bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thymus size at birth is associated with infant mortality: a community study from Guinea‐Bissau
Authors: Aaby P , Marx C , Trautner S , Rudaa D , Hasselbalch H , Jensen H , Lisse I 
Published: August 2010

A few studies have suggested that thymus atrophy is associated with severe malnutrition and increased morbidity; however, no study of thymus size has been undertaken in countries with high mortality. This study examined the relation between thymus size at birth and subsequent mortality in an urban West African community. The size of the thymus was assessed by sonography as a volume estimate, the thymus index. A total of 278 children born at the local health centre in Bandim in Bissau, Guinea‐Bissau, was enrolled in the study. Children were followed to the age of 2 y. Thymus size at birth was associated with most strongly weight, as well as with length and arm circumference. Controlling for weight and other risk factors, boys had larger thymus indices than girls [means ratio (MR) = 1.07, 95% confidence interval (95% CI) 1.01–1.14)]. Thymus size was also associated with prematurity, ethnic group, season and investigator, but not with birth order, mother's age, socioeconomic factors or the use of health services. Infant mortality was 117/1000. In a multivariate analysis, excluding premature infants and adjusting for age, gender, ethnic group, season of birth and investigator, higher birthweight (MR = 0.35, 95% CI 0.16–0.74) and larger thymus size (MR = 0.17,95% CI 0.06–0.48) were independently associated with lower infant mortality. When both indices were estimated in the same model, the thymus index was associated with infant mortality (MR = 0.27, 95% CI 0.07–1.00), whereas birthweight had a non‐significant effect (MR = 0.59, 95% CI 0.24–1.47). After 1 y of age neither birthweight nor thymus size at birth was associated with mortality. Conclusion: As all deaths were due to infectious diseases, thymus size at birth may be an important predictor of immune competence. Future studies should examine the determinants of thymus growth.
Body composition, as assessed by bioelectrical impedance spectroscopy and dual‐energy X‐ray absorptiometry, in a healthy paediatric population
Authors: Fors H , Gelander L , Bjarnason R , Albertsson‐Wikland K , Bosaeus I 
Published: August 2010

The aim of this study was to determine the level of agreement between body composition measurements by dual‐energy X‐ray absorptiometry (DXA), single‐frequency bioelectrical impedance analysis (BIA) and multifrequency bioelectrical impedance spectroscopy (BIS). Fat‐free mass (FFM), body fat mass and body fatness (percentage fat) were measured by DXA, BIA and BIS in 61 healthy children (37M, 24F, aged 10.9–13.9 y). Estimates of FFM, body fat mass and body fatness were highly correlated (r= 0.73–0.96, p > 0.0001) between the different methods. However, a Bland‐Altman comparison showed wide limits of agreement between the methods. The mean differences between methods for FFM ranged from 2.31 ± 7.76 kg to 0.48 ± 7.58 kg. Mean differences for body fat mass ranged from 0.16 ± 5.06 kg to 2.95 ± 5.65 kg and for body fatness from 2.3 ± 7.8% to 0.8 ± 9.3%. Calculations of body composition with BIS were not superior to BIA. However, BIA overestimated fat mass in lean subjects and underestimated fat mass in overweight subjects more than BIS, compared with DXA. Conclusion: The methods used provided estimates of FFM, body fat mass and body fatness that were highly correlated in a population of healthy children. However, the large limits of agreement derived from the Bland‐Altman procedure suggest that the methods should not be used interchangeably.
Health, health‐compromising behaviour, sexuality and involvement in pregnancy among 18‐year‐old Swedish males: a cross‐sectional survey
Authors: Holmberg L , Berg‐Kelly K 
Published: August 2010

The aim of this study was to determine whether there are differences regarding well‐being, health habits and health‐compromising behaviour between Swedish young men who had never had sexual intercourse (group I), those who were sexually active but without a pregnancy record (group II), and those who had caused pregnancies (group III). A self‐report questionnaire was used covering questions regarding health, health habits and risk behaviour. Tests of significance for differences between the three groups were performed with χ2‐tests. Differences were found in health, health behaviour and risk‐taking behaviour between the three groups of young men, with an apparent tendency towards riskier lifestyles from group I, through group II, to group III. Two especially striking findings were the more frequent use of anabolic steroids and the reported high rate of sexual offences in group III compared with groups I and II. Conclusion: This study highlights serious health‐compromising behaviours in 18‐y‐old men involved in pregnancies in a medium‐sized Swedish city. This group has been largely ignored both in clinical practice and in scientific studies, in contrast to the huge efforts directed towards pregnant adolescent females. Public health workers, school health programmes and adolescent clinics need to acknowledge this and work accordingly.
Proteinuria and its consequences in renal disease
Authors: Schieppati A , Remuzzi G 
Published: August 2010

Chronic renal diseases that involve proteinuria are typically characterized by an inexorable progression to end‐stage renal failure. Many studies suggest that this progression may be the result of factors, such as intraglomerular hypertension and glomerular hypertrophy, that are unrelated to the initial disease. This paper reviews the mechanisms of progression of chronic renal diseases and discusses therapeutic strategies that should prevent or minimize further renal damage and the applicability of these strategies to patients with the rare X‐linked lysosomal storage disorder Fabry disease. Renal involvement is a major feature of Fabry disease, which is characterized by vacuolated epithelial cells in the glomerulus and distal tubules, resulting from lipid inclusions within these cells. Although enzyme replacement therapy is the key strategy to halt the progression of Fabry disease, additional therapeutic options include blood pressure control, reduction of proteinuria, lipid control and inhibition of the renin‐angiotensin system. Conclusion: A range of therapeutic options, used in conjunction with enzyme replacement therapy, may have beneficial effects on the renal manifestations of Fabry disease.
Inner ear function in children with Fabry disease
Authors: Keilmann A 
Published: August 2010

Aim: The prevalence of hearing loss in patients with Fabry disease is still uncertain. This paper examines hearing loss in a group of young patients with Fabry disease.Methods: A clinical ear nose and throat examination, pure‐tone air and bone conduction audiometry, speech audiometry and middle ear testing (tympanometry and acoustic reflex testing) were carried out in four girls and two boys with Fabry disease (age, 7–17 years), receiving enzyme replacement therapy (ERT).Results: None of the patients complained of a hearing disorder or suffered from hearing loss. Three female patients reported tinnitus; however, this was not reported as being a problem. One boy reported tinnitus for the first time during 6 months of ERT.Conclusion: Based on this small sample of patients, it appears that the hearing disorders associated with Fabry disease develop mainly in adulthood. Tinnitus may be an earlier symptom than previously thought in Fabry disease.
Higher drive for thinness in adolescent males with insulin‐dependent diabetes mellitus compared with healthy controls
Authors: Svensson M , Engström I , Åman J 
Published: August 2010

Eating behaviour in adolescent males with insulin‐dependent diabetes mellitus (IDDM) living in central Sweden was compared with that of healthy age‐matched male controls using the Eating Disorder Inventory for Children and an interview. The patients were heavier than controls (p= 0.004) and had higher Drive for Thinness scores (p= 0.002). None was diagnosed as having a current eating disorder. Conclusion: The results of the study may indicate an increased risk of future eating disorders in males with IDDM.
Adolescent‐friendly services
Authors: Berg‐Kelly K 
Published: August 2010

The time has come to discuss adolescent‐friendly services and what these should entail. Conclusion: The attitudes and skills of the staff are the keys to successful healthcare for the adolescent. Communication skills include providing time without parental presence. Confidentiality in the patient‐provider context is important but rules and practices vary from country to country and have to be learned. The United Nations Convention on the Rights of Children is a generic framework that makes a good starting‐point. Ambiguous cases should be referred to groups of professionals and lay people trained in medical ethics.
The importance of diet on exposure to and effects of persistent organic pollutants on human health in the Arctic
Authors: Odland JØ , Deutch B , Hansen JC , Burkow IC 
Published: August 2010

Aim: To describe the importance of diet on exposure to and possible health effects of persistent organic pollutants (POPs) in the Arctic. Methods: The study is based on a literature review. Results: Minor decreases in POPs and minor increases in Hg levels in Arctic populations in Greenland, Eastern Russia, Western Alaska and Eastern Canada are likely to occur by the year 2010 and major decreases in both POPs and Hg levels in these same populations by 2030. Levels of POPs and metals in populations in the Faeroe Islands and the Scandinavian countries are already reasonably low and are only likely to decline marginally by 2030. Estimating the effects on the basis of current knowledge is difficult, but the combination of improved methodology and selection of risk groups will be a progressive step in the process. Any strategies based on traditional food substitution should ensure that the value of the dietary components is sustained. Conclusions: To improve our understanding of the health effects associated with exposure to contaminants in the Arctic, we recommend that circumpolar epidemiological studies should be implemented on a larger scale. MeHg‐ and POPs‐related effects are still the key issues. However, the role of newly discovered contaminants, such as PBDEs (polybrominated diphenyl ethers) and PCNs (polychlorinated naphthalenes), should be investigated. For exposure assessment, mixtures and nutritional interactions should be considered in epidemiological studies. Epidemiological studies on nutritional benefits of traditional foods should be incorporated in risk‐assessment profiles. We need a more nuanced view on human dietary exposure to xenobiotics. Risk should not be evaluated alone, but seen in relation to benefits from specific diets. It is essential that countries ratify and implement multinational environmental agreements.
Hand strength in juvenile chronic arthritis: a two‐year follow‐up
Authors: Lindehammar H 
Published: August 2010

Aim: To describe changes in muscle strength in the hands of children with juvenile chronic arthritis (JCA) and to examine the relationship between muscle strength, presence of local arthritis and disease subtype. Methods: Twenty children (10 girls and 10 boys) with JCA aged 7 to 18 y were followed for two years. Isometric muscle strength in wrist dorsiflexors and handgrip strength were measured repeatedly. The results were compared with reference values for the same methods. Arthritis severity in the hand was scored every third month. Nerve conduction velocities were measured twice. Results: Seven out of 20 patients had initially low or decreasing strength in one or both of the two tests. Five out of 20 children had reduced strength (more than two standard deviations below the mean of the reference group) in at least one test. Four children showed a significant reduction in muscle strength in at least one test during the observation time. The greatest reduction in strength was measured in four children with polyarticular disease. These children also had local arthritis in the hand. A greater proportion of children with polyarthritis had low or decreasing strength compared with children with oligoarthritis. The same was true for children with active arthritis in the hand. Nerve conduction velocities were normal in all cases and did not change. Conclusion: The majority of children with JCA have normal strength in the hand. Some children, especially those with polyarthritis and hand arthritis, have reduced muscle strength in the hand. Risk factors for low or decreasing strength are polyarthritis and/or active arthritis in the hand.
Total energy expenditure, body composition and weight gain in moderately preterm and full‐term infants at term postconceptional age
Authors: Olhager E , Forsum E 
Published: August 2010

Aim: To assess total energy expenditure (TEE) and body composition, i.e. total body water (TBW) and adipose tissue volume (ATV), at term age in 8 healthy preterm infants, born between gestational weeks 30 and 33, and in 9 healthy full‐term newborns. Methods: Total and subcutaneous ATVs were assessed using magnetic resonance imaging, while TEE and TBW were estimated using doubly labelled water. Results: Total ATV was 272 ±21 and 261 ± 56 ml/kg body weight, while subcutaneous ATV was 88.9 ± 1.6 and 89.7 ± 2.0% of total ATV for preterm and full‐term infants, respectively. The corresponding figures for TBW (as percentage of body weight) were 67.4 ± 2.5 and 68.1 ± 4.1, respectively. A significant correlation between ATV/kg body weight and body weight was found for full‐term (p < 0.0001) but not for preterm infants. TEE for preterm infants was 315 ± 20 kJ/kg body weight/24 h, which was significantly higher (p < 0.05) than TEE for full‐term infants (254 ± 45 kJ/kg body weight/24 h). At the time of investigation preterm infants weighed significantly (p < 0.05) less (540 g) than full‐term infants. After the time of investigation, weight gains of preterm and full‐term infants were 38 ± 12 and 24 ± 14 g/24 h, respectively. Conclusion: When compared to full‐term newborns, predominantly breastfed healthy preterm infants at term postconceptional age were significantly smaller, had a similar average proportion of body fat and showed catch‐up growth. Their higher TEE/kg body weight can be explained by a higher growth rate and possibly also by higher physical activity.
Parental perception of educational, behavioural and general health problems in school‐age survivors of bacterial meningitis
Authors: Koomen I , Grobbee DE , Jennekens‐Schinkel A , Roord JJ , van Furth AM 
Published: August 2010

Aim: To determine the occurrence of educational, behavioural and general health problems in Dutch school‐age survivors of bacterial meningitis. Methods: A cohort of 680 school‐age survivors of meningitis caused by the most common Gram‐positive and Gram‐negative bacteria was established approximately 6 y after the children's illness. Children with Haemophilus influenzae type b (Hib) meningitis were excluded because this form of the disease has virtually disappeared. Parents completed questionnaires on educational, behavioural and general health problems. The reference group comprised 304 school‐age siblings and peers. Results: Postmeningitic children were more likely than controls to under achieve at school: 20% vs 5% (odds ratio 5.6; 95% confidence interval 3.0–10.7). The postmeningitic children repeated a year twice as often as the children in the reference group (16% vs 8%, odds ratio: 2.5, 95% confidence interval 1.5–4.2) and were referred to a special‐needs school four times more frequently (8% vs 2%, odds ratio: 5.5; 95% confidence interval 2.0–15.4). Parents also reported more behavioural problems at home. More than half of the postmeningitic children experienced general health problems. The causative pathogen or age at infection had no influence on the relative frequency of educational and behavioural problems, and reduced auditory functioning played only a small part in these problems. Conclusion: Parents perceive educational, behavioural and general health problems in more than 30% of postmeningitic children. Until it is clear which children are at highest risk of developing these problems, it will be necessary to follow postmeningitic children into their school‐age years.
Stability of longitudinal motor development in very low birthweight infants from 5 months to 5.5 years
Authors: Erikson C , Allert C , Carlberg E Brogren , Katz‐Salamon M 
Published: August 2010

Aim: The motor performance of 165 very low birthweight (VLBW) infants was assessed prospectively at 5, 10, 18 mo and 5.5 y. The aim of the study was to evaluate longitudinal stability of motor development and its association with birthweight (BW), gestational age at birth, intraventricular haemorrhage (IVH), periventricular leucomalacia (PVL) and retinopathy of prematurity (ROP). Furthermore, at 5.5 y the motor behaviour of the VLBW population was compared with that of 124 children born at term. Methods: The results of each examination were ranked into four levels and the stability of motor development was evaluated on the basis of this ranking. At 5.5 y, VLBW children and controls were compared according to percentiles in the Movement ABC. Results: Fifty‐three percent of the VLBW infants displayed a stable motor development. Only PVL and BW contributed significantly to the variability in their motor performance. Forty‐seven percent of the infants exhibited an unstable motor development with no association to risk factors. In the entire group only IVH and severe ROP were related to poor motor performance. The majority of the VLBW children performed within the normal range at 5.5 y but their performances were inferior to those of control children. Conclusion: VLBW infants with poor early motor performance and/or severe IVH/PVL and ROP should be recruited into individualized follow‐up programmes, whereas regular ongoing monitoring by follow‐up may be sufficient for those with normal early motor performance and normal ultrasound findings.
Factors of significance for mobility in children with myelomeningocele
Authors: Norrlin S , Strinnholm M , Carlsson M , Dahl M 
Published: August 2010

Aim: To investigate neurological impairment, hand function and cognitive function in a group of children with myelomeningocele, in order to identify factors of significance for independent mobility and the physical assistance required for mobility in daily activities. Methods: The study material comprised 32 children, aged 6–11 y and without mental retardation. Mobility was assessed with the Pediatric Evaluation of Disability Inventory, scored as caregiver assistance. Statistical differences and correlations between the caregiver assistance scores and the selected variables were analysed. Results: Nine children scored independent mobility. The independent children had better hand coordination (p= 0.004) and walking ability (p= 0.01), lower cele levels (p= 0.011), higher performance IQ (p= 0.027), better visuospatial function (p= 0.029) and executive function (p= 0.037) than the others. The caregiver assistance scores were lower for both the children with early and severe symptoms of brainstem dysfunction and the children with scoliosis. Statistically significant correlations were found between the need for caregiver assistance and reduced walking ability, high cele level, poor hand strength and coordination, visuospatial function, executive function and performance IQ. In the subgroup of children who needed a wheelchair or walking aids, hand strength was the only variable significantly correlated with caregiver assistance (rs= 0.703, p= 0.000). Conclusion: Most of the children were dependent on others in daily activities. Impaired hand function and cognitive function were significant for mobility, and this has implications for the therapy programme in children with myelomeningocele.
Secular changes in body height and weight in children and adolescents in Poznan, Poland, between 1880 and 2000
Authors: Krawczynski M , Walkowiak J , Krzyzaniak A 
Published: August 2010

Aim: A secular trend in body height and weight is well documented. The first observations concerning this phenomenon in Poland were made at the end of the 19th century. The aim of this study was to assess changes in body height and weight during the 20th century, with special emphasis on the last decade. Methods: The results of body height and weight measurements obtained in eight subsequent surveys (1880–1886, 1922–1927, 1946–1950, 1960–1961, 1970–1971, 1980–1981, 1990–1991 and 1999–2000) were included in the analysis. Mean values were compared and differences between the surveys were analysed. Results: In general, in the 20th century, children grew taller and heavier and reached final body height and weight more rapidly. The biggest differences in body height and weight in the 20th century, observed at growth spurt, were about 17 cm and 11kg, respectively, for boys, and 13 cm and 13 kg for girls. The magnitude of secular changes in body height and weight in the 20th century was not stable. There were periods of increased and decreased intensity of acceleration of physical development (the 1950s and 1970s, and the 1960s and 1980s, respectively), as well as a period of deceleration (the 1940s). In the last decade, the tendency has been towards deceleration in most age groups studied. Conclusion: The acceleration of physical development in children in Poznan has now ceased.
Treatment of urinary tract infection with gentamicin once or three times daily
Authors: Chong C‐Y , Tan AS‐L , Ng W , Tan‐Kendrick A , Balakrishnan A , Chao S‐M 
Published: August 2010

Aim: To examine the safety and efficacy of once‐daily (OD) gentamicin treatment compared with conventional 8‐hourly dosing (TDS) for urinary tract infection (UTI). Methods: This was a prospective, randomized, controlled trial of children 1 mo to 13 y of age with presumed UTI. Children were randomly assigned to OD gentamicin 5 mg kg−1 d−1 or TDS gentamicin 6 mg kg−1 d−1 divided 8 hourly. Microbiological efficacy, nephrotoxicity, ototoxicity and renal scarring were assessed at the end of treatment. Results: 210 patients with presumed UTI were recruited, of whom 172 were analysable (OD 84, TDS 88). The median age was 7 mo, 50% were male and 74% (n= 127) of patients had pyelonephritis. The majority of infections were due to Escherichia coli (n= 153, 89%), of which 9 (5.2%) were bacteraemic. Comparing the two groups, there was no significant difference in age, gender, duration of fever before admission, pyuria, nitrite positivity or initial total white blood cell count. All patients had negative urine cultures after 2–3 d of treatment, demonstrating 100% microbiological efficacy. There was no difference between the two groups in terms of ototoxicity, nephrotoxicity, duration of gentamicin treatment or time to fever defervescence. Conclusion: OD gentamicin is as efficacious as TDS gentamicin in the treatment of UTI in children, with no difference in ototoxicity and nephrotoxicity.