bluuebunny/crossref_metadata_2025 huggingface dataset:
Sulphasalazine and Sulphapyridine Serum Levels in Children to Mothers Treated with Sulphasalazine during Pregnancy and Lactation
Authors: ESBJÖRNER E. , JÄRNEROT G. , WRANNE L.
Published: January 2008

ABSTRACT. Serum concentrations of sulphasalazine and sulphapyridine were measured during the first week of life in 15 children whose mothers had been on sulphasalazine during pregnancy. The serum concentrations of sulphapyridine and sulphasalazine were similar in the children and their mothers at delivery. The elimination rate of the drugs in the newborn children was slow but the concentrations were not so high that a bilirubin displacing effect could be expected. In eight mothers who were breast‐feeding and taking sulphasalazine, analyses were done of mothers'serum, breast‐milk and serum from their children. The results showed that the amount of sulphasalazine and sulphapyridine transferred to the child via the breast‐milk is negligible with regard to the risk of kernicterus. It is concluded that a woman in need of sulphasalazine treatment can continue the medication throughout pregnancy and lactation without risk of development of kernicterus in her child. Only term infants without haemolytic disease were included in the study. Thus our conclusion is not necessarily valid for the prematurely born child or the child with haemolytic disease.
Screening for Cystic Fibrosis
Authors: DANKERT‐ROELSE JEANNETTE E. , TE MEERMAN GERARD J. , MARTIJN ALBERT , TEN KATE LEO P. , KNOL KLAAS
Published: January 2008

ABSTRACT. A neonatal screening program for CF by determination of albumin in meconium was performed in the north eastern part of the Netherlands from 1973 to 1979. In this period 94043 newborns were screened and 116953 were not. A follow‐up study of CF patients in the above cohorts was started in 1980. The purposes of this study were to evaluate the effects of early diagnosis and treatment in CF patients by comparing the outcome in the two groups of patients. Although the results indicate that very early diagnosis and treatment have a beneficial effect on outcome, more studies are needed before a definite answer can be given as to whether or not mass neonatal screening should be started.
Tick‐borne Borrelia‐Meningitis in Children An Outbreak in the Kalmar Area during the Summer of 1984
Authors: JÖRBECK H. J. A. , GUSTAFSSON P. M. , LIND H. C. F. , STIERNSTEDT G. T.
Published: January 2008

ABSTRACT. Nine children, aged 5 to 11 years, with subacute or chronic meningitis were studied. Symptoms started during the summer season in all patients and in eight of the patients the disease began with a localized erythematous lesion (ECM), mostly in the face. In one patient only there was a history of an insect bite at the site of the erythema. The neurological abnormalities included aseptic meningitis, peripheral facial nerve palsy (5/9) and oculomotor nerve palsy (1/9). Most children complained of headache, fatigue, loss of appetite and had a low grade fever. High antibody titers to Borrelia spirochetes in serum and/or cerebrospinal fluid (CSF) were demonstrated by ELISA in eight of the nine patients and by indirect immunofluorescence assay (IFA) in three patients. All patients had a dramatic improvement in their general condition and became afebrile within three days of institution of i.v. penicillin G treatment (i.v. cefuroxime in one patient).
Outbreak of Coxsackievirus A‐14 Meningitis among Newborns in a Maternity Hospital Ward
Authors: HELIN I. , WIDELL A. , BORULF S. , WALDER M. , ULMSTEN U.
Published: January 2008

ABSTRACT. During the late winter of 1983, 16 newborns with vague symptoms of failure to thrive, reluctance to feed and a slight rise in body temperature, were found to have meningitis caused by Coxsackievirus A‐14. The cerebrospinal fluid showed pleocytosis with polymorphonuclear cells in excess but was otherwise normal. The clinical course was uneventful in all infants, but two of them demonstrated clinical signs of incipient cerebral oedema during the acute phase of the illness. An electroencephalogram (EEG) during the initial course of the disease and at nine months of age was normal in all. During a follow‐up period of 21/2 years they all developed normally and no sequelae were noted. The presentation also demonstrates the usefulness of Vero cells for the propagation of the responsible virus.
Etiological Factors Associated with the Development of Periventricular Leukomalacia
Authors: CALVERT S. A. , HOSKINS E. M. , FONG K. W. , FORSYTH S. C.
Published: January 2008

ABSTRACT. Prenatal, intrapartum and postnatal factors are compared between 15 preterm infants, known to have periventricular leukomalacia (PVL) on ultrasound and 15 infants of similar birthweight and gestation who ultrasonographically showed no evidence of cystic lesions, and who are known to be neurologically normal at follow up. Prenatally, the incidence of antepartum haemorrhage was significantly higher in the PVL group. Intrapartum factors were similar between the two groups but postnatally, the PVL group had significantly lower PaCO2 readings during the first 72 h of life. It is postulated that a severe maternal bleed in late pregnancy and neonatal hypocarbia could significantly decrease cerebral perfusion and cause areas of ischaemia and infarction resulting in periventricular leukomalacia.
Protein and Energy Intake during Weaning: I. Effects on Growth
Authors: AXELSSON I. , BORULF S. , RIGHARD L. , RÄIHÄ N.
Published: January 2008

ABSTRACT. The growth and food consumption of 30 healthy infants from 4 to 6 months of age have been measured. Two groups were assigned randomly to either a formula with 1.9 g of protein and 72 kcal per 100 ml (F1) or 2.7 g of protein and 69 kcal per 100 ml (F2). A third group of infants were fed breast milk (0.96 g of protein and 65 kcal per 100 ml (HM). All infants received supplementary food according to the same regimen and were fed ad libitum. The mean protein intake was 1.3, 2.6 and 3.6 g/kg/day in the HM‐, F1‐ and F2‐groups respectively. The corresponding mean energy intake was 80, 101 and 94 kcal/kg/day. The formula‐fed infants had significantly higher protein and energy intakes when compared to the breast‐fed group. No significant differences were found in the rate of growth of crown‐heel length, head circumference or in weight gain. The differences in protein intake between the breast‐ and formula‐fed infants without differences in growth indicate that the formulas may provide a protein intake in excess to the needs.
Hyponatraemia in Premature Babies and Following Surgery in Older Children
Authors: JUDD A. , HAYCOCK G. B. , DALTON N. , CHANTLER C.
Published: January 2008

ABSTRACT. Hyponatraemia implies water retention in excess of sodium with or without increased loss of sodium from the body; extracellular fluid volume may be increased, normal or reduced. It has many causes which are briefly reviewed. Among these is the rare syndrome of inappropriate secretion of antidiuretic hormone (SIADH). It is suggested that SIADH is often diagnosed incorrectly because the raised ADH levels are appropriate for the volume status of the child. Precision in the diagnosis is important because whilst water restriction is necessary for the treatment of SIADH, other measures including the administration of extra fluid are often required if the raised ADH is appropriate. Hyponatraemia in the newborn may be caused by prerenal failure, renal failure or renal sodium wasting which is common in premature infants. Careful control of sodium intake as well as water intake is vital in this age group. Surgery is associated with water retention, but recent studies suggest that ADH levels are raised post‐operatively because of volume depletion and that present recommendations for fluid therapy during and following surgery are inadequate. The use of electrolyte‐free dextrose solutions should be abandoned and more liberal use of physiological saline or colloid is recommended.
Epidemiology of Infantile Hydrocephalus in Sweden
Authors: FERNELL E. , HAGBERG B. , HAGBERG G. , von WENDT L.
Published: January 2008

ABSTRACT. The aetiology of infantile hydrocephalus (IH) was studied in a population‐based series of 141 children with IH, born at term in southwestern Sweden 1967–82. A prenatal aetiology was present in 81 children (57%), a pre‐ and perinatal in 6(4%), a perinatal in 27(19%), and a postnatal in 8(6%); the origin in 19 children (13%) remained untraceable. A variety of aetiologies were revealed or indicated among prenatal conditions. The dominant intrauterine infection was toxoplasmosis. The predominant perinatal condition was posthaemorrhagic IH. The broad outline of outcome differed between pathogenetic groups. Children with a clear prenatal onset of IH were found to be at high risk for early death or multiple neurological impairments. Thirteen of 63(21%) within this group had died before 2 years of age and 34 of the 50(68%) survivors showed major neurological dysfunction. This contrasted to the incidences of 3% deaths and 30% sequelae in children with IH of other onset.
Protein Intake during Weaning
Authors: AXELSSON I. , BORULF S. , RÄIHÄ N.
Published: January 2008

ABSTRACT. Metabolic responses to different feeding regimens during the weaning period have not previously been studied. In this study 30 healthy infants aged 4–6 months were divided into three feeding regimens with 10 infants in each. The regimens were: Human milk (HM‐group), formula F1 with 1.9g protein/100 ml (F1‐group) or formula F2 with 2.7 g protein/100 ml (F2‐group). All infants received the same supplementary food and were fed ad libitum. Concentrations of serum urea were significantly higher (p<0.001) in the formula groups as compared to the breast‐fed infants throughout the entire study period. Serum albumin concentrations were within normal limits in the breast‐fed infants indicating adequate protein nutritional status. There were no differences in the concentrations of creatinine and total nitrogen in urine between the artificially fed and the breast‐fed infants at the beginning of the study (4 months), but at 6 months these concentrations were significantly higher in the formula‐fed infants (p<0.001). The results suggest that formulas now in common use during weaning provide amounts of protein which produce metabolic manifestations implying excessive protein intakes.
Muscle Strength in Girls with Congenital Adrenal Hyperplasia
Authors: RODDA CHRISTINE , JONES D. A. , ROUND JOAN , GRANT D. B.
Published: January 2008

ABSTRACT. To assess whether exposure to excessive adrenal androgens increases muscle strength in girls with congenital adrenal hyperplasia, eighteen girls with 21 hydroxylase type congenital adrenal hyperplasia (CAH), aged 4.3–12.1 years were studied and compared with 78 healthy control girls aged 4–16 years. Maximum voluntary isometric strength was measured using a muscle testing chair, and the highest value from at least three attempts with each leg was recorded. Height and weight were also measured in the patients and controls. When compared with normal girls of similar age, some of the girls with CAH seemed unusually strong, but this difference was less marked when the CAH girls were compared with controls of similar weights. However, our data suggest that girls diagnosed later in childhood may have unusual muscle strength.
C2 Deficiency, Moderately Low lgG2 Concentrations and Lack of the G2m(23) Allotype Marker in a Child with Repeated Bacterial Infections
Authors: SJÖHOLM A. G. , HALLBERG T. , OXELIUS V.‐A. , HAMMARSTRÖM L. , SMITH C. I. E. , LINDGREN F.
Published: January 2008

ABSTRACT. C2 deficiency was demonstrated in an 11‐year‐old boy with a past history of recurrent purulent otitis media, pneumonia, H. influenzae meningitis and S. pneumoniae septicaemia. The major histocompatibility complex haplotypes present, A10, B18, DR2, BF*S, C2*QO, C4*A4, C4*B2 and A28, B18, DR2, BF*S, C2*QO, C4*A4, C4*B2, were in accord with previous observations in C2 deficiency. The concentrations of C1q, C5, factor B and factor D were in the low normal range and the hemolytic activity of the alternative pathway was slightly decreased. In addition, the patient showed moderately low IgG2 concentrations and lacked the IgG2 subclass marker G2m(23). The findings indicate that the patient's susceptibility to bacterial infections may be due to C2 deficiency in combination with the presence of an IgG allotype associated with impaired antibody responses to carbohydrate antigens.
Fatal Aplastic Anemia in a Child with Down's Syndrome
Authors: HANUKOGLU A. , MEYTES D. , FRIED A. , ROSEN N. , SHACKED N.
Published: January 2008

ABSTRACT. An infant with Down's syndrome developed severe persistent neutropenia at the age of 9 months and fluctuating anemia and thrombocytopenia at one year of age which terminated as full‐blown aplastic anemia at 26 months of age. Immunological evaluation revealed increased peripheral and bone marrow lymphocytes and impaired blood OKT4: OKT8 ratio. Bone marrow granulocyte‐macrophage colony forming cells (GM‐CFC) were markedly increased, while peripheral blood mononuclear cells (PBMN) produced normal numbers of colonies. The patient's PBMN and serum were both somewhat inhibitory to normal bone marrow derived GM‐CFC, suggesting the existence of a suppressor activity both in his serum and PBMN. This unusual course of aplastic anemia and the abnormalities in T‐cells and hematopoiesis in Down's syndrome are discussed.
Vipera berus Bites in Children—Experience of Early Antivenom Treatment
Authors: CEDERHOLM I. , LENNMARKEN C.
Published: January 2008

ABSTRACT. Children are a risk group for snake bites. Treatment with antivenom is controversial. Three cases of snake bite (Vipera berus) in children are reported. Antivenom was given due to serious toxic reactions. The clinical course in these three cases indicate that in children treatment with antivenom should be seriously considered at an early stage when there are signs of exposure to a considerable amount of poison, i.e. hypotension, drowsiness or confusion, acidosis and leucocytosis. Allergic diathesis is a relative contraindication.
Risk Factors for Wheezing during Infancy A Study of 5953 Infants
Authors: BISGAARD HANS , DALGAARD PETER , NYBOE JØRGEN
Published: January 2008

Risk factors for the development of wheezing during infancy were studied in 5953 children. The data for the study were collected from a large prospective investigation of children born in 1959–61, who had attended a one‐year follow‐up examination. Wheezing was diagnosed when the symptom had been observed at least once during the first year of life, not in conjunction with pneumonia, epiglottitis or acute laryngitis. Logit analysis was used for the purpose of assessing the causal effect of environmental and other factors on the risk of wheezing among infants. The assessment of a risk factor by means of regression technique, requires certain other variables to be included in the regression model. A general rule concerning inclusion of other variables has been formulated and applied to the above data. The study demonstrated that the risk of wheezing was affected by a number of factors—particularly environmental. Poor social environment increases the risk of wheezing, as does the mother's smoking, and placement of the baby in day‐care. Boys experienced wheezing more often than girls. Premature infants are more liable to develop wheezing than mature children. Remarkably, children born in the period April through September develop wheezing, but not bronchitis, more often than children born in October through March.
Early and Late Discharge after Hospital Birth: Breastfeeding
Authors: WALDENSTRÖM U. , SUNDELIN C. , LINDMARK G.
Published: January 2008

Breastfeeding was studied among women discharged early and late after normal delivery in a hospital. Early discharge was defined as leaving the hospital 24–48 h after delivery in combination with domiciliary visits, and late discharge as the regular hospital postpartum care (mean 6 days). 164 women interested in participating in the early discharge study were randomly allocated in late pregnancy to a group offered early discharge (Experimental group = EG) or a group offered the traditional later discharge (Control group = CG). After medical exclusions and non‐medical withdrawals, 50 mother‐infant couples remained in EG and 54 in CG. Regular breastfeeding at 6 months after birth was reported by 63% of the multiparae in EG and 41% in CG (p=0.06). Thirty‐three per cent of the primiparae in each group were still breastfeeding at 6 months. 2% of the infants in EG and 72% in CG received supplementary breastmilk at least once during their first week of life. Infants discharged early were breastfed more often on the 2nd (NS), 3rd (p<0.05) and 4th day (p<0.001) after birth, compared with infants who stayed longer in hospital. There were no statistically significant differences between EG and CG women in their experiences of success in breastfeeding according to daily records from the first 14 days after the birth.
Perinatal Retinal Haemorrhages and DevelopmentFollow‐up in Seven Year Olds
Authors: GILLEBO K. , BOSTAD R. , OFTEDAL G. , RYE H. H. , EGGE K.
Published: January 2008

Depending on methods of delivery, 7–50% of all children are born with retinal haemorrhages (RH). To assess the prognostic value of extensive RH for the future development of the child, the ophthalmological, neurological and psychological status of 52 children, 26 born with RH and 26 controls, were examined at the age of seven years. There were significant differences between the two groups using only psychological measures. Children with RH performed poorer than the control group, but the results did not point to any particular cerebral areas being affected. However, children with both RH and low socio‐economic status were significantly less emotionally stable than the controls. Socio‐economic factors also seem to be more highly correlated with later performance than do RH.
Plasmid Profiles of Multi‐Resistant Staphylococcus aureus at a Children's Hospital
Authors: JUN TANG , XIAO WU SHI
Published: January 2008

Twenty‐six strains of multi‐resistant Staphylococcus aureus (MRSA) recovered from November 1985 to February 1986 were screened for their plasmid profiles. Among them, 11 strains were recovered from 8 patients with definite nosocomial infections. The results showed that one MRSA strain carrying 5 plasmids with molecular weight ranging from 1.75 × 106 to 5 × 106 daltons was epidemic in our hospital while 3 other distinct strains caused cross infections in both the burn ward and the medical wards. The epidemic strain and two other hospital‐acquired strains were found in identical form in the community, suggesting that the pattern of nosocomial MRSA can be affected by strains outside hospital. The plasmid profile analysis was employed to differentiate the epidemic isolates from the coisolates and to study the relation between clinical isolates. The method is apparently superior to antibiogram.
A Population‐Based Study of Childhood Acute Lymphoblastic Leukemia Diagnosed from July 1981 through June 1985 in the Five Nordic Countries
Authors: GUSTAFSSON G. , GARWICZ S. , HERTZ H. , JOHANESSON G. , JONMUNDSSON G. , MOE P. J. , SALMI T. , SEIP M. , SIIMES M. A. , YSSING M. , ÅHSTRÖM L.
Published: January 2008

Six hundred and fifty‐six children with acute lymphoblastic leukemia (ALL) have been diagnosed in the five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) during the period from July 1981 through June 1985. Annual incidence of ALL was 3.6/100000 children aged < 15 years, with an incidence for males of 3.8 and for females of 3.4 respectively. Half of the children were younger than 5 years of age at diagnosis, with a peak incidence between 2–3 years of age. The leukemias were classified as Standard Risk (SR), Intermediate Risk (IR) or High Risk (HR) leukemia according to prognostic criteria at diagnosis. The remission rate was 95%. In children 1 year of age with non‐B‐cell ALL at diagnosis, the Event‐Free Survival (EFS) was 0.58; 0.65 for SR‐children, 0.51 for IR‐children and 0.52 for HR‐children. WBC count at diagnosis was the most important prognostic factor and a WBC count of 11‐20×109/l was associated with the worst prognosis of all WBC values (EFS=0.30), independent of other prognostic factors. Male sex was the second most important adverse prognostic criterion. The follow‐up in January 1986 (observation time 6–54 months), showed that 442 of the 656 children (67%) were in complete continuous remission. The total results indicate a possibility to improve the prognosis for most of the risk groups of ALL with a more intensive treatment.
Sitting Heights in Sheffield, 1985: Have Standards Changed?
Authors: HERBER S. M. , MILNER R. D. G.
Published: January 2008

A community study was performed on 354 schoolchildren aged 4 to 13 years to assess whether the published UK standards for sitting height and leg length applied to the local population. The schoolchildren showed no significant difference from UK standards in standing height, but had significantly shorter sitting heights and significantly longer legs. When compared to children measured in several European studies, the Sheffield children had normal sitting: standing height ratios, whereas ratios from the published UK standards were significantly greater than those from the rest of Europe.
Clinical Experience with Authentic Recombinant Somatropin – German Collaborative Study
Authors: RANKE MICHAEL B. , BIERICH JÜRGEN R.
Published: January 2008

A multicentre clinical trial with recombinant somatropin was initiated in West Germany in early 1986. Acceptance of patients to the study was determined according to criteria outlined in a detailed study protocol. To the present time, 41 patients with hGH deficiency not previously treated (naive) and 28 patients previously treated with pituitary hGH have been admitted. Recombinant somatropin is given, 12 IU/m2/week s.c, divided into six doses. Height velocities during treatment rose dramatically for naive patients from 3.5 cm/year (n = 40, before treatment), to 15.0 cm/year (n = 19, calculated at 3 months), and 13.3 cm/year (n = 8, calculated at 6 months). For previously treated patients, the increase in height velocity was from 5.8 cm/year (n = 20) to 9.2 cm/year (n = 19, after 3 months) and 8.6 cm/year (n = 9) at 6 months. Tolerance of recombinant somatropin was good, and no anti‐hGH antibodies were detected in any of the patients.
Evaluation of Growth Hormone Secretion: Provocative Testing vs Endogenous 24‐hour Growth Hormone Profile
Authors: SHULMAN DOROTHY I. , BERCU BARRY B.
Published: January 2008

Shulman, D. I. and Bercu, B. B. (University of South Florida College of Medicine, All Children's Hospital, Florida, USA). Evaluation of growth hormone secretion: provocative testing vs endogenous 24‐hour growth hormone profile. Acta Paediatr Scand [Suppl] 337:61, 1987.

A total of 55 children underwent hGH provocative testing with two or more provocative agents, and measurement of endogenous 24‐hour hGH secretion. Patients were divided into groups according to their peak hGH secretory response to provocative testing and their mean 24‐hour hGH concentration. Peak hGH response to provocative testing was significantly greater in control children and in children with hGH neurosecretory dysfunction (GHND) than in the classical hGH deficient group. Mean 24‐hour hGH concentration was significantly greater in the control group than in either the classical hGH deficient or GHND groups. Responses to provocative stimuli were intermediate for the GHND group compared to the classical hGH deficient and the control groups. The mean peak hGH secretory response to insulin‐induced hypoglycaemia in the GHND group was poor compared to controls and was greatest following clonidine. The mean peak hGH response to an intravenous bolus of growth hormone releasing hormone was intermediate for the GHND group compared to hGH deficient and control groups. Highest nocturnal peak, first hGH pulse after sleep, mean peak hGH pulse and total number of pulses were also intermediate for the GHND group compared to the other groups. The control group had significantly more pulses greater than 5 ng/ml than did the other groups. Night‐time and daytime hGH pools were lower in the classical hGH deficient and GHND groups compared to controls; however, there was overlap between groups. Six of seven children in the GHND group have responded to exogenous hGH therapy with increased linear growth velocity. Measurements of endogenous 24‐hour hGH secretion may identify a subgroup of hGH deficient children who are not detected by provocative testing yet who may respond to exogenous hGH therapy with improved linear growth.
Multicentre Clinical Trial of Authentic Recombinant Somatropin in Growth Hormone Deficiency
Authors: BIERICH J. R.
Published: January 2008

Bierich, J. R. (Department of Paediatrics, University of Tübingen, Tübingen, West Germany). Multicentre clinical trial of authentic recombinant somatropin in growth hormone deficiency. Acta Paediatr Scand [Suppl] 337:135, 1987.

A German multicentre trial of recombinant somatropin was cdmmenced in March 1986. A total of 77 patients with hGH deficiency were recruited, with heights at least 2.5 SD below the normal mean. Of these, 49 were previously untreated (naïve) and 28 had previously received pituitary hGH. Recombinant somatropin, 12 IU/m2/week was administered subcutaneously, divided into six doses. In the naive group, the height velocity reached 14.9 cm/year in the first 3 months, and thereafter stabilized at 12 cm/year. In the previously treated patients, the growth rate was 10.7 cm/year in the first 3 months, and 8.5 cm/year at 9 and 12 months. There were no abnormal findings in tests of laboratory parameters. No anti‐hGH antibodies were detected in any of the patients; seven patients had anti‐ECP antibodies, but in six of these the antibodies were already present before treatment.
Current Clinical Trials with Authentic Recombinant Somatropin in Japan
Authors: HIBI ITSURO , TAKANO KAZUE , SHIZUME KAZUO
Published: January 2008

Hibi, I., Takano, K. and Shizume, K. (National Children's Hospital and Tokyo Women's Medical College, Institute of Clinical Endocrinology, Tokyo, Japan). Current clinical trials with authentic recombinant somatropin in Japan. Acta Paediatr Scand [Suppl] 337:141, 1987.

A total of 25 children with hGH deficiency were treated with recombinant somatropin, 0.5 IU/kg/week i.m. for approximately 12 months in a multicentre study. Sixteen patients were previousky untreated with any hGH preparation (naïve group) and 9 patients had been treated with pituitary hGH for 4–42 months (previously treated group). The height gain after 12 months with the present treatment was 7.7 ± 1.8 cm/year in the naive group and 5.8 ± 1.0 cm/year in the previously treated group. Using the criteria proposed by the Foundation for Growth Science in Japan, recombinant somatropin treatment was effective in 15 of 16 patients (93.8%) of the naive group and in all of the 9 patients (100%) in the switched group. Anti‐hGH antibody was observed in none of 9 patients in the previously treated group throughout the study period. It was observed in only 2 of 16 patients after 6 months of treatment and 1 of 16 patients after 12 months of treatment in the naïve group. No side‐effects or abnormalities in laboratory findings were observed.
Type of Milk Feeding and Nutrient Intake during Infancy The Leiden Pre‐School Children Study
Authors: HORST C. H. , BOER G. L. OBERMANN‐de , KROMHOUT D.
Published: January 2008

ABSTRACT. During infancy different types of milk feeding can be used, i.e. breast milk, formula or cow's milk. In the Leiden Pre‐School Children Study food intake and anthropometric data of four‐, six‐ and nine‐month‐old infants were collected to study the influence of the type of milk feeding on the energy and nutrient intake on one hand and on height and weight on the other hand. All three different types of milk feeding were studied in the four‐month‐old infants. In the six‐ and nine‐month‐old infants food intake data of those breast‐fed were not collected. No differences in energy intake and in height and weight were found between formula‐fed infants and infants fed on cow's milk at the three age‐levels. The influence on nutrient intake, on the contrary, was substantial. Compared to formula feeding, cow's milk feeding resulted in a significantly higher intake of protein, sodium, potassium, calcium and phosphorus and a significantly lower intake of linoleic acid, iron and ascorbic acid. Cow's milk feeding at four months was more prevalent among less educated mothers than among mothers with higher education. Breast feeding was strongly positively related to educational level of the mother at all three ages. It can be concluded that more information should be given about the advantages and disadvantages of different types of milk feeding especially to less educated mothers.
Early Intravenous Indomethacin Prolongs Respiratory Support in Very Low Birth Weight Infants
Authors: VINCER M. , ALLEN A. , EVANS J. , NWAESEI C. , STINSON D. , REES E. , FRASER A.
Published: January 2008

ABSTRACT. Infants weighing 1500 g at birth requiring either intermittent positive pressure ventilation or continuous positive airway pressure by 12 hours of age were entered in a randomized double blind controlled trial to test the efficacy of early intravenous indomethacin therapy in preventing chronic pulmonary disease of prematurity. Of the 30 newborns enrolled, 15 were treated with indomethacin and 15 were treated with placebo at 12, 24 and 36 hours of age. The groups were similar for birth weight, gestational age, sex, hyaline membrane disease and intracranial hemorrhage. Infants in the placebo group were successfully weaned from intermittent positive pressure ventilation at an earlier age than infants in the indomethacin group (p <0.05). Furthermore, chronic pulmonary disease of prematurity was similar in the two groups despite a reduction in the incidence of patent ductus arteriosus in the indomethacin group.
The Epidemiology of Sudden Infant Death Syndrome and Attacks of Lifelessness in Sweden
Authors: WENNERGREN G. , MILERAD J. , LAGERCRANTZ H. , KARLBERG P. , SVENNINGSEN N. W. , SEDIN G. , ANDERSSON D. , GRÖGAARD J. , BJURE J.
Published: January 2008

ABSTRACT. Infants who died showing the syndrome of sudden infant death (SIDS) and infants who survived attacks of lifelessness (AL) were examined in a prospective epidemiological multicentre study over 24 months covering close to 40% of all births in Sweden. Seventy SIDS cases and 34 cases of AL were observed, giving an incidence for SIDS of 0.94/1000 and for AL of 0.46/1000. This SIDS incidence is higher than that observed during the seventies. The boy/girl ratio was 1.4: 1 for SIDS and 1.6: 1 for AL. The age distribution for AL resembled that for SIDS. Similarities were also seen with regard to place of occurrence. Sixty per cent of the SIDS cases occurred during the daytime/evening. Twenty‐nine per cent of the infants with AL had more than one apneic spell during the three‐day‐period around the attack, indicating a period of respiratory instability, but only 12% had such spells later on. None of the infants who had had AL died from SIDS. The possible relationship between AL and SIDS is discussed.
Serum Acute Phase Reactants in Necrotizing Enterocolitis
Authors: ISAACS D. , NORTH J. , LINDSELL D. , WILKINSON A. R.
Published: January 2008

ABSTRACT. The serum acute phase reactants, C‐reactive protein (CRP) and orosomucoid, rose significantly within 24 to 48 hours of presentation in infants with definite necrotizing enterocolitis (NEC) compared with the levels in infants with symptoms who tolerated early reintroduction of enteral feeds. A serum CRP value >10 mg/l within 48 hours identified infants with definite NEC with a 92% sensitivity and an 81% specificity. Serum CRP values remained elevated at 7 to 10 days in 4 infants with late septicaemia and in 4 of 5 infants with abscess or early stricture requiring surgery. Serum acute phase reactants are a potentially valuable adjunct to clinical assessment in the management of infants with suspected NEC.
Plasma Lipid Peroxides in Cholestatic Children
Authors: LEMONNIER F. , CRESTEIL D. , FÉNÉANT M. , COUTURIER M. , BERNARD O. , ALAGILLE D.
Published: January 2008

ABSTRACT. Plasma lipid peroxide levels were studied in 40 children with chronic cholestasis comprising 21 with syndromatic paucity of interlobular bile ducts (PILBD) and 19 with biliary atresia. Compared to the controls, mean lipid peroxide values were twice as high in children with biliary atresia (4.56±2.28 nmol/ml) and four times as high in those with PILBD (9.62±3.3 nmol/ml). These differences are highly significant. In patients with biliary atresia, the increase in lipid peroxide levels was clearly related to the bilirubin, cholesterol and phospholipid concentrations. In the PILBD group, however, there was little evidence of such a relationship. Vitamin E treatment seemed to have no effect on these increased lipid peroxide levels during the evolution of chronic cholestasis, and further investigations are necessary to clarify the pathological mechanisms involved.
Metabolic Differences between AGA‐ and SGA‐Infants of Very Low Birthweight
Authors: BOEHM G. , SENGER H. , BRAUN W. , BEYREISS K. , RÄIMÄ N. C. R.
Published: January 2008

ABSTRACT. Metabolic response to human milk feeding was studied in 12 appropriate (AGA) and 12 small for gestational age (SGA) infants of very low birthweight (VLBW) on the eighth day of life. Protein intake ranged from 1.98 to 2.47 g/kg/day and caloric intake from 94 to 126 kcal/kg/day with no significant differences between the groups. Alpha‐amino‐nitrogen, the total bile acid concentration in serum and total‐ as well as alpha‐amino‐nitrogen excretion in the urine were estimated. The alpha‐amino‐nitrogen and the total bile acid concentration in serum increased with increasing degree of intrauterine growth retardation. Also renal total‐and alpha‐amino‐nitrogen excretion increased significantly in relation to the degree of intrauterine growth retardation. Thus, despite a relatively low protein intake in severely growth retarded VLBW‐infants, metabolic changes could be found similar to those observed in AGA‐infants on high protein intakes. The data suggest that during the first weeks of postnatal life VLBW‐infants with intrauterine growth retardation have a decreased capacity to utilize or to metabolize protein when compared to AGA‐infants with comparable birth‐weights. These metabolic differences have to be considered in the nutritional management of VLBW‐infants.
Protein and Energy Intake during Weaning
Authors: AXELSSON I. , BORULF S. , ABILDSKOV K. , HEIRD W. , RÄIHÄ N.
Published: January 2008

ABSTRACT. Preprandial plasma amino acid concentrations were measured at 5 and 6 months of age in 30 healthy term infants who were either breast‐fed ad libitum or fed one of two different formulas (1.9 g of protein per 100 ml with a whey: casein ratio of 50:50; 2.9 g of protein per 100 ml with a whey: casein ratio of 20:80) ad libitum, plus the same supplementary food regimen. The mean plasma concentrations of total amino acids and especially total essential amino acids were higher in the formula‐fed infants. Those fed formula also had plasma concentrations of methionine, isoleucine, phenylalanine, leucine, valine, threonine, aspartate, proline, lysine, tyrosine, histidine that exceeded plasma concentrations of breast‐fed infants by 2 or more standard deviations. Concentrations of arginine, glutamic acid, glutamine, ornithine, serine, cystine did not differ and taurine was higher in the breast‐fed infants. The data indicate that formulas in common use today during weaning (4–6 months) provide excessive protein intakes when compared to the breast‐fed control infants. A lowering of protein concentration and a further manipulation of the whey: casein ratio is necessary if plasma amino acid patterns similar to those found in breast‐fed infants is to be achieved with artificial feeding.
Detection of Cow's Milk Protein Intolerance by an Enzyme‐Linked Immunosorbent Assay
Authors: TAYLOR C. J. , HENDRICKSE R. G. , McGAW J. , MACFARLANE S. B. J.
Published: January 2008

ABSTRACT. Circulating IgG antibodies to cow's milk proteins have been quantified in 182 children using an enzyme‐linked immunosorbent assay (ELISA). Antibody levels in children with cow's milk protein intolerance (CMPI) were compared with those in control groups comprising other diarrhoeal diseases, atopic children, and a “normal” sample including children with toddler diarrhoea. Mean IgG antibody levels in children with CMPI were significantly higher than in any of the control groups. There were clear differences in peak antibody levels between CMPI and all other groups for each of the protein fractions tested. There was some overlap in titres between CMPI and other enteropathies but the assay gave 88% sensitivity and specificity for the diagnosis of CMPI overall and was 100% specific against the combination of non‐enteropathic controls in this study. These findings indicate that the assay could be applied as an outpatient screening test for CMPI and would be particularly useful in differentiating “toddler” diarrhoea from CMPI.
Fasting Plasma Amino Acid Concentrations in PKU Children on Two Different Levels of Protein Intake
Authors: KINDT E. , LUNDE H. A. , GJESSING L. R. , HALVORSEN S. , LIE S. O.
Published: January 2008

ABSTRACT. Two groups of children with phenylketonuria were treated with different amounts of protein. One group (RDA group) received protein as recommended by the U.S. Food and Nutrition Board, the other (FAO group) the amount recommended by the FAO/WHO 1973 ad hoc Expert Committee. Two of the children in the FAO group showed a decrease in length/growth velocity which raised the question of the adequacy of the protein content in the diet. Since deviations from normal plasma amino acids have been observed in protein deficient, energy‐adequate diets, we examined these parameters in the PKU children. In the two children with retardation in length/growth, very high glycine values as well as very high alanine values were observed at the end of the study. These observations strengthened our suspicion that the FAO/WHO 1973 recommendations are marginal.
Lidocaine for Treatment of Severe Seizures in Newborn Infants
Authors: HELLSTRÖM‐WESTAS L. , WESTGREN U. , ROSÉN I. , SVENNINGSEN N. W.
Published: January 2008

ABSTRACT. The anticonvulsive effect of lidocaine was evaluated in 46 newborn infants with severe, recurrent seizures. Before the lidocaine all infants were being given phenobarbital, and 22 infants were also treated with diazepam. Different dosages of lidocaine were tested. A loading dose of 2 mg/kg followed by i.v. infusion of 6 mg/kg/hour was the most effective dosage and had an immediate anticonvulsive effect in 18 of 25 infants; within 30 min the same effect was attained in another five of the infants, with an overall seizure control in 92% of the sample population. During the lidocaine treatment cerebral electrical activity was followed continuously with a cerebral function monitor (CFM), which also enabled evaluation of the treatment. No serious side effects on blood‐pressure, heart‐rate or cerebral electrical activity were registered. For newborn infants with severe recurrent seizures not responding to other drugs, lidocaine is an effective additional mode of treatment.
Epidemiology of Schönlein‐Henoch Purpura
Authors: NIELSEN H. E.
Published: January 2008

ABSTRACT. The purpose of this study was to determine if Schönlein‐Henoch purpura represents an abnormal host response to microorganisms. Among 1222 cases, representing all new Danish cases in children during the years 1977–84, there was no tendency for the cases to cluster; this means that the disease is not caused by a single, contagious agent. In a smaller sample of 281 children examined in detail, a higher number than expected attended day nursery or nursery school and 17% had received antibiotic treatment during the week prior to admission. The latter findings, together with the seasonal variation of the incidence and the activation of the immune apparatus in many cases, suggest that Schönlein‐Henoch purpura may be triggered by infection with several different microorganisms, but there is no evidence that a single one such as the streptococcus is the major offender.
Breast‐Feeding and Its Promotion
Authors: KOCTÜRK T. , ZETTERSTRÖM R.
Published: January 2008

An increase in the rate of breast‐feeding is beneficial for the developing countries both with regard to economy and health (1). The nutritional and immunological superiority of breastfeeding compared to artificial feeding is universally recognized. Breast‐feeding has advantages not only for the infant but also for the mother and the family unit. It has also been recognized as the most effective method of birth‐spacing in developing countries (2, 3) and it has advantages for the family because of its convenience and low cost (4).
Forehead Skin Blood Flow in Normal Neonates during Active and Quiet Sleep, Measured with a Diode Laser Doppler Instrument
Authors: SUICHIES H. E. , AARNOUDSE J. G. , OKKEN A. , JENTINK H. W. , de MUL F. F. M. , GREVE J.
Published: January 2008

ABSTRACT. Changes in forehead skin blood flow during active and quiet sleep were determined in 16 healthy neonates using a recently developed semi‐conductor laser Doppler flow meter without light conducting fibres. Measurements were carried out at a postnatal age varying from 5 hours to 7 days. The two sleep states could be distinguished in 17 recordings. The mean skin blood flow values during active sleep were significantly higher (p<0.01) than those during quiet sleep, the mean increase being 28.1%. The variability of the flow signal, expressed as the coefficient of variation, changed significantly from 23.1% during active sleep to 18.2% during quiet sleep.
Dumping Syndrome in Children
Authors: KNEEPKENS C. M. FRANK , FERNANDES JOHN , VONK ROEL J.
Published: January 2008

ABSTRACT. Dumping syndrome is rarely seen in children. We studied ten children with symptoms following various types of gastric surgery. All had abnormal blood glucose and breath hydrogen responses after oral glucose challenge, indicating reduction of both glucose tolerance and glucose absorption, as compared to controls. Glucose tolerance was best expressed as the difference between peak and subsequent lowest blood glucose level, the upper limit of normal (mean + 3 SD) being 5.9 mmol/l. In eight children with persisting symptoms we tested the effects of glucomannan, a highly hygroscopic tasteless fibre, on glucose tolerance and glucose absorption. Glucomannan significantly improved glucose tolerance, but did have no overall effect on glucose absorption. Four children tested glucomannan added to the main meals. Breath hydrogen excretion, as established with the daytime breath hydrogen profile, decreased significantly in two, but complaints increased in three children. Glucomannan does not appear to be suitable for the treatment of dumping syndrome in children as the side effects seem to overrule the beneficial effects.
Anaphylaxis and Angioedema Due to Rubber Allergy in Children
Authors: AXELSSON I. G. K. , ERIKSSON MARGARETA , WRANGSJÖ KARIN
Published: January 2008

ABSTRACT. Delayed hypersensitivity to rubber chemicals is well known but there are an increasing number of case reports on an immediate type of hypersensitivity inducing contact urticaria and anaphylaxis in adults. We now report on three atopic children who developed angioedema, which in two of them progressed to anaphylaxis after exposure to natural rubber products. All three patients showed positive skin prick tests and one had a positive RAST test to latex from the rubber tree (Hevea brasiliensis). It is dear that sensitized subjects are at risk of developing anaphylaxis when exposed to natural rubber products, e.g. during medical examination or surgery when rubber gloves are used.
Feeding, Behavioural State and Cardiorespiratory Control
Authors: DANIELS H. , DEVLIEGER H. , CASAER P. , RAMAEKERS V. , BROECK J. VAN DEN , EGGERMONT E.
Published: January 2008

ABSTRACT. The aim of the present study was to examine whether immaturity of cardiorespiratory control corresponds to a less mature behavioural state pattern and/or to less efficient feeding behaviour. Fifty‐four infants were observed and data polygraphically recorded for 6 hours; a feeding session was included. It was found that infants with immature cardiorespiratory control spent more time in REM‐sleep, less time in the active awake state, and were more likely to be inefficient feeders. In addition, 100 infants were observed for risk signs of sudden infant death syndrome and their parents were asked to answer a questionnaire on the sleeping and feeding behaviour of their infants. The majority of the infants with immature cardiorespiratory control were described as bad feeders but good sleepers. We conclude that gathering information about sleeping and feeding behaviour is useful when screening for immaturity of cardiorespiratory control.
Daily Chromium Intake by Infants in Belgium
Authors: DEELSTRA H. , SCHOOR O. VAN , ROBBERECHT H. , CLARA R. , EYLENBOSCH W.
Published: January 2008

ABSTRACT. The chromium content of human breast milk, infant formulae, cow's milk and beikost was measured by graphite furnace atomic absorption spectrometry following different digestion steps. No significant variation in chromium concentration during lactation was found. The mean concentration was 0.18 ng/ml. The daily chromium intake for Belgian infants of 3 months of age using different types of food was estimated. Exclusively breast fed infants consumed 0.1 μg/day, while for infants fed cow's milk the intake was five times higher. The exclusive use of commercial infant formulas resulted in an intake of 2 up to 10 μg chromium a day.
Children with Craniopharyngioma
Authors: SORVA RITVA
Published: January 2008

ABSTRACT. Pre‐ and postoperative growth was analyzed in 22 children with craniopharyngioma. In 19 children a growth failure preceded the diagnosis by a mean of 4 years. Six children were obese preoperatively. During the first 3 postoperative months relative weight increased 7gt;10% in 14/21 children (there was one surgical death). One year after surgery 13/21 were obese. Neither the size of the tumor nor the mode of surgery was decisive in the development of the obesity. Serum insulin and insulin‐like growth factor I (IGF‐I) were assessed in four children with growth hormone deficiency (GHD) who, after surgery for craniopharyngioma, were growing normally without GH substitution. One of them was normal in weight and had normal insulin and IGF‐I levels; the others were obese and had supranormal insulin and subnormal IGF‐I levels. One of the four and two other children with unsubstituted GHD reached final height SDS ‐0.8, ‐2.0 and ‐2.4. One child with normal postoperative GH response reached final height SDS ‐0.7. Final height SDS ≧‐2.5 was gained with GH substitution by 6/11 children. It was >2.0 SD below the height SDS expected from the heights of the parents in 7/11. An adequate monitoring of children's growth would lead to earlier diagnosis and probably better outcome.