bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surfactant phospholipids and surface activity among preterm infants with respiratory distress syndrome who develop bronchopulmonary dysplasia
Authors: Kazzi SNJ , Schürch S , McLaughlin KL , Romero R , Janisse J 
Published: August 2010

Our objective was to determine if preterm infants with respiratory distress syndrome who develop bronchopulmonary dysplasia have abnormalities in surfactant phospholipids and/or function. Tracheal aspirate samples obtained from preterm infants with respiratory distress syndrome on days 1, 3–5, 7–10, 14–17, 21–24 and 27–30 were analyzed for total phospholipids and phospholipids fractions by determination of total phospholipid phosphorus and thin layer chromatography, respectively. Surfactant properties were assessed with captive bubble surfactometer. Sixteen out of 56 (29%) infants died during the first 30 d of life. Infants who died were more immature, required more ventilatory support and had a surfactant with lower surface‐tension‐reducing properties than infants who survived (p < 0.05). Surviving infants were divided into group I (no bronchopulmonary dysplasia at 27–30 d, n= 25) and group II (with bronchopulmonary dysplasia at 27–30 d, n= 15). No significant differences in concentrations of surfactant phospholipids nor measurements of surface tension were noted among groups of infants.Surfactant therapy after birth was associated with a significant increase in concentrations of total phospholipids, lecithin, phosphatidylinositol and lower surface‐tension measurements at 3–5 d of age among surviving infants (p < 0.01). Abnormalities in concentrations of surfactant phospholipids or surfactant function could not be demonstrated during the first month of life among preterm infants with respiratory distress syndrome who develop bronchopulmonary dysplasia.
Effect of training on peak oxygen uptake and blood lipids in 13 to 14‐year‐old girls
Authors: Stoedefalke K , Armstrong N , Kirby BJ , Welsman JR 
Published: August 2010

The aim of this study was to investigate the effects of exercise training on the peak oxygen uptake (peak VO2) and blood lipid profile of 13 to 14‐y‐old postmenarcheal girls. Treadmill determined peak VO2, total cholesterol, high density lipoprotein cholesterol, low density cholesterol, and triglycerides were the outcome measures assessed at baseline and following exercise training. Twenty girls completed a 20‐wk programme of exercise training which involved maintaining the heart rate at 75–85% maximum for 20 min, three times per week. Heart rate was rigorously monitored using telemetry throughout each training session. Eighteen girls acted as the control group. There were no significant (p≫ 0.05) changes in the outcome measures following the training programme. Conclusions: These findings suggest that exercise training of this frequency, intensity and duration for a period of 20 wk has no significant effect on either the peak VO2 or blood lipid and lipoprotein profile of normolipidaemic, postmenarcheal girls.
Cag A seropositivity and the severity of Helicobacter pylori infection in dyspeptic children
Authors: Lerro P , Perrucci V , Morra I , Lombardo L , Gaido F , Ansaldi N 
Published: August 2010

Aim: To assess the incidence of cag A (cytotoxin‐associated protein) and to evaluate its correlation with endoscopic‐histologic findings and with eradication rate in a series of children affected by Helicobacter pylori (H. pylori) gastritis. Methods: Fifty consecutive H. pylori gastritis children (27M; median age 10 y and 11 mo) were tested for IgG cag A protein (Western Blot technique). Pretreatment H. pylori infection was assessed on the grounds of endoscopic antral biopsy specimens by means of rapid urease test and histologic examination (Giemsa staining). All the children were treated with omeprazole (1 mg/kg/d), clarithromycin (15mg/kg/d) and amoxycillin (50 mg/kg/d) for 2 wk. According to universally accepted clinical practice, outcome of treatment was assessed by 13C urea breath test at least 6 wk after the end of therapy. Results: Thirty‐five children (70%) were seropositive to cag A+ protein (median age 11 y and 1 mo). Endoscopic findings of cag A+ patients were similar to those of cag A‐ patients. In cag A seropositive patients the severity of histologic gastritis was higher (p < 0.05) and the granulocytic infiltration more marked (p < 0.01) than in seronegative ones. In cag A+ children, H. pylori eradication rate was significantly lower (p < 0.02).Conclusions: cag A testing may be of useful clinical interest because its positivity can imply a more severe gastritis and a lower susceptibility to eradication treatment.
Does early hospital discharge with home support of families with preterm infants affect breastfeeding success? A randomized trial
Authors: Gunn TR , Thompson JMD , Jackson H , McKnight S , Buckthought G , Gunn AJ 
Published: August 2010

The aim of the present study was to determine if earlier discharge of preterm infants (<37 wk) from hospital is safe and if it affects breastfeeding rates. In a pilot observational study, premature infants received full oral (sucking) feeds for a mean (SD) 7.7 ± 7.9 d before discharge. In the main study, 308 preterm infants were randomly assigned to either Early Discharge (148 infants) when fully orally fed but not yet gaining weight or Routine Discharge (160 infants) when fully orally fed and also gaining weight before discharge. A further 122 mothers declined randomization. The Early Discharge group was followed by Visiting Nurse Specialists who were available 24 h a day, while the Routine group was followed by the Home Care Nurses available on week days. There were no significant differences between the groups in birthweight or gestational age. The Early Discharge group were discharged 2.5 ± 2 d after full oral feeding compared to 4.4 ± 2.7 d for the Routine group (p < 0.001) and 6.1 ± 5 d for those who declined. However, there was no significant difference between the Early and Routine groups for breastfeeding either at discharge (80 vs 83%), or 6 wk (55 vs 60%) or 6 mo after discharge (36 vs 36%), or for weight gain, or rates of re‐hospitalization (8.8% vs 11.9% at 6 wk, p = 0.37). Conclusion: Early discharge from hospital once a preterm infant can take full oral feeds does not alter later breastfeeding rates when adequate visiting nursing support is available.
Epidemiology of pneumococcal infections in French children
Authors: Gaudelus J , Cohen R , Reinert P 
Published: August 2010

Since 1977, resistance to ß‐lactams and other families of antibiotics among isolates of Streptococcus pneumoniae has increased alarmingly worldwide. France is particularly affected by this phenomenon; in 1997 the French National Reference Centre for Pneumococci reported that 44% of S. pneumoniae strains were penicillin non‐susceptible (PNSS). Furthermore, resistance to macrolides (53%) and sulphonamides (37%) was comparable; in addition, >50% of PNSS had a high level of resistance to penicillin and were multiresistant. The highest frequency of resistance is observed in children, particularly those with acute otitis media (AOM). Conclusion: The clinical consequences of increasing antibiotic resistance are evident for meningitis and AOM, prompting clinicians to consider alternative agents such as high‐dose cefotaxime (300 mg/ kg/d) or ceftriaxone (100mg/kg/d) plus vancomycin (60 mg/kg/d) for meningitis, and high‐dose amoxicillin (>80 mg/kg/d) or ceftriaxone (50 mg/kg/d) for AOM.
Intraepithelial lymphocytes and coeliac disease: permanent changes in CD3−/CD7+ and T cell receptor γβ subsets studied by flow cytometry
Authors: Camarero C , Eiras P , Asensio A , Leon F , Olivares F , Escobar H , Roy G 
Published: August 2010

Permanent changes in intestinal intraepithelial lymphocytes have been observed in coeliac patients. The aim of this investigation was to study small intestinal intraepithelial lymphocytes by using flow cytometry and to evaluate its diagnostic value in coeliac disease. Three‐colour flow cytometry analyses were performed on isolated epithelial cells of 117 intestinal biopsies obtained from 113 children (54 coeliac disease, 4 other enteropathies, 18 Helicobacter pylori associated gastritis and 37 normal controls). A multiple logistic regression model was developed to select the best intraepithelial lymphocytes subset predictor of coeliac disease. Coeliac patients had significant higher levels of T cell receptor yS intraepithelial lymphocytes than control patients (p < 0.01), H. pylori patients (p < 0.01) and other enteropathies (p < 0.05). The density of CD3∼/CD7+ intraepithelial lymphocytes, a intraepithelial lymphocyte subset poorly characterized by immuno‐histochemical methods, was significantly lower in coeliac patients than in the control group (p < 0.01), H. pylori group (p < 0.01) and other enteropathies (p < 0.01). Both changes remained altered independent of the coeliac patient's diet. The data were used on a logistic regression analysis in order to calculate sensitivity [94.4%; 95% confidence interval (CI) 83.7‐98.6%], specificity (94.9%; 95% CI 84.9‐98.7%) and likelihood ratio for a positive test 18.5 (95% CI 6.1‐55.8) in the diagnosis of coeliac disease.Conclusion: Changes in T cell receptor γβ and CD3−/CD7+ intraepithelial lymphocytes subsets are permanently observed in paediatric coeliac disease. Their assessment, by three‐colour flow cytometry on routine diagnostic biopsies, permits a better characterization of coeliac enteropathy and represents a valuable procedure to identify coeliac patients with different clinical presentations.
Deficits in attention, motor control and perception (DAMP): a simplified school entry examination
Authors: Landgren M , Kjellman B , Gillberg C 
Published: August 2010

Objective: To suggest an empirically based school entry screening examination for the detection of deficits in attention, motor control and perception (DAMP) in 6‐y‐old children. Material and methods: A population‐based cohort of 113 children, 6‐7 y of age (62 with and 51 without DAMP), compared on measures of attention, motor functions, language and cognition. Results: Attention deficits were convincingly identified by both parents and paediatrician. The motor function tests clearly distinguished between the two groups. Linguistic and meta‐linguistic tests demonstrated greater phonological processing difficulties in the DAMP group. The cognitive test revealed an overall lower IQ but no consistent characteristic pattern in the DAMP group.Conclusions: A simplified paediatric school entry examination test is suggested. Four motor tests (standing on one foot, Fog test, design copying and diadochokinesis) administered by the paediatrician, combined with a brief structured clinical observation and a structured parent interview, identified 80% of children with DAMP–and all those with severe DAMP–as well as a small number of false positives.
Effect of indomethacin on IL‐1β, IL‐6 and TNFα production by mononuclear cells of preterm newborns and adults
Authors: Sirota L , Punsky I , Bessler H 
Published: August 2010

The in vitro effect of indomethacin (IM) on the production of interleukin (IL)‐1β, IL‐6 and tumor necrosis factor (TNF)α by cord blood mononuclear cells (CBMC) from preterm newborns was compared to that of peripheral blood MC of adults (PBMC). MC isolated from peripheral blood of adults (PBMC) and cord blood of preterm newborns (CBMC) were incubated without or with lipopolysaccharide (LPS) in the absence or presence of various concentrations of IM. The levels of IL‐1β, IL‐6 and TNFα in the supernatants were tested by ELISA. MC isolated from preterm newborns were less sensitive to the in vitro effect of IM on IL‐1β and TNFα secretion than adult cells. While the spontaneous secretion of IL‐1β and TNFα and the production of TNFα induced by LPS were significantly increased following incubation of adult PBMC with IM, only the spontaneous synthesis of TNFα by CBMC of preterm newborns was affected by this drug. The in vitro production of IL‐6 by MC in the two groups was not affected by the addition of IM.It is suggested that IM may affect the preterm's immune response. However, the role of the drug in the frequency and severity of infections in the neonatal intensive care unit needs further investigation.
Magnetic resonance imaging at term and neuromotor outcome in preterm infants
Authors: Valkama AM , Päkö ELE , Vainionpää LK , Lanning FP , Ilkko EA , Koivisto ME 
Published: August 2010

In order to evaluate the value of neonatal brain magnetic resonance imaging (MRI) for predicting neuromotor outcome in very low birthweight (VLBW) preterm infants, 51 such infants with gestational age <34 wk underwent brain MRI at term age. Myelination, parenchymal lesions (haemorrhage, leukomalacia, infarction, reduction of white matter), parenchymal lesions without subependymal haemorrhage, ventricular/brain ratios and widths of the extracerebral spaces were assessed. The MRI findings were compared with cranial ultrasound (US) performed at term. Infants' neuromotor development was followed up until 18 mo corrected age. Parenchymal lesions seen in MRI at term predicted cerebral palsy (CP) with 100% sensitivity and 79% specificity, the corresponding figures for US being 67% and 85%, respectively.Parenchymal lesions in MRI, excluding subependymal haemorrhages, predicted CP with a sensitivity of 82% and a specificity of 97%, the corresponding figures for US being 58% and 100%, respectively. Delayed myelination, ventricular/brain ratios and widths of the extracerebral spaces failed to predict CP. Term age is a good time for neuroradiological examinations in prematurely born high‐risk infants. Parenchymal lesions seen in MRI are reliable predictors for CP.
Unnecessary water supplementation for babies: grandmothers blame clinics
Authors: Almroth S , Mohale M , Latham MC 
Published: August 2010

This study was designed to obtain policy‐and programme‐relevant data on exclusive breastfeeding in Lesotho at a time when global recommendations for exclusive breastfeeding were new. During both phases of field research, conducted in 1991 and 1992, qualitative information was obtained through focus groups and individual interviews with mothers, grandmothers and nurses. This was complemented during the second phase with quantitative data collected through a clinic‐based survey of mothers. The qualitative and the quantitative findings consistently converged, illustrating a culture of infant feeding in which breastfeeding was central, but exclusive breastfeeding was an unknown concept and not practised. Grandmothers seemed to be more in tune with the ideal of exclusive breastfeeding as they had given their young infants thin gruel only occasionally. Contemporary mothers, in contrast, were regularly giving their young infants water. Mothers and grandmothers frequently cited nurses as the source of advice for giving water. Grandmothers were adamant in pointing out that they had never given water to their own young infants and asserted that they avoided giving it to their grandchildren as they considered it unnecessary and harmful. According to the grandmothers, water supplementation was a new practice that had been introduced through the clinics. Conclusion: Efforts to discourage water supplementation and encourage exclusive breastfeeding in this setting need to be directed both at mothers and health providers.
Elevated serum creatinine levels in infants with congenital hypothyroidism: reflection of decreased renal function?
Authors: Asami T , Uchiyama M 
Published: August 2010

The effects of hypothyroid status on renal function have been poorly studied in children. We assessed the renal function of hypothyroid infants detected during neonatal mass screening for congenital hypothyroidism (CH). Eighty hypothyroid infants and 20 age‐matched normal infants for controls were enrolled. The 80 patients, aged 1 mo, were divided into two groups based on the initial thyroid stimulating hormone (TSH) and free thyroxine (FT4) values: a mild‐moderately hypothyroid (MHT) group (n= 64, 31M and 33F) and a severely hypothyroid (SHT) group (n= 16, 3M and 13F). Serum creatinine (SCr), TSH, FT4 and other chemicals were compared before and 2 mo after L‐thyroxine (LT4) substitution therapy. The following results were obtained: SCr levels were significantly higher in the SHT group (33.2 ± 10.0 mol/L, p < 0.001) compared with the MHT group (20.6 ± 6.4 mol/L) and normal control group (21.0 ± 4.4 mol/L). Two months after the LT4 replacement therapy, the elevated SCr levels in the SHT group decreased by 41.3% to the level (19.5 ± 6.0 mol/L) very close to that in the MHT group (18.8 ± 5.1 mol/L). No significant differences were noted among BUN levels in the three groups. Although serum creatinine kinase levels were significantly higher in the SHT group (230.3 ± 102.3 U/L, p < 0.001) than in the MHT group (121.1 ± 60.8 U/L), rhabdomyolysis was not considered to be responsible for the impaired renal function. Conclusion: From these results we conclude that serum creatinine levels are elevated in congenitally hypothyroid infants. This is a reversible change with thyroid hormone replacement therapy. The possibility of impaired renal functions should be kept in mind when treating hypothyroid infants.
Budesonide delivered by dosimetric jet nebulization to preterm very low birthweight infants at high risk for development of chronic lung disease
Authors: Jónsson B , Eriksson M , Söder O , Broberger U , Lagercrantz H 
Published: August 2010

We investigated the effect of an aerosolized corticosteroid (budesonide) on the oxygen requirement of infants at high risk for developing chronic lung disease (CLD) in a randomized, double‐blind study. The study objective was to attain a 30% decrease in FiO2 levels in the budesonide treatment group after 14 d of therapy. Thirty very low birthweight (VLBW) infants (median (range)) gestational age 26 wk (23–29) and birthweight 805 g (525–1227) were randomized. Inclusion criteria were mechanical ventilation on day 6 of life, or if extubated on nasal continuous positive airway pressure with FiO2± 0.3. The budesonide (Pulmicort™ dose was 500 μg bid, or placebo. The aerosol was delivered with a dosimetric jet nebulizer, with variable inspiratory time and breath sensitivity. Inhalations were started on day 7 of life. Twenty‐seven patients completed the study. A significant lowering of the FiO2 levels at 21 d of life was not detected. Infants who received budesonide were more often extubated during the study period (7/8 vs 2/9) and had a greater relative change from baseline in their oxygenation index (budesonide decreased 26% vs placebo increased 60%). Subsequent use of intravenous dexamethasone or inhaled budesonide in the treatment group was significantly less. All patients required O2 supplementation on day 28 of life. At 36 wk postconceptual age, 61% of infants in the budesonide group needed supplemental O2 as opposed to 79% in the placebo group. No side effects on growth or adrenal function were observed Conclusion: We conclude that inhaled budesonide aerosol via dosimetric jet nebulizer started on day 7 of life for infants at high risk for developing CLD decreases the need for mechanical ventilation similar to intravenous dexamethasone, but without significant side effects.
Influence of the initial management regimen and family social situation on glycemic control and medical care in children with type I diabetes mellitus
Authors: Forsander GA , Sundelin J , Persson B 
Published: August 2010

It is well known that social family factors are of importance in diabetes care, but it is not clear whether the initial management regimen can buffer these factors. In a prospective, randomized intervention study, 36 children with diabetes mellitus (type I) were followed, the aim being to study if a family psychosocial intervention at diagnosis could improve glycemic control and minimize hospital admissions. The control group was treated initially in a hospital ward, while the study group received problem‐based learning and family‐therapeutic and social support in an out‐hospital training apartment. A number of family social variables were evaluated at the time of diagnosis and 6, 12 and 24 mo later. Family function was assessed using the self‐estimated Family Climate Test at these same time‐points. HbA1c values and information concerning in‐ and out‐hospital visits to the pediatric clinic were collected for the 5‐y period following diagnosis. We found no association between the offered management regimen and glycemic control or rate of readmission. In the study group only, both parents reported a significant improvement of the family climate. An increased risk for poor glycemic control was recorded in children living in one‐parent families (p= 0.03) or in families where the father had a low level of education (p= 0.04). Younger age (p= 0.05), a single‐parent family (p= 0.05) and poor glycemic control (p= 0.02) were associated with more days of rehospitalization. The rate of divorce in the whole group was at least as high as in the normal population but, surprisingly, maternal dysfunction was associated with lower HbA1c value.The conclusion is that even with an initial management regimen designed to offer a family‐individual care regimen based on accurate estimation of the psychological and pedagogical needs, the social family background is a most important factor for the glycemic control and need for readmission.
Children of mothers abusing amphetamine: head circumference during infancy and psychosocial development until 14 years of age
Authors: Eriksson M , Jonsson B , Zetterström R 
Published: August 2010

Objective: To study the relationship between head circumference (HC) at birth (HO) and at 1 y of age (HI) and later outcome variables in children exposed to amphetamine during fetal life through maternal drug abuse. Method: Prospective longitudinal study of 65 children born to women abusing amphetamine. Potential bivariate and partial correlations between HC and outcome variables at 4, 8 and 14 y of age were studied. In multivariate analyses on outcome variables, HC, maternal and perinatal factors were used as predictors. Analyses were performed for all children and separately for boys and girls. Results: Head circumference at birth and 1 y of age were significant predictors for the level of achievement in Swedish language at 14 y. Head circumference at birth was a significant predictor for grades in mathematics in boys. Combined assessment of psychomotor development and psychosocial adjustment at 4 and 8 y correlated with HI in girls. Conclusion: Head circumference at birth and at 1 y of age correlated with school achievement at 14 y. HI also correlated with adjustment at 4 and 8 y in girls. A difference in vulnerability between girls and boys is important and should be considered in longitudinal studies of risk cohorts.
Clinical features, laboratory findings and differential diagnosis of benign acute childhood myositis
Authors: Zafeiriou DI , Katzos G , Gombakis N , Kontopoulos EE , Tsantali C 
Published: August 2010

We report clinical and laboratory data from 32 children with benign acute childhood myositis (BACM), children who presented with calf tenderness and gait abnormality. Laboratory evidence of a viral infection was evident in 23 patients, while serum creatine phosphokinase was uniformly increased (558 to 6800 U/L). Twenty‐five patients (78.1%) were given a diagnosis other than BACM by their general practitioner or paediatrician. All patients made a rapid recovery within one week.We conclude that BACM should be encountered among the main causes of sudden‐onset gait abnormality in young children.