bluuebunny/crossref_metadata_2025_split huggingface dataset:
SYSTEMATIC REVIEW OF DIAGNOSTIC CRITERIA AND CLINICAL FEATURES OF FAMILIAL HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS
Authors: Gholam Caroline 
Published: January 2008

INTRODUCTION: Familial lymphophagocytic histiocytosis (FHL) is an autosomal-recessive immunologic disorder that is fatal if untreated. The quoted incidence is 1.2 in 1 000 000; fewer than 1 of 3 patients are diagnosed while alive. The true incidence of FHL may be much higher.
OBJECTIVE: With this project we aimed to identify consensus information required for early recognition and diagnosis of patients with FHL to initiate life-saving treatment.
METHODS: An extensive Medline search that covered the last 20 years produced 17 relevant articles. The hemophagocytic lymphohistiocytosis 2004 protocol produced by the American Histiocyte Society provided additional information.
RESULTS: From this review, the consensus diagnostic criteria for FHL are (1) familial disease/known genetic defect, (2) clinical and laboratory criteria (5 of 8 criteria), (3) fever, (4) splenomegaly, (5) cytopenia in ≥2 cell lines, (6) hypertriglyceridemia and/or hypofibrinogenemia, (7) high ferritin level, (8) high levels of soluble CD25 (interleukin 2 receptor), and (9) hemophagocytosis in bone marrow, cerebrospinal fluid, or lymph nodes. Results of tests of initial bone marrow aspirate may be inconclusive, and repeated ones may be necessary. Half of the patients have abnormal cerebrospinal fluid findings. Several symptoms and laboratory findings provide supportive evidence.
CONCLUSIONS: Diagnostic criteria and supportive features are consistent throughout literature and are aided by the recent addition of genetic and protein-based testing. Diagnostic difficulty lies in the lack of pathognomonic features or specific diagnostic tests for FHL. Not all features present at the initial stage. Treatment should be initiated in cases of strong clinical suspicion.
CEREBRAL OXYGENATION RESPONSES DURING SKIN-TO-SKIN CARE IN LOW BIRTH WEIGHT INFANTS
Authors: Begum Esmot Ara , Bonno Motoki , Ohtani Noriko , Yamashita Shigeko , Tanaka Shigeki , Yamamoto Hatsumi , Kawai Masatoshi , Komada Yoshihiro 
Published: January 2008

INTRODUCTION: Kangaroo care (KC) has been thought of as an important intervention for improving the care of low birth weight infants; however, the physiological effect of KC is still controversial.
OBJECTIVE: The aim of this study was to investigate physiological responses during KC.
METHODS: Sixteen low birth weight (&lt;1600 g) infants with gestational ages of 24 to 32 weeks were studied. Heart rate (HR), respiration rate, pulse oxygen saturation (SPo2), and regional cerebral oxygenation (rSo2) were obtained in 3 periods continuously: before, during, and after KC. Spectral analysis was performed. Total amplitude, the power of low-frequency (LF; 0.06–0.10 Hz) band, high-frequency (HF, 0.15–0.40 Hz) band, and the ratio of LF/HF were calculated. Three groups were compared by analysis of variance.
RESULTS: Significant differences were not observed during KC in terms of mean HR, SPo2, and rSo2. By amplitude, these parameters were significantly decreased during KC (P &lt; .001) and increased after KC (P &lt; .001). The power of LF or HF was either significantly decreased during KC in HR, SPo2, and rSo2 (P &lt; .05); however, the ratio of LF/HF was increased during KC in HR, whereas the ratio was decreased in rSo2 (P &lt; .05).
CONCLUSIONS: These results suggest that KC influences the stability of rSo2 as well as HR and SPo2. Discrete results in the LF/HF ratio of rSo2 may indicate that KC has different effects on rSo2 associated with cerebral function.
INTRAVENOUS MAGNESIUM FOR TREATING ACUTE EXACERBATIONS OF ASTHMA IN CHILDREN: A SYSTEMATIC REVIEW
Authors: Rackham Oliver , Paize Fauzia 
Published: January 2008

INTRODUCTION: Inhaled bronchodilators and systemic corticosteroids are the mainstay of treatment for acute exacerbations of asthma. A systematic review of the use of magnesium has been published, but the results are incomplete and the recommendation is “weak.”
OBJECTIVE: The objective of this study was to determine the effect of intravenous magnesium in children with acute asthma.
METHODS: Randomized, controlled trials were identified by searching the Cochrane, Medline, Embase, CINAHL, and ProQuest databases. Other sources were used to identify “gray literature.” Randomized, controlled trials in which children with an acute exacerbation of asthma were treated with intravenous magnesium versus placebo were included. Data were extracted from the full papers, and methodologic quality was assessed using a scale from 0 to 5.
RESULTS: Six studies involving 215 patients were included. Hospital stay was reduced in the magnesium-treated group. The percentage improvement in the percentage predicted peak expiratory flow rate was 43.5% greater in the treatment group. Significant differences were also seen in the forced expiratory volume in 1 second (weighted mean difference: 74.5%) and the forced vital capacity (weighted mean difference: 64.5%). There was improvement in asthma scores in 3 of the 4 studies that reported this outcome. There were no clinically significant differences in vital signs. No major adverse events were reported.
CONCLUSIONS: Intravenous magnesium is safe and beneficial as adjuvant therapy in the treatment of children with moderate to severe acute asthma. Magnesium should be for children who have moderate to severe acute exacerbations of asthma that do not respond to nebulized β-2 agonist.
DIAGNOSTIC BRONCHOALVEOLAR LAVAGE FOR PULMONARY FUNGAL INFECTIONS IN CRITICALLY ILL CHILDREN
Authors: Ashraf Maged , Kotby Alyaa , Shaheen Malak , Basim Hadia , El Masry Ahmed , Mansour Mervat 
Published: January 2008

INTRODUCTION: The incidence of pulmonary fungal infection is increasing worldwide, particularly in critically ill patients.
OBJECTIVE: The objective of this study was to assess bronchoalveolar lavage (BAL) as a diagnostic specimen for clinically and radiologically suspected fungal pneumonia in critically ill children.
METHODS: Thirty-five children who were admitted to the PICU of Ain Shams University because of their critical illness were included. All children underwent full medical history; thorough clinical examination, including general and local chest examination and basic laboratory investigations (from that, the Pediatric Risk of Mortality [PRISM] score was calculated to evaluate the critical illness severity); chest imaging; and bronchoscopic collection of BAL and microbiological assessment of BAL and blood using direct microscopic examination, cultured on Sabouraud dextrose agar, and fungal antigen detection using the enzyme-linked immunosorbent test for both Aspergillus galactomannan antigen and Candida mannan antigen.
RESULTS: Pulmonary fungal infection was documented in 77% of the studied children. BAL investigations proved to have a higher diagnostic yield in comparison with blood. Positive fungal antigens in BAL fluid were significantly higher than positive BAL fungal cultures in studied children. Analysis of the risk factors for fungal infection among the studied patients revealed that prolonged PICU stay (≥1 week) and high PRISM score (mean: 35.9 ± 6.46) were significant risk factors for fungal infection.
CONCLUSIONS: BAL fluid investigation has a significantly higher diagnostic value for pulmonary fungal infections than that of the blood. The results may be further improved especially if both culture and antigen fungal detections are combined.
CYTOKINE PROFILE IN LONG-TERM USE OF INHALED CORTICOSTEROID IN ASTHMATIC CHILDREN RECEIVING SPECIFIC IMMUNOTHERAPY
Authors: Harsono Ariyanto 
Published: January 2008

INTRODUCTION: Inhaled corticosteroids are widely used for the management of persistent asthma, including by those who receive specific immunotherapy.
OBJECTIVE: Our goal was to elucidate the cytokine profile in long-term use of corticosteroid inhalation in asthmatic children who were receiving specific immunotherapy.
METHODS: We performed a randomized, paralleled, comparative study of asthmatic children allocated into 3 groups: those in group A received inhaled budesonide, those in group B received specific immunotherapy, and those in group C received both specific immunotherapy and inhaled budesonide. The primary outcomes were interleukin 4 (IL-4), IL-5, interferon γ (IFN-γ), and IL-2 levels and forced expiratory volume in 1 second (FEV1) reversibility.
RESULTS: Significant differences were observed before and after treatment in all groups (P &lt; .05). Patients who received inhaled budesonide showed attenuation of IL-4, IL-5, IFN-γ, and IL-2 and 29% failure of FEV1 reversibility. Patients who received immunotherapy showed attenuation of IL-4 and IL-5, elevation of IFN-γ and IL-2, and 24% failure of improvement of FEV1 reversibility. Patients who received inhaled corticosteroids and immunotherapy showed attenuation of IL-4 and IL-5, elevation of IFN-γ and IL-2, and 100% improvement of FEV1 reversibility. Analysis of the discriminator yielded IL-2 as the primary discriminator, which correlated with the decrease of IL-5.
CONCLUSIONS: Long-term use of inhaled corticosteroids by children with asthma who received immunotherapy resulted in elevation of IFN-γ and IL-2 and a decrease of IL-4 and IL-5. Addition of inhaled corticosteroids to immunotherapy resulted in marked attenuation of IL-5 and correlated with greater elevation of IL-2.
RESPIRATORY SYNCYTIAL VIRUS INDUCED MORE SERIOUS INFECTION AND INFLAMMATION IN NUDE MICE THAN IN BALB/c MICE
Authors: Zhou Juan , Yang Xi-Qiang , Fu Zhou , Zhao Xiao-Dong , Jiang Li-Ping , Wang Li-Jia , Cui Yu-Xia 
Published: January 2008

INTRODUCTION: Respiratory syncytial virus (RSV) infection is ubiquitous and leads to severe disease in immunocompromised individuals.
OBJECTIVE: Our goal was to compare RSV infection and inflammation between immunocompetent BALB/c mice and immunodeficient nude mice.
METHODS: Pulmonary viral titers, histology, immunohistochemistry for CD14 and CD56, leukocyte counting, and cytokines were assayed by enzyme-linked immunosorbent assay in bronchoalveolar lavage fluid.
RESULTS: RSV titers peaked on the third day after inoculation in both types of infected mice. Infected nude mice had higher-level and more durative viral replication, more severe pulmonary histopathology, and a larger number of leukocytes in bronchoalveolar lavage fluid than infected BALB/c mice. Infected nude mice displayed more pulmonary (CD14+) macrophages (114.34 ± 20.24 vs 75.46 ± 12.37; P = .05) and (CD56+) natural killer cells (37.87 ± 8.07 vs 11.06 ± 5.37; P = .05) than infected BALB/c mice. RSV infection enhanced production of tumor necrosis factor α, interleukin 12 (IL-12), interferon γ, and IL-10 in both types of mice. Infected nude mice had a higher level of tumor necrosis factor α (40.30 ± 7.34 vs 24.24 ± 9.54; P = .05), IL-12 (83.96 ± 12.32 vs 68.21 ± 7.42; P = .05), and IL-10 (125.01 ± 18.97 vs 77.56 ± 9.01; P = .05) than infected BALB/c mice.
CONCLUSIONS: RSV-infected nude mice are a good model for assessing severe and persistent infection in individuals at high risk. RSV-induced inflammation is not parallel to the immune response of T cells, and macrophages and natural killer cells contribute to severe infection and inflammation of RSV-infected cellular-immunodeficient individuals.
ASSOCIATION OF COMORBIDITY WITH OBESITY IN MEXICAN CHILDREN AND ADOLESCENTS
Authors: Perea-Martinez Arturo , Carbajal R. L. , Rodriguez H. R. , Zarco R. J. , Barrios F. R. , Loredo A. A. 
Published: January 2008

INTRODUCTION: Obesity is a chronic and recurrent inflammatory disease, associated with high risk to health. It is a world public health problem that affects children and adolescents. It is present in rich and poor countries. Type 2 diabetes, systemic arterial hypertension, blood lipid disorders, and cardiovascular disease together compose the metabolic syndrome (BMI &gt; 95th percentile, weight circumference ≥ 85th percentile, serum glucose ≥ 100 mg/dL, high-density lipoprotein cholesterol ≤ 40 mg/dL, serum triglycerides ≥ 110 mg/dL); orthopedic lesions and psychosocial problems (marginalization and depression) are present early in life in obese individuals.
OBJECTIVE: The objective of this study was to describe the frequency of comorbidity in a cohort of 185 obese Mexican children and adolescents.
METHODS: A total of 185 obese Mexican children and adolescents were included in the study. The following parameters were measured: BMI, serum lipid profile, serum glucose, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and serum uric acid. Complete physical examinations were performed, including blood pressure measurements.
RESULTS: BMI was at the 95th percentile in 97% of cases; 75% had ≥1 clinical indicator of comorbidity associated with obesity. Skin lesions (nigricans acanthosis; folliculitis; and grooves in hip, abdomen, and upper and lower extremities), serum lipid disorders (high level of serum triglycerides, low level of high-density lipoprotein cholesterol), systemic arterial hypertension, and others (eg, hypertransaminemia, hyperuricemia, orthopedic lesions) were the most common.
CONCLUSIONS: Obesity in children and adolescents is a severe world public health problem. Obese children and adolescents frequently had associated comorbidity. It is necessary to improve health, juridical, and educational world policies that prevent and support the treatment of obesity in early life.
EVALUATION OF TUBERCULIN SKIN TEST IN UNVACCINATED 0- TO 7-YEAR-OLD CHILDREN OF NORTHERN GREECE
Authors: Aivazis Victor , Vasiliadis Angelos , Aivazi Dimitra , Zardava Georgia , Sakellaropoulou Afroditi , Papadimitriou Eleni , Thanos Vasilios , Roilidis Emannouil 
Published: January 2008

INTRODUCTION: The tuberculin skin test (TST) is an important tool in the diagnosis of tuberculosis in children.
OBJECTIVE: The purpose of this study was to evaluate the proportion of 0- to 7-year-old children with induration of 5 to 9 or ≥10 mm after TST.
METHODS: During the 5-year period 2001–2005, 65 401 0- to 7-year-old children (50.2% female) were enrolled in this study and TST was performed before BCG vaccination. Mantoux reaction and the extent of induration of the transversal diameter were evaluated. Among 65 401 children, 8018 were 0 to 5 years of age (group A) and 57 383 were 6 to 7 years of age (group B).
RESULTS: In group A, 19 (0.23%) children had induration within 5 to 9 mm (mean diameter: 6.81 mm) and 42 children (0.52%) had induration within 10 to 25 mm (mean: 14.4 mm). In group B, 62 (0.1%) children had induration within 5 to 9 mm (mean: 7.27 mm) and 186 (0.32%) children had induration within 10 to 30 mm (mean: 14.57 mm). Children with TST induration ≥10 mm were given treatment for tuberculosis; for those with induration of 5 to 9 mm, their environment was examined for the presence of risk factors.
CONCLUSIONS: The discovery of a high number of children with positive TST results (≥10 mm) in both groups indicates a remaining tuberculosis problem in Greece. The extent of induration up to 30 mm reveals the exposure of children of these age groups to high mycobacterial burden from adults with tuberculosis, especially immigrants from countries of Eastern Europe.
THYROID FUNCTION AND GHRELIN AND LEPTIN LEVELS IN OBESE CHILDREN AND ADOLESCENTS WITH AND WITHOUT INSULIN RESISTANCE
Authors: Stylianou Charilaos , Galli-Tsinopoulou Assimina , Kokka Paraskevi , Farmakiotis Demetrios , Koliakos George , Varlamis George 
Published: January 2008

INTRODUCTION: Thyroid hormones ghrelin, leptin, and insulin are implicated in energy metabolism.
OBJECTIVE: The objective of this study was to investigate any relationship between thyroid function and ghrelin and leptin levels in selected euthyroid (thyrotropin: 0.35–4.94; free thyroxine [fT4]: 0.8–1.8; no autoimmune thyroiditis or iodine deficiency, no medications intake) obese children and adolescents with and without insulin resistance (IR).
METHODS: Forty obese children and 40 obese adolescents were enrolled. BMI, percentage of body fat, fasting glucose, insulin, ghrelin, leptin, thyrotropin, free triiodothyronine (fT3), and fT4 were measured. IR was estimated with homeostasis model assessment of IR index. The Mann-Whitney U test for independent samples was applied. Correlations were assessed by the Spearman coefficient.
RESULTS: In adolescents, fT3 levels were positively correlated with insulin and homeostasis model assessment of IR. In children, fT4 levels were negatively correlated with BMI and percentage of body fat (Table 1).
CONCLUSIONS: The observed positive correlation between IR and fT3 in adolescents might indicate an interplay between thyroid function and IR. Ghrelin levels are negatively affected by IR but not directly associated with thyroid hormone concentrations.
TABLE 1.Thyroid Function and Ghrelin and Leptin Levels in Obese Children and Adolescents With and Without Insulin ResistanceObese ChildrenObese AdolescentsIRNIR P IRNIR P n 20202020BMI, kg/m228.87 ± 3.8427.11 ± 4.53.12130.54 ± 4.7429.43 ± 3.87.678Body fat, %35.68 ± 4.7133.28 ± 4.98.15735.59 ± 6.0134.33 ± 5.14.461Homeostasis model assessment, IR5.00 ± 4.041.55 ± 0.64.0004.51 ± 1.531.80 ± 0.56.000Insulin, μIU/mL22.53 ± 15.027.33 ± 2.64.00020.04 ± 5.769.01 ± 2.65.000Ghrelin, pmol/L831.29 ± 379.19902.96 ± 360.49.355860.12 ± 289.891102.09 ± 366.10.043Leptin, ng/mL36.22 ± 14.9435.20 ± 23.43.30142.31 ± 21.8134.75 ± 17.93.221Thyrotropin, μIU/mL2.28 ± 1.222.15 ± 0.75.7792.20 ± 1.152.06 ± 1.24.659fT3, pg/mL4.61 ± 0.924.59 ± 0.64.9894.19 ± 0.684.12 ± 1.08.529fT4, ng/dL1.32 ± 0.141.37 ± 0.22.4951.22 ± 0.121.29 ± 0.17.398
OUTBREAK OF HUMAN METAPNEUMOVIRUS INFECTION IN CHILDREN IN CHONGQING, CHINA
Authors: Zhao Xiaodong , Chen Xin , Zhang Zhiyong 
Published: January 2008

INTRODUCTION: Human metapneumovirus (hMPV) is a newly discovered respiratory pathogen. Understanding of the epidemiology of hMPV infection is limited in China.
OBJECTIVE: The objective of this study was to describe an outbreak of hMPV infection in Chongqing, China, and study the high coinfection rates of hMPV and respiratory syncytial virus (RSV).
METHODS: A total of 93 nasopharyngeal aspirates (NPAs) were collected from hospitalized children with acute respiratory diseases during December 2006 to January 2007. Total RNA was extracted from NPAs by using QIAmp viral RNA minikit and amplified for hMPV F gene and RSV G gene by real-time reverse-transcription polymerase chain reaction (RT-PCR) and traditional PCR, respectively. Most of the hMPV-positive samples were confirmed by traditional RT-PCR and subsequent nucleotide sequence analysis.
RESULTS: Of 93 NPAs, 38 (40.9%) were positive for hMPV and 52 (55.9%) were positive for RSV. Twenty-three (24.7%) revealed coinfection with both viruses. Ages of patients with hMPV infection ranged from 1 month to 31 months; 78.9% were younger than 2 years, and 47.4% were younger than 6 months. Cough was the most common symptom, 78.9% (30 of 38) had wheezing, and 42.1% had fever.
CONCLUSIONS: HMPV seems to be an important respiratory pathogen in young children in Chongqing, China. Coinfection of hMPV and RSV may frequently occur during the winter season. Whether coinfection leads to more severe disease remains unknown.
HLA-DQB1*05 ASSOCIATION WITH HASHIMOTO THYROIDITIS IN CHILDREN OF NORTHERN GREEK ORIGIN
Authors: Giza Styliani , Galli-Tsinopoulou Assimina , Lazidou Panagiota , Fleva Alexandra , Goulis Dimitrios , Trachana Maria , Nousia-Arvanitakis Sanda 
Published: January 2008

INTRODUCTION: Hashimoto thyroiditis (HT), an organ-specific autoimmune disorder of the thyroid gland, is considered to be associated with the major histocompatibility complex. Association studies of human leukocyte antigens (HLAs) with HT concern adults and have not revealed consistent results.
OBJECTIVE: We sought to investigate HLA-DRB1 and HLA-DQB1 gene polymorphisms in Greek children and adolescents with HT.
METHODS: We analyzed the distribution of HLA-DRB1 and HLA-DQB1 alleles in 17 Greek children and adolescents with HT and in 181 randomly chosen healthy subjects from northern Greece. The typing of HLA-DRB1 and HLA-DQB1 genes was performed by using polymerase chain reaction with sequence-specific primers. Differences of frequencies for HLA alleles were tested by the χ2 test.
RESULTS: There was no significant association detected between HT and HLA-DRB1 or HLA-DQB1 alleles. However, HLA-DRB1*16 was slightly significantly increased in patients with HT (41.2%) compared with that in controls (19.3%) (P = .057; relative risk: 2.92), and HLA-DQB1*05 was significantly increased in patients with an age of diagnosis of &gt;10 years (87.5%) as compared with those with an age of diagnosis of ≤10 years (33.3%) (P = .05; relative risk: 14).
CONCLUSIONS: This is the first study to examine children and adolescents from northern Greece with HT and analyze the distribution of HLA-DRB1 and HLA-DQB1 alleles according to the age of onset of HT. However, this study needs to include a greater number of patients to ascertain the possibility of an association and avoid the result of a chance event or random variation.
BREASTFEEDING AND ATOPIC DISEASE IN CHILDHOOD: THE GENESIS STUDY
Authors: Kortsalioudaki Christine , Tzavara Chara , Baglatzi Labrini , Papadopoulos Nikos , Manios Yannis 
Published: January 2008

INTRODUCTION: The prevalence of asthma and atopic disease in childhood is increasing yearly. A protective connection between breastfeeding and development of atopy has been suggested in several studies.
OBJECTIVE: Our goal was to investigate the correlation between breastfeeding and atopy.
METHODS: We screened 1525 children aged 2 to 5 years. Information on the outcome variables “ever wheezing,” “recurrent wheezing,” “diagnosed asthma,” “itchy rash,” “recurrent rash,” and “diagnosed atopic dermatitis” was obtained. Multiple logistic regression analysis was used to estimate the association of outcome variables with the independent variable (breastfeeding) after adjustment for gender and parental history of allergy.
RESULTS: Median duration of exclusive breastfeeding was 1 month (range: 0–2 months). Children who were breastfed exclusively for &gt;3 months had 28% (95% confidence interval [CI]: 0.53%–0.98%) and 29% (95% CI: 0.51%–1.00%) lower likelihood of ever developing wheezing and recurrent wheezing, respectively. Partial breastfeeding seemed to place the children at significantly greater risk for ever and recurrent wheezing when compared with exclusive breastfeeding. There was no significant difference between exclusive breastfeeding versus formula feeding. Of the ever-breastfed children, 15.2% developed itchy rash versus 10.9% of those who never breastfed. Girls had a significant lower odds ratio (OR) for ever wheezing (OR: 0.76 [95% CI: 0.62–0.94]) and “diagnosed asthma” (OR: 0.60 [95% CI: 0.43–0.85]). Of the children studied, 3.7% had a positive parental background for allergy. Parental history of allergy comprised a significant factor that indicated a greater OR for all outcome variables apart from “diagnosed asthma.”
CONCLUSIONS: Breastfeeding seems to have a significant protective effect against the development of wheezing and asthma but not toward the development of skin atopy. A prospective randomized, controlled trial with longer follow-up time is required to confirm our findings.