bluuebunny/crossref_metadata_2025_split huggingface dataset:
Corticosteroids for the treatment and prevention of chronic lung disease
Authors: Soll R. F. 
Published: August 2010

Postnatal corticosteroids may prevent chronic lung disease in ventilated very low birthweight infants. However, concern regarding serious neurodevelopmental consequences of therapy has led to strong recommendations to curtail use of this treatment. Conclusion: Despite the high risk of severe neurological side effects, centers in Europe and North America continue to utilize postnatal corticosteroids, frequently in a fashion that is not supported by the available evidence.
Increased QT dispersion in epileptic children
Authors: Akalin F , Tirtir A , Yilmaz Y 
Published: August 2010

Aim: Epilepsy is a common paroxysmal disorder in childhood. Tachyarrhythmia, bradyarrhythmia, asystole, atrioventricular block, ventricular fibrillation or sudden death may occur during seizures. Mutations of ion‐channel coding genes are found in patients with idiopathic or cryptogenic epilepsy. The ion channels also play a role in arrhythmogenesis. QT dispersion is a non‐invasive method for assessment of regional repolarization differences within the myocardial tissue. This study investigated QT and QTc dispersion (QTcd) and the risk of dysrhythmia in epileptic children. Methods: The first group included 28 patients with newly diagnosed epilepsy and not taking antiepileptic treatment (range 10 mo to 15 y, mean ± SD 6.86 ± 3.92 y), the second group included 34 patients taking antiepileptic treatment (range 1–14 y, mean ± SD 7.51 ± 3.68y) and the control group included 52 healthy children (range 4 mo to 15 y, mean ± SD 6.94 ± 3.92 y). Twelve‐lead ECGs were obtained and heart rate, RR interval, P wave amplitude and duration, PR interval, QRS duration, QRS axis and QT intervals were measured, and QTc, QTd, QTcd were calculated in all subjects. The measurements were repeated in the first group under antiepileptic treatment. Results: While no significant difference in terms of heart rate, RR interval, P wave amplitude and duration, PR interval, QRS duration, QRS axis, QT intervals or QTc intervals was found, QTd and QTcd values were significantly increased in epileptic children compared with the control group. QTd was 58.1 ± 13.4 ms and 35.9 ± 9.3 ms and QTcd was 91.0 ± 22.9 and 68.6 ± 18.0 ms in patients and controls, respectively. Antiepileptic treatment did not affect QT dispersion. Conclusion: QT dispersion is increased in epileptic children. Further investigation is needed to reveal the pathogenesis of myocardial repolarization abnormalities in epileptic patients.
Nutritional relevance of trans isomeric fatty acids in human milk
Authors: Decsi T 
Published: August 2010

Trans isomeric fatty acids amount to about 2% of the fatty acid composition of human milk in Europe, whereas lower values were seen in Africa, and higher values were reported for North‐America. At least five human studies indicate that trans fatty acids may interfere with the metabolism of long‐chain polyunsaturated fatty acids. Conclusion: Trans isomeric fatty acids in human milk should be regarded as a potential confounding variable in studies investigating the role of long‐chain polyunsaturated fatty acids in the development of breastfed infants.
Cardiac troponin I, cardiac troponin T and creatine kinase MB concentrations in umbilical cord blood of healthy term neonates
Authors: Trevisanuto D , Pitton M , Altinier S , Zaninotto M , Plebani M , Zanardo V 
Published: August 2010

Aims: To measure and compare cardiac troponin I, cardiac troponin T and creatine kinase MB concentrations in the umbilical cord blood of healthy term infants and to investigate the relationship between maternal and neonatal troponin values at birth. Methods: Troponin I, troponin T and creatine kinase MB concentrations were measured from the umbilical cord samples of 85 healthy term neonates and in the blood samples of their respective mothers at birth. Results: Median (interquartile range) umbilical cord concentrations were 0 μg/L (0–0) for troponin I, 0 μg/L (0–0.019) for troponin T and 4.90 μg/L (3.90–6.61) for creatine kinase MB. Troponin I and T concentrations were higher than the detection limit for the assay in 2 (2.3%) and 41 (48.2%) neonates, respectively. Two mothers (2.3%) had cTnT levels above the detection limit; none of them had increased levels of cTnI. Conclusion: Probably owing to differences in expression and assay detection limits, cord blood troponin T concentrations are frequently over the detection limit at birth, while troponin I is mostly undetectable and comparable with that in healthy pregnant women. These cardiac regulatory proteins are of neonatal origin and are not influenced by maternal levels.
Compliance of present recommendations of fatty acids in formulas for term infants with the actual human milk fatty acid composition in different populations
Authors: Agostoni C 
Published: August 2010

Fats are the only dietary agents possibly modulating the individual membrane composition, which otherwise is “genetically” determined. In infancy, human milk represents the first natural source of fats. Although the fat intake of breastfed infants is quantitatively and qualitatively unique, it is not known to what extent their varying requirements are met by the fat composition in the milk of their mothers. Conclusion: The fat composition of arbitrarily chosen human milk is not always the best standard for that in infant formula.
Disaccharidase activities in Belgian children: reference intervals and comparison with non‐Belgian Caucasian children
Authors: Blomme B , Gerlo E , Hauser B , Vandenplas Y 
Published: August 2010

Aim: To establish reference values for disaccharidase activities in Belgian children and to compare enzyme activities with those of non‐Belgian Caucasian children. Methods: Data from Belgian children who had undergone endoscopic jejunal biopsies (1994–2000) for suspected malabsorption were reviewed. The patients were divided into three groups based on histology: (A) normal (n= 201), (B) moderate changes (n= 58) and (C) (sub)total atrophy (n= 14). The 95% reference limits for disaccharidase activities (U/g protein) were calculated for group A after exclusion of patients with a positive hydrogen breath test, a history of lactose intolerance or coeliac disease (final population: n=151, 0.1–12 y). Values were compared with those of 34 non‐Belgian Caucasian children with normal histology (28 of Mediterranean origin). Results: The reference limits (90% confidence interval) were 86 (65–111)–423 (366–494) for maltase, 9 (6–12)–91 (78–122) for lactase and 24 (18–30)–155 (120–184) for sucrase. No gender‐related differences in enzyme activities were found. Lactase levels showed a slight decrease with increasing age. Disaccharidase activities of children with histologically confirmed mucosal injury were significantly lower than those of children with normal histology: median values for groups A, B and C were 208, 181 and 96, respectively, for maltase, 40, 28 and 7, respectively, for lactase and 69, 54 and 25, respectively, for sucrase. Median disaccharidase activities in biopsies with normal histology were lower in non‐Belgian children, the difference being only statistically significant for lactase, 33 versus 40. Conclusion: The reference values for Belgian children are well in line with other reported values from Caucasian children. Although enzyme activities are lower in children with histologically confirmed mucosal damage, they do not allow differentiation between histology groups. Lower lactase values were found in non‐Belgian children.
Birth season and environmental influences on patterns of thymic growth in rural Gambian infants
Authors: Collinson AC , Moore SE , Cole TJ , Prentice AM 
Published: August 2010

Aim: In rural Gambia, birth season predicts infection‐related adult mortality. Seasonal factors in early life may programme the immune system, possibly via an effect on thymic development. This study tested whether thymus size in rural Gambian infants is affected by birth season, defined as January‐June (harvest, few infections) versus July‐December (hungry, high infectious load). Methods: Thymic volume (thymic index) was assessed sonographically at 1, 8, 24 and 52 wk in 138 singleton infants born over 14 consecutive months. Growth and morbidity were regularly assessed. Results: Mean thymic index increased from 19.9 at 1 wk to 30.9 at 8 wk and 35.7 at 24 wk, then fell to 32.0 at 52 wk. Thymic index was associated with each preceding thymic index up to 24 wk. This tracking persisted after correcting for infant weight and month of measurement (p < 0.01). Thymic index at 1 wk was marginally but non‐significantly lower in hungry season births (p= 0.06). Thymic index was lower in hungry season measurements; this effect persisted after adjusting for current weight and infection markers, and was strongest at 8 wk (p= 0.001). Conclusion: These results describe a pattern of thymic growth followed by diminution in size. An infant's thymic index tracks despite changes in body weight and season. Thymic index was lower in the hungry season. This appears not to be explained by infection or nutritional status. A possible influence of trophic factors in breast milk merits investigation.
Pinpoint skin lesions in a familial hypercholesterolaemia homozygote
Authors: Milionis HJ , Miltiadous GA , Cariolou M , Elisaf MS 
Published: August 2010

The case is reported of a 2‐y‐old girl referred to the outpatient lipid clinic because of a tiny cutaneous xanthoma on the dorsum of the left foot and a family history of hyperlipidaemia and coronary heart disease (CHD). Fasting serum total cholesterol levels were remarkably high (27.1 mmol l−1, 1050 mg dl−1) and DNA analysis confirmed homozygous familial hypercholesterolaemia (class II mutation). Serum lipids were not affected by dietary intervention and cholestyramine treatment, so low‐density lipoprotein apheresis was scheduled to commence at the age of 4 y. Conclusion: An early lipid profile determination should be performed in children with a family history of premature CHD, since the physical examination may be unremarkable even in cases of severe hyperlipidaemia during the first years of life.
Childhood sarcoidosis in Denmark 1979–1994: incidence, clinical features and laboratory results at presentation in 48 children
Authors: Hoffmann AL , Milman N , Byg K‐E 
Published: August 2010

Aim: To describe the incidence, clinical presentation and paraclinical findings in childhood sarcoidosis in Denmark, 1979–1994. Methods: Patients (n= 5536) with a diagnosis of sarcoidosis were drawn from the nationwide Patient Registry; 81 patients were ±15 y of age. The diagnosis of sarcoidosis was reconfirmed in 48/81 (59%) patients. In 35/48 (73%) patients, diagnosis was verified by histology, and in 13 it was substantiated by paraclinical/clinical findings. Results: The series comprised 26 boys and 22 girls (male/female ratio 1.18). Median age at diagnosis was 13 y (range 0.7–15). In 1979–1994 the incidence was 0.29 per 100 000 person‐years ±15 y of age. The incidence was 0.06 in children ±4 y of age and increased gradually with age to 1.02 in children aged 14–15 y. General malaise, fever, weight loss, abdominal discomfort, respiratory symptoms, lymphadenopathy and central nervous system symptoms were common; 31% of patients had erythema nodosum, 12.5% sarcoid skin lesions, 25% uveitis/iridocyclitis and 4.2% sarcoid arthritis. Chest X‐rays were normal (stage 0) in 10% of patients, and showed pulmonary infiltrates stage I in 71%, stage II in 8.3% and stage III in 8.3%. Lung function tests were examined in 13 patients: 50% had decreased FEV1 and vital capacity, 80% decreased DLCO. Haemoglobin values were normal. Some patients had mild leukopenia, some moderate leukocytosis and a few had moderate eosinophilia. Erythrocyte sedimentation rate was elevated in 40% of the patients. Plasma calcium was elevated in 30% of the patients; 4 patients had severe hypercalcaemia and elevated plasma creatinine, and 1 patient had nephrocalcinosis. Serum angiotensin‐converting enzyme was elevated in 55% of the patients. Liver function tests were normal with no sarcoid hepatitis. Urinary examination (glucose, albumin, haemoglobin) was normal in 96% of the patients; the patient with nephrocalcinosis had albuminuria and haematuria. Conclusion: The incidence of sarcoidosis in Danish children is low and increases with age. Sarcoidosis in young children may present clinical features that are different from the appearance of those in older children and often constitute a diagnostic challenge. In older children, the clinical appearance has many features in common with the presentation in adults.
One‐third of term babies after perinatal hypoxia–ischaemia have transient hearing impairment: dynamic change in hearing threshold during the neonatal period
Authors: Jiang ZD , Wang J , Brosi DM , Shao XM , Wilkinson AR 
Published: August 2010

Aim: To examine the process of change in hearing threshold during the neonatal period after perinatal hypoxia‐ischaemia. Methods: The threshold of brainstem auditory evoked responses (BAER) was measured serially during the first month after birth in 92 term babies who suffered hypoxia‐ischaemia. Results: The mean BAER threshold in these babies was significantly increased on day 1 (ANOVA p < 0.001). The elevated threshold decreased progressively on days 3 and 5, but was still significantly higher than that in normal controls (p < 0.01). The elevation continuously decreased more slowly on days 10 and 15, and to a near normal level on day 30. Threshold elevation was seen in 31.7% of the babies on day 1, and 34.5% during the first three days. The rate of elevation decreased progressively thereafter. On day 30, 10.6% of the subjects still had increased thresholds. Moderate to severe elevation occurred mainly during the first week and severe elevation occurred predominately on day 1. Threshold elevation starting after days 3–5 is likely to be due to middle‐ear disorders. As a whole, during the first month, 44.6% (41/92) of the babies studied had threshold elevation. BAER threshold was correlated weakly with the stage of hypoxic‐ischaemic encephalopathy on days 1 and 3. The threshold was significantly higher in babies with severe encephalopathy than in those with mild or moderate encephalopathy during the first 3 d of life. Conclusion: Hearing threshold is elevated in about one‐third of term babies after hypoxia‐ischaemia. The elevated threshold decreases progressively after birth, and returns to normal by one month in most babies. The threshold correlates weakly with the severity of encephalopathy.
Early motherhood and disruptive behaviour in the school‐age child
Authors: Trautmann‐Villalba P , Gerhold M , Laucht M , Schmidt MH 
Published: August 2010

Aim: To determine the significance of young maternal age, family adversity and maternal behaviour during mother‐toddler interaction in the prediction of child disruptive behaviour at age eight. Methods: From an ongoing longitudinal study of infants at risk for later psychopathology (n= 362), 72 young mothers aged between 15 and 24 y (median 22 y) at first birth were compared with 197 primiparous older mothers ranging in age from 25 to 41 y (median 29 y). Family adversity at childbirth was assessed using a modified version of Rutter's Family Adversity Index (FAI) and measures of child disruptive behaviour at age eight were obtained using Achenbach's Teacher Report Form (TRF). An observational procedure was used to assess maternal behaviour during mother‐child interaction at the age of 2 y. Results: Young mothers encountered more adverse family characteristics and were more inadequate, restrictive and more negative during interaction with their toddlers. Their school‐aged children showed higher scores on all disruptive behaviour scales of the TRF. Hierarchical regression analyses revealed that family adversity and maternal behaviour during toddler interaction could account for most of the association between early motherhood and child disruptive behaviour. Conclusion: The impact of young motherhood on child mental health is not confined to teenage mothers and is mainly attributed to psychosocial and interactional factors.
The Danish national study in infants with extremely low gestational age and birthweight (the ETFOL study): respiratory morbidity and outcome
Authors: Kamper J , Jørgensen N Feilberg , Jonsbo F , Pedersen‐Bjergaard L , Pryds O ,   the Danish ETFOL Study Group
Published: August 2010

Aim: To describe and analyse neonatal care, short and long‐term morbidity with special reference to ventilatory support and chronic lung disease (CLD) in a population‐based study. Methods: During 1994 and 1995 a prospective, nation‐wide, multicentre study was conducted, comprising 477 liveborn infants with gestational age (GA) >28 wk and/or birthweight >1000 g. Of these, 407 infants received active treatment. The ventilatory treatment was based on the principle of permissive hypercapnia and early nasal continuous positive airway pressure (NCPAP) supplemented with surfactant and ventilator therapy in case of CPAP failure. Results: Among actively treated infants 85% received CPAP and 23% mechanical ventilation from the first day of life. A total of 269 infants (56%) survived to discharge. Of these, 195 had a GA >28wk. One‐hundred and five survivors with GA >28 wk survived with NCPAP as sole respiratory support. In surviving infants, periventricular leucomalacia/intraventricular haemorrhage grade 3–4 was found in 10%, retinopathy of prematurity grade >2 in 4%, and oxygen requirement at 36 and 40 wk of postmenstrual age (CLD) in 16 and 5%, respectively. Three infants either died of CLD (n= 1) or required oxygen therapy beyond 43 wk of postmenstrual age. Logistic regression analysis showed significant associations between oxygen requirement at 40 wk and GA, septicaemia, mechanical ventilation, symptomatic patent ductus arteriosus and Clinical Risk Index for Babies score. Only the two last‐mentioned factors proved significant in infants with GA >28 wk. No infant died after discharge and 253 (94%) were followed up at 2 y of corrected age; one or more moderate to severe impairments were found in 66 (26%) of the examined children. Conclusion: Ventilatory treatment in extremely premature and extremely low‐birthweight infants based on early NCPAP and permissive hypercapnia may result in comparable survival rates and sensorineural outcome; however, the incidence of CLD seems lower than that reported on conventional treatment.
Changes in parental risk behaviour after an information campaign against sudden infant death syndrome (SIDS) in Norway
Authors: Hill SAR , Hjelmeland B , Johannessen NM , Irgens LM , Skjærven R 
Published: August 2010

Aim: To assess parental risk behaviour before and after a sudden infant death syndrome (SIDS) information campaign with special emphasis on associations with maternal age, education, marital status and birth order. Methods: Data from questionnaires sent to all mothers who gave birth in Norway during a period before the campaign were compared with corresponding data obtained after the campaign. Results: Prevalence of non‐supine sleeping position decreased from 33.7% to 13.6% while changes in smoking, non‐breastfeeding and co‐sleeping were disappointing. Risk factors were particularly prevalent in young mothers, but also in mothers with a minimum period of education, non‐cohabitation and at birth order 2+. Conclusions: Non‐supine sleeping decreased to a level that has never been reported before. In future campaigns, subgroup‐specific measures may be needed.
Body mass index rebound and overweight at 8 years of age in hyperphenylalaninaemic children
Authors: Scaglioni S , Verduci E , Fiori L , Lammardo AM , Rossi S , Radaelli G , Riva E , Giovannini M 
Published: August 2010

Aim: To evaluate whether the age at body mass index (BMI) rebound may be associated with overweight at age 8 y in hyperphenylalaninaemic (HPA) children. Methods: A longitudinal observational study including 97 HPA children born 1984–1993 and detected by the National Neonatal Screening programme. Children were followed up at the same institution and evaluated for dietary intakes and anthropometrical parameters from diagnosis up to the age of 8 y. Outcome measure was overweight at age 8 y, defined according to the International Obesity Task Force. The age at BMI rebound, BMI before and at rebound were considered as potential determinants. Familial overweight, breastfeeding and macronutrients intake at age 1 y were considered as confounders. Results: Mean (95% confidence interval [CI]) age at BMI rebound was 5.0 (4.7–5.3) y. At the age of 8 y, 24.7% (95% CI 16.3–33.1%) of children was overweight. Children overweight at the age of 8y exhibited earlier BMI rebound than non‐overweight children (mean difference [95% CI] —2.1 [‐2.8 to ‐1.4] y) and higher BMI from the age of 1 y (mean difference [95% CI] 1.2 [0.9–2.5] kg/m2) onward. Overweight was more likely in children with, rather than without, parental overweight (41.0% vs 19.8%). After adjustment for confounders, logistic analysis showed that earlier BMI rebound (odds ratio [OR] 2.4, 95% CI 1.2–4.8) and BMI at age 1 y (OR 2.3, 95%CI 1.1–4.98) were independently associated with overweight at the age of 8 y. Conclusion: Within the population of this study, overweight at age 8 y was positively associated with early BMI rebound and BMI at age 1 y.
Extracorporeal life support for children with meningococcal septicaemia
Authors: Luyt DK , Pridgeon J , Brown J , Peek G , Firmin R , Pandya HC 
Published: August 2010

Objective: To describe the short‐term outcome of children with meningococcal sepsis treated with extracorporeal membrane oxygenation (ECMO) in a single centre. Design: Retrospective analysis of case notes. Setting: The Heartlink ECMO Centre, Glenfield Hospital, Leicester. Patients: Eleven children (8 boys) out of a total caseload of 800 patients were treated for meningococcal sepsis with ECMO. Interventions: Extracorporeal membrane oxygenation. Results: All children with meningococcal sepsis treated with ECMO had a Glasgow Meningococcal Septicaemia Prognostic Score (GMSPS) >12 (positive predictive risk of death of approximately 90%). Five children had adult respiratory distress syndrome (ARDS) and six had refractory shock with multi‐organ dysfunction syndrome (MODS) at presentation for ECMO. All five children in the ARDS group survived, four of five receiving veno‐venous (VV‐) ECMO therapy. In contrast, only one of six children with refractory shock with MODS survived, all of whom required veno‐arterial (VA‐) ECMO therapy.Conclusions: Most children with meningococcal sepsis and severe ARDS can be successfully treated with VV‐ECMO. In contrast, children with refractory shock and MODS die despite treatment with VA‐ECMO. This report does not resolve whether ECMO therapy offers any advantage over conventional therapy in treating severe meningococcal sepsis.