bluuebunny/crossref_metadata_2025_split huggingface dataset:
Addition of sufentanil to bupivacaine in caudal block effect on stress responses in children
Authors: EROL ATILLA , TUNCER SEMA , TAVLAN AYBARS , REISLI RUHIYE , AYSOLMAZ GÖKHAN , OTELCIOGLU SEREF 
Published: November 2007

AbstractBackground: The aim of the present randomized study was to determine the effect of adding sufentanil to bupivacaine, compared with bupivacaine alone in caudal block, on the surgical stress response in children.Methods: The children were premedicated with midazolam 0.5 mg/kg. All children received induction with nitrous oxide and sevoflurane. Anesthesia was maintained with the same volatile agents in the both groups. The children were randomly allocated to two groups. Group I received bupivacaine alone (n = 17) and group II received bupivacaine + sufentanil (n = 16). Caudal block was performed with 0.25% bupivacaine 2 mg/kg (group I) or 0.25% bupivacaine 2 mg/kg with sufentanil 0.5 μg/kg (group II) after induction of anesthesia. Blood samples were obtained after induction of anesthesia (T0) to measure baseline concentrations of cortisol, prolactin, glucose and insulin. Additional samples were obtained 30 min after the start of surgery (T1), and 60 min after the end of surgery (T2).Results: All of the basal values (T0) were within the normal ranges of the authors’ laboratory for children of this age group and there were no differences between the groups (P > 0.05). In both groups, glucose concentration increased at T1, compared with T0 and T2 (P < 0.05). The glucose concentration was unchanged at T2 compared with T0 in both group (P > 0.05). In both groups, prolactin concentration increased at T1, compared with T0 and decreased at T2, compared with T1 (P < 0.05). Cortisol decreased at T1 and T2, compared with T0 in both groups. (P < 0.05). Insulin concentration remained unchanged at T0 and T2, but increased slightly at T1 in both groups (P > 0.05). There were no significant differences in plasma prolactin, cortisol, glucose and insulin levels between the two groups at T1 and T2 (P > 0.05).Conclusion: There is no advantage in adding 0.5 μg/kg sufentanil to bupivacaine over bupivacaine alone in the caudal block, with regard to the surgical stress response in children.
Epidural air associated with spontaneous pneumomediastinum in children: Uncommon complication?
Authors: KONO TATSUO , KUWASHIMA SHIGEKO , FUJIOKA MUTSUHISA , KOBAYASHI CHIE , KOIKE KAZUTOSHI , TSUCHIDA MASAHIRO , SEKI ICHIRO 
Published: November 2007

AbstractBackground: The purpose of the present study was to evaluate the incidence of epidural air associated with spontaneous pneumomediastinum in children.Methods: The subjects consisted of 25 boys and 17 girls with an age range of 3–14 years (mean age: 8.5 years) who underwent chest computed tomography (CT) for evaluation of spontaneous pneumomediastinum. The CT scans and medical records were reviewed retrospectively.Results: Of the 42 patients, four (9.5%) had intraspinal air on CT. The air was interpreted as epidural in every patient. The small number of patients with epidural air meant that there was no significant difference in age, gender, or clinical manifestations between groups with and without epidural air. Subcutaneous emphysema was identified in all four patients with epidural air versus 18 out of 38 patients (47%) without epidural air. The patients with epidural air did not have any neurologic symptoms. Irrespective of the presence or absence of epidural air, every patient had a favorable outcome without any serious complications.Conclusion: In patients with spontaneous pneumomediastinum, epidural air may be more common than was previously realized. It is suggested that an air leak may spread from the mediastinum into the epidural space via the cervical fascial planes and neural foramina.
Human milk reduces the risk of retinal detachment in extremely low‐birthweight infants
Authors: OKAMOTO TOSHIO , SHIRAI MASARU , KOKUBO MASAYO , TAKAHASHI SATORU , KAJINO MAYUMI , TAKASE MASASHI , SAKATA HIROSHI , OKI JUNICHI 
Published: November 2007

AbstractBackground: Retinopathy of prematurity (ROP) is a major cause of blindness in children. Because the use of oxygen is a known risk factor for development of ROP, supplemental oxygen is used carefully. However, it does not necessarily reduce the morbidity of ROP‐induced blindness. The aim of the present study was to identify the possible risk factors for progression to retinal detachment, a most relevant cause of visual impairment, in extremely low‐birthweight infants (ELBWI).Methods: The medical records of the 42 ELBWI who were admitted to the neonatal intensive care unit in Asahikawa Kosei Hospital from April 1999 to March 2004 were retrospectively reviewed. Seven infants (16.7% of the ELBWI) developed retinal detachment and two of them became blind. Perinatal and postnatal variables in these infants with retinal detachment were compared with those in infants without retinal detachment.Results: A striking difference in the daily intake of human milk was found between the infants with or without retinal detachment when their gestational ages at birth were matched. The infants without retinal detachment were fed more human milk (67–83% volume of total nutritional intake) as compared to those with retinal detachment (24–38% volume of total nutritional intake) at a specific postnatal period, 5–7 weeks postnatal age.Conclusions: Human milk may contain some beneficial factors to reduce the severity of ROP. Identifying these factors in human milk may contribute to development of a strategy to rescue premature infants from blindness.
Nosocomial Gram‐positive bacterial infections in children: Results of a 7 year study
Authors: CELEBI SOLMAZ , HACIMUSTAFAOGLU MUSTAFA , OZDEMIR OZLEM , OZAKIN CUNEYT 
Published: November 2007

AbstractBackground: The aim of the present paper was to determine the rate of culture‐proven nosocomial infections and evaluate the episodes of nosocomial Gram‐positive (GP) bacterial infections in pediatric patients.Methods: The data of children with positive culture, who were diagnosed as having nosocomial infection on the Centers for Disease Control and Prevention criteria, were examined and only the patients with nosocomial GP bacterial infections were included in the study.Results: Between January 1997 and January 2004 a total of 836 episodes of nosocomial GP bacterial infections were observed. The most frequently seen nosocomial GP bacterial infections were primary bloodstream infections (BSI; 43%), ventriculoperitoneal shunt infections (18%), and nosocomial pneumonias (11%). Coagulase‐negative staphylococci (CONS; 46%) were the most common nosocomial GP bacteria isolated, followed by Staphylococcus aureus (33%). Methicillin resistance rates for CONS and S. aureus were 85% and 25.2%; respectively. The mortality rate was 4% of all children with nosocomial GP bacterial infections in the present study.Conclusion: In the present patients primary BSI were the most common nosocomial GP bacterial infections and CONS were the most frequent GP pathogen isolated. Antimicrobial resistance in GP isolates is an increasing problem.
Mycophenolate mofetil therapy for children with intractable nephrotic syndrome
Authors: OKADA MITSURU , SUGIMOTO KEISUKE , YAGI KAZURO , YANAGIDA HIDEHIKO , TABATA NOBUTADA , TAKEMURA TSUKASA 
Published: November 2007

AbstractBackground: Cyclosporin A (CyA) can suppress relapses and reduce proteinuria in frequent‐relapse nephrotic syndrome (FRNS) and steroid‐resistant nephrotic syndrome (SRNS). However, some patients remain resistant to CyA therapy. The purpose of the present paper was to evaluate mycophenolate mofetil (MMF) treatment in pediatric patients with CyA‐resistant intractable nephrotic syndrome.Methods: MMF therapy was given to 11 patients with FRNS who had relapse despite CyA therapy, and one patient with SRNS who had been receiving combined therapy using steroid and CyA until immediately before the start of MMF. MMF was administered at a daily dose of 750–1000 mg/m2 in two divided doses.Results: Ten of the 11 patients with FRNS were able to maintain remission. Among them, seven patients remained relapse free for 1 year, and two patients had a decrease in the frequency of relapse after initiation of MMF therapy. One patient, however, had repeated cycles of remission and relapse, and was considered resistant to MMF therapy. The total prednisolone dose during the period from month 6 to month 12 after the start of MMF therapy was significantly lower than that during the 6 month period before the start of MMF therapy. The patient with SRNS, who had not achieved remission despite CyA administration, had complete remission on MMF. No serious adverse effects were seen in any of the present patients.Conclusion: MMF could be useful in CyA‐treatment‐refractory FRNS and CyA‐resistant SRNS.
Utility of diagnostic tests for detection of Helicobacter pylori in children in northeastern Mexico
Authors: MENDOZA‐IBARRA SANDRA IVETH , PEREZ‐PEREZ GUILLERMO IGNACIO , BOSQUES‐PADILLA FRANCISCO JAVIER , URQUIDI‐RIVERA MARTHA , RODRÍGUEZ‐ESQUIVEL ZULMA , GARZA‐GONZÁLEZ ELVIRA 
Published: November 2007

AbstractBackground: The presence of Helicobacter pylori in pediatric population has been associated with recurrent abdominal pain (RAP), although this association is unclear. One of the major problems in studying the role of H. pylori in RAP is that methods used to detect the bacteria in children have poor sensitivity and specificity. The aims of the present study were to determine the prevalence of H. pylori in pediatric patients with RAP in northeastern Mexico and to assess the diagnostic utility of invasive tests and serology in this population.Methods: A total of 40 patients (mean age, 7.9 years; range 2–16 years; F: M, 0.81), who underwent an endoscopy procedure for RAP, were studied. The presence of H. pylori was assessed using invasive diagnostic tests (culture, rapid urease test, polymerase chain reaction and histology) and one non‐invasive test: determination of IgG antibodies. The prevalence of H. pylori in the present group and the diagnostic utility for each test were evaluated.Results: The prevalence of H. pylori in the present pediatric group with RAP was 12.5–42.5% depending on the criteria of positivity used. The non‐invasive methods (serology) had acceptable values in sensitivity and specificity in comparison with invasive tests.Conclusions: This is the first report on prevalence of H. pylori in pediatric patients with RAP from the northeastern region of Mexico. The prevalence of H. pylori was low compared with the adult population in the same geographic region. Serology had the best diagnostic utility.
Hemodynamic features of congenital aortic valve stenosis with patent ductus arteriosus in children
Authors: XIE CHUNHONG , XIA CHENGSEN , ZHAO ZHENGYAN , ZHOU YINBAO 
Published: November 2007

AbstractBackground: The aim of the present paper was to investigate the hemodynamic features of congenital aortic valvar stenosis (AS) associated with patent ductus arteriosus (PDA), and to develop information to guide management of AS with coexistent PDA.Methods: Hemodynamic measurements were performed in eight of 11 patients with AS before and following transcatheter closure of a PDA. Doppler cardiac ultrasound and chest X‐rays were performed during follow up.Results: In each of the 11 patients, aortic valve gradient was markedly reduced following transcatheter ductal closure. In only one of them was balloon aortic valvuloplasty necessary.Conclusion: Aortic valve gradient was markedly overestimated before closure of PDA. The significance of this finding has focused on selecting appropriate management so that a PDA is not overlooked when intervention for AS is performed.
Stromal cell‐derived factor‐1α improves infarcted heart function through angiogenesis in mice
Authors: SASAKI TAKASHI , FUKAZAWA RYUJI , OGAWA SHUNICHI , KANNO SHIGETO , NITTA TAKASHI , OCHI MASAMI , SHIMIZU KAZUO 
Published: November 2007

AbstractBackground: Local delivery of stromal cell‐derived factor‐1α (SDF‐1) has been demonstrated to improve hind limb ischemia through enhanced neovascularization in animals. It was hypothesized that local administration of SDF‐1 also contributes to neovascularization of ischemic heart.Method: Acute myocardial infarction was created by left coronary artery ligation in C57BL/6J mice. Immediately after infarction induction, mice were treated by injection directly into the center of ischemic myocardium either with saline (control group) or SDF‐1 (SDF‐1 group). Cardiac function was measured on echocardiogram 2 and 4 weeks after infarction. On week 4 mice were killed to evaluate infarction size and capillary vessel density. To determine the contribution of bone marrow cells to angiogenesis, the same procedures were performed on C57BL/6J chimeric mice reconstituted with green fluorescent protein‐positive bone marrow cells.Results: Fractional shortening was greater in the SDF‐1 group at 4 weeks (0.31 ± 0.06% vs 0.23 ± 0.03%, P = 0.037). The infarct area was smaller in the SDF‐1 group compared to the control group (9.31 ± 2.76% vs 18.07 ± 5.69%, P = 0.028). Green fluorescent protein‐positive cells accumulated predominantly at the peri‐infarction site, and were located with the capillary vessels. Capillary vessel density was significantly increased in the SDF‐1 group (13.08 ± 4.11 vessels/mm2 vs 34.50 ± 7.59 vessels/mm2, P = 0.014).Conclusions: SDF‐1 protects against deterioration of cardiac function after acute myocardial infarction by promoting angiogenesis. The safety and long‐term prognosis of this treatment remains to be determined.
Are foot posture and functional health different in children with growing pains?
Authors: EVANS ANGELA MARGARET , SCUTTER SHEILA DOREEN 
Published: November 2007

AbstractBackground: The aim of the present paper was to investigate and compare findings of foot posture and functional health between groups of children aged 4–6 years with and without leg pain (described as “growing pains”). The null hypothesis: that there is no difference in measures of either foot posture or functional health between groups of children with and without leg pain.Methods: A stratified random sample of children was obtained. The children were identified with and without leg pain using a validated questionnaire for parents. The examiner was blind to the children’s pain status. The schools and child care centers were from each geographical quadrant of metropolitan Adelaide and a northern rural region of South Australia. One hundred and eighty children (94 boys, 86 girls) entered and completed the study. Children whose parents returned a completed questionnaire and consent form were entered into the study. All participants were assessed by the one examiner. The foot posture measures used were those found to be most reliable in previous studies and for which the intra‐rater reliability of the examiner was ascertained.Results: Initial analysis of foot posture measures between the leg pain and no leg pains groups indicated a statistically significant result for the measure of navicular height, but only on the left side (P =  0.033). Logistic regression modeling showed that navicular height (left foot only) was positively yet weakly related to growing pains (odds ratio, 1.072; 95% confidence interval: 0.991–1.160) and the effect was not significant (P =  0.08). Measures of functional health returned many statistically significant yet weakly correlated relationships.Conclusions: The null hypothesis of the present study was supported in terms of clinical significance. While the foot posture measure of navicular height on the left foot was statistically significant it was not predictive for growing pains nor clinically significant as a measure between groups. The present study does not support the anatomical theory for growing pains and does not find a meaningful relationship between foot posture or functional health measures and leg pain in young children.
Study of Japanese encephalitis and other viral encephalitis in Nepali children
Authors: RAYAMAJHI AJIT , SINGH RUPA , PRASAD RAJNITI , KHANAL BASUDHA , SINGHI SUNIT 
Published: November 2007

AbstractBackground: A hospital‐based prospective cross‐sectional study was conducted in children aged 1 month–14 years to identify the proportion of viral encephalitis due to Japanese encephalitis (JE) and compare the clinico‐laboratory profile and outcome of JE with that of other viral encephalitis (non‐JE).Methods: All probable cases of viral encephalitis on clinical and laboratory evaluation were confirmed as JE on anti‐JE IgM in cerebrospinal fluid (CSF) and/or serum. Patients not having anti‐JE IgM in CSF and/or serum were diagnosed as having non‐JE.Results: Of 94 cases, 58 were JE and 36 non‐JE. Although practice of rearing pigs at home was associated with JE (P = 0.0001), significantly higher serum creatinine, protein, aspartate aminotransferase and CSF protein levels were observed in non‐JE. Longer duration of fever was associated with complete recovery in JE whereas shorter duration of fever was associated with recovery in non‐JE. Risk of neurological sequelae (P = 0.01), especially hemiparesis (P = 0.03) was significantly more in JE. Sequelae were observed at 6 weeks follow up in 18.8% of JE and 13.9% of non‐JE.Conclusion: JE was the most common cause of viral encephalitis in eastern Nepal and should be suspected in encephalitic patients having pig rearing at home and neurological sequelae. Although duration of hospitalization and complication were higher in JE, final outcome was similar to non‐JE. Longer duration of fever in JE and shorter duration of fever in non‐JE correlated with recovery, while altered sensorium and focal neurological deficit were independent predictors of sequelae at 6 weeks only in JE and not in non‐JE.
Antithrombin improves fetal condition in women with severe pre‐eclampsia before 32 weeks of gestation; a randomized, double‐blind, placebo‐controlled trial
Authors: Sameshima Hiroshi , Kodama Yuki , Ikenoue Tsuyomu , Kajiwara Yayoi 
Published: November 2007

AbstractAim:  To see if antithrombin (AT) supplementation improved fetal outcomes in early onset (<32 weeks) severe pre‐eclampsia.Methods:  A subgroup re‐analysis of an original randomized controlled trial of AT in pre‐eclampsia between 24 and 35 weeks of gestation was performed. Either AT (3000 IU/day, n = 42) or placebo (Albumin 582 mg/day, n = 42) were administered for 7 days. Fetal weight gain, biophysical profile score and fetal heart rate monitoring were evaluated during the treatment week and until delivery. Comparisons were performed by intent‐to‐treat and relative risk (RR) and 95% Confidence Intervals (CI) were obtained.Results:  In each group, 27 women (64%) completed the allocated intervention. AT significantly decreased the worsening of the fetal biophysical profile score or fetal heart rate monitoring (RR 0.24, 95% CI 0.07–0.8), increased the incidence of estimated weight gain >15 g/day during the intervention week (3.1, 1.0–9.9), and prolonged gestational age to ≥34 weeks (3.6, 1.05–12.6), however infant mortality rates did not differ between the two groups. No adverse events related to AT were observed.Conclusions:  Supplementation of AT preserves fetal biophysical condition and weight gain in early onset severe pre‐eclampsia and most likely prolongs pregnancies ≥34 weeks of gestation.
Clinical significance of pregnancies with circumvallate placenta
Authors: Suzuki Shunji 
Published: November 2007

AbstractAim:  This study examined the clinical significance of patients complicated by circumvallate placenta in comparison with patients with a normal placenta.Methods:  Data were collected from 139 singleton deliveries complicated by circumvallate placenta and from 7666 unaffected controls managed at Japanese Red Cross Katsushika Maternity Hospital between 2002 and 2005.Results:  The incidence of premature delivery, oligohydramnios, non‐reassuring fetal status on cardiotocogram, placental abruption and intrauterine fetal death in patients complicated by circumvallate placenta were significantly higher than those in control patients. The odds ratio of placental abruption in patients complicated by circumvallate placenta was 13.1 (95% confidence limits: 5.65–30.2).Conclusion:  A circumvallate placenta is associated with a higher incidence of serious perinatal complications such as placental abruption.
Effect of vaginal pH on the efficacy of vaginal misoprostol for induction of midtrimester abortion
Authors: Abd‐El‐Maeboud Karim H. I. , Ghazy Abbas A. S. , Nadeem Amr A‐A. , Al‐Sharaky Amr , Khalil Alaa‐Eddin I. 
Published: November 2007

AbstractAim:  To evaluate the effect of vaginal pH on the efficacy of misoprostol for induction of midtrimester abortion.Methods:  The study comprised 110 women, with a gestational age of 14–26 weeks, with a missed abortion as an indication for the induction of abortion. On admission, the vaginal pH was measured and two groups were generated: (A) those with pH < 5 (n = 63); and (B) those with pH ≥ 5 (n = 47). All of the women received intravaginal misoprostol tablets moistened with 3 mL of 5% acetic acid, 200 μg every 4 h for a maximum of 5 doses within 24 h. If the patient did not have adequate uterine contractions, the same regimen was repeated over the following 24 h and if no response was achieved, this was considered a failure of therapy.Results:  All patients aborted within 48 h. A significant positive correlation between vaginal pH and the misoprostol application‐abortion interval was found. The mean induction‐abortion interval was significantly shorter in group A compared to group B (12.1 vs 23.6 h, P < 0.001), with abortion rates at 24 h being 100% and 63.8%, respectively. Moreover, a significantly lower dose of misoprostol was used in group A with a lower incidence of fever and abdominal pain.Conclusion:  Vaginal pH influences the efficacy of misoprostol administered vaginally for the induction of midtrimester abortion. The presence of this relationship, despite premoistening misoprostol with an acidifying agent, suggests that the effect of vaginal pH might extend beyond affecting the pharmacokinetics of the drug.
Prevention of adhesion formation following ovarian surgery in a standardized animal model: Comparative study of Interceed and double layer Surgicell
Authors: Ates Ugur , Ata Baris , Ortakuz Serpil , Seyhan Ayse , Urman Bulent 
Published: November 2007

AbstractAim:  Comparison of antiadhesive performances of double layer Surgicell and single layer Interceed following ovarian surgery in a rabbit model.Methods:  Prospective randomized controlled trial performed at the animal laboratory of a university. Thirty‐nine New Zealand White female rabbits of reproductive age were included. Ovaries were bivalved with a no. 15 scalpel. One of the ovaries was covered with a single layer of Interceed while the other was covered with a double layer of Surgicell. In the control group no adhesion barriers were used. Four weeks later adhesions were scored macroscopically. Following oophorectomy specimens were evaluated microscopically for mesothelial proliferation. The macroscopic adhesion score according to Blauer's criteria and the number of mesothelial cell layers were compared.Results and Conclusion:  The control group had significantly higher adhesion scores than the barrier groups. Macroscopic adhesion scores were not different among the barrier groups. The average number of mesothelial cell layers was 1.77 ± 2.68, 1.69 ± 2.58 (range 0–8) and 2.04 ± 2.84 (range 0–10) for ovaries in the control, Interceed and Surgicell groups, respectively: the difference was not significant. Our results demonstrate that a double layer of Surgicell is as effective as Interceed in reducing postoperative adhesion formation in a rabbit model.