bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors influencing management and comparison of outcomes in paediatric intussusceptions
Authors: Saxena A K , Höllwarth M E 
Published: May 2008

AbstractAim: This study aims to compare management strategy and outcomes of paediatric ileocolic intussusceptions (ICI) versus small‐bowel intussusceptions (SBI).Methods: Hospital charts of patients with intussusceptions between January 1999 and June 2006 were reviewed retrospectively.Results: A total of 135 patients with the diagnosis of intussusceptions were found in the database. In 111 patients the diagnosis was confirmed using ultrasound. The median age of the patients was 2.25 years (range 9 weeks–10 years). ICI were documented in 83 patients (74.8%) and SBI in 28 (25.2%). Spontaneous reductions were observed in 11 of 83 (13.3%) ICI and 18 of 28 (64.3%) SBI. Pneumatic reductions were attempted and were successful in 61 of 67 (91%) ICI and 6 of 7 (85.7%) SBI. Surgery was performed in 11 of 83 (13.3%) ICI and 4 of 28 (14.3%) SBI; with 2 of 83 (2.4%) ICI and 3 of 28 (10.7%) SBI patients requiring bowel resections. The median age of patients requiring surgery was 9 months in ICI and 6 years in SBI.Conclusion: There are differences in ICI and SBI with regard to spontaneous reductions, and bowel resection, and age with regard to surgery and bowel resection. The treatment efficacy depends on time of presentation, intussusception type, pathologic lead points, ultrasound/colour Doppler interpretation and expertise in reduction techniques.
Reduced IL‐10 production and ‐receptor expression in neonatal T lymphocytes
Authors: Schultz C , Strunk T , Temming P , Matzke N , Härtel C 
Published: May 2008

AbstractAim: To further evaluate the underlying mechanism of a formerly demonstrated immature anti‐inflammatory response in neonates (1).Methods: Interleukin (IL)‐10 production was measured by enzyme‐linked immunosorbent‐assay (ELISA) after anti‐CD3/anti‐CD28 costimulation of neonatal and adult T cells. IL‐10 receptor expression on T lymphocytes, B lymphocytes and monocytes were analysed by flow cytometry in neonates and adult controls.Results: After anti‐CD3/anti‐CD28 costimulation, IL‐10 production of neonatal T lymphocytes was profoundly reduced (median 247 pg/mL vs. 1062 pg/mL, p < 0.0001). IL‐10 receptor expression was diminished on neonatal T lymphocytes compared to adults (3% vs. 39.5% IL‐10 receptor positive lymphocytes; p < 0.0001). On neonatal B lymphocytes and monocytes the IL‐10 receptor expression was comparable to adult controls.Conclusion: The strongly reduced IL‐10 receptor expression on the main immune regulative T lymphocytes in conjunction with a significantly impaired synthesis of IL‐10 may play a crucial role in the formerly demonstrated deficient anti‐inflammatory immune response in neonates.
High‐sensitivity C‐reactive protein in children at risk for coronary artery disease
Authors: Guran Omer , Akalin Figen , Ayabakan Canan , Dereli Feyza Yagmur , Haklar Goncagul 
Published: May 2008

AbstractAim: To determine the value of high‐sensitivity C‐reactive protein (hs‐CRP) in predicting risk factors for coronary heart disease (CHD) in children.Methods: We measured hs‐CRP levels in 51 children (11.79 ± 3.14 years) with risk factors for CHD (hypercholesterolemia, hypertension, obesity, low HDL cholesterol and familial history of CHD). The results were compared with 26 children (12.98 ± 2.59 years) without any risk factors.Results: The children with risk factors had significantly higher serum levels of hs‐CRP compared to the control group (3.33 ± 4.58 vs. 0.92 ± 1.90 mg/L, respectively, p < 0.01). CRP concentrations significantly increased in children with three or more risk factors. Hs‐CRP levels correlated to body mass index (r = 0.411, p = 0.003), diastolic blood pressure (r = 0.323, p = 0.021), fibrinogen (r = 0.447 and p = 0.004) and HDL cholesterol levels (r =−0.461 and p = 0.001). Cutoff value for CRP was 1.04 mg/L with 58% sensitivity and 92% specificity.Conclusion: Serum hs‐CRP level is a useful marker in screening the children who are under the risk of CHD in adulthood. Early identification of the children with risk factors and intervention for obesity, harmful habits and life style in childhood might decrease the incidence of coronary heart disease in adulthood.
Congenital heart defects—chromosomal anomalies, syndromes and extracardiac malformations
Authors: Meberg Alf , Hals Jardar , Thaulow Erik 
Published: May 2008

AbstractAim: To register chromosomal anomalies, syndromes and extracardiac malformations in patients with Congenital heart defects (CHDs).Method: Population‐based prospective observational study.Results: Of 57 027 live births during 1982–2005, CHDs were detected in 662 (11.6 per 1000), of whom 146 (22%) had associated anomalies. Of these 52 (36%) had chromosomal anomalies (exclusive microdeletions), 26 (18%) genetic syndromes/microdeletions, 1 (0.7%) a teratogenous syndrome and 67 (46%) extracardiac malformations. In perimembraneous ventricular septal defects (VSDs), associated anomalies occurred in 22 of 70 (31%) compared to 27 of 298 (9%) in VSDs located in the muscular part of the septum (p < 0.0001). The prevalence of CHDs with associated disorders increased significantly from the cohort born during 1982–1993 to those born during 1994–2005 (2.0 vs. 3.1 per 1000, respectively; p < 0.0001), mainly caused by an increase of chromosomal trisomies (0.5 vs. 1.1 per 1000; p = 0.026). The percentage of women giving live birth at 35 years of age or more was 7.6% for the period 1982–1993 compared to 13.4% for 1994–2005 (p = 0.001).Conclusions: Chromosomal anomalies, syndromes and extracardiac malformations occurred in nearly one‐fourth of CHD cases. Muscular VSDs had a low prevalence of such conditions. The prevalence of CHDs with chromosomal trisomies increased, and was probably related to an increasing age of women giving birth.
Omitting control biopsy in paediatric coeliac disease: a follow‐up study
Authors: Killander Anna , Arnell Henrik , Hagenäs Lars , Finkel Yigael 
Published: May 2008

AbstractAim: To evaluate the practice of diagnosing coeliac disease with only one small‐bowel mucosal biopsy in a selected group of children with suspected coeliac disease.Methods: A retrospective review of medical records and a follow‐up interview of 102 children (65 girls, 37 boys) at diagnosis of coeliac disease. The inclusion criteria were age >18 months, increased levels of serum antitissue transglutaminase IgA antibodies and pathologic small‐bowel mucosal biopsy. Anthropometric data were calculated for children 1.5–11 years of age.Results: The levels of serum antitissue transglutaminase IgA antibodies were either normal (92%) or slightly elevated (8%) in all children after 1 year on a gluten‐free diet. The height‐for‐age Z score increased in 52 of 61 (85%) children, (median 0.26 SD, range −0.45 to 1.83 SD) and the weight‐for‐age Z score increased in 50 of 61 (82%) children (median 0.42 SD, range −0.77 to 2.24 SD). Sixty of 61 (98%) children showed normal or catch‐up growth. Regression of symptoms after 1 year on a gluten‐free diet was reported for 71 of 72 (98%) children.Conclusion: We propose that a control biopsy is not necessary for the diagnosis of coeliac disease in these children.
Postnatal management of isolated mild pelvic dilatation detected in antenatal period
Authors: Merlini L , Parvex P , Anooshiravani‐Dumont M , Girardin E , Hanquinet S 
Published: May 2008

AbstractAim: Mild antenatal renal pelvic dilatation (ARPD) revealed by prenatal ultrasound (US) raises the question whether or not screening for vesicoureteral reflux (VUR) is mandatory. The aim of our study was to suggest guidelines for postnatal management of infants with mild ARPD defined as an antero‐posterior (AP) dilatation >5 and <10 mm.Method: Therefore we assessed the value of postnatal US at day 30 to predict VUR, the incidence of VUR at day 30 and the rate of spontaneous resolution at 1 year. Two hundred (200) infants with ARPD were included and had renal US and voiding cystourethrography (VCUG) at day 30. If VUR was present, VCUG was repeated 1 year later.Results: Incidence of VUR was 10% (20/200) at day 30 after birth and only 3% (6/200) 1 year later. VUR at day 30 was twice as frequent in children with postnatal dilatation (11%) than in nondilated kidneys (6%).Conclusions: Considering the low incidence of VUR at 1 year, screening for VUR in mild ARDP seems not to be justified. However follow‐up by US to detect increase in dilatation and clinical monitoring for signs of urinary infection is required.
Effects of the home environment on unintentional domestic injuries and related health care attendance in infants
Authors: De Lourdes Drachler Maria , De Carvalho Leite José Carlos , Marshall Tom , Anselmo Hess Almaleh Carla Maria , Feldens Carlos Alberto , Vitolo Márcia Regina 
Published: May 2008

AbstractAims: To examine the effects of the home environment on unintentional domestic injuries and related health care attendance in infants from deprived families.Methods: Ten mechanisms that caused unintentional domestic injury during the first year were investigated in a population‐based study of 1‐year‐old children in southern Brazil. Odds ratios of injury‐related health care attendance were estimated by number of injury mechanisms reported. Variation in number of mechanisms (in the whole sample) and odds ratios of care attendance (in children with reported injuries) were estimated for socioeconomic and psychosocial variables.Results: Among all children (394) 86% had injuries; 10.9% care attendance and 0.5% hospitalisation were reported, and 14.5% presented dental trauma. Injury‐related care attendance increased with the number of injury mechanisms (linear trend OR = 1.34, 95% CI = 1.09–1.66). In multivariable linear regression, injury mechanisms increased with the number of home hazards (p = 0.047) and decreased with duration of exclusive breastfeeding (p = 0.039), maternal involvement‐responsiveness (p = 0.037) and mother's paid work (p = 0.018). Injury‐related health care attendance among children with reported injuries was positively associated with maternal involvement‐responsiveness (OR = 2.27, 95% CI = 1.11–4.67) and home organization (OR = 2.25, 95% CI = 1.09–4.65).Conclusion: Injury control can benefit from policy and practice that improve housing, reduce home hazards and promote breastfeeding, maternal bonds, safety practices and injury care.
Perinatal and socioeconomic determinants of breastfeeding duration in very preterm infants
Authors: Flacking R , Wallin L , Ewald U 
Published: May 2008

AbstractAim: To describe the impact of prematurity, size at birth, neonatal disorders and the families' socioeconomic status (SES) on breastfeeding duration in mothers of very preterm infants.Methods: Prospective population‐based cohort study. Data on breastfeeding, registered in databases in two Swedish counties in 1993–2001, were matched with data from two national registries: the Medical Birth Registry and Statistics Sweden. Mothers of 225 very preterm singleton infants were identified and included.Results: Seventy‐nine percent of the mothers breastfed at 2 months, 62% at 4 months, 45% at 6 months, 22% at 9 months and 12% at 12 months. Prematurity, size at birth and neonatal disorders did not show an effect on breastfeeding duration. Being adversely exposed to any of the SES factors (maternal education, unemployment benefit, social welfare and equivalent disposable income in the household) was significantly associated with earlier weaning up to 6 months of infants' postnatal age.Conclusions: This study shows new and noteworthy results concerning breastfeeding duration in mothers of very preterm infants, which was not influenced by degree of prematurity, size at birth or neonatal disorders but was affected by SES. This highlights the need for improved support of socioeconomically disadvantaged mothers, during and after the hospital stay.
Coping strategies among Swedish children and adolescents with mobility impairment in relation to demographic data, disability characteristics and well‐being
Authors: Jemtå L , Dahl M , Nordahl G , Fugl‐Meyer KS 
Published: May 2008

AbstractAim: The first aim of the present study was to evaluate the applicability of a four‐dimensional model of coping strategies, which includes ‘active coping’, ‘distraction’, ‘avoidance’ and ‘support seeking’ strategies, on children and adolescents with mobility impairment. The second aim was to identify coping strategies in this group. Finally, we analysed the relation between coping strategies and demographic data, disability characteristics and well‐being.Methods: Children and adolescents aged 7–18 years with mobility impairment (n = 133) were interviewed, and demographic and disability characteristics were recorded. The Children's Coping Strategies Checklist, a 52‐item self‐report inventory, was used to characterise dispositional style in coping.Results: The four‐factor model of coping strategies provides an adequate fit to the data of the sample studied. Three of the four coping strategies, all except ‘avoidance’, were significantly related to several demographic and disability features. Well‐being was not significantly related to any of the four coping strategies, although the higher the trust in the strategies, the higher the estimation of one's own well‐being.Conclusion: Identification of coping strategies among children and adolescents with mobility impairment should form the basis of our understanding of how they face the complexity of challenges while growing up.
Survey of neonatal respiratory support strategies
Authors: Sharma Atul , Greenough Anne 
Published: May 2008

AbstractAim: To survey current practice regarding neonatal respiratory support strategies to determine whether it reflected evidence from randomised trials.Methods: A questionnaire (in Supplementary Material online) survey of all U.K. neonatal units was undertaken to determine what modes of ventilation, types of endotracheal tube, lung function monitoring and oxygen saturation levels were used.Results: There was an 80% response rate. Most (73%) units used in prematurely born infants (in the first 24 h) the intermittent positive pressure ventilation, and other respiratory modes included: CPAP (2%), triggered ventilation with or without volume guarantee (22%) and high frequency oscillation (2%). Only 15% of units used assist control mode for weaning; the preferred weaning mode was synchronous intermittent mandatory ventilation (73%). Few units used shouldered endotracheal tubes (3%) or lung function measurements (25%) to aid choice of ventilator settings. Oxygen saturation levels from 80% to 98% were used, levels greater or equal to 95% were used by 11% of units for infants with acute respiratory disease but by 34% of units for BPD infants (p < 0.001).Conclusion: Many practitioners do not base their choice of neonatal respiratory support strategies on the results of large randomised trials; more effective methods are required to ensure evidence‐based practice.
Delayed diagnosis of critical congenital cardiovascular malformations (CCVM) and pulse oximetry screening of newborns
Authors: Aamir Tajwar , Kruse Lakota , Ezeakudo Osita 
Published: May 2008

AbstractObjective: Congenital cardiovascular malformations (CCVMs) are relatively common with a prevalence of 5–10 per 1000 live births. Pulse oximetry screening is proposed to identify newborns with critical CCVMs which are missed by routine prenatal ultrasound and by pre‐discharge physical examinations. The purpose of this study was to identify the number of infants with a delayed diagnosis of critical CCVMs potentially detectable by pre‐discharge pulse oximetry screening.Patients and Methods: Hospital Discharge records in New Jersey from 199–2004 for infants with critical CCVMs were identified using ICD‐9 codes. These records were matched to the Electronic Birth Certificate records to identify newborns who were discharged as normal newborns and were later admitted with a diagnosis of critical CCVMs. Chart review was completed on these cases to confirm a delay in diagnosis.Results: Chart reviews confirmed delayed diagnosis of critical CCVM in 47 infants out of 670,245 births. Coarctation of the Aorta was the most common delayed diagnosis. The age at final diagnosis varied from 3 days to 6.5 months.Conclusions: Further examination of pulse oximetry as a routine newborn screening service is warranted. Implementation of pre‐discharge pulse oximetry screening for newborns may improve the timely detection of asymptomatic critical CCVMs.
Effect of intravenous pamidronate therapy on everyday activities in children with osteogenesis imperfecta
Authors: Löwing Kristina , Åström Eva , Oscarsson Katarina Allbrink , Söderhäll Stefan , Eliasson Ann‐Christin 
Published: May 2008

AbstractAim: To evaluate the effect of intravenous pamidronate therapy on everyday activities, well‐being, skeletal pain and bone density in children with osteogenesis imperfecta (OI).Methods: In a prospective observational study, monthly intravenous pamidronate infusions were given to 43 children (aged 4 months–16 years) with different severity and form of OI. Outcome measures included the Pediatric Evaluation of Disability Inventory (PEDI), a score of well‐being, registration of days with pain and bone density measured by using dual energy X‐ray absorptiometry (DXA). Data were collected before and after the first year of treatment.Results: Self‐care and mobility measured by PEDI increased significantly in both the Functional Skill scale and in the Caregiver Assistance scale. The youngest children improved more than the older ones according to the PEDI. The days with skeletal pain were reduced and both well‐being and bone density increased.Conclusions: Intravenous treatment with bisphosphonates influenced health status, according to the International Classification of Functioning, Disability and Health (ICF). This group of 43 children experienced beneficial effects on everyday activities, skeletal pain, well‐being and bone density.
Evaluation of the educational impact of the WHO Essential Newborn Care course in Zambia
Authors: McClure E M , Carlo W A , Wright L L , Chomba E , Uxa F , Lincetto O , Bann C 
Published: May 2008

AbstractObjectives: To evaluate the effectiveness of the World Health Organization (WHO) Essential Newborn Care (ENC) course in improving knowledge and skills of nurse midwives in low‐risk delivery clinics in a developing country.Methods: The investigators identified the content specifications of the training material, developed both written and performance evaluations and administered the evaluations both before and after training clinical nurse midwives in Zambia.Findings: Based on these evaluations, both the knowledge and skills of the nurse midwives improved significantly following the course (from a mean of 65% correct pretraining to 84% correct post‐training and from 65% to 77% correct on the performance and written evaluations, respectively). The ENC course written evaluation was validated and both tools allowed evaluation of the ENC course training.Conclusions: We found significant improvements in trainees' knowledge and skills in essential newborn care following the WHO ENC course; however, lack of basic resources may have limited the application of the ENC guidelines. Implementation of the ENC course should be undertaken in consideration with the local conditions available for newborn care.
The postnatal changes in red blood cell NO levels
Authors: Bard Harry , Bellemin Karine , Gagnon Carmen 
Published: May 2008

AbstractAim: To determine the levels of RBC HbSNO and HbFe(II)NO using chemiluminescence in very low birth weight infants breathing room air, during the first 2 days of life.Method: RBC NO values were compared to the levels obtained in cord blood at birth from infants of similar gestational age. Five infants ranging from 25 to 27 weeks of gestation were sampled between 12 and 24 h after birth. These infants were considered as the postnatal group and had normal blood gases at room air.Results: The HbSNO levels were increased in the postnatal group from 49.0 ± 17.4 nm to 152.3 ± 54.3 nm (p = 0.0006). There was no difference in HbFe(II)NO levels between the two groups (mean of 267.6 ± 186.5 nm in cord blood and 180.3 ± 89.2 nm in the postnatal sample.Conclusion: The increase in HbSNO postnatally could be an important mechanism for the neonatal pulmonary adaptation to extra‐uterine life.
Wheeze detection as a measure of bronchial challenge in young children with cough‐variant asthma and with classic asthma
Authors: Koh Young Yull , Kang Hee , Yoo Young , Kim Do Kyun , Yu Jinho , Kim Chang Keun 
Published: May 2008

AbstractAim: Tracheal and chest auscultation for wheeze and transcutaneous oximetry have both been suggested as outcome measures of bronchial provocation tests in young children. The aims of this study were to compare the sensitivity of these two techniques as endpoints for methacholine challenge in young children with cough‐variant asthma (CVA) and with classic asthma (CA), and to investigate whether oxygen saturation levels at the presence of wheezing differ in these two groups.Methods: We performed a retrospective analysis of methacholine challenge test data from 4‐ to 6‐year‐old children with CVA (n = 41) and from those with CA (n = 53). The challenges used a modified auscultation method that set wheeze detection and/or oxygen desaturation for determining the endpoint.Results: The frequency of wheeze detection at the endpoint was significantly lower than that of oxygen desaturation (46.3% vs. 78.0%) in the CVA group, which contrasted with findings (75.5% vs. 50.9%) in the CA group. Oxygen saturation levels at the presence of wheezing were significantly lower in the CVA group than in the CA group (94.5 ± 1.5% vs. 95.9 ± 1.8%, p = 0.006).Conclusion: Wheeze detection is a less sensitive outcome measure than oxygen desaturation and is associated with a lower oxygen saturation level in young children with CVA, compared to those with CA.
Benefits of breastfeeding in cystic fibrosis: A single‐centre follow‐up survey
Authors: Colombo Carla , Costantini Diana , Zazzeron Laura , Faelli Nadia , Russo Maria Chiara , Ghisleni Diana , Gatelli Italo , Giovannini Marcello , Riva Enrica , Zetterström Rolf , Agostoni Carlo 
Published: May 2008

AbstractAim: To study the effect of breastfeeding (BF) on growth, lung function and number of infections during the first 3 years of life in children with cystic fibrosis (CF).Material and methods: One hundred forty‐six CF patients, 5–18 years old, were recruited at their annual care visit. Information about infant feeding, psychosocial and socioeconomic conditions and smoking exposure was obtained by interviews. Anthropometric parameters at 1 year of age and the number of infections and hospitalisations during the first 3 years of life were obtained from clinical charts. Anthropometrics and pulmonary function parameters were obtained at enrolment.Results: In CF patients, particularly those with pancreatic insufficiency, the prevalence of BF was lower than the general Italian population. After multivariate analysis patients with prolonged BF showed higher values of CED expiratory volume in 1 sec (FEV‐1) (p = 0.001) and a lower number of infections during the first 3 years of life (p = 0.098).Conclusion: Prolonged BF is beneficial in children with CF and may protect them against decline of pulmonary function. Particular attention should be paid to promote BF in infants with CF.