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1.
Ursula Kiechl‐Kohlendorfer Elisabeth Ralser Ulrike Pupp Peglow Nicola Pehboeck‐Walser Barbara Fussenegger 《Acta paediatrica (Oslo, Norway : 1992)》2013,102(1):66-71
Aim
To unravel risk predictors for impaired numerical skills at 5 years of age in a population‐based cohort of very preterm infants.Methods
Between January 2003 and August 2006, we prospectively enrolled all infants born in Tyrol with <32 weeks of gestation. A total of 161 of 223 preterm infants (participation rate 72.2%) had a detailed examination at 5 years of age including cognitive assessment (Hannover‐Wechsler Intelligence Test for preschool children, third edition (HAWIVA‐III) or Snijders‐Oomen Nonverbal Intelligence Test (SON‐R)). In 135 children, numerical abilities were assessed with the dyscalculia test TEDI‐MATH. The association between pre‐ and postnatal factors and impaired numerical skills was analyzed by means of logistic regression analysis.Results
Dyscalculia test showed delayed numerical skills (TEDI‐MATH Sum T‐score <40) in 27 of 135 children tested (20.0%). In half of the children tested, delayed numerical abilities were related to lower IQ scores. Smoking in pregnancy, intracerebral haemorrhage and chronic lung disease were predictive of delayed numerical skills at 5 years of age in the multivariate analysis.Conclusion
This study identified risk predictors for impaired numerical skills in preterm infants. Our data support the role of both pre‐ and perinatal factors in the evolution of mathematical deficits.2.
Observation study showed that the continuity of skin‐to‐skin contact with low‐birthweight infants in Uganda was suboptimal
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《Acta paediatrica (Oslo, Norway : 1992)》2018,107(9):1541-1547
Aim
Kangaroo mother care (KMC) is a safe and effective method of reducing neonatal mortality in resource‐limited settings, but there has been a lack of data on the duration of skin‐to‐skin contact (SSC) in busy, low‐resource newborn units. Previous studies of intermittent KMC suggest the duration of SSC ranged from 10 minutes to 17 hours per day.Methods
This was an observational study of newborn infants born weighing less than 2000 g, which collected quantitative data on SSC over the first week after birth. The study took place in July 2016 in the newborn unit of a low‐resource facility in Uganda.Results
The mean daily duration of SSC over the first week after birth was three hours. This differed significantly from the World Health Organization recommendation of at least 20 hours of SSC per day. SSC was provided by mothers most of the time (73.5%), but other family members also took part, especially on the day of birth.Conclusion
Our study found a disappointingly low daily duration of SSC in this Ugandan newborn unit. However, advocacy and community education of SSC may help to decrease the stigma of KMC, improve overall acceptance and reduce the age at SSC initiation.3.
Thomas Rossor Ingran Lingam Abdel Douiri Ravindra Bhat Anne Greenough 《Acta paediatrica (Oslo, Norway : 1992)》2018,107(9):1535-1540
Aim
To determine whether a pH probe or multichannel intraluminal impedance (MII) more frequently detected gastro‐oesophageal reflux and test the hypothesis that acid reflux was associated with lower baseline impedance.Methods
A prospective study of infants in whom reflux was suspected and evaluated using combined pH and multichannel impedance. Studies were considered abnormal if the acid index was >10% or there were >79MII reflux events in 24 hours. The acid index was the percentage of total study time with a pHResults
Forty‐two infants [median gestational age 31 (range 23–42) weeks] were assessed. Only nine infants (21%) had abnormal studies, seven detected by pH monitoring, one by MII monitoring and one by both techniques (p = 0.04). After correcting for gestational age and post‐natal age, baseline impedance remained negatively correlated with the acid index (r = ?0.34, p = 0.038) and the maximum ACT (r = ?0.44, p = 0.006).Conclusion
Clinical suspicion of reflux was frequently incorrect, and reflux was more frequently detected by a pH probe. The inverse relationship of acid reflux to baseline impedance suggests that mucosal disruption may result from acid reflux in this population.4.
《Acta paediatrica (Oslo, Norway : 1992)》2018,107(9):1494-1499
Aim
From birth to old age, males generally have poorer disease outcomes compared to females. Preterm infants display a marked gender disparity in disease outcomes, and the underlying mechanisms are not well delineated. Our aim was to review the literature on clinical outcomes between preterm infants of different genders and discuss the potential mechanisms underlying the differences observed.Methods
A literature review was undertaken for experimental and clinical research related to gender differences in preterm outcomes.Results
Preterm male infants appear to have consistently worse outcomes compared to females, and the aetiology of these differences, while mostly undetermined, is likely multifactorial.Conclusion
The male disadvantage in preterm outcomes is likely multifactorial with hormonal, genetic and immunological differences likely playing key roles. Gender is an important variable in preterm outcome and should be considered when designing clinical and experimental research.5.
6.
Review shows that parental reassurance and nutritional advice help to optimise the management of functional gastrointestinal disorders in infants
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《Acta paediatrica (Oslo, Norway : 1992)》2018,107(9):1512-1520
Aim
Regurgitation, infantile colic and functional constipation are common functional gastrointestinal disorders (FGIDs) during infancy. Our aim was to carry out a concise review of the literature, evaluate the impact of these common FGIDs on infants and their families, and provide an overview of national and international guidelines and peer‐reviewed expert recommendations on their management.Methods
National and international guidelines and peer‐reviewed expert recommendations on the management of regurgitation, infantile colic and functional constipation were examined and summarised.Results
Regurgitation, infantile colic and functional constipation cause frequent parental concerns, lead to heavy personal and economic costs for families and impose a financial burden on public healthcare systems. Guidelines emphasise that the first‐line management of these common FGIDs should focus on parental education, reassurance and nutritional advice. Nutritional advice should stress the benefits of continuing breastfeeding, while special infant formulas may be considered for non‐breastfed infants with common FGIDs. Drug treatment is seldom required, with the exception of functional constipation.Conclusion
By providing complete and updated parental education, reassurance and nutritional advice, healthcare professionals can optimise the management of FGIDs and related symptoms and reduce the inappropriate use of medication or dietary interventions.7.
Perspectives on periviability counselling and decision‐making differed between neonatologists in the United States and the Netherlands
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《Acta paediatrica (Oslo, Norway : 1992)》2018,107(10):1710-1715
Aim
American guidelines suggest that neonatal resuscitation be considered at 23 weeks of gestation, one week earlier than in the Netherlands, but how counselling practices differ at the threshold of viability is unknown. This pilot study compared prenatal periviability counselling in the two countries.Methods
In 2013, a cross‐sectional survey was sent to 121 Dutch neonatologists as part of a nationwide evaluation of prenatal counselling. In this pilot study, the same survey was sent to a convenience sample of 31 American neonatologists in 2014. The results were used to compare the organisation, content and decision‐making processes in prenatal counselling at 24 weeks of gestation between the two countries.Results
The survey was completed by 17 (55%) American and 77 (64%) Dutch neonatologists. American neonatologists preferred to meet with parents more frequently, for longer periods of time, and to discuss more intensive care topics, including long‐term complications, than Dutch neonatologists. Neonatologists from both countries preferred shared decision‐making when deciding whether to initiate intensive care.Conclusion
Neonatologists in the United States and the Netherlands differed in their approach to prenatal counselling at 24 weeks of gestation. Cross‐cultural differences may play a role.8.
Karin Persson Inger
hlund Lisbeth Nordstrm Anna Winberg Eva Rnmark Christina E West 《Acta paediatrica (Oslo, Norway : 1992)》2013,102(6):644-649
Aim
At the extremes of latitude, UVB intensity is insufficient for adequate vitamin D synthesis in winter. Fatty fish, vitamin D enriched milk, margarine and eggs are main dietary sources of vitamin D. Their elimination may increase the risk of vitamin D deficiency. The aim was to assess vitamin D status in food‐allergic adolescents eliminating milk, egg and/or fish compared with adolescents on normal diets.Methods
In winter, vitamin D intake was assessed by a food frequency questionnaire in 20 food‐allergic adolescents and 42 controls in the population‐based Obstructive Lung Disease In Northern Sweden (OLIN) cohort studies. Vitamin D supplementation was queried. Serum 25‐hydroxyvitamin D [S‐25(OH)D] and S‐parathormone (S‐PTH) levels were determined.Results
Mean (SD) dietary vitamin D intake was 7.9 (3.6) μg/day in allergic adolescents and 7.8 (3.4) in controls (p > 0.05). Mean (SD) S‐25(OH)D levels in supplement consumers were 44 (18) nmol/L compared with 35 (10) in non‐consumers (p = 0.03). S‐25(OH)D and S‐PTH levels were similar in food‐allergic adolescents and controls (p > 0.05). Eighty‐two percentage had deficient S‐25(OH)D levels <50 nmol/L, and none reached levels >75 nmol/L.Conclusion
Vitamin D deficiency was as common in food‐allergic adolescents as in controls although the vitamin D intake met national recommendations. Large‐scale studies on the prevalence of vitamin D deficiency in this region are needed.9.
Tokuo Miyazawa Kazuo Itabashi Masanori Tamura Hideaki Suzuki Tsuyomu Ikenoue Prevention Recurrence Committee Japan Obstetric Compensation System for Cerebral Palsy 《Acta paediatrica (Oslo, Norway : 1992)》2020,109(6):1154-1161
Aim
This study aimed to identify the clinical features of infants who were healthy at birth, but developed sudden unexpected collapse and were then diagnosed with cerebral palsy before 5 years of age.Methods
We retrospectively analysed 1182 records from the no-fault Japan Obstetric Compensation System for Cerebral Palsy database up to 2016. This identified 45 subjects (3.8%) who were subsequently diagnosed with severe cerebral palsy due to sudden unexpected postnatal collapse (SUPC). They were all healthy at birth, based on the criteria of five-minute Apgar scores of seven or more, with normal umbilical cord blood gases and no need for neonatal resuscitation within five minutes of birth.Results
The median birth weight of the 45 subjects (26 males) was 2770 g (range 2006-3695 g). Of these, 10 developed SUPC during early skin-to-skin contact (SSC). Medical personnel were not present in all 10 cases: nine were being breastfed at the time and eight of the mothers did not notice their infant's abnormal condition until medical staff alerted them.Conclusion
This national study of children with cerebral palsy who appeared healthy at birth found that unsupervised breastfeeding was a common factor in cases of SUPC during early SSC.10.
Virus detection in critically ill children with acute respiratory disease: a new profile in view of new technology
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Atsushi Kawaguchi Angela Bates Bonita E. Lee Steven Drews Daniel Garros 《Acta paediatrica (Oslo, Norway : 1992)》2018,107(3):504-510
Aim
To describe the epidemiology of critically ill children admitted to a paediatric intensive care unit (PICU) with acute respiratory disease. The association with intubation was analysed for the three most prevalent viruses and in those with and without viral co‐infection.Methods
Patients admitted to the PICU (2004–2014) with acute respiratory disease were included. Analyses were performed utilising each respiratory viral infection or multiple viral infections as an exposure.Results
There were 1766 admissions with acute respiratory disease of which 1372 had respiratory virus testing and 748 had one or more viruses detected. The risk of intubation before or during the PICU stay was higher if parainfluenza virus was detected compared to respiratory syncytial virus (RSV) (OR: 2.20; 95% CI: 1.06–4.56). Sixty‐three admissions had two or more viruses detected, and the combination of RSV and Rhinovirus/enterovirus was the most common. No significant difference was observed in the risk of intubation between patients with multiple and single viral infections.Conclusion
Higher risk of intubation was found in patients with parainfluenza as compared to RSV. The risk of intubation comparing parainfluenza virus to other viruses and for patients with multiple versus single virus needs to be further studied.11.
Nutritional therapy complications in children with ultra‐short bowel syndrome include growth deficiency but not cholestasis
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Katarzyna Olszewska Janusz Ksiazyk Dariusz Kozlowski Magdalena Pajdowska Malgorzata Janusz Maciej Jaworski 《Acta paediatrica (Oslo, Norway : 1992)》2018,107(6):1088-1093
Aim
Children with ultra‐short bowel syndrome (USBS) have not been extensively studied to date because the condition is rare. The aim of the study was to assess the nutritional status of children with USBS receiving home parenteral nutrition, using citrulline serum concentration and cholestasis.Methods
We studied 17 patients with USBS, with a median age of 6.6 years and median duration of parenteral nutrition of 6.6 years. The study was carried out at The Children's Memorial Health Institute, Warsaw, from January 2014 to January 2015.Results
The median standard deviation score (SDS) was ?1.2 for body mass according to chronological age, ?1.72 according to height and ?0.59 according to height for age. Patients requiring seven days per week parenteral nutrition had a citrulline concentration below 10 μmol/L. Decreased bone‐mineral density was observed in 87% of the patients. Low values of 25‐hydroxyvitamin D were found in 53% of the children. None of the patients had elevated conjugated bilirubin levels above 34.2 μmol/L.Conclusion
Children with USBS were growth deficient according to their chronological age, with frequent abnormal bone mineralisation and vitamin D deficiency. Children requiring parenteral nutrition seven days a week had citrulline concentrations below 10 μmol/L. Cholestasis was not seen.12.
Review shows that Icelandic society is taking firmer steps to tackle the diverse forms of child abuse and neglect that its children are exposed to
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《Acta paediatrica (Oslo, Norway : 1992)》2018,107(9):1500-1511
Aim
This review examined and summarised the research published on child abuse in Iceland, which was mainly in the country's native language, to make the findings more accessible to English speakers. It specifically focused on child rearing and the physical, emotional and sexual abuse, neglect and intrafamilial conflicts suffered by children at the hands of their parents and other carers.Method
The review drew on published research, books and reports and compared the findings with Nordic research and global estimates of child abuse.Results
Qualitative and quantitative research revealed that the prevalence of different forms of child abuse, child neglect and intra‐familial conflicts in Iceland was similar to, or higher than, global and Nordic estimates. Younger respondents reported less physical abuse than older respondents, but higher levels of emotional abuse. Legislation, greater awareness, public debates and research on child abuse in Iceland have contributed to the growing recognition of the negative consequences of child abuse and strengthened support for prevention strategies.Conclusion
Icelandic children have reportedly experienced diverse forms of child abuse and neglect from their parents and other carers. Diverse initiatives have been put in place that underline the urgent need to tackle such behaviour.13.
Accurate and fast neonatal heart rate assessment with a smartphone‐based application – a manikin study
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《Acta paediatrica (Oslo, Norway : 1992)》2018,107(9):1548-1554
Aim
This study determined the accuracy and speed of the NeoTapLifeSupport (NeoTapLS), a free smartphone application that aims to assess a neonate's heart rate.Methods
We asked 30 participants with a variety of backgrounds to test the NeoTapLS, which was developed by our own nonprofit organisation Tap4Life, to determine a randomly selected heart rate by auscultation or palpation. The study was carried out in 2014 at Sachs’ Children and Youth Hospital, Sweden, using a Laerdal SimNewB manikin that simulates true values. The NeoTapLS calculates the heart rate based on the user's last three taps on the smartphone screen.Results
A total of 1200 measurements were carried out. A high correlation was found between measured and true values by auscultation (correlation coefficient 0.993) as well as by palpation (correlation coefficient 0.986) with 93.5% of the auscultations and 86.3% of the palpations differing from the true value by five beats or fewer. The mean time to the first estimated heart rate was 14.9 seconds for auscultation and 16.3 seconds for palpation.Conclusion
Heart rates could be accurately and rapidly assessed using the NeoTapLS on a manikin. A globally accessible mobile health system could offer a low‐cost alternative to expensive medical equipment.14.
Minna Honkila Marjo Renko Irma Ikäheimo Tytti Pokka Matti Uhari Terhi Tapiainen 《Acta paediatrica (Oslo, Norway : 1992)》2018,107(5):774-779
Aim
Our aim was to study prospectively the aetiology of neonatal conjunctivitis in a population‐based setting.Methods
Altogether 173 neonates with clinical conjunctivitis aged on average 20 (SD 10) days were recruited from child welfare clinics in Oulu, Finland, in 2010–2015. Conjunctival specimens were collected from 167 neonates for multiplex polymerase chain reaction to detect 16 respiratory viruses, from 163 for polymerase chain reaction to detect Chlamydia trachomatis and Neisseria gonorrhoeae and from 160 for bacterial culture studies. The cases were followed up until the age of 18 months.Results
Viral conjunctivitis was diagnosed in 8/167 (4.8%; 95% CI 2.1–9.2%), chlamydial or gonococcal conjunctivitis in 0/163 cases (0%; 95% CI 0–2.2%) and other bacterial conjunctivitis in 58/160 (36%; 95% CI 29–44%). Rhinovirus was found at the ocular site in 4/167 (2.4%) neonates, adenovirus in 3/167 (1.8%) and bocavirus in 1/167 (0.6%). The most commonly isolated bacteria included Staphylococcus aureus (16%), Moraxella catarrhalis (9.4%) and Streptococcus pneumoniae (3.1%). None of these pathogens was associated with the 4/173 (2.3%) cases later operated on for persistent nasolacrimal duct obstruction.Conclusion
Chlamydia trachomatis was a rare pathogen in neonatal conjunctivitis in a population‐based setting, but respiratory viruses were detected more frequently than indicated earlier.15.
Christian Heiring Henrik Verder Peter Schousboe Torben E. Jessen Lars Bender Finn Ebbesen Marianne Dahl Christian Eschen Jesper Fenger-Grøn Agnar Höskuldsson Morgaine Matthews Jes Reinholdt Nikolaos Scoutaris Heidi Smedegaard 《Acta paediatrica (Oslo, Norway : 1992)》2020,109(2):285-290
Aim
To evaluate the accuracy of our new rapid point-of-care (POC) test for lung maturity. The method as we describe in an accompanying article was developed with the purpose of improving the outcome from respiratory distress syndrome (RDS). The test enables the delivery of surfactant in infants with immature lungs already at birth and ensures that infants with mature lungs are not treated unnecessarily.Methods
Fresh gastric aspirate (GAS) was sampled at birth in a cohort of preterm infants with gestational ages ranging between 24 and 31 completed weeks for lung surfactant measurement as lecithin–sphingomyelin ratio (L/S). L/S was prospectively compared with RDS development. The clinical outcome was blinded for the investigators of L/S. The time for analysis was <15 minutes.Results
GAS was obtained from 72 infants. Forty-four (61%) developed RDS. The cut-off for L/S was 3.05; predicting RDS with a sensitivity of 91% and specificity of 79%.Conclusion
The new improved spectroscopic L/S method of lung maturity on GAS has high sensitivity. The method is designed for use as a POC test at birth, and a spectroscopic prototype has been developed for bedside use. Clinical trials with this new lung maturity test are planned.16.
Jacques Rigo Jean-Michel Hascoët Jean-Charles Picaud Fabio Mosca Amandine Rubio Elie Saliba Michaël Radkë Umberto Simeoni Bernard Guillois Nicholas P. Hays Mickaël Hartweg Claude Billeaud Johannes Spalinger 《Acta paediatrica (Oslo, Norway : 1992)》2020,109(3):527-533
Aim
This study examined the influence of different human milk fortifiers on biomarkers of gastrointestinal immaturity and inflammation in preterm infants.Methods
We report secondary outcomes from a controlled, double-blind, randomised, parallel group study conducted from 2011 to 2014 in neonatal intensive care units at 11 metropolitan hospitals in France, Belgium, Germany, Switzerland and Italy. Preterm infants born at up to 32 weeks or weighing up to 1500 g were randomised to a new powdered human milk fortifier (n = 77) or a control fortifier (n = 76) for a minimum of 21 days. We analysed faecal markers of gut inflammation, namely alpha-1 antitrypsin and calprotectin, and maturity, namely elastase-1.Results
Faecal alpha-1 antitrypsin was slightly lower in the new than control fortifier group after 21 days of full enteral feeding, with a geometric mean and standard deviation of 1.52 ± 1.32 vs 1.82 ± 1.44 mg/g stools (P = .01). There was no significant difference in faecal calprotectin (median [Q1-Q3] of 296 [136-565] μg/g stools in both groups combined at study day 21). Faecal elastase-1 was lower in the new fortifier than control fortifier group (202.5 ± 1.6 vs 257.7 ± 1.5 μg/g stools, P = .016).Conclusion
Mean values for each parameter were within the ranges in healthy term infants, indicating favourable markers of gastrointestinal status in both groups. In addition, for faecal calprotectin, the relatively high concentration observed in preterm infants fed fortified human milk suggests that the threshold level for detecting necrotising enterocolitis should be revised.17.
Elisabeth J. M. Straathof Kirsten R. Heineman Elisa G. Hamer Mijna Hadders-Algra 《Acta paediatrica (Oslo, Norway : 1992)》2020,109(7):1423-1429
Aim
To determine the prevalence of prevailing head position to one side (PHP) in young infants and to evaluate its associations with reaching performance, neurological condition and perinatal and socio-economic factors.Methods
Observational study in 500 infants (273 boys) 2-6 months corrected age, representative of the Dutch population (median gestational age 39.7 weeks (27-42); birthweight 3438 g (1120-4950). Prevailing head position to one side and reaching performance were assessed with the Infant Motor Profile; neurological condition with the Standardized Infant NeuroDevelopmental Assessment. Socio-economic information and perinatal information were obtained by questionnaire and medical records. Associations were analysed with uni- and multivariable statistics.Results
Prevailing head position to one side was observed in 100 infants (20%), and its prevalence decreased from 49% at 2 months to 0% at 6 months. Only in infants aged 4-5 months PHP was significantly associated with worse reaching and an at-risk neurological score. Prevailing head position to one side was weakly associated with prenatal substance exposure, post-natal admission to a paediatric ward and paternal native Dutch background.Conclusion
Prevailing head position to one side at 2-3 months is a frequently occurring sign with limited clinical significance. Yet, PHP at 4-5 months is associated with a worse functional and neurological condition. Therefore, PHP at 4-5 months could serve as a red flag indicating possible challenges in later development.18.
Prevalence and characteristics of human parechovirus and enterovirus infection in febrile infants
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Kentaro Sano Hiromichi Hamada Shoko Hirose Kenta Sugiura Satoko Harada Mai Koizumi Mayumi Hara Haruna Nishijima Masakatsu Taira Atsushi Ogura Tomoko Ogawa Jun‐ichi Takanashi 《Pediatrics international》2018,60(2):142-147
19.
Ashok Srinivasan MD Winfred C. Wang MD Aditya Gaur MD Teresa Smith BS Zhengming Gu PhD Guolian Kang PhD Wing Leung MD PhD Randall T. Hayden MD 《Pediatric blood & cancer》2014,61(3):507-511
Background
Human rhinovirus (HRV), human coronavirus (hCoV), human bocavirus (hBoV), and human metapneumovirus (hMPV) infections in children with sickle cell disease have not been well studied.Procedure
Nasopharyngeal wash specimens were prospectively collected from 60 children with sickle cell disease and acute respiratory illness, over a 1‐year period. Samples were tested with multiplexed‐PCR, using an automated system for nine respiratory viruses, Chlamydophila pneumoniae, Mycoplasma pneumoniae, and Bordetella pertussis. Clinical characteristics and distribution of respiratory viruses in patients with and without acute chest syndrome (ACS) were evaluated.Results
A respiratory virus was detected in 47 (78%) patients. Nine (15%) patients had ACS; a respiratory virus was detected in all of them. The demographic characteristics of patients with and without ACS were similar. HRV was the most common virus, detected in 29 of 47 (62%) patients. Logistic regression showed no association between ACS and detection of HRV, hCoV, hBoV, hMPV, and other respiratory pathogens. Co‐infection with at least one additional respiratory virus was seen in 14 (30%) infected patients, and was not significantly higher in patients with ACS (P = 0.10). Co‐infections with more than two respiratory viruses were seen in seven patients, all in patients without ACS. Bacterial pathogens were not detected.Conclusion
HRV was the most common virus detected in children with sickle cell disease and acute respiratory illness, and was not associated with increased morbidity. Larger prospective studies with asymptomatic controls are needed to study the association of these emerging respiratory viruses with ACS in children with sickle cell disease. Pediatr Blood Cancer 2014;61:507–511. © 2013 Wiley Periodicals, Inc.20.
Japanese clinical practice guidelines for allied disorders of Hirschsprung's disease, 2017
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Mitsuru Muto Hiroshi Matsufuji Takeshi Tomomasa Masaki Nio Hiroshi Tamai Masanori Tamura Haruhiko Sago Akira Toki Shunsuke Nosaka Tatsuo Kuroda Masahiro Yoshida Atsushi Nakajima Hiroyuki Kobayashi Hideki Sou Kouji Masumoto Yoshio Watanabe Yutaka Kanamori Yoshinori Hamada Atsuyuki Yamataka Naoki Shimojima Akio Kubota Kosuke Ushijima Ken Haruma Shin Fukudo Yuko Araki Takahiro Kudo Satoshi Obata Wataru Sumita Toshihiko Watanabe Suguru Fukahori Yoshimitsu Fujii Yoshiyuki Yamada Keisuke Jimbo Fujimi Kawai Tomoya Fukuoka Shinsuke Onuma Toshio Morizane Satoshi Ieiri Genshiro Esumi Takahiro Jimbo Tomoko Yamasaki 《Pediatrics international》2018,60(5):400-410