bluuebunny/crossref_metadata_2025_split huggingface dataset:
Balloon dilatation of critical left heart stenoses in low birthweight infants
Authors: Koch A , Buheitel G , Gerling S , Klinge J , Singer H , Hofbeck M 
Published: August 2010

We describe the results of balloon angioplasty in 5 infants with body weights of 850‐2400 g. Three patients with severe aortic valve stenosis and two patients with isthmic coarctation of the aorta experienced relief of stenosis. Two patients with aortic valve stenosis developed thrombosis of the femoral artery; however, complete resolution of the compromised pulse occurred following thrombolytic therapy. In both patients with isthmic coarctation, pulses on the right leg remained diminished. All patients are doing well 0.28 to 3.32 y after the procedure; none has required additional therapy. Our results in a limited number of consecutive low birthweight infants show that balloon dilatation is feasible and can be performed successfully even in neonates with body weights <1500g. According to our experience, balloon dilatation in infants with body weights >2000 g does not differ significantly from standard procedures. In very small infants, however, balloon angioplasty requires special precautions to avoid temperature loss. Arterial access is the major problem in small children, and requires further improvement. Conclusion: Balloon dilatation is feasible even in neonates < 1500 g. However, special precautions to avoid temperature loss are required and arterial access is the major problem.
Quality of life in childhood asthma: use of the Paediatric Asthma Quality of Life Questionnaire in a Swedish sample of children 7 to 9 years old
Authors: Reichenberg K , Broberg AG 
Published: August 2010

Reichenberg K, Broberg AG. Quality of life in childhood asthma: use of the Paediatric Asthma Quality of Life Questionnaire in a Swedish sample of children 7 to 9 years old. Acta Pædiatr 2000; 89: 989‐95. Stockholm. ISSN 0803‐5253To validate a Swedish translation of the Paediatric Asthma Quality of Life Questionnaire (PAQLQ) and to study determinants of asthmatic children's quality of life, seventy‐one 7‐9‐y‐old children and their families were approached. Sixty‐one children (86%) participated, 36 boys and 25 girls: 11 children with mild, 40 with moderate and 10 with severe asthma. The mean age was 8.7 y. Most commonly restricted activities during the week preceding the investigation were running (74%), gymnastics (30%), walking uphill (26%), playing football (20%) and shouting (13%).Parental rating of symptoms (Spearman's rho =–0.40,p= 0.001), percentage of expected peak flow rate (PEFR) (rho = 0.30, p= 0.009) and physicians' grading (mild, moderate and severe asthma, p= 0.047) all correlated significantly with PAQLQ scores. Younger children reported more impairment of QoL, as did children of parents not sharing household. Sex or presence of eczema or rhinoconjunctivitis did not significantly affect the scores. Children suffering from food allergy scored less impairment of QoL. The instrument was easy to administer, was well accepted by the children and had acceptable internal consistency.
A regional study of underlying congenital diseases in term neonates with necrotizing enterocolitis
Authors: Bolisetty S , Lui K , Oei J , Wojtulewicz J 
Published: August 2010

Aim of the study: The aetiology of necrotizing enterocolitis (NEC) remains poorly understood in infants of all gestation, particularly when it occurs at term. We hypothesize that NEC in term infants is rare but often associated with underlying congenital illnesses. Method: Records of all term infants hospitalized with radiologically or surgically proven NEC in the 10 tertiary centres of two geographical regions of Australia during a 6.5‐y period were reviewed. Regional birth data were obtained and a special care nursery survey was conducted. Results: Twenty‐nine infants had proven NEC giving a population incidence of 0.05 per 1000 live births. Nineteen (66%) of them had underlying congenital diseases. Five (17%) infants had endocrine disorders, which included panhypopituitarism, hypothyroidism, hypoparathyroidism and congenital adrenal hyperplasia. Ten infants had congenital heart disease, eight being cyanotic. Six of them developed NEC prior to any invasive cardiac procedures. Seven of the other nine infants without any congenital diseases had perinatal risk factors associated with NEC. The severity of illness was not different amongst the three groups. All infants, except two, survived. Conclusion: NEC in term infants is commonly secondary to or preceded by underlying congenital diseases. A considerable proportion of NEC cases had co‐existing endocrine illnesses.
Breathing patterns, oxygen and carbon dioxide levels in sleeping healthy infants during the first nine months after birth
Authors: Horemuzova E , Katz‐Salamon M , Milerad J 
Published: August 2010

Data on arterial oxygen saturation (SaO2), transcutaneous pO2, pCO2 (tcpO2, tcpCO2) and breathing patterns in sleeping healthy term infants were obtained during the first 9 mo after birth. Forty‐four healthy infants, mean GA at birth 40 ± 1.0 wk, mean BW 3520 ± 562 g were examined between 2 wk and 9 mo postnatally in a cross‐sectional study. SaO2, tcpO2, tcpCO2, heart rate (HR), rib cage and abdominal respiratory movements were recorded during natural nocturnal sleep, stratified for sleep states (active sleep (AS), indeterminate sleep (IS), quiet sleep (QS)). The data on AS and IS were pooled as in previous studies. The variables were analysed with respect to age. SaO2 in AS + IS and QS was 96.1 ± 1.3%, 96.6 ± 1.4%, respectively. TcpO2 in AS + IS was 10.6 ± 1.1 kPa and 10.7 ± 1.3 kPa in QS, while tcpCO2 in AS + IS was 5.4±0.3kPa and 5.4 ± 0.4kPa in QS. Neither SaO2 nor tcpO2 was influenced by age. TcpCO2 decreased significantly postnatally. Five infants (11.3%) experienced episodes of hypoxaemia with a mean decrease in SaO2 to 86 ± 1.5%. In four infants these hypoxaemic episodes were linked to upper airway obstructions. Episodes of SaO2 < 90% in conjunction with a decrease in HR to <100bpm were detected in one infant only. Periodic breathing (PB) was observed in 38.6% of infants. Conclusion: Oxygenation and carbon dioxide levels in sleeping healthy term infants were comparable to those reported in older children. Hypoxaemic episodes, if present, are associated with upper airway obstruction. PB, often assumed to be a pathological feature, is a normal breathing pattern in this age group.
Heart rate variability in infants with apparent life‐threatening events
Authors: Edner A , Katz‐Salamon M , Lagercrantz H , Ericson M , Milerad J 
Published: August 2010

Heart rate variability (HRV) is often used as an index of sympatho‐vagal balance. A decreased HRV has been observed in patients with central hypoventilation and in infants who have later succumbed to sudden infant death syndrome (SIDS). The aim of the present study was to investigate whether HRV is altered in infants with apparent life‐threatening events (ALTE), a group with an increased risk of SIDS. Fifty infants with ALTE were compared with 50 age‐ and sex‐matched controls. ECG was recorded overnight in all infants. Two sequences of RR intervals free of artefacts were selected from each sleep state and spectral analysis of RR variability was performed. The mean and SD of RR and the low (LFPow) and high (HFPow) frequency power were analysed. In active sleep (AS) the LF/HF ratio was lower in ALTE infants, but no differences were seen in either the LFPow or the HFPow. In quiet sleep (QS), however, ALTE infants had higher SD‐RR (p= 0.006), greater HFPow (p= 0.02) and VLFPow (very low frequency power, p= 0.02) than the control infants. The same results were seen when the two sleep states were combined for analysis, ALTE infants had higher SD‐RR (p= 0.004), HFPow (p= 0.006) and VLFPow (p= 0.04). Conclusion: The different HRV pattern in ALTE infants compared to healthy controls suggests an altered autonomic control.
Abnormal fetal aortic velocity waveform and postnatal growth
Authors: Ley D , Laurin J , Marsal K 
Published: August 2010

Postnatal growth from birth up to 7 y of age was evaluated in 151 children with varying degrees of intrauterine growth retardation who were previously examined in their intrauterine life with Doppler velocimetry of the thoracic descending aorta. The children with abnormal fetal aortic blood flow class (BFC), of which 39/46 (85%) had a birthweight 2 SD below the mean of the population, were lean at birth and had a high rate of catch‐up growth in weight and length during the first 3 and 6 mo, respectively. After the initial phases of rapid catch‐up in weight and length, mean values of SD scores for weight and height remained relatively unchanged up until 2 y of age, thereafter increasing gradually up to 7 y of age, leaving 4/46 (8%) and 4/46 (8%) below –2 SD for weight and height, respectively.The pattern of changes in length/height and weight over time did not differ between those infants with abnormal BFC and those with normal BFC. The abnormal fetal aortic waveform was not related to rate of early catch‐up growth or to height or weight at 7 y of age after adjustment for deviation in growth at birth. The magnitude of deficit in weight and length at birth was more predictive of subsequent growth.
Efficacy and safety of rectal thiopental sedation in outpatient echocardiographic examination of children
Authors: Okutan V , Lenk MK , Sarici SÜ , Dündaröz R , Akin R , Gokçay E 
Published: August 2010

The efficacy and safety of rectal thiopental administration in sedation for paediatric echocardiographic examination were prospectively investigated in infants with known or suspected congenital heart disease in an outpatient manner. A total of 1150 patients (546F, 604M) were studied; 264 were 7 d to 6 mo old (group I), 572 were 6 mo to 2‐y‐old (group II), and 314 were 2 to 6‐y‐old (group III). Thiopental sodium dissolved in 10 ml of water in a syringe to which a 6‐F feeding catheter was attached was administered prior to echocardiographic examination to patients in groups I, II and III with doses of 50, 35 and 25 mg/kg, respectively in an emergency care environment. Length of time to achieve sedation (induction time), duration of sedation, length of time to return to normal activity (recovery time), whether sedation was successful and side effects were recorded. In the overall study population, sedation was successful in 1094 (95.1%) of the patients, the induction time was 16.34 ± 3.69 min, the duration of sedation was 35.07 ± 7.04 min, the recovery time was 63.25 ± 10.17 min and the overall side‐effect prevalence was 2%. Sedation was significantly more successful, the induction time was significantly shorter, the recovery time was significantly longer and side effects significantly more prominent in groups I and II compared to group III. Conclusion: Rectally administered thiopental is a safe and efficacious agent for sedation of infants and young children with known or suspected congenital heart disease who are undergoing echocardiography in an outpatient cardiology clinic, provided that it is used in an emergency care setting considering the risk of respiratory depression even though the prevalence of this side effect is significantly low.
Nutrient intake among two‐year‐old children on cows' milk‐restricted diets
Authors: Henriksen C , Eggesbø M , Halvorsen R , Botten G 
Published: August 2010

Approximately 2‐3% of young children develop allergy or intolerance to cows' milk. The only available treatment is elimination of milk from the diet. However, as milk is an important source of nutrients in childhood, a milk‐free diet may not adequately meet the child's nutritional needs. A dietary survey was conducted to assess the nutrient intake of children on cows' milk‐restricted diets. A population‐based sample of families with young children (31‐37 mo) with adverse reaction to cows' milk and/or eggs was contacted, of which 75% agreed to complete a dietary intake assessment. Dietary intake was assessed using a 4‐d weighed recording. The nutrient intake in a group of children on cows' milk protein‐free (n= 16) and cows' milk reduced (n = 8) diets were compared to a group of cows' milk consumers (n = 10). There were significant differences in nutrient intake of children on milk‐free diets and children consuming milk. Children on milk‐free diets had significantly lower intake of energy, fat, protein, calcium, riboflavin and niacin. Use of milk substitutes improved the nutritional content of the cows' milk‐free diets; however, the recommendations for riboflavin and calcium were still not met.Conclusion: The results reveal a risk for malnutrition in children on cows' milk‐free diets, unless precautions are taken to replace the valuable nutrients from milk in the diet. Parents of children on milk‐free diets need advice about food choices in order to reduce the risk of low intake of energy, fat and protein. Supplements with calcium, vitamin D and riboflavin are indicated.
Abnormal fatty acid composition in umbilical cord blood of infants at high risk of atopic disease
Authors: Beck M , Zelczak G , Lentze MJ 
Published: August 2010

It is well known that patients with atopic disease have anomalies of fatty acid composition in their blood. The aim of the present study was to evaluate whether infants from atopic families also have abnormal cord blood levels of long‐chain polyunsaturated fatty acids (LC‐PUFA) in plasma and red blood cells. The levels of LC‐PUFA in umbilical cord blood of 50 healthy, full‐term infants with a hereditary risk of atopic disease were analysed and compared with a control group of 50 infants from families without a history of atopic disease. The atopy group was comprised of children from families suffering from atopic dermatitis, allergic rhinitis, asthma bronchiale and food allergy. Within this group, a group (n= 11) was formed in which the risk was determined only by paternal atopy. Fatty acids of plasma and red blood cell phospholipids, triglycerides and sterol esters were separated by high‐resolution gas‐liquid chromatography. In particular, the levels of arachidonic acid (C20:4n‐6) and docosatetraenoic acid (C22:4n‐6) were significantly lower in infants at risk of atopic disease than in infants not at risk. Interestingly, there were more significant differences shown between the control group and the paternal atopy group than between the control group and the entire atopy group.Conclusion: The results of this study could be due to a genetic influence of fatty acid metabolism or could reflect the different dietary behaviours of the mothers during pregnancy.
Consequences of infections for three‐month length increment in young children in rural Zambia
Authors: Hautvast JLA , Tolboom JJM , Willems JL , Mwela CM , Monnens LAH 
Published: August 2010

It was the aim of this study to describe the relationship of infections with subsequent 3‐mo length increment in children below 2 y of age in rural Zambia. Children aged 6‐9 mo (‘infants’;n= 84) and 14‐20 mo (‘toddlers’;n= 81) attending Mother‐and‐Child Health clinics, were included and followed up after 3.0 mo (min‐max; 2.1‐3.7 mo). Anthropometric measurements were taken at each visit. At baseline, C‐reactive protein (CRP), α1‐acid glycoprotein (AGP), retinol and malaria parasitaemia were assessed. Length increment during the 3.0 ± 0.5 mo was 1.0 ± 0.5 cm/mo for infants and 0.6 ± 0.4 cm/mo for toddlers; 50‐71% of the children showed increased acute phase proteins, 79‐83% had malaria parasitaemia and 55‐64% had low serum retinol concentrations. In the total group of children, serum AGP concentrations (r= ‐0.18;p= 0.03) and serum CRP concentrations (r= ‐0.15;p= 0.05) showed a negative relation with length increment. After correcting for micronutrient status, dietary intake and maternal height, results of multiple regression analyses showed that the relation between serum AGP concentration and subsequent length increment remained significant.We conclude that, within the multifactorial model, presence of infections in these Zambian children contributes to the short‐term retardation of linear growth.
Residual pulmonary hypertension in children after treatment with inhaled nitric oxide: a follow‐up study regarding cardiopulmonary and neurological symptoms
Authors: Göthberg S , Edberg KE , Tang SF , Michelsen S , Winberg P , Holmgren D , Miller O , Thaulow E , Lönnqvist P‐A 
Published: August 2010

Inhaled nitric oxide is a potent vasodilator in acute severe pulmonary hypertension and is increasingly used as rescue treatment in intensive care algorithms aiming at reducing severe hypoxaemia in neonates and children. Although the immediate effects may seem impressive, long‐term outcome regarding residual pulmonary hypertension and other sequelae has been studied in only a very few patients. The aim of the present study was to evaluate residual pulmonary hypertension, cardiopulmonary or neurological symptoms in children after treatment with inhaled nitric oxide in severely hypoxaemic and/or pulmonary hypertensive mechanically ventilated children. The study was performed in four paediatric intensive care units in university hospitals in Sweden, Norway and Australia. Patients who had received inhaled nitric oxide as part of their intensive care treatment for severe hypoxaemia and/or pulmonary hypertension, and in whom 6 mo had elapsed since treatment, were included for evaluation. Thus 36 paediatric or neonatal patients were examined for circulatory, respiratory or neurological disorders with clinical examination, echocardiography, chest X‐ray and a capillary blood sample. Four patients with congenital heart disease had residual pulmonary hypertension. Nine patients were receiving bronchodilators. Sixteen patients had minor (n= 15) or moderate (n= 1) changes on a chest X‐ray. One patient had a possible delay in psychomotor development. Conclusions: In spite of the severity of their primary illness, we found that the overwhelming majority of the surviving children were asymptomatic and doing well. The few residual circulatory and respiratory symptoms could be related to the initial condition.
HLA ‐ DQA1*05‐DQB 1*0201 positivity predisposes to coeliac disease in Czech diabetic children
Authors: Šumník Z , Koloušková S , Cinek O , Kotalová R , Vavřinec J , Snajderová M 
Published: August 2010

The aims of this study were to estimate the prevalence of coeliac disease (CD) in Czech children with insulin dependent diabetes mellitus (IDDM), and to determine the contribution of HLA‐DQA1 and DQB1 to CD susceptibility among diabetic children. We screened 345 children with IDDM (186 boys and 159 girls, aged 0 to 18 y) for coeliac disease using the IgA endomysial antibodies (EMA) test. In all EMA‐positive children, small bowel biopsy was performed to confirm CD. To determine the role of the HLA‐DQA1*05‐DQB1*0201 (DQ2) and the DQA1*03‐DQB 1*0302 (DQ8) molecules in CD susceptibility among diabetic children, the HLA‐DQA1‐DQB1 was genotyped in all EMA‐positive, and in 186 of EMA‐negative diabetic patients. EMA positivity was found in 15/345 (4.3%) diabetic children. The diagnosis of CD was established in 14/345 (4.1%) children based on a bioptic finding of villous atrophy, while the remaining EMA‐positive patient had a normal bioptic finding, being diagnosed as a potential CD. The HLA DQA1*05‐DQB1*0201 (DQ2) molecule conferred a significant risk of CD among diabetic children (odds ratio = 4.1, CI 95% 1.1–15), being found more frequently in diabetic children with CD (80%) than in diabetic children without CD (49%). Conclusion: The high prevalence of CD (4.1%) found in Czech children with IDDM emphasizes the need for their regular screening. We suggest that this CD screening protocol may be individualized according to the DQA1*05‐DQB 1*0201 positivity.
Early motor development of premature infants with birthweight less than 2000 grams
Authors: Pedersen SJ , Sommerfelt K , Markestad T 
Published: August 2010

The aim was to assess motor function during infancy in order to predict later function, mainly cerebral palsy. The neuromotor development of a population‐based cohort of 209 of 236 (89%) survivors with a birthweight less than 2000 g was assessed using the Infant Neurological International Battery (INFANIB) and detailed neurological assessment. The infants were classified as being normal, dystonic, hypotonic or having suspected cerebral palsy (CP) at 4, 7, 13 and 18 mo corrected age if birthweight was less than 1500 g (n= 119) and at 7 and 13 mo if birthweight was 1500–1999 g (n= 90). Those with dystonia or suspected CP were followed until diagnosed as normal or as having CP after at least 36 mo of age. Fourteen (7%) finally developed CP. Motor function at 4 mo was inaccurate in predicting function at 7 mo and later. All who were normal at 7 mo remained normal in the follow‐up period. Eight of 65 who were dystonic at 7 mo developed suspected CP, and three judged as suspected CP were eventually normal. The 14 who developed CP were judged as suspected CP (n= 5) or dystonic (n= 8) and one as hypotonic at 7 mo of age. Conclusions: The specificity of motor evaluation at 7 mo corrected age regarding CP is unsatisfactory, since dystonia at this age is most often transient. A normal neuromotor assessment at 7 mo is highly predictive of subsequent normal motor function.
Does maternal or paternal heredity affect carotid atherosclerosis in children with familial hypercholesterolaemia?
Authors: Tonstad S , Joakimsen O , Leren TP , Ose L 
Published: August 2010

Maternal hypercholesterolaemia has recently been shown to increase the number of fatty streaks in the foetal aorta, as well as subsequent progression of fatty streaks to more advanced lesions. We compared carotid intima‐media thickness by B‐mode ultrasonography in children who inherited familial hypercholesterolaemia from their mothers or fathers, hypothesizing that children whose mothers were hypercholesterolaemic during pregnancy had increased atherogenesis compared with children whose mothers did not have familial hypercholesterolaemia.We found that carotid intima‐media thickness and prevalence of plaque did not differ between children with familial hypercholesterolaemia who inherited FH maternally or paternally.
Heart weight in infants—a comparison between Sudden Infant Death Syndrome and other causes of death
Authors: Råsten‐Almqvist P , Eksborg S , Rajs J 
Published: August 2010

Heart and body weights were compared with regard to heart pathology and cause of death in well‐defined groups of infants under I y of age. In the period 1980 to 1998, out of 468 infants autopsied at the Department of Forensic Medicine in Stockholm, Sweden, 331 died of sudden infant death syndrome (SIDS), while 137 died of other causes. Physical violence was the known cause of death in 30 infants and cardiovascular malformations in another 19. Inflammatory alterations of the myocardium were found in 74 cases (16%): in 17 cases (3.6%) myocarditis was interpreted as the main cause of death; in 45 (10%) it was interpreted as contributing to SIDS and in 12 cases (2.5%) it was observed but judged not to be a contributory cause of death in non‐SIDS victims. Two of these infants died as a result of physical violence. Body weight was the best predictor for heart weight as analysed by multiple regression, including age, sex, body weight, length, BMI and birth weight. An equation for estimating heart weight from body weight gave an accuracy within the range 0.75–1.25 in 89.2% and 85.0% of the SIDS and non‐SIDS groups, respectively. Conclusion: Body weight is the best predictor for estimating heart weight. No evidence supported the notion that heart weight, body weight or birth weight of SIDS victims differs from non‐SIDS, although heart weight in infants with cardiovascular malformations deviated from observations in the other groups.