bluuebunny/crossref_metadata_2025_split huggingface dataset:
Duration of breastfeeding and breastfeeding problems in relation to length of postpartum stay: a longitudinal cohort study of a national Swedish sample
Authors: Waldenström U , Aarts C 
Published: August 2010

Aim: To investigate the association between length of postpartum stay and duration of breastfeeding and breastfeeding problems, with special focus on early hospital discharge. Methods: Swedish‐speaking women were recruited from all antenatal clinics in Sweden during 3 wk evenly spread over 1 y in 1999 to 2000. In total, 3293 women (71% of those who were eligible) consented to participate in the study. Data were collected by questionnaires in early pregnancy, 2 mo and 1 y postpartum, and from the Swedish Medical Birth Register. For the purpose of this study, only data from the 2709 women (82%) who filled in the question about length of stay in the 2‐mo questionnaire were analysed. Women were divided into six groups according to length of postpartum stay (day 1: < 24h to day 6: ± 120h). Results: The median duration of any breastfeeding was 7 mo in women discharged on day 1, and 8 mo in women discharged on any of the following days; a non‐significant difference (p= 0.66). Besides hospital policies regarding length of stay (residential area) and number of domiciliary visits, early discharge was associated with the following maternal characteristics, which could be divided into three categories: (1) older, multipara, many children; (2) positive experience of the first breastfeeding after birth; (3) low education, economic problems, smoking, lack of support from partner. Late discharge was associated with operative delivery, preterm birth and low infant birthweight. When these factors were controlled for by Cox regression analysis, no statistical differences were found between the six groups in the relative risk of discontinuing to breastfeed. Breastfeeding problems, such as engorgement and mastitis, did not differ, but women discharged on day 6 or later had fewer problems with sore or cracked nipples during the first week and more problems 4–8 wk postpartum. Conclusion: Maternal characteristics may be more important predictors of the duration of breastfeeding than length of stay in hospital after the birth. The effect of domiciliary support needs further research.
Oral anticoagulant treatment in children based on monitoring at home
Authors: Mähönen S , Riikonen P , Väätäinen R‐L , Tikanoja T 
Published: August 2010

Aim: To evaluate the feasibility of home monitoring of oral anticoagulant treatment (OAT) in paediatric patients. Methods: A total of 19 paediatric patients received OAT and then monitored their treatment at home with CoaguChek±. Data on their International Normalized Ratio (INR) values were collected retrospectively from hospital records and from the notes kept by the families. The families of the patients were also asked to fill in a questionnaire. Results: No thrombotic or haemorrhagic complications occurred during a total amount of 44.7 follow‐up years. INR: the proportion of INR values measured at home falling within the therapeutic range for the given patient varied from 33 to 86% (median 69%). The questionnaire: all respondents were satisfied with home monitoring, and 63% felt that a major advantage of home monitoring was that there was no need to perform venipuncture. While 47% of the respondents reported no disadvantages of home monitoring, 42% reported that they occasionally lacked confidence in their ability to conduct OAT correctly at home. Conclusion: Home monitoring of OAT is feasible and reasonably reliable in paediatric patients. However, it is crucial that healthcare professionals supervise the treatment and the families are provided with detailed and precise instructions on how to act in a variety of clinical situations.
A short‐term follow‐up of children with poor word production at the age of 18 months
Authors: Westerlund M , Eriksson M , Berglund E 
Published: August 2010

Aim: (a) To study the stability of poor language development assessed by a new screening instrument based on parents' recognition of words their 18‐mo‐old children use; (b) to evaluate the predictability of the less‐than‐eight‐words cut‐off used by Child Health Centres (CHCs) in Sweden at the present 18‐mo check‐up—an assessment based on parents' recall of their children's vocabulary. Methods: All failures of the less‐than‐eight‐words criterion, corresponding to about 10% of 1000 children from a community‐based study, were followed up within half a year after the first assessment. The follow‐up instrument was an extensive, internationally well‐known and structured parent questionnaire, standardized for Swedish children. Results: Almost half of the followed‐ ups performed below the 10th percentile and more than two‐thirds were found below the 20th percentile. Thus, after a few months about one‐third of the children had caught up to a fairly normal level of performance. Two of the children who had recovered performed above median. More relaxed cut‐off criteria were applied ad hoc, reducing the proportion of children with a fast recovery. Conclusion: Age of language assessment and/or the level of cut‐off criterion presently used at Swedish CHCs should be reconsidered.
Acute hyperammonaemic encephalopathy in a female newborn caused by a novel, de novo mutation in the ornithine transcarbamylase gene
Authors: Valik D , Sedova Z , Starha J , Zeman J , Hruba E , Dvorakova L 
Published: August 2010

A full‐term female offspring of a first and uneventful pregnancy presented at 60 h of life with irritability, tachypnea and respiratory alkalosis progressing to deep coma with clinically dominant circulatory failure, tachycardia and hypotension. Diagnosis of ornithine transcarbamylase (OTC) deficiency was made on the basis of hyperammonaemia, hypocitrullinaemia and extreme hyper‐excretion of orotic acid. The baby was treated with peritoneal dialysis, arginine hydrochloride and adequate energy supply. DNA analysis revealed an as of yet unidentified missense mutation in the 6th exon of the OTC gene, resulting in a change of lysine to glutamine at position 210 (K210Q). Her parents were not found to carry this mutation, implying that this mutation may have occurred either de novo in the patient or in a parental germ cell. Conclusion: An acute neonatal form of OTC deficiency should be considered in the differential diagnosis of coma in female newborns.
Acinar dysplasia: a rare cause of neonatal respiratory failure
Authors: Gillespie LM , Fenton AC , Wright C 
Published: August 2010

Acinar dysplasia is a rare cause of death in the first few hours of life, due to an absence of alveoli. This report presents the first case associated with additional major renal malformations. The diagnosis of acinar dysplasia was unexpectedly made at autopsy. Conclusion: Even in the presence of antenatally diagnosed severe anomalies, autopsy may reveal diagnostically important information.
An unusual case of an atypical eating disorder masquerading as a serious multi‐systemic illness
Authors: Mehta A , Viner R , Christie D , Newson T , Dattani MT 
Published: August 2010

An early diagnosis and multidisciplinary team approach are mandatory in the management of eating disorders. Serious organic symptoms and nutritional effects can mimic a systemic illness, particularly in those with atypical presentations. A 15‐y‐old adolescent male presented with poor growth, low weight, abdominal pain and yellow pigmentation. Further bizarre multi‐system symptomatology resulted in a protracted admission with multiple investigations. An initial diagnosis of teratoma proved negative on abdominal laparotomy. A multidisciplinary approach followed by a feeding challenge led to the diagnosis of an eating disorder. The disorder, although more common in girls and adolescents, is increasing in incidence in both males and younger children. Conclusion: Atypical eating disorders are potentially serious and life‐threatening illnesses, and paediatricians and psychologists should be aware of unusual presentations.
Monitoring of IgE‐mediated food allergy in childhood
Authors: Foucard T , Lilja G 
Published: August 2010

Testing for IgE‐mediated allergy is performed to reach or refute a suspected allergy. But a positive test does only indicate sensitization and not necessarily clinical allergy. A diagnostic challenge procedure is therefore necessary. Also, in the phase of tolerance development a challenge is needed as clinical tolerance is reached before allergen‐specific IgE antibodies have disappeared. During recent years, an increasing interest has been given to the possibility of using the concentration of specific IgE and the size of the skin prick test wheal to tell the optimal time to do a challenge without exposing the child to a risk of a severe reaction.Conclusion: Algorithms on when to do and when not to do a food challenge may be useful but should be used with great caution. Reasonable consideration should be paid to the severity of previous reactions and the kind of allergen involved.
Neural maturation of breastfed and formula‐fed infants
Authors: Khedr EMH , Farghaly WMA , Amry S El‐Din , Osman AAA 
Published: August 2010

Background: Human milk provides infants with a full complement of all polyunsaturated fatty acids, including docosahexaenoic acid (DHA) and arachidonic acid (AA). Formula milks only contain the precursors of DHA, AA and linoleic acid, and hence formula‐fed infants must synthesize their own DHA and AA. Aim: To evaluate the effect of feeding—whether breastfeeding or formula‐feeding—in early infancy upon subsequent neurodevelopment and achievement of optimum brain function. Subjects and methods: The study included 53 normal, healthy infants (30 exclusively breastfed infants and 23 exclusively formula‐fed infants) at the age of 1 y (±1 mo). Each infant was subjected to a full physical and neurological examination together with neurophysiological studies including flash visual evoked potential (FVEP), brainstem auditory evoked potential (BAEP) and somatosensory evoked potential (SSEP). Results: There was significant prolongation of P100 wave latency of FVEP in formula‐fed infants, together with significant prolongation of absolute latency of waves I, III and V of BAEP in formula‐fed infants compared with breastfed infants. There was significant prolongation in inter‐peak latencies between cortical and Erb's components in formula‐fed infants compared with breastfed infants.Conclusion: We can conclude that VEP, BAEP and SSEP are more mature in breastfed infants relative to formula‐fed infants at 1 y of age, and thus breast milk helps earlier development and maturation of some aspects of the nervous system than milk formulas.
Bone mass evaluated by calcaneous ultrasound and radial peripheral computed tomography in 726 youngsters
Authors: Volta C , Bagni B , Iughetti L , Rossi M , Corazzari T , Bagni I , Bernasconi S 
Published: August 2010

Aim: To compare the results of ultrasound and computed peripheral tomography in evaluating bone mass in a population of normal children. Methods: Seven hundred and twenty‐six healthy school children (260 males; age 8.3–20.9 y) underwent calcaneous ultrasound and peripheral computed tomography at the ultradistal radius. Broadband ultrasound attenuation (BUA) and areal and volumetric bone mineral density (aBMD and vBMD) were evaluated. The results were compared and correlated among them and with auxological parameters (height, BMI and pubertal stages) using the software package SPSS for Windows. Results: The three variables examined (BUA, aBMD and vBMD) all showed a progressive increase with age and a positive correlation with age, height and BMI. When the population was subdivided according to pubertal stages, all variables showed a progressive increase, the difference being significant when stages 1–2 were compared with stages 4–5. A significant correlation was present among BUA, aBMD and vBMD even if the Pearson correlation coefficient was not high.Conclusions: The similar pattern of BUA, aBMD and vBMD with respect to age, height and pubertal stages indicates that ultrasound could be a reliable method to screen bone mass abnormalities in children. The low correlation coefficient, however, suggests that the methods employed measure different bone parameters. Moreover, the different skeletal locations could also account for these results.
Nicotine exposure in breastfed infants
Authors: Dahlström A , Ebersjö C , Lundell B 
Published: August 2010

Aim: To study exposure to nicotine in breastfed infants in relation to parental smoking habits.Material and Methods: Forty mother‐infant pairs were studied. Twenty non‐smoking mothers, 18 smoking (2–20 cigarettes per day) and two snuff‐taking mothers were included. All infants were healthy, exclusively breastfed and their postnatal age was 6 wk. During a home visit, parental smoking habits were recorded, and the time of mothers' last smoke or taking of snuff and breastfeeding were recorded. Breast milk and infant urine samples were collected. Concentrations of nicotine and cotinine were analysed with gas chromatography. The amount of milk ingested during the home visit was calculated by weighing the infants.Results: Two nonsmoking and non‐snuff‐taking women had milk containing nicotine (28 and 13 μg/l, respectively). Both had smoking spouses. In the smoking and snuff‐taking group, the mean (SD) milk nicotine concentration was 44 (38) μg/l (n= 36). When milk samples taken 7h and 0.6 h after smoking were compared, the concentration of milk nicotine increased from 21 to 51 μg/l (p< 0.01). The two snuff‐taking mothers exposed their children to higher milk nicotine concentrations than all but two of the smokers. The concentrations of the metabolite cotinine in infant urine correlated with the dose of nicotine ingested during the home visit (r= 0.84,p< 0.01).Conclusions: Breastfed infants with a smoking or snuff‐taking mother are exposed to nicotine in breast milk. The mean intake of nicotine via milk is 7 μg/kg/d. With a shorter time between the mothers' smoking and breastfeeding, the milk nicotine concentration will increase. Both passive smoking at home and snuff‐taking were associated with measurable nicotine levels in milk. Healthcare personnel promoting breastfeeding should be aware of these factors influencing exposure to nicotine in the breastfed infant.
Characteristics of respiratory syncytial virus‐related apnoea in three infants
Authors: Rayyan M , Naulaers G , Daniels H , Allegaert K , Debeer A , Devlieger H 
Published: August 2010

Apnoea is a common sign in respiratory syncytial virus (RSV) infections in young infants and can be the first presentation of an acquired RSV infection. We describe polysomnographic recordings of three infants revealing prolonged RSV‐related apnoea before RSV infection was diagnosed. The apnoeas were of central origin. The caregivers had not noted any apparent life‐threatening events (ALTE) prior to the polysomnography. Cardiorespiratory monitoring after the acute infection did not reveal any further apnoeas.Conclusion: Central, prolonged apnoea can be the first sign of an acquired RSV infection in young infants in the absence of other respiratory symptoms and without any previous observation of apnoea by the caregivers.
Incidence of autism spectrum disorders: Changes over time and their meaning*
Authors: Rutter M. 
Published: August 2010

AbstractAim:Several reviews have noted a huge increase in the rate of diagnosed autism spectrum disorders. The main aims of this paper are: 1) to use published empirical findings to consider whether the rise reflects a true increase in incidence, as distinct from the consequences of better ascertainment and a broadening of the diagnostic concept; and 2) to consider how epidemiological data may be used to test hypotheses about possible causal influences, using MMR and thimerosal as examples.Methods:Search of the literature for studies with a large epidemiological base population, systematic standardized screening, a focus on an age group for which diagnostic assessments are reliable and valid, and diagnosis by trained professionals using high‐quality research assessments. Also, search of a broader literature to consider the evidence from all epidemiological studies with respect to the hypothesized causal effect of MMR and thimerosal on autism spectrum disorders.Results:The true incidence of autism spectrum disorders is likely to be within the range of 30–60 cases per 10 000, a huge increase over the original estimate 40 years ago of 4 per 10 000. The increase is largely a consequence of improved ascertainment and a considerable broadening of the diagnostic concept. However, a true risk due to some, as yet to be identified, environmental risk factor cannot be ruled out. There is no support for the hypothesis for a role of either MMR or thimerosal in causation, but the evidence on the latter is more limited.Conclusion:Progress in testing environmental risk hypotheses will require the integration of epidemiological and biological studies.
Is screening ultrasound of the urinary tract indicated in infants with hypertrophic pyloric stenosis?
Authors: Cascio S. , Siddiqui M. M. F. , Barrett A. M. 
Published: August 2010

Abstract Aim: Few retrospective studies have evaluated infants with hypertrophic pyloric stenosis (HPS) for associated urological anomalies. They have led to contradictory conclusions. The aim of this study was to evaluate the incidence of urinary tract anomalies in infants with HPS and to establish the clinical significance of this association. Methods: One hundred and twenty‐two infants (100 boys) who underwent pyloromyotomy between 1992 and 2002 were prospectively evaluated. Screening ultrasound (Us) of the urinary tract was performed in 107 infants, while 15 did not attend their ultrasound appointment. Results: Renal ultrasound was abnormal in 4 (4%) of 107 screened patients with HPS. Three patients were found to have mild hydronephrosis and, in one patient, a small, normal kidney was detected. Two patients with hydronephrosis had Us follow‐up and the third patient underwent Tc‐99 mercaptoacetyl triglycine (MAG 3) scan. In all three patients, the hydronephrosis resolved completely on follow‐up scan. Conclusion: The incidence of abnormal renal ultrasound in children with HPS is similar to the reported incidence of 3–6% determined with routine ultrasound screening of healthy newborns. The abnormalities detected were not clinically relevant and did not require surgical intervention. We do not recommend screening of the urinary tract in infants with HPS.
Determination of the six major human herpesviruses in cerebrospinal fluid and blood specimens of children
Authors: Dong G. , Shang S. , Liang L. , Yu X. 
Published: August 2010

Abstract Aim: To detect and differentiate six major human herpesviruses in the cerebrospinal fluid (CSF) and blood of children by polymerase chain reaction restriction fragment length polymorphism (PCR‐RFLP). Methods: We synthesized two pairs of primers in the well‐conserved regions of the DNA polymerase gene in human herpesviruses. One pair was designed to amplify cytomegalovirus (CMV), Epstein‐Barr virus (EBV), herpes simplex virus type 1 (HSV‐1) and type 2 (HSV‐2), and the other pair to amplify varicella‐zoster virus (VZV) and human herpesvirus 6 (HHV‐6) by PCR. Virus species identification was achieved by restriction enzyme digestion with BamHI and BstUI. Ninety‐eight CSF and 75 blood specimens were analysed by this technique. At the same time, all blood specimens were also examined by enzyme‐linked immunosorbent assay (ELISA). Results: Thirteen (13.3%) of 98 CSF specimens and 26 (34.7%) of 75 blood specimens were positive for herpesvirus DNA in this PCR assay. Only 10 (13.3%) of the blood specimens were positive in ELISA for virus‐IgM antibody. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of PCR in detecting herpesvirus infections compared with ELISA were 100% (10/10), 75.4% (49/65), 38.5% (10/26) and 100% (49/49), respectively. These results indicate that the positive rate of PCR was significantly higher than that of ELISA (p<0.05). The herpesvirus type of these positive specimens was rapidly detected using restriction enzyme digestion with BamHI and BstUI. Conclusions: PCR‐RFLP is a specific, sensitive and accurate technique for the identification of herpesvirus infections in the CSF and blood of children.
Effects of Saccharomyces boulardii in children with acute diarrhoea
Authors: Kurugöl Z. , Koturoğlu G. 
Published: August 2010

Abstract Aim: Certain probiotic agents, e.g. Lactobacillus GG, have shown efficacy in clinical trials for the treatment of acute childhood diarrhoea, but few studies have examined the effect of Saccharomyces boulardii. We evaluated the effect of S. boulardii in children with acute diarrhoea. Methods: Two hundred children were randomized to receive S. boulardii in a granulated form in a daily dose of 250 mg (S. boulardii group) or placebo (placebo group) for 5 d. Clinical and demographic characteristics on admission were similar between the study groups. Results: The medians of the average stool frequency after the second day of the treatment were significantly lower in the S. boulardii group than in the placebo group (p=0.003). The duration of diarrhoea significantly reduced in the S. boulardii group compared with the placebo group (4.7 vs 5.5 d, p=0.03). The effect of S. boulardii on watery diarrhoea became apparent after the second day of the treatment. The duration of hospital stay was shorter in the S. boulardii group than in the placebo group (2.9 vs 3.9 d, p<0.001). Four children from the placebo group versus only one child from the S. boulardii group had persisting diarrhoea. Conclusion: The placebo‐controlled study suggested that S. boulardii significantly reduced the duration of acute diarrhoea and the duration of hospital stay. S. boulardii seems to be a promising agent for the amelioration of the course of acute diarrhoea in children when used therapeutically.
Extreme hyperbilirubinaemia in term and near‐term infants in Denmark
Authors: Ebbesen F. , Andersson C. , Verder H. , Grytter C. , Pedersen‐bjergaard L. , Petersen J. R. , Schaarup J. 
Published: August 2010

Abstract Aim: To determine the incidence amongst infants born at term or near‐term of extreme hyperbilirubinaemia, i.e., with a serum concentration of unconjugated bilirubin exceeding the limit above which an exchange transfusion was indicated according to the authorized guidelines. Method: The investigation period covered 2 y, 1 January 2000 to 31 December 2001, and included all infants born alive at term or near‐term in Denmark. All infants with extreme hyperbilirubinaemia admitted to paediatric departments were recorded. Results: Thirty‐two infants developed extreme hyperbilirubinaemia, i.e., an incidence of 25 per 100 000. The maximum total serum bilirubin concentration (TSB) was 492 (385–689) μmol/l (median (range)). The median value of the exchange transfusion limits was 450 μmol/l. Twelve infants had signs and symptoms of central nervous system involvement; 11 had acute bilirubin encephalopathy phase‐1 symptoms; and one had phase‐2 symptoms. Nineteen infants developed extreme hyperbilirubinaemia during primary admission to the maternity ward or neonatal department; the others after having been discharged. There was no difference in maximum TSB between those infants not discharged from hospital and those infants admitted to hospital from home. Maximum TSB appeared latest amongst those infants admitted from home (p<0.01), and these more often had signs and symptoms of central nervous system involvement (p<0.05). Ten infants were of non‐Caucasian extraction. Less than half of all Danish mothers receive both verbal and written information after birth on jaundice in the infant. Conclusion: Twenty‐five per 100 000 infants born at term or near‐term developed extreme hyperbilirubinaemia, the majority of them whilst in hospital. Infants admitted from home more often had signs and symptoms of central system involvement.