bluuebunny/crossref_metadata_2025 huggingface dataset:
Zinc Deficiency in the Weanling—How Important?
Authors: HAMBIDGE K. M.
Published: January 2008

ABSTRACT. A wide spectrum of zinc deficiency states has been recognized in the weanling. Severe zinc deficiency affects most organ systems and causes a wide variety of clinical manifestations; these occur only in special circumstances. Zinc deficiency of intermediate severity has been reported in malnourished infants, in whom it may contribute to the clinical manifestations and limit the rate of recovery from protein energy malnutrition. Results of randomized, controlled studies of dietary zinc supplementation in Denver indicate that mild nutritional zinc deficiency is one cause of failure to thrive. Better laboratory indices for the determination of mild zinc deficiency are needed before the epidemiology of this syndrome can be understood. Quantitative data on zinc absorption from dflerent weanling diets are required before it will be possible to determine the adequacy of zinc intake.
Current Research on Recombinant Human Growth Hormone and the Related Growth Factors, IGF‐1 and GRF
Authors: FRYKLUND LINDA
Published: January 2008

ABSTRACT. A brief introduction is provided to the physiological actions of somatostatin, somatomedins and growth hormone releasing factor (GRF) in relation to human growth hormone (hGH). The development of recombinant DNA techniques allowed the biosynthesis of somatrem (methionyl hGH), and as the methods were refined, authentic recombinant hGH (methionyl‐free) has been produced. rhGH is currently undergoing clinical trials in several countries. Recombinant IGF‐1 has also been developed by similar methods, utilizing a yeast as the host cell. In contrast, GRF is too small to be biosynthesized, but can be produced by classical peptide synthesis. Only the N‐terminal sequence is required for biological activity, and may be 29, 40 or 44 residues long. Research into the biological effects of both IGF‐1 and GRF is underway.
Diagnostic Accuracy of Two‐dimensional Echocardiography Combined with Doppler Echocardiography in Neonates and Infants with Cardiac Symptoms
Authors: OLSSON B. , BJÖRKHEM G. E. , LUNDSTRÖM N.‐R.
Published: January 2008

ABSTRACT. In a previous study the diagnostic accuracy of two‐dimensional echocardiography was demonstrated. In a review of our clinical material from the last three years the additional value of Doppler echocardiography was evaluated. Doppler echocardiography did improve the diagnostic accuracy in a few groups of patients (patent ductus arteriosns, aortic stenosis and to some extent coarctation of the aorta). The main value of Doppler was however the possibility to obtain information about now patterns, valve obstruction or regurgitation.
Water, Sodium and Acid‐Base Balance in Premature Infants: Therapeutical Aspects
Authors: EKBLAD H. , KERO P. , TAKALA J. , KORVENRANTA H. , VÄLIMÄKI I.
Published: January 2008

ABSTRACT. One of the main targets of fluid therapy in premature infants is to avoid variations in osmolality, which mainly means providing a stable sodium, glucose, and acid‐base balance. Water, sodium, and acid‐base balance were measured in 20 infants appropriate‐for‐gestational age with a gestational age 34 weeks. The infants were randomly assigned to one of two treatment groups. Fluid intake was restricted and air humidity in the incubator was high in order to minimize insensible water loss. Sodium intake in Group 1 was 2 mmol/kg/day and consisted of sodium chloride. Sodium intake in Group 2 was 4 mmol/kg/day and consisted of both sodium chloride and acetate. Weight loss was appropriate in both groups. In the high sodium intake group there was a tendency towards a more stable plasma sodium concentration than in the low sodium intake group. The use of sodium acetate was efficient and practical as normal acid‐base balance was maintained. The protocol with restricted fluid intake (1st day 50 ml/kg, 2nd day 70 ml/kg, 3rd day 90 ml/kg, and 4th day 110 ml/kg), high air humidity, a sodium supply of 3 to 4 mmol/kg/day, and a slow correction of metabolic acidosis with sodium acetate, yields suitable guidelines in planning fluid and electrolyte therapy in premature infants 34 weeks' gestation.
The Urinary C‐Peptide Excretion in Normal Healthy Children
Authors: WALLENSTEEN M. , PERSSON B. , DAHLQUIST G.
Published: January 2008

ABSTRACT. The 24 h urinary C‐peptide excretion was determined in 137 normal healthy children, 52 girls and 85 boys, 3–15 years of age. No significant difference was found between boys and girls. Median value of urinary C‐peptide for boys and girls was 0.24 nmol/kg/24 h with a range of 0.07‐0.61 nmol/kg/24 h. Urinary C‐peptide correlated positively and significantly with age, weight, height, body surface area and the 24 h urinary creatinine excretion. Since the values of C‐peptide excretion were not normally distributed they were log transformed and plotted against body weight. The linear regression and the 95% confidence limits were then calculated. Girls at puberty, 11–15 years of age, had significantly higher C‐peptide excretion per kg body weight and per body surface area than younger girls, 3–10 years of age. Boys 13–15 years of age had significantly higher C‐peptide excretion per body surface area than younger boys, 5–12 years of age. This indicates that children during the maximal growth spurt have an increased insulin secretion as measured by urinary C‐peptide per body surface area.
Fatty Acid Composition of Subcutaneous Adipose Tissue in Mother‐Infant Pairs
Authors: ANDERSEN G. E. , CHRISTENSEN N. C. , PETERSEN M. B. V. , JOHANSEN K. B.
Published: January 2008

ABSTRACT.The fatty acid composition of microsamples from 10 AGA term, 8 SGA term, 7 AGA preterm and 4 SGA preterm, 2–4 day old infants and their mothers were analyzed. In AGA preterm newborns the mean percent of palmitic and stearic acid was lower and the mean percent of linoleic acid was higher than in AGA term infants indicating that there is an increase in fatty acids derived by synthesis from glucose throughout gestation. SGA infants had relative amounts of palmitic and stearic acid similar to what was found in AGA term infants. This indicates that the enzymes involved in synthesis of fatty acids from glucose are intact in intrauterine growth retardation (IUGR). The absolute amount of adipose tissue and fatty acids, however, is smaller in SGA infants due to a reduced availability of glucose in IUGR gestation. No differences were found in the fatty acid composition of subcutaneous adipose tissue from the mothers in the 4 groups. All mothers had a lower mean percent of palmitic and stearic acid and a higher mean percent of oleic and linoleic acid than their infants, ensuring a transplacental gradient to the fetus of this latter essential fatty acid. The fatty acid composition of plasma free fatty acids generally reflected the composition of the subcutaneous adipose tissue in the infants.
Etiology and Diagnosis of Neonatal Conjunctivitis
Authors: SANDSTRÖM I.
Published: January 2008

ABSTRACT. Chlamydia trachomatis was isolated from the most inflamed eye of 13 of 107 (12%) infants with neonatal purulent conjunctivitis and from none of 100 healthy infants (p<0.01). Staphylococcus aureus was recovered from 49 (46%) inflamed eyes and from 8 (8%) healthy eyes (p<0.01). Streptococcus pneumoniae, Haemophilus influenzae, Branhamella catar‐rhalis, Escherichia coli and Klebsiella pneumoniae were isolated from very few infants with conjunctivitis but not from controls. No organisms could be recovered from 23 (22%) infants with conjunctivitis and from 60 (60%) healthy infants (p<0.01). The incidence of neonatal purulent conjunctivitis was 107 (2%), of 5924 births. Eyes infected with C. trachomatis were significantly more inflamed than eyes from which S. aureus or no organisms could be isolated. Furthermore, conjunctival “psendomembranes” were associated with C. trachomatis. The age at onset of the chlamydial conjunctivitis was higher compared to the age at onset of conjunctivitis in which S. aureus or no organisms were isolated.
A Comparative Trial of Rapid Oral and Intravenous Rehydration in Acute Diarrhoea
Authors: VESIKARI TIMO , ISOLAURI ERIKA , BAER MAIJA
Published: January 2008

37 children under the age of 5 years hospitalized for acute diarrhoea and dehydration were randomized to receive oral or intravenous rehydration during 6 to 12 hours. Rehydration was satisfactory in both groups, with correction of dehydration, metabolic acidosis and sodium deficit at equal rates. The reintroduction of normal feedings was successful in most of the orally rehydrated children after 12 hours, but often unsuccessful in the i.v. therapy group. Consequently the orally rehydrated children showed a 2.9% weight gain by the time of discharge whereas the intravenously treated children did not gain weight in the hospital. The duration of diarrhoea was also shorter in the orally rehydrated children. Thus oral rehydration therapy was equal or superior to even rapid intravenous rehydration therapy in the management of acute diarrhoea in children.
Three Different Manifestations of Congenital Muscular Aplasia in a Family
Authors: MEBERG A. , SKOGEN P.
Published: January 2008

ABSTRACT. This report concerns three different manifestations of congenital muscular aplasia/hypoplasia in a mother (aplasia of the left tensor fasciae latae muscle) and her two children (aplasia of the left depressor anguli oris muscle, right hemidiaphragm hypoplasia), indicating autosomal dominant inheritance with variable expression (pleiotropy) as aetiology for the conditions.
Severe Hypocarbia in Preterm Infants and Neurodevelopmental Deficit
Authors: GREISEN GORM , MUNCK HANNE , LOU HANS
Published: January 2008

ABSTRACT. We report significant neurological abnormality at 18 months of age in 3 of 7 very low birth weight infants (≤ 1500 g), who during mechanical ventilation inadvertently became severely hypocarbic (arterial carbondioxide tension less than 2.0 kPa (15 mmHg)) at some time during the first 24 h of life. Although the number is small the outcome was significantly worse than the outcome in two fairly similar groups of infants selected as controls (p=0.026). The infants in one of the control groups were also mechanically ventilated but remained normocapnic. Germinal layer haemorrhage (GLH) was more frequent among these infants compared with the severely hypocarbic infants (p=0.022). The infants in the other control group was not mechanically ventilated. In all the severely hypocarbic infants the Bayley mental developmental index uncorrected for prematurity was at or below the median for the total sample (p=0.01). The results suggest that neonatal cerebral ischaemia, for instance due to hypocarbia, is of greater prognostic significance than GLH.
Oral Rehydration Therapy in Neonates and Young Infants with Infectious Diarrhoea
Authors: MARIN L. , SANÉR G. , SÖKÜCÜ S. , GÜNOZ H. , ZETTERSTRÖM R.
Published: January 2008

ABSTRACT. The clinical response and changes in water and salt homeostasis during ORT was studied in 15 infants less than 2 months old (range 2–50 days) with acute diarrhoea. Eight patients were neonates and 7 were 1–2 months old. The oral rehydration solution contained 60 mmol sodium per litre. All patients except one were successfully rehydrated. The fluid retention was significantly higher in neonates and young infants than in infants above 3 months of age treated in the same way. One patient in the group of neonates who had a normal sodium level on admission developed Hypernatremia with a sodium level of 162 mmol/l 36 hours after the start of ORT. The urinary sodium excretion was lower in the neonates than in the young infants.

The results show that neonates and young infants have a lower capacity than older infants to excrete water and salt and therefore run a great risk of developing fluid and salt retention during ORT. The risk is most pronounced in neonates who, due to immaturity of the renal function, are unable to excrete excess fluid and salt.
Stable Glucose Balance in Premature Infants with Fluid Restriction and Early Enteral Feeding
Authors: EKBLAD H. , KERO P. , TAKALA J.
Published: January 2008

ABSTRACT. Hyperglycemia readily develops during intravenous glucose administration in premature infants. In this study glucose homeostasis was measured in 24 infants appropriate‐for‐gestational age with a gestational age between 27 and 34 weeks and a birthweight between 1150 and 2610g. The infants were randomly assigned to one of two treatment groups. Fluid intake consisted of intravenous infusion of 5% glucose in Group 1 and 10% glucose in Group 2, and increasing amounts of human milk from the first day of life. The infants were treated in incubators with high air humidity in order to minimize insensible water loss and total fluid intake was restricted. The fluid restriction and early enteral feeding decreased the total amount of glucose given parenterally and thereby the risk of hyperglycemia. Glucose homeostasis was efficiently maintained in both groups and under the conditions described hydration by intravenous infusion of 5% and 10% glucose appear equally well tolerated.
Studies in Renal Response to Various Protein Intakes in Preterm Infants
Authors: HERIN P. , ZETTERSTRÖM R.
Published: January 2008

ABSTRACT. The renal effects of two diets—breast‐milk and breast‐milk with extra human protein (7 g/l breast‐milk)—were compared in very low birth weight infants with a gestational age of 26 to 30 weeks. When the infants were given the high protein diet for one week the glomerular filtration rate (GFR) increased significantly more than when breast‐milk alone was given. Sodium clearance showed a similar increase in proportion to the GFR during the two diets. The high protein diet raised the urine osmolality moderately in all individuals, while the diuresis remained unchanged. The data in the present study indicate that the function of the immature kidney is influenced by the amount of protein in the diet. However, the long‐term renal effects in preterm infants maintained on a high protein intake remain unknown.
EEG Depression and Germinal Layer Haemorrhage in the Newborn
Authors: GREISEN G. , HELLSTRÖM‐WESTAS L. , LOU H. , ROSÉN I. , SVENNINGSEN N. W.
Published: January 2008

ABSTRACT. Amplitude integrated EEG (aEEG) recordings from 32 mechanically ventilated infants, gestational age 32 weeks or less, were analysed. All recordings were started within 24 h of birth and continued for at least 50 h. Germinal layer haemorrhage (GLH) was diagnosed by repeated ultrasonography. In six infants neither GLH nor hypocalcaemia were diagnosed; aEEG in these infants rapidly became more active after birth: at 30 h of age continuous background activity was present for more than 20% of the time, and a seizure‐like pattern was exceptional. In seven infants without GLH but with hypocalcaemia and other signs of metabolic derangement, continuous background activity appeared later and seizure‐like activity was frequent. In the infants with GLH, depression of the background activity was apparent. This finding was particularly distinct in the presence of severe haemorrhages. Four infants developed GLH after 30 h of age. All these infants had depressed aEEG beforethe development of GLH, with less than 20% continuous activity at 30 h of age. In ten infants an analysis of the aEEG during the occurrence of GLH was possible. In six of these, cortical electrical activity decreased. Due to the limitation of GLH timing, it was not possible to decide whether this decrease closely preceded or followed GLH. We suggest that GLH primarily occurs in brains with a preceding metabolic and neurophysiologic abnormality, and that further functional deterioration is caused by the most severe haemorrhages.
Neonatal Hyperexcitability in Relation to Plasma Ionized Calcium, Magnesium, Phosphate and Glucose
Authors: NELSON N. , FINNSTRÖM O. , LARSSON L.
Published: January 2008

ABSTRACT. Twenty‐two full‐term babies were examined with a quantitative neurological assessment on days 1, 2 and 5 in order to confirm the clinical impression of hyperexcitability observed at the routine examination on day 1. Ultrasound examination of the head was normal in all cases. Plasma ionized calcium, phosphate and glucose in the hyperexcitability group fell within the neonatal reference ranges, as described previously. However, serum magnesium was significantly lower on day 1, but spontaneously normalized on day 5. Routine check‐ups at the wellbaby‐clinics did not reveal any major illnesses or develpmental abnormalities.
HLA in Juvenile Liver Disease with Alpha‐one‐Antitrypsin Deficiency
Authors: NEMETH ANTAL , MÖLLER ERNA
Published: January 2008

ABSTRACT. The possible role of HLA phenotypes was investigated in the development of juvenile liver disease in persons with α1‐antitrypsin deficiency. Seventeen patients were investigated between the ages of 3–25 years. All of them had α1‐antitrypsin phenotype PiZ. After a longer follow‐up a clinical diagnosis was established by the help of physical status, biochemical liver function tests and—in the cases of suspected liver disease—liver biopsy. The clinical course was correlated to the HLA phenotypes of the patients. In 2 cases all first degree relatives were investigated, as well. Our studies on the 17 unrelated patients indicated no correlation between HLA and juvenile liver disease in α1‐antitrypsin deficiency. The family studies confirmed these findings.
Factors Affecting the Occurrence of Acute Otitis Media during the First Year of Life
Authors: KERO P. , PIEKKALA P.
Published: January 2008

ABSTRACT. A regional birth cohort of 5356 infants was enrolled into a follow‐up study in order to investigate the determinants of the development of infectious diseases in children. The infants were examined at three months, six months and twelve months of age by the physicians at the well‐baby clinics. At these occasions the number of episodes of acute otitis media in the infants, the duration of breast‐feeding, the number of siblings, the type of day care, parental smoking, the presence of animal pets at home and the number and type of other illnesses than otitis were registered. Two thirds of the infants had no episodes of acute otitis media. The median age for the first episode of acute otitis media was eight months. About 10% of the infants had experienced recurrent otitis media (three episodes or more) during their first year of life. Significant associations were found between the occurrence of acute otitis media and the number of siblings, the type of day care, the sex of the infant, the duration of breast feeding, maternal socioeconomic status and prematurity.
Simplified Immunoglobulin Treatment of Idiopathic Thrombocytopenic Purpura
Authors: ROSTHØJ S. , STEFFENSEN G. K. , GLUD T. K.
Published: January 2008

ABSTRACT. The recommended dose of intravenous IgG for idiopathic thrombocytopenic purpura has been 0.4 g/kg on 5 consecutive days. A simplified approach, giving a single infusion of 0.8–1.0 g/kg over 8 hours, has been tried in a series of 11 children with newly diagnosed disease. In 8 cases the infusion produced a prompt platelet response culminating at 128–502×109/1 after 3–13 days, and 4 of these cases required no further treatment while 2 needed a booster infusion due to an early relapse and 2 followed a chronic course. In 3 cases platelet responses were poor in spite of supplementary doses to a total of 1.4–2.0 g/kg: 2 infants failed to achieve normal platelet counts and 1 case with fulminant bleeding manifestations proved completely resistant. Significant side effects were not observed. These results indicate that IgG‐therapy practically may be initiated with a single infusion, the resulting platelet response indicating the need for further infusions.
Treatment of Caffeine Intoxication by Exchange Transfusion in a Newborn
Authors: PERRIN C. , DEBRUYNE D. , LACOTTE J. , LALOUM D. , BONTE J.‐B. , MOULIN M.
Published: January 2008

ABSTRACT. The symptoms of acute poisoning after accidental administration of ten times the usually prescribed dosage of caffeine in a premature infant included the following neurological signs: incessant tremors, hypertonia, continuous opisthotonos posture, whining and crying and digestive disturbances. The very high serum caffeine levels, 160 mg/l, determined 66 hours after the first administration was confirmed by the very high cerebrospinal fluid caffeine concentration 115 mg/l. Two exchange transfusions performed at an interval of 16 hours produced a large decrease in serum caffeine levels of approximately 40 mg/l each time, and a similar decrease in the cerebrospinal fluid concentration. The clinical status of the infant improved very rapidly and the child's psychomotor development was normal at 3 months of age.
Synchronous Respiration: Which Ventilator Rate Is Best?
Authors: GREENOUGH A. , GREENALL F. , GAMSU H.
Published: January 2008

Twenty‐four infants were ventilated through a series of rates (30, 60 and 120/min), to determine which rate was most successful in provoking synchronous respiration. Their spontaneous respiratory rate was also documented during a temporary disconnection from the ventilator: respiratory rate and gestational age were significantly correlated (r=–0.85). Seventeen infants showed synchronous respiration at a ventilator rate of 120/min and 4 at 60/min. Of the remaining 3 infants, 2 only showed synchrony if ventilated at their own spontaneous respiratory frequency (between 60–75/min) and 1 infant was asynchronous at all rates including her own spontaneous respiratory frequency. The 17 infants synchronous at a ventilator rate of 120/min were significantly less mature (p<0.01) and had a faster spontaneous respiratory rate (p<0.01) than the 6 infants synchronous at ventilator rates of 60–75/min.
Evidence for Colonic Absorption of Protein Nitrogen in Infants
Authors: HEINE W. , WUTZKE K. D. , RICHTER I. , WALTHER F. , PLATH C.
Published: January 2008

The absorption of protein nitrogen by the colon was assessed in 6 infants with colostomy by giving 15N yeast protein in a dosage of 5–20 mg 15N/kg (92.4 atom‐%15N). The absorption of 15N ranged between 87.1 and 98.1% of the administered dose, and the retention in the protein pool ranged between 79.0 and 94.2%. The incorporation of 15N in the plasma proteins was demonstrated by 15N excess values between 0.02 and 0.10 atom‐%. The results suggest that the colon can assimilate proteins when insufficient absorption of protein nitrogen in the small intestine occurs. The breakdown of protein is thought to result from the action of colonic flora.
Acute Gastroenteritis in Children Attending Day‐Care Centres with Special Reference to Rotavirus Infections
Authors: HJELT K. , NIELSEN O. H. , PÆRREGAARD A. , GRAUBALLE P. C. , KRASILNIKOFF P. A.
Published: January 2008

In a prospective study of a cohort of 214 children (aged 6 months – 7 years) attending day‐care centres, a total of 197 episodes of acute gastroenteritis (GE) occurred in 109 children (i.e. 51% of the participants) during a 12‐month observation period. Rotavirus, pathogenic bacteria and Giardia lamblia caused GE in 24%, 6% and 2% of the cases, respectively. The aetiology of the remaining 68% was not discovered. Generally, the symptoms of GE were light and only two episodes led to hospitalization. Thirty‐two rotavirus infections were asymptomatic. Two rotavirus GE reinfections occurred. They showed less severe symptoms than the primary infections. The older children (>1.5 years) with rotavirus GE had lighter symptoms than the younger ones (1.5 years). Compared with children with non‐rotavirus GE, those with rotavirus GE showed the following clinical features: (1) Age between 6 months and 2 years. (2) Occurrence of rotavirus GE almost exclusively during the rotavirus season, i.e. January to April (winter). (3) High frequency of vomiting, the onset of which often preceded that of diarrhoea. However, these signs did not form a safe basis for the clinical diagnosis of rotavirus GE. One or more upper respiratory manifestations (URM) were observed in 39% of the children with rotavirus GE and in 36% of those with non‐rotavirus GE. The occurrence of URM was age‐related being highest in children less than 2 years. Consequently, the existence of a rotavirus syndrome is questioned. It is argued that URM in children with rotavirus GE may be due to a co‐infection of the upper respiratory tract by a different micro‐organism.
Precocious Puberty in the McCune‐Albright Syndrome Progression from Gonadotrophin‐Independent to Gonadotrophin‐Dependent Puberty in a Girl
Authors: PASQUINO A. M. , TEBALDI L. , CIVES C. , MACIOCCI M. , BOSCHERINI B.
Published: January 2008

A 5‐year‐old girl with McCune‐Albright syndrome, was observed over a 7‐year period. She presented with gonadotrophin‐independent puberty and later developed gonadotrophin‐dependent puberty. Hormonal signs of central puberty remained unchanged over the last 2 years.
An Unusually Mild Variant of Hunter's Syndrome in a 14‐Year‐Old Boy Normal Growth and Development
Authors: TSUZAKI S. , MATSUO N. , NAGAI T. , OSANO M. , ORII T.
Published: January 2008

An unusually mild variant of Hunter's syndrome was described in a 14‐year‐old Japanese boy. He has maintained normal growth (25th percentile on the growth curve), and development (IQ 120‐130) until 14 years and 4 months of age.
An epidemiological study of injuries to children as car passengers in road traffic accidents
Authors: GUSTAFSSON H. , NYGREN Å. , TINGVALL C.
Published: January 2008

Injured child car occupants were compared with injured adults in respect to various factors, namely the risk of injury, the severity and pattern of the injuries, lost years, end the risk of serious consequences, such as death and disability.

The material used was codad according to the Abbreviated Injury Scale (AIS) and some injured children and adults were followed up for five years to study long‐term consequences. The Injury Severity Score (ISS) was used to assess the severity of multiple injuries.

It was found that children and adults have different trauma epidemiology patterns, but that the methods wed to asseas injuries in adults can be applied to children, with some modifications concerning the risk of disability.

Protective measures should be focused on the head region, as both fatal and disabling injuries occur mainly in this part of the body.
Injuries to restrained children in cars involved in traffic accidents
Authors: TINGVALL C.
Published: January 2008

In road traffic accident research, injuries to persons protected by any safety measure are important subjects of study, as they may provide information on ways in which the measure in question can be developed further.

In the present study injuries to children wearing protective restraints who were injured as car passengers in traffic accidents were analysed. The material consisted of all such injured children reported to the police during an 18‐month period. Drivers of the cars in which the children were injured were, when possible, contacted and questioned concerning restraint use, type of restraint, injuries and injury sources. All injuries were coded according to the Abbreviated Injury Scale (AIS). The Injury Severity Score (ISS) and the risk of permanent disability were calculated.

The material was complementary added with such cases that were not reported by the police but to an insurance company.

It is concluded that although child restraints are effective, injuries still occur and thus give reason for further development of car interior safety for children.
SOCIAL ADJUSTMENT AND FUNCTIONING OF CHRONICALLY ILL AND IMPARED CHILDREN AND ADOLESCENTS
Authors: Sillanpää Matti
Published: January 2008

A cluster sample of 532 children aged 8 to 19 years with certain impairments were compared to a matched sample of 316 healthy children of the same age. Almost half (46 %) of the impaired had a disability, which was mostly in the domain of body disposition ability (in 88 %), behaviour (63 %) and situational functioning (54 %). In the controls, where 12 % had some kind of disability, the corresponding figures were 13 %, 11 % and 15 %. The most disabling conditions were CP (67 % handicapped), MBD (52 %) and epilepsy (42 %). The most frequent non‐compènsated handicaps were those of occupation (44 % of impaired), mobility (31 %) and social integration (22 %). More than one handicap was associated most frequently with CP (76 %) and with epilepsy (36 %). Neurological impairments are more disabling and handicapping than non‐neurological ones, with the exception of mobility and occupation handicaps in asthmatics.
Clinical Trial with Authentic Recombinant Somatropin in Japan
Authors: TAKANO KAZUE , SHIZUME KAZUO , HIBI ITSURO , OKUNO AKIMASA , HIRONORINAKAJIMA  , SUWA SEIZO , NOGAWA TAKAYUKI , KONDO TAKUMA , MOMOI TOHRU , IWATANI NORITAKA , SHIRAKAWA ETSUHISA , KOHNO HITOSHI
Published: January 2008

Recombinant somatropin, produced by recombinant DNA technology, was administered by injection in daily doses of 8 IU to six healthy young volunteers. Daily injection for 4 days did not cause any significant change in the results of physical examination, blood count or urinalysis. Non‐esterified fatty acid levels increased significantly from 0.45 ± 0.16 to 1.08 ± 0.12 mEq/litre (mean SEM) at 4 hours after the first injection (p<0.001). Plasma IGF‐1 levels increased from 0.80 ± 0.14 units/ml to 1.72 ± 0.50, 3.22 ± 1.02, 3.17 ± 1.20 and 3.63 ± 0.78 units/ml at 24 hours after each daily injection for 4 days (p<0.001). Plasma hGH reached peak levels at 3 hours after intramuscular injection of recombinant somatropin, 4 IU, and this peak value was 57.3 ± 2.8 ng/ml. A total of 21 patients with pituitary dwarfism were also treated with recombinant somatropin for 6 months at a dose of 0.5 IU/kg/week. Their heights increased by 2.2–5.0 cm during the 6 months of treatment, which was calculated to be equivalent to 4.4–10.0 cm/year with a mean growth rate of 7.4 ± 0.4 cm/year. Anti‐hGH antibody with a titre of 10 was observed in two patients at the end of 6 months of treatment.
Preliminary Results of Authentic Recombinant Somatropin Treatment in Human Growth Hormone Deficient Children. French Collaborative Study
Authors: RAPPAPORT R.
Published: January 2008

A total of 50 children with hGH deficiency have been enrolled in a multicentre open trial of recombinant somatropin in France. Recombinant somatropin, 0.2 IU/kg s.c, was administered 3 times/week (0.6 IU/kg/week). Results are available after 3 months’treatment for 24 of the patients (11 prepubertal, 13 pubertal). The mean growth rate increased from 3.8 ± 1.5 cm/year to 9.9 ± 3.6 cm/year. Only one child developed anti‐hGH antibodies with a very low binding capacity of 0.02 mg/litre; adverse events were uncommon and probably unrelated to treatment.
Clinical Trial with Authentic Recombinant Somatropin in Sweden and Finland
Authors: ALBERTSSON‐WIKLAND KERSTIN
Published: January 2008

A total of 47 prepubertal children with hGH deficiency were treated for up to 6 months with recombinant somatropin. All the children markedly increased their growth rate; 21 of them were naive (not previously treated with hGH), and increased their growth rate from 4.2 ± 0.2 cm/year to 13.9 ± 0.9 cm/year (calculated from growth data after 6 months’treatment, n = 11). Of the 47 children, 26 had been previously treated for 2 ± 0.3 years (range 0.3 ‐ 8.3 years) with pituitary hGH. After a period of 0.9 ± 0.03 years (range 5–15 months) without any hGH therapy, their growth rate increased from 2.9 cm/year to 11.1 cm/year on recombinant somatropin therapy (calculated from growth data after 6 months’treatment, n = 10). One child reacted with temporary local erythema at the injection site. Anti‐hGH antibodies, with a binding capacity of 0.02 mg/litre, were detected in 1 of the 16 children after 6 months of therapy. No adverse effect on her growth rate was seen. No changes in levels of antibodies to Escherichia coli proteins were detected. No other allergic manifestations or systemic side‐effects were demonstrable.
Nine Months' Subcutaneous Therapy with Synthetic Growth Hormone Releasing Factor in Children with Short Stature
Authors: HÜMMELINK R. , ROHWEDDER R. , SIPPELL W.G.
Published: January 2008

The growth promoting potential of GRF(1–29)NH2 was studied in nine boys with short stature over three periods of 3 months. Their short stature was due to partial hGH deficiency/hGH neurosecretory dysfunction and was diagnosed by arginine and insulin stimulation tests and hGH nocturnal profiles. Four patients (Group I) were given GRF, 3–4 μg/kg s.c. b.d. during the first period of 3 months, and after an interval of 1 month, the same dose once daily during the second treatment period of 3 months. Five patients (Group II) were given GRF, 3–4 μg/kg s.c., once daily during the first and b.d. during the second 3 months of therapy. After a second interval of 1 month without any GRF treatment, the third 3‐month period for both groups consisted of one daily injection of GRF, 8–10 μg/kg s.c. at 19.00 hours. Total body height and lower leg length were measured by stadiometry and knemometry, respectively. GRF intravenous bolus tests were performed in each patient following fasting, before and at the end of the first and second 3‐month periods. Serum IGF–1 and urinary hydroxyproline excretion were determined monthly. Stadiometric growth rate, determined over the whole study period of 11 months including the treatment‐free intervals, increased from 4.92 cm/year to 5.97 cm/year (p>0.05). Mean knemometric growth rates increased from 0.28 mm/week before therapy, to 0.35 mm/week during the one injection/day period at low dose, to 0.39 mm/week (p<0.05) during the b.d. period, and to 0.40 mm/week during the last 3 months of high‐dose GRF given once daily. IGF‐1 levels increased during GRF therapy and were highest during the high‐dose period. Urinary hydroxyproline excretion and peak plasma hGH levels after intravenous GRF did not correlate with the GRF dose administered in any of the treatment phases. GRF dose and frequency of administration were probably suboptimal in this group of patients; higher dose frequencies might be necessary to achieve growth rates comparable with those observed during hGH substitution therapy.
Can the Knemometer Shorten the Time for Growth Rate Assessment?
Authors: HERMANUSSEN MICHAEL , GEIGER‐BENOIT KARIN , BURMEISTER JENS , SIPPELL WOLFGANG G.
Published: January 2008

Hermanussen, M., Geiger‐Benoit, K., Burmeister, J., and Sippell, W. G. (Endocrine Unit, Department of Paediatrics, Children's Hospital, and Institute for Jnformatics and Practical Mathematics, University of Kiel, Kiel, West Germany. Acta Paediatr Scand [Suppl] 337:30, 1987.

A total of 105 healthy children of both sexes and various ages were measured once or twice weekly by knemometry over periods of 161–202 days on 11–50 occasions. These data were used to calculate percentiles of the predictive error that occurred if short‐term lower leg length differences were used to extrapolate half‐annual growth rates. From these data, and observations on day‐to‐day variations of the lower leg length, it was concluded that growth rates derived from single differences between two consecutive lower leg length measurements are invalid and without predictive power for mean long‐term lower leg increments. However, a novel statistical approach is presented, which results in the evaluation of daily lower leg growth rates to visualize quasi‐continuous growth kinetics. Examples of successful and unsuccessful growth promoting therapeutic interventions are provided to demonstrate knemometric assessment of a significant modification of short‐term growth kinetics.
A National Cooperative Growth Study of Protropin
Authors: SHERMAN BARRY M.
Published: January 2008

Sherman, B. M. (Department of Clinical Research, Genentech Inc, South San Francisco, California, USA). A National Cooperative Growth Study of Protropin. Acta Paediatr Scand [Suppl] 337:106, 1987.

Nearly 2000 hGH deficient patients have been enrolled in a study of Protropin and followed up for up to 1 year. This has provided valuable information on the character of this population and its response to therapy. Overall there was a predominance of males, with a disproportionate number of short mothers. The mean Protropin dose was 0.07 mg/kg, given three timedweek. There was a significant dose‐response relationship up to 0.125 mg/kg three timedweek.
Assessment of Quality of Life in Chronic Diseases
Authors: JÖNSSON B.
Published: January 2008

Jönsson, B. (Department of Health and Society, Linköping University, Linköping, Sweden). Assessment of quality of life in chronic diseases. Acta Paediatr Scand [Suppl] 337:164, 1987.

Quality of life refers to a person's subjective perceptions of his or her well‐being, and undertaking an assessment of quality of life involves a number of methodological considerations. Indeed, a number of studies have applied methods for such assessments in chronic disease. These studies are relevant as a means of optimizing treatment and for establishing priorities on health care resources.
Delayed Hypersensitivity Responses in Children after Local Cutaneous Anesthesia
Authors: BJÖRKSTÉN B. , JUNG B. , TÅGSJÖ E.‐B. , GROTH O.
Published: January 2008

ABSTRACT. The effect of cutaneous analgesia on delayed type hypersensitivity (DTH) reactions as challenged by injections in the skin was assessed by comparing a lidocain/prilocain mixture with placebo. Application of 5 g of the mixture 90 min before testing significantly (p<0.001) reduced pain but did not influence the DH‐reactions as read after 48 hours. Based on these findings, DTH to several antigens were measured in 116 school children, aged 7–15 years. All the children were positive to either tetanus antigen, 7.5 Lf/ml (98% at 48 hours) or mumps test antigen (82%), while positivity to tuberculin 2 TU/ml and Candida 1000 PNU/ml were only 11 and 62% respectively. Therefore, DTH tests in an adequately immunized population of children can be limited to two antigens. Application of cutaneous analgesia is recommended as a routine procedure in DTH testing in young children.
Concentrations of C1q, Factor B, Factor D and Properdin in Healthy Children, and the Age‐Related Presence of Circulating C1r‐C1s Complexes
Authors: PRELLNER K. , SJÖHOLM A. G. , TRUEDSSON L.
Published: January 2008

ABSTRACT. The concentrations of C1q, factor B, factor D and properdin were determined in healthy children belonging to various age groups of one through five years of age. All concentrations were found to be age‐dependent, though they varied from one component to another with regard to ontogenetic pattern. Thus, the concentrations of factor B were high, and those of factor D low throughout the age range studied. C1q and properdin levels were lowest in the younger children, who also showed a failry high incidence of C1r‐C1s complexes in excess of C1q. Since the concentrations of C1q are influenced by those of IgG, the presence of C1r‐C1s complexes might partly have reflected maturation of immunoglobulin synthesis during ontogeny.
A Prospective Study of Respiratory Infections in 12‐Year‐Old Children Actively Engaged in Sports
Authors: ÖSTERBACK L. , QVARNBERG Y.
Published: January 2008

ABSTRACT. Data on the incidence of respiratory tract infections, antimicrobial treatment, days with fever and absence from school on account of these infections were studied in children participating in extracurricular sports activities with regular supervised training and competitive events. Swimmers, ice‐hockey players and apparatus gymnasts were compared to a control group of children. Their mean age was 12.7 years at the end of the one year study. The children were examined three times during the year. More information was collected by a nurse who contacted the mothers of the children every two months. The girls had contracted more respiratory tract infections than the boys during the study. This difference was only seen regarding common colds, not regarding major bacterial respiratory infections, i.e. otitis media, tonsillitis, sinusitis and pneumonia. Because of this difference the results were analysed separately for the sexes. No differences between the sports and the control groups were seen in any respect regarding respiratory infections. Contrary to general opinion, sports participation does not seem to have a preventive effect on the occurrence of respiratory infections in children.
Assessment of the Usefulness of Weekly Knemometric Measurements in Growth Studies
Authors: WIT J. M. , van KALSBEEK E. J. , van WIJK‐HOEK J. M. , LEPPINK G. J.
Published: January 2008

ABSTRACT. In 31 healthy children the variability of lower leg length growth over 12 weekly measuring sessions, each consisting of 6 measurements, was assessed with a knemometer. The average SD of 6 measurements was 0.12 mm. In many cases not only a rising trend, but also a zig‐zag pattern was observed. The linear regression was not significant (p >0.05) in 1 child. The average (±SD) lower leg length velocity (LV) was 0.36±0.14 mm/week, and the average statural growth velocity 1.27±0.54 mm/week. The median ratio was 3.3. The range of both velocities was greater than the range of annual height velocities. When LV over the first 6 weeks was compared with LV over the next 6 weeks, a significant difference was found in 5 children. If the effect of growth‐promoting or ‐inhibiting drugs were to be analyzed over such periods, a difference of 0.37 mm/week over two 6‐week‐periods would be necessary for significance at a 5% level. This would be equivalent with a statural growth response of at least 6.3 cm/year. In conclusion, short‐term knemometric growth response cannot be used as a reliable predictor of long‐term statural growth response.
Determinants of Polychlorinated Biphenyls (PCBs) in Human Milk
Authors: DRIJVER M. , DUIJERS T. J. , KROMHOUT D. , VISSER T. J. , MULDER P. , LOUW R.
Published: January 2008

ABSTRACT. In a longitudinal pilot study on the course of the PCB concentration in human milk during six months of lactation, some important PCB determinants could be studied in 23 women and their infants. PCB values were within the range of those found in the literature. Pearson correlation coefficients were calculated to investigate the association of the mean PCB concentration over the first half year of lactation with maternal parameters, such as age, height, weight, previous lactation period, education, occupation, residence, smoking, drinking and dietary habits as well as the infant parameters gestational age, birthweight and weight gain in the first six months of life. Since the PCB concentration on fat basis and the fat content of the milk were strongly inversely related, statistical analyses were carried out both on fat and on milk basis. In univariate analyses the PCB concentration on fat basis was most strongly associated with pre‐ versus post‐pregnancy weight gain, age and occupation. After multiple regression analysis PCB concentration on fat basis remained significantly associated with weight gain changes and remained borderline (p < 0.10) significantly related with occupation. The pre‐pregnancy Quetelet Index of the mother (height/weight2) and the estimated PCB content of the diet (primarily fish) were strongly correlated with the PCB concentration on milk basis. Only the Quetelet Index remained significantly related after multiple regression analysis.
A New Method of Expired Gas Collection for the Measurement of Breath Hydrogen (H2) in Infants and Small Children
Authors: TADESSE K. , LEUNG D. T. Y. , LAU S. P.
Published: January 2008

ABSTRACT. The measurement of hydrogen (H2) in breath is becoming increasingly useful as a diagnostic and research tool, but there is still no satisfactory method of sampling expired air in infants and small children. We tested a modified open‐flow hood method where the child's head is put in a perspex box and expired air is collected by sucking air from the box by means of an air pump. Comparison of this method with end‐expiratory sampling by a modified Haldane‐Priestly and nasopharyngeal catheter gave a correlation coefficient of 0.83 and 0.65, respectively, We conclude that expired air sampling in children with this method is a more satisfactory and as reliable a method as any available at present, and has the added advantage of being quantitative.
Postnatal Development of Renal Function in Very Low Birth weight Infants
Authors: VANPEÉ M. , HERIN P. , ZETTERSTRÖM R. , APERIA A.
Published: January 2008

ABSTRACT. The postnatal development of renal function was compared in infants with a gestational age of 25–30 weeks, mean 27.8 weeks (GA 28), and in infants with a gestational age of 31–34 weeks, mean 32.5 weeks (GA 32). The infants were comparable with regard to postnatal course, fluid, caloric and salt intake. Observations were made during the 1st, 2nd and 4th‐7th (mean 5th) postnatal weeks. From the 1st to the 5th postnatal week the creatinine clearance (CCr ml/min/1.73 m2), increased from 11 to 20 in GA 28 and from 15 to 30 in GA 32. At 2 weeks of age CCr was significantly lower in GA 28 than in GA 32. During the first week of life diuresis was lower in GA 28 than in GA 32 but thereafter was the same in both groups. We interpret this as a sign of dehydration in GA 28. Serum arginine vasopressin (S‐AVP) concentrations were high in both groups at all ages. Mean urine osmolality was low (<300) regardless of postnatal age and S‐AVP. Urinary sodium excretion was high at 1 week of age in both groups and decreased with increasing postnatal age. Na excretion was slightly higher in GA 28 than in GA 32 at 1 but not at 2 and 5 weeks. UK/UNa was below 1 in both groups during the first week of life and increased with postnatal age. Urinary aldosterone excretion was high in both GA 28 and GA 32 at all ages. Serum sodium levels were lower in GA 28 than in GA 32 at all ages. Hyponatremia was observed in 13/32 infants in GA 28 and in 1/45 infants in GA 32. We conclude that the postnatal development of renal function is retarded in all preterm infants and is slightly slower in infants with a GA below 31 weeks than in infants with a GA of 31–34 weeks. Extrarenal factors must contribute to the low serum Na values in infants with GA <31 weeks.
Plasma Fatty Acid Composition during the First Week of Life Following Feeding with Human Milk or Formula
Authors: SANJURJO PABLO , RODRIGUEZ‐ALARCON JUSTINO , RODRIGUEZ‐SORIANO JUAN
Published: January 2008

ABSTRACT. Plasma fatty acids were studied in 20 full‐term newborn infants fed human milk and in 17 newborn infants of identical characteristics fed an adapted cow's milk formula. Plasma fatty acids were measured in cord blood and at 7–9 days of age. No differences were present at birth but, after a period of feeding, infants receiving breast milk had higher plasma concentrations of stearic acid, di‐homo‐γ‐linolenic acid and arachidonic acid, while infants receiving formula had a higher plasma concentration of oleic acid. The importance of these findings in relation to the lipidic structure of the nervous system remains to be determined.
Neonatal Chlamydial Conjunctivitis
Authors: SANDSTRÖM I. , KALLINGS I. , MELEN B.
Published: January 2008

ABSTRACT. Chlamydia trachomatis (Ct) was isolated from eyes of 33 out of 160 infants with neonatal conjunctivitis. In nineteen (58%) of the infants with chlamydial conjunctivitis Ct could also be isolated from the nasopharynx. All infants were treated with oral erythromycin ethylsuccinate 25 mg/kg every 12 hours for 14 days combined with lid hygiene. All were clinically cured, and none had a relapse of clinical Ct conjunctivitis during an observation period of one year. However, one infant had persistent asymptomatic chlamydial eye infection, two displayed a persistant infection of the nasopharynx, and one infant's vagina was infected despite therapy. Serum IgG antibodies to Ct were significantly more often detected in clinical cases (90%) than in controls (33%) (p<0.01). Infants with conjunctivitis developed detectable IgM antibodies to Ct in 43% as compared to 7% in controls (p<0.01).
Transient Hyperphosphatasemia of Infancy
Authors: OGGERO R. , MOSTERT M. , SPINELLO M. , IAVARONE A. , BUFFA J.
Published: January 2008

ABSTRACT. Alkaline phosphatase was assayed as part of the routine examinations performed in all children hospitalized for the first time in our ward. Fifteen children had transient hyperphosphatasemia of infancy (THI). Their clinical features suggested the presence of an infectious agent.