bluuebunny/crossref_metadata_2025_split huggingface dataset:
Calcium and phosphorus retention in extremely preterm infants supplemented individually
Authors: Trotter A , Pohlandt F 
Published: August 2010

The aim of this study was to investigate the correlation between the retention of calcium (Ca) and phosphorus (P) and weight gain and intake of Ca and P when using the concept of individualized Ca and P supplementation in extremely low birthweight infants. Three‐day Ca and P balances were performed in 20 infants with a mean gestational age of 26.6 wk (between 24.1 and 28.7 wk) and a birthweight of 744 g (450–990), when the infant was able to tolerate at least 100 ml/kg/d of milk. The daily supplementation with Ca and P was individually adjusted to achieve a simultaneous excretion of ± 1.2 mmol/L Ca and ± 0.4 mmol/L P in the urine. In 16 of the 20 infants, the urinary concentrations of both Ca and P exceeded the lower limits. The retention of Ca (mean 3.8 mmol/kg/d, minimum 0.9; maximum 8.1; 57% of intake, 34–80) and P (2.4,1.1–4.2; 76%, 52–96) was significantly correlated with both the daily weight gain (16 g, 3–28; Ca r2= 0.22, p= 0.02; P r2= 0.21, p= 0.03) and the intake of Ca (6.5 mmol/kg/d, 2.4–10.2; r2=0.67, p > 0.001) and P (3.1,1.9–5.3; r2= 0.85, p > 0.0001). The molar ratio of the Ca and P intake was 2.2 (1.3–4.0). Conclusion: It was found that Ca and P retention was a function of growth and intake.
Breastfeeding practices in an area of high HIV prevalence in rural South Africa
Authors: Bland RM , Rollins NC , Coutsoudis A , Coovadia HM ,   for the Child Health Group
Published: August 2010

Exclusive breastfeeding (EBF) from 0 to 6 mo of age is recommended by the World Health Organization as the optimal feeding method for infants, including infants of human immunodeficiency virus (HIV)‐infected women from developing countries who choose to breastfeed. EBF may be associated with less risk of postnatal HIV transmission than mixed feeding, but is still uncommonly practised for reasons that are poorly understood. This study aimed to assess EBF rates and the impediments to EBF in a South African rural area of high HIV prevalence where most mothers are unaware of their status. In a longitudinal study, 130 women attending 3 clinics, chosen for their disparate socioeconomic characteristics, were interviewed at weekly postnatal intervals. Follow‐up to 16wk was completed on 119 infants. In an additional cross‐sectional survey mothers of 445 infants, aged 0–12 mo, attending immunization clinics were interviewed. In the longitudinal study 46% of infants received non‐breast‐milk fluids or feeds within 48 h of birth; only 10% were exclusively breastfed for 6 wk and 6% for 16wk. Supplements, most commonly formula milk, were introduced for perceived milk insufficiency. Feeding choices were mainly self‐determined (43% of women), but health staff (22%) and grandmothers (16%) were cited as sources of advice. In the cross‐sectional survey caregivers reported that 47% of infants aged 2 wk, 40% aged 6 wk and 33% aged 12 wk had been exclusively breastfed since birth. Conclusion: EBF is uncommon in this area in spite of a baby‐friendly hospital initiative in the district. Strategies to promote exclusive breastfeeding in developing countries where HIV and infant feeding policies are being formulated must strongly address local perceptions on the need for supplements and sources of feeding advice.
Calcium, iron and zinc availability from weaning meals
Authors: Bosscher D , Van Cauwenbergh R , Van der Auwera JC , Robberecht H , Deelstra H 
Published: August 2010

During the weaning period, solid foods are introduced in the diet to complement human milk or infant formula. Consequently, marginal deficiencies may easily develop because of inappropriate feeding and low bioavailability of nutrients. The objective of this study was to determine calcium, iron and zinc availability from weaning foods that contained a variety of ingredients but almost the same dietary fibre content, and to describe dietary factors that influence availability in a linear matter. Availability measurements from eight meals were made in vitro by a continuous‐flow dialysis system with preliminary intraluminal digestion. Calcium, iron and zinc were analysed by flame atomic absorption spectrometry; ascorbic acid content was taken from food‐composition tables; and macronutrient and mineral contents were obtained from the manufacturer. Calcium availability was higher in fruits (mean ± SD, 39.2 ± 4.1%) than vegetables (31.7 ±5.8%) (p 0.001). Iron availability was marginally significant higher in vegetables (13.0 ±4.7%) than fruits (10.2 ± 1.6%) (p= 0.027). Zinc availability showed higher availability in fruits (52.3 ± 22.3%) than vegetables (22.1 ± 5.6%) (p± 0.001). Conclusion: A major portion (47.8%) of the variance in calcium availability, as determined by multiple regression, could be explained by protein (p= 0.058, β=–0.691). Major predictors of iron availability among the nutrients were iron content of the meal (p= 0.014, β=–0.838), carbohydrates (p= 0.044, β=–0.610) and dietary fibre (p= 0.235, β=–0.285). Zinc availability was merely influenced by the protein (p= 0.010, β=–0.876) and fat content of the meals (p= 0.295, β= 0.255) in relation to other nutrients.
Evolution of renal pathology in Fabry disease
Authors: Sessa A , Meroni M , Battini G , Righetti M , Nebuloni M , Tosoni A , Vago GL ,   on behalf of Studio Multicentrico Italiano sulla Malattia di Anderson‐Fabry (SMIMAF)
Published: August 2010

Fabry disease is a rare lysosomal storage disorder which results from deficient activity of the enzyme α‐galactosidase A. The resultant deposition and progressive accumulation of glycosphingolipids in all types of body tissue leads to severe clinical manifestations involving the heart, CNS and kidney. Renal manifestations are observed relatively early in the course of the disease, and progression to end‐stage renal failure is common in hemizygous males in the third to fifth decades of life.Renal biopsy specimens reveal evidence of diffuse intracytoplasmic glycosphingolipid accumulation, mainly affecting podocytes and epithelial cells of distal tubules, which are strikingly enlarged and vacuolated. On electron microscopy the deposits appear as typical osmiophilic inclusion bodies in the cytoplasm of all kinds of renal cells, and show a characteristic ‘onion skin’ or ‘zebra’ appearance. These pathological features are also evident in heterozygous females. Deposits occur before the development of renal impairment. As patients age, the disease progresses in cells throughout the kidney, and is associated with increasing glycosphingolipid accumulation. Conclusion: The age‐related evolution of renal pathology in Fabry disease is closely correlated with progressive intracellular deposition of glycosphingolipid and ultimately leads to end‐stage renal failure.
Auditory and vestibular findings in Fabry disease: a study of hemizygous males and heterozygous females
Authors: Conti G , Sergi B 
Published: August 2010

Aim: This study aimed to evaluate audiological and vestibular involvement in Fabry disease and the early effects of enzyme replacement therapy with human α‐galactosidase A. Methods: Fourteen patients (10 males, 4 females) aged 14–57 years were studied. Each patient underwent a clinical (history of otological and vestibular aspects, otoscopy) and instrumental (pure tone and speech audiometry, impedance, auditory brainstem response and otoacoustic emission recordings, vestibular caloric tests, electronystagmography during acceleratory stimulation, dynamic posturography) evaluation before starting enzyme replacement therapy. Results: Fifty per cent of patients complained of hearing symptoms (hearing loss, tinnitus, ear fullness). Subjective hearing loss was present in six cases and in three cases it was the first reported symptom of Fabry disease. In six of the seven cases the onset and/or progression of hearing symptoms were sudden. Vertigo or dizziness was reported by four patients and in two cases was associated with hearing symptoms. Audiological evaluation showed sensorineural hearing loss in eight patients (5 males, 3 females). Hearing loss was unilateral in six cases and bilateral in the remaining two cases. The hearing loss (HL) ranged from 30 to 80 dB HL (mean, 43 dB HL) and the lesion was always cochlear. Vestibular examination showed abnormalities in four patients (bilateral weak/abolished response in three cases, side prevalence in one case), which were not related to either the audiological results or the history of vertigo/dizziness. Conclusion: Involvement of the inner ear is common in men and women with Fabry disease. We found a high incidence of cochlear hearing loss, which was typically unilateral and showed onset and/or progression by sudden episodes. Vascular or hydropic mechanisms could be hypothesized to explain audiological findings. Vestibular involvement had a lower incidence and showed a different pattern, thus suggesting that several pathophysiological mechanisms could play a role in determining inner ear damage in Fabry disease. Our preliminary results show that enzyme replacement therapy may stabilize hearing function; however, further follow‐up is required.
Renal parenchymal damage in sibling vesicoureteric reflux
Authors: Cascio S , Yoneda A , Chertin B , Colhoun E , Puri P 
Published: August 2010

Aim: To compare the incidence of renal damage in siblings of patients with vesicoureteric reflux (VUR) who presented with a documented history of urinary tract infection (UTI) with asymptomatic siblings who were diagnosed with reflux during a screening programme for hereditary VUR. Methods: Medical and radiological records of the VUR patients (1990–2000) were examined for age, gender, mode of presentation, reflux grade and renal damage. Results: VUR was noted in 226 siblings (352 ureters) in 107 families. Of the 119 siblings of index patients, 64 were investigated for a documented UTI and 55 with no history of UTI were detected during screening for sibling reflux. Dimercaptosuccinic acid scan revealed reflux nephropathy in 25 (26%) of the 97 renal refluxing units (RRU) of siblings who presented with a UTI and in 6 (7%) of the 89 RRU of asymptomatic siblings who underwent screening voiding cystourethrography (p= 0.0006). Mild renal damage was present in 20 (21%) RRU of siblings with UTI and in 2 (2%) RRU of the screened siblings (p < 0.001). Moderate to severe renal damage was present in 5 (5%) RRU of siblings with UTI and in 4 (4%) RRU of the screened siblings (p > 0.05). Conclusion: This study demonstrated that the incidence of mild renal scarring was much higher in siblings who presented with UTI than in asymptomatic siblings. However, the incidence of moderate and severe renal scarring among asymptomatic siblings was comparable to that in siblings with VUR and UTI.
Role of plasma and urinary calcium and phosphorus measurements in early detection of phosphorus deficiency in very low birthweight infants
Authors: Catache M , Leone CR 
Published: August 2010

Aim: To analyse the role of serum and urinary calcium and phosphorus levels in early detection of mineral deficiency in very low birthweight (VLBW) infants born appropriate (AGA) and small for gestational age (SGA). Methods: 64 VLBW infants were included in a cohort study and divided into two groups: AGA (n= 30) and SGA infants (n= 34). Then, they were divided according to the presence of radiological signs of metabolic bone disease (MBD): with MBD (n= 21) and without MBD (n= 34). Blood samples and 6 h urine collections were obtained for calcium, phosphorus, alkaline phosphatase activity and creatinine determinations between 3 and 5 wk of life. Results: There were no biochemical differences between AGA and SGA. Higher values of urinary calcium (MBD = 31.9 ± 20.2, without MBD = 19.8 ± 15.4; p= 0.017), calciuria (MBD = 2.3 ± 0.3, without MBD =1.4 ± 0.8; p= 0.037) and alkaline phosphatase activity (MBD = 369 ± 114, without MBD = 310 ± 93; p= 0.04) were found in infants who developed MBD. Both groups showed high tubular phosphorus reabsorption indicating mineral deficiency. Conclusion: Serum calcium and phosphorus levels are not good markers in early detection of mineral deficiency. However, the monitoring of calcium urinary levels may be helpful in early detection of mineral deficiency.
Retroperitoneal abscess and omphalitis in young infants
Authors: Feo CF , Dessanti A , Franco B , Ganau A , Iannuccelli M 
Published: August 2010

Aim: To evaluate the aetiopathogenetic factors in cases of retroperitoneal abscess in young infants, particularly the correlation with omphalitis. Methods: We describe the cases of two infants, aged 8 and 3 wk, respectively, with a history of omphalitis during the first weeks of life and subsequent development of a retroperitoneal abscess. Both infants underwent surgical drainage of the abscess. Results: In case 1, Staphylococcus aureus was found in cultures from abscess pus, and in case 2 from umbilical pus, abscess purulent material and blood. Both infants are in good health after a follow‐up of 6 mo and 8 y, respectively. Conclusion: Retroperitoneal abscesses in young infants are usually considered to be idiopathic. A correlation with omphalitis was found in both of the reported cases and it is thought that this could have been due to an aetiopathogenetic factor. Furthermore, we stress the importance of suspicion of retroperitoneal abscesses for early diagnosis and treatment, and discuss the therapeutic strategies.
Group A streptococcal osteomyelitis: severe presentation and course
Authors: Turner D , Einhorn M 
Published: August 2010

Aim: To evaluate the course of group A streptococcal osteomyelitis associated with severe disease nowadays. Methods: Three consecutive cases of severe group A streptococcal disease with osteomyelitis in children that were documented in Beer Sheva, Israel are described in detail. Results: Two of the three cases were postvaricella. Early in the course of the disease, the presentation resembled that of severe cellulitis. All three patients had severe osteomyelitis and required surgery, and one patient developed chronic osteomyelitis. Sepsis was diagnosed in two cases. Conclusion: Our cases are distinguishable from typical haematogenous staphylococcal osteomyelitis by the severe course and the extensive involvement of bone and soft tissues. The increase in severity of invasive group A streptococcal infections documented throughout the world could account for the difference between our complex cases and the previous reports.
Age differences in human skeletal muscle fatigue during high‐intensity intermittent exercise
Authors: Ratel S , Lazaar N , Williams CA , Bedu M , Duché P 
Published: August 2010

It has been shown at similar relative work rates that children have higher resistance to fatigue than adults during repeated bouts of high‐intensity exercise. This age‐related difference in fatigue resistance may be explained by factors including muscle mass, muscle morphology, energy metabolism and neuromuscular activation. Conclusion: During high‐intensity intermittent exercise, recovery periods play an important role in limiting fatigue. Age‐related differences in fatigue resistance could also be explained by differences in the rates of resynthesis of some energetic substrates and the rates of removal of various muscle metabolites.
Respiratory syncytial virus infection—risk factors for hospital admission: a case‐control study
Authors: Nielsen HE , Siersma V , Andersen S , Gahrn‐Hansen B , Mordhorst CH , Nørgaard‐Pedersen B , Røder B , Sørensen TL , Temme R , Vestergaard BF 
Published: August 2010

Most infants are infected with respiratory syncytial virus (RSV) during the first 2 y of life. The majority have only a mild upper respiratory tract infection, but 1–2% develop a more severe illness and are admitted to hospital. Aim: To carry out a study of risk factors for hospital admission because of RSV infection in Denmark in children aged less than 2 y of age. Methods: The study population included all 1252 children admitted to hospital with verified RSV infection in two Danish counties during the 5‐y period 1990–1994. The investigation comprised a retrospective case‐control study with five matched controls per case. In a multivariate analysis the risk factors included medical and demographic variables, and in infants < 3 mo of age at hospitalization, two aspects of innate immunity: mannose‐binding lectin (MBL) concentration and maternal RSV serum antibody titre, measured on eluates from stored dried blood from the infants’4th day of life. The effect of each risk factor is expressed as an odds ratio, corresponding to the relative risk of being a case rather than a control if the risk factor is present. Results: The following independent risk factors were identified: age, sex, month of birth, gestational age, birthweight, presence of a sibling, up to 5 y older than the case, and maternal smoking during pregnancy. There was a marginal effect of maternal RSV antibody levels, but no effect of neonatal serum MBL concentration or of crowding in the household. Conclusions: Ninety percent of cases and 80% of controls had one or more risk factors. Even though several factors were found to increase the risk for hospitalization for RSV disease, all the effects were small and no single specific factor could be identified to explain the hospitalization of the minority of children with RSV infection.
Consultations with adolescents: the gap between their expectations and their experiences
Authors: Rutishauser C , Esslinger A , Bond L , Sennhauser FH 
Published: August 2010

Aim: To study the expectations and experiences of adolescents when in consultation with doctors, particularly with regard to issues of confidentiality. Methods: In a cross‐sectional study, 613 seventh‐ and ninth‐grade students (347 students aged 13 y and 266 students aged 15 y) completed a 40‐item questionnaire specifically developed for this study. Students anonymously completed the self‐administered questionnaire at school. Results: Of these adolescents, 89% aged 13 y and 57% aged 15 y were accompanied by one of their parents to appointments with private practitioners. Of the respondents, 33%/52% (13‐y‐olds/15‐y‐olds) said that seeing the doctor alone for some time was important but only 18%/20% were given the opportunity to do so. Although 79%/90% of respondents stated that it was important for the doctor to keep information confidential, on request, only 37%/40% of private practitioners had spoken about confidentiality; 64%/78% of adolescents said that doctors should give assurance of confidentiality even with regard to their parents. However, only 26%/27% of private practitioners explicitly assured confidentiality with regard to parents. Acceptance of conditional confidentiality was high in all subpopulations. Short waiting times and the opportunity to talk about topics such as nutrition, drugs and sexuality were rated as important. Conclusion: Physicians should adapt their consultation style to the needs of adolescents by seeing the adolescent patient alone for some time and by assuring them of conditional confidentiality. Furthermore, they should provide opportunities to talk specifically about issues of potential concern to adolescents such as nutrition, drugs and sexuality. To accomplish these tasks, educational curricula in adolescent healthcare are required for physicians.
Incidence of hyponatraemia and hyponatraemic seizures in severe respiratory syncytial virus bronchiolitis
Authors: Hanna S , Tibby SM , Durward A , Murdoch IA 
Published: August 2010

Aim: To document the incidence and early evolution of hyponatraemia (serum sodium <136 mmol 1−1) associated with respiratory syncytial virus (RSV) bronchiolitis in infants requiring intensive care. Methods: In a retrospective review over two winter seasons, 130 infants were admitted with confirmed RSV infection, of whom 39 were excluded because of either pre‐existing risk factors for hyponatraemia: diuretic therapy (n= 14), cardiac disease (n= 10), renal disease (n= 2) or lack of admission sodium data (n= 13). Results: The incidence of admission hyponatraemia in the remaining infants (median age 6 wk) was 33% (30/91), with 11% (10/91) exhibiting a serum sodium less than 130 mmol 1−1. Hyponatraemic and normonatraemic infants were of a similar age (median 6 vs 7 wk, p= 0.82). With fluid restriction and diuretic therapy, the incidence of hyponatraemia at 48 h had decreased to 3.3%, odds ratio 0.07 (95% confidence interval 0.02–0.24, p < 0.001). Four infants (4%) suffered hyponatraemic seizures at admission (sodium 114–123 mmol 1−1); three had received hypotonic intravenous fluids at 100–150 ml kg−1 d−1 before referral to intensive care. All four were managed successfully with hypertonic (3%) saline, followed by fluid restriction, resulting in immediate termination of seizure activity and normalization of serum sodium values over 48 h. Conclusion: Hyponatraemia is common among infants with RSV bronchiolitis presenting to intensive care. Neurological complications may occur and fluid therapy in vulnerable infants should be tailored to reduce this risk.
A very rare cause of intestinal atresia: intrauterine intussusception due to Meckel's diverticulum
Authors: Kilic N , Kiristioglu I , Kirkpinar A , Dogruyol H 
Published: August 2010

Intrauterine intussusception is one of the rare causes of intestinal atresia. Conclusion: A case of ileal atresia due to intrauterine intussusception caused by Meckel's diverticulum is reported.
Paraurethral cysts in female neonates. Case reports
Authors: Fathi K , Pinter A 
Published: August 2010

Paraurethral or Skene's duct cysts are a rare congenital abnormality in the female neonate and are characterized by a round, yellow or orange‐coloured cystic mass on either side of the urethra meatus. In the past 17 y we have treated six cases of paraurethral cysts in our unit. All patients underwent incision and unroofing of the cyst resulting in complete healing. The diagnosis and therapeutic options for this rare lesion are reviewed. Conclusion: Paraurethral cysts are not as rare as suggested in the literature. Excision, marsupialization and needle aspiration of the cyst are all effective methods of treatment. However, spontaneous resolution has also been reported. It is suggested that the least aggressive therapy should be used.