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Journal: Acta paediatrica (Oslo, Norway : 1992)

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To evaluate the effect of breastfeeding on long (breast carcinoma, ovarian carcinoma, osteoporosis and type-2 diabetes mellitus) and short term (lactational amenorrhea, postpartum depression, postpartum weight change) maternal health outcomes.

Concepts: Diabetes mellitus

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AIMS: To test the hypothesis that exposure to ambient language in the womb alters phonetic perception shortly after birth. This two-country study aimed to see if neonates demonstrated prenatal learning by how they responded to vowels in a category from their native language and another nonnative language, regardless of how much postnatal experience the infants had. METHOD: A counterbalanced experiment was conducted in Sweden (n=40) and the USA (n=40) using Swedish and English vowel sounds. The neonates (mean postnatal age = 33 hrs) controlled audio presentation of either native or nonnative vowels by sucking on a pacifier, with the number of times they sucked their pacifier being used to demonstrate what vowel sounds attracted their attention. The vowels were either the English /i/ or Swedish /y/ in the form of a prototype plus 16 variants of the prototype. RESULTS: The infants in the native and nonnative groups responded differently. As predicted, the infants responded to the unfamiliar nonnative language with higher mean sucks. They also sucked more to the nonnative prototype. Time since birth (range: 7-75 hours) did not affect the outcome. CONCLUSION: The ambient language to which foetuses are exposed in the womb starts to affect their perception of their native language at a phonetic level. This can be measured shortly after birth by differences in responding to familiar vs. unfamiliar vowels. ©2012 The Author(s)/Acta Paediatrica ©2012 Foundation Acta Paediatrica.

Concepts: Pregnancy, Childbirth, Infant, Fetus, Linguistics, International Phonetic Alphabet, English language, Vowel

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Aim:  Do different clothing styles have an influence on the doctor-patient-parent relationship and which kind of outfit is preferred by children and parents. Methods:  One hundred and seven children and 72 parents were visited by a paediatrician randomly wearing one of the three different outfits (casual, semiformal, formal) during a hospital stay. Parents and children between 6 and 18 years were then interviewed about their opinion by use of a semi-structured questionnaire, while children between 0 and 6 years were observed concerning their behaviour during the examination. Results:  Using a ‘likert scale’, the casual outfit received the best mark by 95.5% of parents (58.3% in the semiformal, 30.8% in the formal group). The degree of the parents' trust in the paediatrician was comparable in all three groups. In children between 6 and 18 years, the casual dress was rated highest in 100%. In children between 0 and 6 years, the outfit had no significant influence on the patients' behaviour. Conclusion:  Apparently, parents do not only tolerate a casual outfit, but even prefer it without any loss of trust. The same holds true for children between 6 and 18 years. For younger children, the paediatricians' outfit seems to play no major role.

Concepts: Motivation, Scale, Preference, Degree of a polynomial, Likert scale, Clothing, Dress code, Casual

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AIM: To characterize Familial Mediterranean Fever (FMF) in western Sweden, focusing on, genotype, clinical picture, prevalence and age of onset as well as time to diagnosis. METHODS: Patients with autoinflammatory diseases are continuously registered at the five main hospitals in Western Sweden. Case records of patients with FMF were analysed retrospectively. Population data on immigration was retrieved from Statistics Sweden. RESULTS: Until 2008, 37 patients with FMF were identified. The prevalence among inhabitants of Turkish, Lebanese, Syrian and Iranian origin was 173, 124, 86 and 17/100 000, respectively. Median age at first symptoms was 4 years (range 3 month - 37 years) and at diagnosis 10 years (range 2 - 44 years). Median time from first symptoms to diagnosis was 4 years (range < 1 year to 34 years). Among 32 patients screened for twelve common mutations, 75% were homozygotes or compound heterozygotes, 16% were heterozygotes and in 9% no mutation was found. In our cohort the frequencies of symptoms were fever 100%, peritonitis 90%, pleuritis 22% and arthritis 12%. CONCLUSIONS: The majority of patients with FMF present during childhood. The prevalence among immigrants in western Sweden is in the same range as in their country of origin. Time to diagnosis needs to be shortened by means of increased awareness of the disease. ©2012 The Author(s)/Acta Paediatrica ©2012 Foundation Acta Paediatrica.

Concepts: Disease, Mutation, Demography, Population, Mediterranean Sea, Familial Mediterranean fever, Arthritis, Peritonitis

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Infants within neonatal intensive care units can receive multiple medically essential painful procedures a day. How they respond to these stimuli, how best to alleviate the negative effects, and the long-term consequences for the infant are all significant questions that have yet to be fully answered. In recent years several studies have examined cortical responses to noxious stimuli in the neonate through the use of near-infrared spectroscopy (NIRS) and electroencephalography (EEG). These investigations dispel any notion that the newborn infant does not process noxious stimuli at a cortical level and open the way for future research. In this Viewpoint article we review these studies and discuss key clinical challenges which may be elucidated with the use of these techniques. Conclusion: Simultaneously measuring the changes that are evoked in behaviour, physiology and the cortex following noxious events will provide the best approach to understanding the neonate’s experience of pain. This article is protected by copyright. All rights reserved.

Concepts: Infant, Brain, Neuroscience, Infant mortality, Pediatrics

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Whole body hypothermia (WBH) exerts proven neuroprotective effects in infants with hypoxic-ischemic encephalopathy (HIE). Our aim was to describe how WBH could impact on respiratory function in mechanically ventilated newborn infants, by recording primary and composite indices of oxygenation and ventilation before, during and after WBH.

Concepts: Infant, Newborn

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AIM: This study was designed to evaluate the diagnostic value of B-type natriuretic peptide (BNP) in syncope in children and adolescents. METHODS: Serum BNP concentration was measured by electrochemiluminescence assay in 62 consecutive children and adolescents hospitalized for syncope. RESULTS: Of the 62 children and adolescents hospitalized for syncope, 39 had non-cardiac syncope, 37 (59.7%) of whom had autonomic-mediated reflex syncope, and two (3.2%) had syncope of unknown cause. Twenty-three patients (37.1%) had cardiac syncope; 11 of these had cardiac arrhythmias and 12 had structural cardiac/cardiopulmonary disease. Patients with cardiac syncope had significantly higher serum BNP than those with non-cardiac syncope (958.78 ± 2443.41 pg/ml vs. 31.05 ± 22.64 pg/ml, p < 0.05). Logistic multivariate regression analysis revealed that urinary incontinence during syncopal episodes, ECG abnormalities and increased serum BNP levels were independent predictors for cardiac syncope. At a cut-off value of 40.65 pg/ml, serum BNP was associated with significant risk for a cardiac cause of syncope, with sensitivity 73.9% and specificity 70.0% for distinguishing cardiac syncope from non-cardiac syncope. CONCLUSION: Serum BNP was helpful in differentiating cardiac syncope from non-cardiac syncope in children and adolescents ©2013 The Author(s)/Acta Paediatrica ©2013 Foundation Acta Paediatrica.

Concepts: Regression analysis, Cardiology, Urinary incontinence, Cardiac arrest, Multivariate statistics, Brain natriuretic peptide, Atrial natriuretic peptide, Cardiac dysrhythmia

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There is a lack of evidence on the best treatment option for umbilical granuloma. The primary aim of this study was to compare three treatments for umbilical granuloma: standard treatment with topical silver nitrate, clobetasol propionate cream (0.05%) and ethanol wipes. The secondary aim was to evaluate whether the treatment could be successfully administered by a parent at home, rather than in the outpatient clinic.

Concepts: Silver, Clinic, Clobetasol propionate, Propionates, Silver nitrate

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To study the associations between protein intake from different sources with anthropometry and serum insulin-like growth factor 1 (IGF-1) in infancy and childhood.

Concepts: Immune system, Signal transduction, Growth factor, Hormone, Insulin-like growth factor 1, Growth factors, Insulin-like growth factor

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In the September 2015 issue of Acta Paediatrica, van der Burg et al reported the findings of a study into the neuropsychological development of preterm infants born to obese mothers when the children reached the age of two (1). The authors used the Bayley’s Scale of Infant Development II and found a higher risk of adverse indices for mental and motor development, which could not be explained by the newborns' systemic inflammation, socio-economic conditions or immaturity. This article is protected by copyright. All rights reserved.

Concepts: Inflammation, Infant, Nutrition, Fatty acid, Triglyceride, Omega-3 fatty acid, Child development, Omega-6 fatty acid