's disease.
Diagnostic accuracy of the atopy patch test and the skin‐prick test for the diagnosis of food allergy in young children with atopic eczema/dermatitis syndrome
Authors: Strömberg L 
Published: August 2010

Aim: To evaluate the diagnostic value of the skin‐prick test and the atopy patch test in diagnosing basic food allergy in young children suffering from atopic eczema/dermatitis syndrome. Methods: 141 children, the majority under 2y of age (mean 16 mo) with atopic eczema/dermatitis syndrome were investigated using skin‐prick and atopy patch tests for milk, egg, wheat and rye. Open diagnostic elimination challenge was done since this has been reported to be a reliable method in young children. Results: A positive challenge response was found to milk in 63 (45%), egg in 78 (55%), wheat in 61 (43%) and rye in 61 (43%). Sensitivity/specificity of the atopy patch test was 60%/97% for milk, 71%/97% for egg, 90%/94% for wheat and 93%/90% for rye. For the skin‐prick test the corresponding figures were 41%/99%, 60%/97%, 13%/98% and 15%/99%. Conclusion: Patch testing was found to be a more sensitive method than the skin‐prick test in diagnosing food allergy in children with atopic eczema/dermatitis syndrome, especially in those under 2 y of age. Many children with a negative skin‐prick test result have a positive patch test result, especially in the case of cereals. A diagnosis of food allergy should be confirmed by elimination and in the research setting also by challenge.