bluuebunny/crossref_metadata_2025 huggingface dataset:
Neonatal Fat Digestion and Lingual Lipase
Authors: SMITH L. J. , KAMINSKY S. , D'SOUZA S. W.
Published: January 2008

ABSTRACT. Lingual lipase (IX) activity, pH, and products of fat hydrolysis were determined in gastric aspirates from preterm infants who received formula milk feeds by a nasogastric tube. In 1‐hourly (n=9), 2‐houriy (n=8) and 3‐hourly (n=9) fed infants LL activity increased to reach its maximum value at 60, 90, and 120 min respectively after the feeds, and gastric pH levels fell from about 6.0 to <3.5. There was a reduction in triglyceride content to 50% of the initial value, measured immediately after a feed, and the products of hydrolysis were mainly di‐glycerides and FFA. In a subsequent study 3‐hourly fed infants (n=8) had a tube feed followed by a bottle feed, and then a bottle feed followed by a tube feed on successive days (cross‐over). The LL activity observed after a bottle feed (mean maximal value 23.8 nmol FFA/ml/h) was significantly higher than after a tube feed (19.1 nmol FFA/ml/h). It is suggested that substantial triglyceride hydrolysis takes place in the stomach due to lingual lipase, and sucking seems to enhance enzyme production.
Diets of Healthy Swedish Children 4‐24 Months Old
Authors: KYLBERG E. , HOFVANDER Y. , SJOLIN S.
Published: January 2008

ABSTRACT. In a semi‐longitudinal investigation comprising a total of 81 infants studied at one or more of the ages 4, 9,15 and 24 months, the food intake was recorded on three consecutive days at 4 months and on seven consecutive days at 9, 15 and 24 months (40, 40, 38 and 40 infants, respectively in the four age groups). The formula‐fed 4‐month‐old infants had a markedly higher intake of all nutrients, except fat and retinol, than the breast‐fed ones. In the three oldest age groups the nutrient intake was high as compared with RDA. The protein intake was exceptionally high. Median intakes that were definitely lower than RDA were noted only for vitamin D, iron and zinc. The nutrient density changed from the age of 9 to 24 months, indicating a transition during that period from infant to adult food habits.
Working Capacity and Pulmonary Gas Exchange in Children with Exercise‐Induced Asthma
Authors: HEDLIN G. , GRAFF‐LONNEVIG V. , FREYSCHUSS U.
Published: January 2008

ABSTRACT. Sixteen children aged 10.1‐14.3 years with a history of exercise‐induced asthma (EIA) were evaluated as to their working capacity both during a maximal exercise test and during sub‐maximal exercise. During submaximal exercise ventilation and alveolar gas exchange were measured. Working capacity was normal with respect to the oxygen uptake and to the maximal load. Arterial blood gases were normal before exercise but PaO2 decreased (p<0.01) during the submaximal exercise test. The values were, however, still within the normal limits in all but two of the children. The flow‐volume data showed bronchial obstruction in the resting state, before exercise, with lower values of MEF50 and MEF25 (p<0.01) than in healthy children. Following exercise, 14 of the 16 children developed clinical symptoms of asthma with increased impairment of the flow‐volume curves. Most of them recovered from asthmatic symptoms within 30 min. Flow‐volume curves were found to be a sensitive measurement of bronchial obstruction during the symptom‐free phase and during EIA although with larger individual variations than FEV1.
Epidemiology of Infantile Hydrocephalus in Sweden
Authors: FERNELL E. , HAGBERG B. , HAGBERG G. , von WENDT L.
Published: January 2008

ABSTRACT. The Hvebirth prevalence of infantile simple hydrocephalus (IH) was investigated in a Swedish population‐based survey. The study comprised all liveborn infants with IH apparent before the age of one year and born in the study area between 1967‐82. A total of 202 infants fulfilled these criteria; of these, 141 (70 %) were born at term and 61 (30 %) were preterm. The mean prevalence was 0.53 per 1000, with a slightly increasing trend from 0.48 in 1967‐70 to 0.63 in 1979‐82. The increase was entirely referable to the preterm group, in which the prevalence rose from 0.13 per 1000 in 1967‐70 to 0.30 in 1979‐82. There was no tendency to an increase in the term group. In 12 of 23 children born very preterm the origin of the IH was a diagnosed cerebral haemorrhage. This is compatible with the increased risk of the latter condition that has been found in very preterm newborns. The mortality among children with IH was highest before the age of one year (15 %), after which it was 1.2 % per year.
Lipid‐A‐Antibodies–Indicators for the Risk of Renal Scarring in Children with Urinary Tract Infection
Authors: MISSELWITZ J. , NEUBERT H. , HORN A. , ERLER W.
Published: January 2008

ABSTRACT. The levels of IgG‐ and IgM‐antibodies against lipid A were determined by an ultramicro‐ELISA in 54 children between 2 months and 13 years of age with non‐obstructive urinary tract infections at the onset of the infection and subsequently after 3, 6 and 12 months. Children older than 2 years who later developed renal scarring as shown by intravenous pyelo‐grams had higher levels of IgG antibodies than those without scars. This correlation was not found in children younger than 2 years of age. IgM‐anribody levels did not correlate with the risk of scar formation. We conclude that the IgG‐antibody level against lipid A is a useful indicator for early recognition of children over the age of two years who will later develop renal scars. The ultramicro‐ELISA technique makes screening for children at risk possible at a low cost.
Abnormal Immune Responses during Hypozincaemia in Acrodermatitis Enteropathica
Authors: ANTTILA P. H. , VON WILLEBRAND E. , SIMELL O.
Published: January 2008

ABSTRACT. Immune responses were characterized in six patients with acrodermatitis enteropathica during a break in zinc supplementation and during ^supplementation. During hypozincaemia the number of T‐cells increased but the amount of B‐cells and the responses of T‐ and B‐lym‐phocytes to phytohaemagglutinin, concanavalin A‐, pokeweed mitogen‐ and Staphylococcus aureus stimulations in vitro were subnormal. Cell counts and stimulation results both normalized when serum zinc values improved. One patient was anergic to tuberculin while showing signs of acrodermatitis enteropathica; she converted during supplementation whereas the others were continuously positive. Three females had antibodies against nuclear antigens and slightly elevated serum IgE concentrations; these values were not affected by the break in supplementation. Four females were continuously rheumatoid factor positive. Our findings suggest that (i) zinc deficiency is closely associated with impaired immune responses in patients with acrodermatitis enteropathica, and (ii) laboratory markers of autoimmunity occur in a considerable number of the acrodermatitis enteropathica patients, irrespective of their zinc status.
Obesity in the Young Child: Whither and Whence?
Authors: POSKITT E. M. E.
Published: January 2008

ABSTRACT. The prevalence of obesity in British infants in the early 1970s has been attributed to overfeeding and early weaning but cannot be totally explained by this. Obesity in early life is a consequence of the cyclical nature of fat deposition in childhood. Fat deposition in early infancy is succeeded by a lean tissue deposition phase and then a further acceleration of fat accretion—the adiposity rebound—in early school years. The age at onset of adiposity rebound relates more closely to later obesity than does the nutritional status in infancy. The propensity to deposit fat readily is probably genetically determined although dependent for expression on the nurturing environment. Since the number of young children at risk of obesity is so great, measures that modify national diet and activity rather than concentrate on controlling individual fat deposition, may be the most efficient way of preventing obesity in adult life. Key words: Obesity, body composition, adiposity rebound.
Rickets—not only the “English Disease”
Authors: BELTON NEVILLE R.
Published: January 2008

ABSTRACT. Nutritional rickets in infancy and childhood due to vitamin D deficiency continues to be a world‐wide problem. Its occurrence is probably higher in many tropical and sub‐tropical countries, despite abundant sunlight than in many more northerly latitudes, where its incidence is mainly lited to children of Asian origin and those with dark skins. Social and cultural customs induding the adherence to a speaal, often vegetarian diet, the avoidance of sunlight together with increasing urbanisation, extended breast feeding and severe malnutrition are recognisable factors in the pathogenesis of rickets. Recent research has suggested that the regulation of vitamin D metabolism may be different in black children compared with those who have a fair skin. Supplementation of mothers in pregnancy and of children in infancy with vitamin D together with health education to promote a diet containing foods rich in vitamin D can ameliorate this preventable disease.
Current Clinical Trials with Authentic Recombinant Human Growth Hormone in Japan
Authors: TAKANO KAZUE , SHIZUME KAZUO
Published: January 2008

ABSTRACT. Daily injections of methionine‐free, recombinant hGH (rhGH), 8IU, were administered in six healthy volunteers. Non‐esterified fatty acid levels increased significantly from 0.45 ± 0.06 to 1.08 ± 0.05 mEq/litre (mean ± SEM) at 4 hours after the first injection of rhGH (p < 0.001). Plasma IGF‐1 levels increased significantly at 24 hours after each of the four daily injections of rhGH (basal, 0.80 ± 0.06 units/ml; 24 hours, 1.72 ± 0.21 units/ml; 48 hours, 3.22 ± 0.42 units/ml; 72 hours, 3.17 ± 0.49 units/ml; 96 hours, 3.63 ± 0.32 units/ml; p < 0.001). Eleven patients with hGH deficiency were treated with rhGH, 0.5 IU/kg/week for 3 months. Their heights increased by between 1.1 cm and 4.1 cm during the 3 months of treatment, which was calculated to be equivalent to 4.4–16.4 cm/year, with a mean height velocity of 8.6 ±1.1 cm/year. Anti‐hGH antibody was observed in one patient treated with rhGH and had a titre of 10.
Experimental Research on IGF‐1
Authors: SKOTTNER A. , FRYKLUND L. , HANSSON H.A.
Published: January 2008

ABSTRACT. IGF‐1 has been produced by recombinant DNA technology; the host cell is a yeast. Studies in hypophysectomized rats show that IGF‐1 has little growth promoting effect unless given by infusion at high doses, and priming with bovine growth hormone did not produce any potentiation. In vitro studies reveal that IGF‐1 cross‐reacts with the insulin receptor on adipose cells. Immunohistochemical studies have revealed high IGF‐1 immunoreactivity in proliferating and differentiating cells in the testes, lymphoid organs and pancreatic islets and particularly in regenerating nerves. Local application of IGF‐1 may stimulate regeneration in damaged peripheral nerves.
Flow Velocity Patterns across Atrial Septal Defects Recorded with Doppler Echocardiography
Authors: HATLE LIV
Published: January 2008

ABSTRACT. During a two‐year period pulsed Doppler combined with two‐dimensional echocardiography was used in evaluating patients for atrial septal defects. Blood flow velocities were recorded with pulsed Doppler in the right atrium along the atrial septum, across the atrioventricular and semilunar valves and when a shunt was detected also on the left side of the phial septum. The typical flow velocity pattern most often seen is described and is related to the differences in pressure between the two atria during the cardiac cycle. Deviations from this velocity pattern are described and their hemodynamic significances discussed. Diagnosis and assessment of pulmonary hypertension from tricuspid and pulmonary flow velocities are described.
Estimation of Outflow Tract Pressure Gradients by Continuous Wave Doppler in Children
Authors: BJÖRKHEM G. E. , LUNDSTRÖM N.‐R.
Published: January 2008

ABSTRACT. Continuous wave Doppler echocardiography was used to estimate pressure gradients in 27 children with right or left ventricular outflow tract obstruction. Tbe pressure gradients predicted by Doppler were compared to peak‐to‐peak and instantaneous gradients measured at cardiac catheterization, When the Doppler study was performed the pressure gradient obtained at catheterization was not known to the examiner. A correlation coeffiaent of 0.76 was found for the comparison between the Doppler predicted gradient and the peak‐to‐peak gradient and 0.78 for the comparison with the instantaneous pressure gradient. Clinically significant obstructions could be reliably separated from insignificant obstructions by the Doppler technique.
Ductus Closure in Preterm Infants Effects on Cerebral Hemodynamics
Authors: LUNDELL B. P. W. , SONESSON S.‐E. , COTTON R. B.
Published: January 2008

ABSTRACT. Idracranial arterial blood flow velocities were studied before and after ductus closure by smgery (n=8) and indomethacin (n=10) in very low birth weight infants. Blood flow velocities were measured non‐invasively through the fontanel with a pulsed Doppler velocimeter. Ligation of the ductus was associated with a 62% increase in mean flow velocity 24 hours after surgery, mainly secondary to increased diastolic flow velocity. Iodomethacin (0.2 nig/kg i.v.) induction of ductus constriction was associated with a 36% decrease of mean flow velocity one hour after administration. At 24 hours, the intracranial blood flow velocity had returned to the pretreatment level but was still significantly lower than after ligation. Ductus dosure is associated with marked changes in cerebral hemodynamics. Ligation causes increased arterial blood flow velocities and indomethacin administration seems to reduce Mood flow velocities to the brain.
Prolonged Exclusive Breast‐Feeding Results in Low Serum Concentrations of Immunoglobulin G, A and M
Authors: SAVILAHTI E. , SALMENPERÄ L. , TAINIO V.‐M. , HALME H. , PERHEENTUPA J. , SIIMES M. A.
Published: January 2008

ABSTRACT. Serum levels of IgG, IgA and IgM were measured in 198 infants at ages 2, 4, 6, 9 and 12 months. By age 9 months 30 infants were still exclusively breast‐fed; their IgG and IgM levels were significantly lower than those of infants weaned early to formula (before age 3.5 months). By 12 months 6 infants were still exclusively breast‐fed; their IgA levels were by then also similarly lower. There was no significant difference in the number of infections experienced by these groups of infants. After 2 months on formula feeding, the IgG and IgM levels of the infants who were exclusively breast‐fed for 9 months had caught up with the levels of the infants weaned early to formula. Only at 12 months of age prealbumin levels of the exclusively breast‐fed infants showed a positive correlation to IgG and IgA levels; no correlation was found between immunoglobulin levels and levels of serum iron and zinc.
Protein C Levels in Infancy and Early Childhood
Authors: WIDDERSHOVEN J. , BERTINA R. , MONNENS L. , LIER H. v. , DE HAAN A.
Published: January 2008

ABSTRACT. Protein C antigen levels were measured in the plasma of healthy full term infants by electroimmunoassay. During the first three months of life (on day four, at one month, two months and three months of age) protein C antigen levels were compared in breast‐fed and bottle‐fed infants. None of the two groups of infants received vitamin K at birth. Only at the age of three months there was a significant difference between the groups. Unexpectedly infants, who were breast‐fed, had a higher protein C level at three months of age. Levels were also measured in 15 healthy children between one and three years of age. The antigen levels increase with age to reach adult values at about three years of age.
Immunoreactive Anionic Trypsin and Anionic Elastase in Human Milk
Authors: BORULF S. , LINDBERG T. , MÅNSSON M.
Published: January 2008

ABSTRACT. Immunoreactive anionic trypsin and anionic elastase have been demonstrated in human milk, by immunodiffusion and Immunoelectrophoresis. Cationic trypsin and cationic elastase could not be detected by these methods. The anionic trypsin is probably present in complex with IgA. No benzoyl‐DL‐arginine‐p‐nitroanilide (BAPNA) splitting activity was found in human skim milk. Anionic trypsin was isolated by immunoadsorption chromatography. The purified enzyme had a BAPNA‐splitting activity.
Decreased Incidence of Intraventricular Hemorrhage in Infants of Opiate Dependent Mothers
Authors: CEPEDA E. E. , LEE M. I. , MEHDIZADEH B.
Published: January 2008

ABSTRACT. The incidence of intraventricular hemorrhage (IVH) in infants born to opiate dependent mothers was compared to infants whose mothers denied the use of addicting substances. The two groups were comparable in birth weight, gestational age, 1 and 5 min Apgar scores, and sex distribution. The incidence of breech presentations, PROM, and type of anesthesia at delivery were similar. However, more infants in the control group were delivered by cesarean section. The incidence of IVH was 52% in the controls and 23% in the opiate infants (p<0.05). Neonatal risk factors such as use of ventilators, incidence of pneumothorax, administration of pressor and sedative drugs, acidosis, use of alkali therapy and volume expanders, fluid therapy in the first three days and transfers to other hospitals were the same.
Long Term Effects of Artificial Ventilation in Neonates
Authors: RIEDEL F.
Published: January 2008

ABSTRACT. In order to evaluate long term effects of artificial ventilation, 27 children, who had been ventilated for more than five days in their neonatal period, were reinvestigated at school age. In 5 of them bronchopulmonary dysplasia had been diagnosed. Seven had more than 10 upper respiratory tract infections per year and 9 had recurrent obstructive airway disease. On pulmonary function testing (n=23) 19% showed some airway obstruction, and in 43% bronchial hyperreactivity was found by bronchial provocation with histamine. There was a significant correlation (p<0.05) between bronchial hyperreactivity and the duration of neonatal ventilation. The degree of hyperreactivity (PC20, FEVI) also correlated with birth weight (p<0.005) and gestational age (p<0.02). It is concluded that prolonged neonatal ventilation might be followed by bronchial hyperreactivity, especially in the small and premature newborn.
Efficiency of Ventilation in Neonatal Pulmonary Maladaptation
Authors: SANDBERG K. , SJÖQVIST B. A. , HJALMARSON O. , OLSSON T.
Published: January 2008

ABSTRACT. Lung physiology was studied in sixteen infants with pulmonary maladaptation (PMA) during the course of the disease and after clinical recovery. A sensitive nitrogen washout method was used. During the disease the infants showed reduced ventilatory efficiency and increased dead space. Total ventilation increased simultaneously, while alveolar ventilation was maintained. The majority of the infants showed greater functional residual capacity during the disease than after clinical recovery. The results suggest that gas mixing efficiency is impaired in infants with PMA and that this might be due to effects on the small airway function in the lungs.
Complement‐Dependent Bactericidal Activity for E. coli K12 in Serum of Preterm Newborn Infants
Authors: FIETTA A. , SACCHI F. , BERSANI C. , GRASSI G. GIALDRONI , STRONATI M. , GANCIA P. , RONDINI G.
Published: January 2008

ABSTRACT. Complement‐dependent serum bactericidal activity for E. coli K12 was assessed in 12 term infants and in 16 preterm infants. In both groups of newborns, at birth, bactericidal reaction by the classical pathway of complement activation was impaired with respect to normal controls at <0.001 level of significance (as estimated by Student's t‐test). The serum bactericidal reaction by the alternative pathway of complement activation was significantly impaired only in preterm newborns, being normal in term infants. At a time corresponding to 40 weeks' gestational age also in preterm newborns alternative pathway mediated bactericidal activity for E. coli K12 was found normal. Classical pathway mediated bactericidal activity became normal only at an age corresponding to 52 weeks' gestational age.
Plasma Growth Hormone (GH) Responses to Growth Hormone Releasing Factor (hp GRF 1–44) in Familial GH Deficiency
Authors: KIBIRIGE M. S. , PRICE D. A. , SHALET S. M. , BAILIE G. R.
Published: January 2008

ABSTRACT. In four children with familial GH deficiency peak and integrated GH responses to an acute intravenous bolus of hp GRF 1–44 were lower than in 18 children with non‐familial idiopathic GH deficiency and in 5 children with structural hypothalamic abnormalities. It is possible that the familial forms of GH deficiency described may be due to absence or biological inactivity of endogenous GRF or possibly GRF receptor or post receptor abnormalities.
Effects of Regular Inhalation of Beclomethasone Dipropionate and Sodium Cromoglycate on Bronchial Hyperreactivity in Asthmatic Children
Authors: KRAEMER R. , SENNHAUSER F. , REINHARDT M.
Published: January 2008

ABSTRACT. The efficacy of beclomethasone dipropionate (BDP) was compared with sodium cromoglycate (SCG) and placebo in a double‐blind parallel group study of 30 asthmatic children over a two‐month period. All the three treatment groups received salbutamol concomitantly. Lung volumes, airway mechanics and the nonspecific bronchial hyperreactivity to carbachol were measured at the beginning and the end of the study. Two patients were excluded because of unequal clinical conditions at the entry and the end of the study and three because of lack of co‐operation. Three patients (1 on SCG, 2 on placebo) dropped out because of worsening clinical symptoms. The improvement in airway mechanics shown by the group treated with BDP (n=7) was significantly greater (p<0.01) than in the group treated with SCG (n=8). Nonspecific hyperreactivity to carbachol improved significantly in the BDP group (factor 5.9) compared to the SCG group (factor 1.9). Childhood asthma seems to be better controlled by a combination of BDP and salbutamol, than by SCG and salbutamol.
Clinical Epidemiology of Symptomatic Primary Herpetic Infection in Children
Authors: TAIEB A. , BODY S. , ASTAR I. , du PASQUIER P. , MALEVILLE J.
Published: January 2008

ABSTRACT. We have studied a series of 50 children with clinical primary herpetic infection during 1975–1985. Our data confirm: absence of sex differences and seasonal variations, a peak age of incidence between 6 and 24 months, a prevalence of patients of lower social status, evidence of recurrent herpes labialis as the most frequent source of infection, and frequency of herpes simplex virus 1 gingivostomatitis. The relevant findings of this study were as follows: 1) herpes simplex virus 2 was isolated in 10% of the patients, 2) 6% of cases occurred in the first six months of life, 3) infection was multifocal in 36% of cases, 4) autoinoculation was a frequent route of transmission of genital primary infection in young children, 5) herpetic Kaposi‐Juliusberg's pustulosis in infants with atopic dermatitis was the most severe presentation of primary infection and should be more adequately prevented.
Two Hereditary Spinal Diseases Producing Kyphosis during Adolescence
Authors: NIELSEN OLE GUDMUND , PILGAARD PEDER
Published: January 2008

ABSTRACT. Familial accumulation of spinal osteochondrosis (Scheuermann's disease) and hereditary juvenile anterior fusion of the vertebral bodies in the thoraco‐lumbal area are reported for the first time in the same family. Radiological examination of the spine in 2 planes of 73 persons formed the basis for the study. Nine cases of spinal osteochondrosis and 5 cases of hereditary juvenile anterior fusion were found. Proliferation and increased height of the anterior surface of the body of the vertebrae and pronounced reduction in the anterior aspect of the intervertebral spaces were characteristic during the early stages of the latter condition, similarly fewer back symptoms and a better prognosis were observed in these patients than was the case of patients with Scheuermann's disease.
Need of Hospital Care for Newborn Infants
Authors: KRANTZ M. E. , HJALMARSON O.
Published: January 2008

ABSTRACT. In a prospective study of a total population the hospital resources required for the care of preterm infants and infants with respiratory disturbances (RD) were analyzed. 5.2% of all the infants were preterm and 7.6% developed RD. For the care of preterm infants the requirements were 63.8 beds per 1000 annual preterm births of which 8.3 beds were attributable to the care of RD in these infants. Full term infants needed 0.88 hospital beds per 1000 annual full term births for respiratory care. The number of days on ventilator for preterms was calculated to 2044 per 1000 annual preterm births. For preterm infants the mode of delivery was not found to affect the length of hospitalization. For the total population the average need of hospital days for full term infants because of RD was 0.29 days after vaginal delivery compared with 0.78 days after elective Caesarean section.
Idiopathic Hypercalciuria in Children
Authors: CERVERA A. , CORRAL M. J. , GÓMEZ CAMPDERA F. J. , DE LECEA A. M. , LUQUE A. , LÓPEZ GÓMEZ J. M.
Published: January 2008

ABSTRACT. Between 1981 and 1983, 49 children aged 2 to 15 years were diagnosed as having idiopathic hypercalciuria (IH). They were divided into 3 groups based on their response to dietary manipulation: group I (32/49) had absorptive hypercalciuria; group II (8/49) had renal hypercalciuria and group III (6/49) had sodium‐dependent hypercalciuria. Response to diet was more reliable than Pak's test in differentiating between the three groups. A control group (CG) of 45 healthy, age matched children determined baseline levels for all metabolic parameters. At the time of presentation IH children did not differ from the CG in height or weight. Fifty percent of IH children had first degree relatives with urolithiasis. Yet, only 16% of the IH children had urolithiasis, the majority presenting with gross hematuria and urinary tract infections (UTI). With few exceptions the clinical symptoms resolved when urine calcium excretion was controlled. Severe calcium restriction in a few patients produced osteoporosis and delayed bone age although growth velocity was unaffected. Thiazide therapy in a few patients produced some metabolic derangements. The authors conclude that IH in childhood is a benign disease which may present with UTI or hematuria. They further propose a new classification method based on response to dietary manipulation.
Pre‐Conceptual Dietary Management for Maternal Phenylketonuria
Authors: FARQUHAR D. L. , SIMPSON G. K. , STEVEN F. , MUNRO J. F. , FARQUHAR J. W.
Published: January 2008

ABSTRACT. Experience of preconceptual dietary management of maternal hyperphenylalaninaemia is limited. Two Edinburgh mothers with hyperphenylalaninaemia and borderline IQ have received dietary advice to maintain normal plasma Phe concentration both before conception and during pregnancy, in an attempt to prevent foetal abnormality. Satisfactory compliance was only obtained after intensive in‐patient instruction and the diets were maintained for long periods prior to conception. Intellectual and psychological factors were very important and the availability of “same day” biochemical reports useful in encouraging the mothers. Both infants have normal Phe concentrations and satisfactory growth and development parameters at present. Further follow‐up continues but these cases provide further evidence in favour of the use of preconceptual dietary advice in the management of maternal hyperphenylalaninaemia.
Evaluation of Renal Parenchyma in Children by DMSA Scientigraphy, X‐ray Computed Tomography and Intravenous Urography
Authors: KULLENDORFF C. M. , LAURIN S. , WHITE T.
Published: January 2008

ABSTRACT. The demonstration of diminished or scarred renal parenchyma in children is often the decisive factor in determining the future management of children with urinary tract malformations. Renal scintigraphy using technetium 99m‐labelled dimercaptosuccinic acid (DMSA), computed tomography (CT) and intravenous urography (IU) were used to evaluate the renal parenchyma prior to ureter re‐implantation in a series of 13 children. Their ages ranged from 5 months to 3 years 8 months. The indication for operation was ureteric reflux in 8 children and distal ureteric stenosis in 5. CT was performed on a Toshiba TCT‐80 scanner. Renal scintigraphy was performed 3 hours after intravenous injection of DMSA. Compared with IU, DMSA imaging gave more information about the renal parenchyma in 6 children, gave equal information in 6 and less in 1. Compared with CT, DMSA imaging gave more information in 2 children, was equally informative in 8 and less so in 3. Accordingly, DMSA imaging was judged to be more sensitive than IU and as sensitive as CT. DMSA imaging can be used both for the initial evaluation and for follow‐up assessment of renal parenchymal damage.
Short‐Term Effect of Low and High Protein Intake on Renal Function in Children with Renal Disease
Authors: BERG U. , BOHLIN A.‐B. , APERIA A.
Published: January 2008

ABSTRACT. The short‐term effect of different levels of protein intake on renal function was investigated in 18 children with moderately (51–85 ml/min/1.73 m2 BSA) or severely (9–50 ml/min/1.73 m2 BSA) reduced glomerular filtration rates (GFR). The GFR and effective renal plasma flow (ERPF), estimated as the clearances of respectively inulin and para‐aminohippuric acid during uncontrolled (2‐2.5 g/kg bw), low (1.2 g/kg bw for 12 days) and high (3–5 g/kg bw for 24 h) protein intake were determined by a standard clearance method employing continuous infusion and spontaneous voiding. There were no significant differences in GFR or ERPF during uncontrolled and low protein intake. During high protein intake the GFR and ERPF increased significantly in patients with GFRs above 50 ml/min/1.73 m2 BSA and ERPFs above 150 ml/min/1.73 m2 BSA. It is concluded that these findings might indicate a functional reserve capacity in children with only moderately reduced renal function.
High Sodium Rehydration Solutions in Well‐Nourished Outpatients
Authors: HERZOG L. W. , BITHONEY W. G. , GRAND R. J.
Published: January 2008

ABSTRACT. We studied the safety and efficacy of high‐sodium oral rehydration solution in the out‐patient management of children with diarrhea, with or without dehydration. We studied 68 outpatients with acute diarrhea; 32% had mild‐to‐moderate dehydration; the rest were not dehydrated. They were treated at home for 24 h with either high‐sodium (90 mmol/l) or low‐sodium (30 mmol/l) solution. None of the patients given high‐sodium solution became hyper‐natremic. Of those patients who were dehydrated, 55% did not take enough fluid at home to repair their dehydration. We conclude that patients must be closely supervised for the initial rehydration period, but that high‐sodium rehydration solutions can be safely given to outpatients for up to 24 hours.
Motilin, Vasoactive Intestinal Peptide and Gastrin in Infantile Colic
Authors: LOTHE L. , IVARSSON S. A. , LINDBERG T.
Published: January 2008

ABSTRACT. Intestinal hyperperistalsis is one part of the clinical picture in infantile colic. Three gut hormones involved in the regulation of gut motility; motilin, vasoactive intestinal peptide (VIP) and gastrin, were measured with the RIA method in: 40 infants with infantile colic, (age 2–22 weeks), 42 healthy age‐matched infants, 11 children (age 3–36 months) with gastrointestinal disorders, and 20 children (age 3–36 months) with non‐gastrointestinal disorder. Basal s‐motilin levels were raised in infants with infantile colic (p<0.01) and in children with other gastrointestinal disorders (p<0.001). Formula‐fed infants had higher basal s‐motilin levels than the breast‐fed infants (p<0.05). P‐VIP and s‐gastrin levels were raised in children with other gastrointestinal disorders (p<0.05), but not in infantile colic. Formula‐fed colicky infants had higher s‐gastrin levels than the breast‐fed colicky infants (p<0.05). We suggest that the increased s‐motilin level in infantile colic might account in part for the clinical picture of this disorder.
Serum Total Cholesterol, HDL Cholesterol and Blood Pressure Levels in 15‐Year‐Old Adolescents in Eastern Finland
Authors: VARTIAINEN E. , PUSKA P. , TOSSAVAINEN K.
Published: January 2008

ABSTRACT. Serum total cholesterol, HDL‐cholesterol and blood pressure were studied among 15‐year‐old school children in Eastern Finland. The mean serum total cholesterol was 4.47 mmol/l in boys and 4.86 mmol/l in girls; mean HDL‐cholesterol was 1.29 mmol/l and 1.46 mmol/l, respectively. The mean blood pressure was 135/65 mmHg in boys and 126/67 mmHg in girls. Obese children had higher blood pressure and lower HDL‐cholesterol levels than others. Among boys sexual maturation decreased the HDL‐cholesterol level. Children whose parents had histories of cardiovascular disease did not have higher cholesterol or higher blood pressure levels than other children. Children at high risk apparently cannot be screened on the basis of parents' history of cardiovascular diseases.
Cardiorespiratory Function during Exercise in Obese Children
Authors: REYBROUCK T. , WEYMANS M. , VINCKX J. , STIJNS H. , VANDERSCHUEREN‐LODEWEYCKX M.
Published: January 2008

ABSTRACT. Fifteen obese children, aged 4 to 16 years and ranging in body weight from 27.3 to 95 kg (median 67.5) and percentage overweight from 22 to 127% (median 40), underwent graded exercise testing on a treadmill and were compared with healthy peers of comparable age. Cardiorespiratory performance capacity was assessed by determination of the ventilatory threshold. This was defined as the highest oxygen uptake at which the pulmonary ventilation stops to increase linearly with increasing exercise intensity. The ventilatory threshold, expressed as ml O2/min/kg, was significantly (p<0.05) lower than in normal children and averaged 70.6±13.5% of the normal mean value, matched for age. The habitual level of physical activity, assessed by a questionnaire, was 27% lower (p<0.01) in the obese children compared to healthy controls. As the ventilatory threshold was strikingly lower and also exceeded sooner in the majority of the obese children, compared with normal controls, it may be assumed that obese children avoid moderate or strenuous exercise, because of the higher degree of effort needed. This may contribute to the maintenance of overweight.
Continuous Transepidermal Water Loss Measurement in Sleeping Infants
Authors: KAHN A. , REBUFFAT E. , BLUM D. , SOTTIAUX M. , MERCKT C. VAN DE , DRAMAIX M. , MONTAUK L.
Published: January 2008

ABSTRACT. Transepidermal water evaporation rate was measured continuously in 8 infants with the use of an evaporimeter during one night of polygraphic sleep recording. Evaporation rates were significantly lower during REM than during NREM sleep. In both sleep stages it decreased during the night with the lowest values between 02.00 and 04.00 h. Evaporation values showed cyclic changes which were studied by measuring minute‐by‐minute differences between the maximum and the minimum values (the “amplitude variability”) and the number of evaporation peaks per minute (the “peak density”). Both the “amplitude variability” and the “peak density” were smaller in REM than in NREM sleep. The “amplitude variability” decreased during the night with lowest values seen between 02.00 and 04.00 h. These changes in evaporation rates could reflect autonomic nervous system activity as well as basal metabolic activity and should be taken into account whenever such measurements are performed in sleeping infants.
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 61 children with IH born 1967–82 at less than 37 weeks of gestation. A prenatal origin was present in 17 children (28%), a pre‐ and perinatal in 17 (28 %), a perinatal in 26 (43 %) and a postnatal in one (1%). The predominant single cause was postaemorrhagic IH, which was diagnosed in 19 (31%). In addition, an undiagnosed cerebral haemorrhage was considered to be the cause in another 25%. The outcome differed between pathogenetic groups. Children with a clear onset of IH (pre‐, peri‐ or postnatal) were found to be at high risk for early death or multiple impairments. Sixteen of 39 (41%) within these groups had died before 2 years of age and 18 of the 23 (78%) survivors showed major neurological dysfunction. This contrasted to no mortality and 41% major dysfunction in children with a less clear onset of IH. A new subgroup consisting of infants born before 28 weeks of gestation emerged in the early 1980s. All infants with IH in this group developed a severe multihandicap condition.
Atrial Natriuretic Peptide and Extracellular Volume Contraction after Birth
Authors: TULASSAY T. , SERI I. , RASCHER W.
Published: January 2008

ABSTRACT. Plasma concentrations of atrial natriuretic peptide (ANP) were measured in full‐term newborns immediately after birth and on the 3rd, 5th, 7th and 10th day of life. The ANP concentrations were within the normal range in the first hours of life. Plasma concentrations of ANP had increased significantly on the 3rd and 5th day of life, while body weight decreased continuously. After the 5th day of life ANP concentration decreased continuously reaching its minimum on the 10th day whereas body weight increased. The mechanism behind ANP release shortly after birth is not known. The increase in ANP concentration in plasma may however induce changes in body fluid compartments shortly after birth which would result in physiological weight loss.
Cryptosporidiosis in Wellnourished and Malnourished Children
Authors: MACFARLANE D. E. , HORNER‐BRYCE J.
Published: January 2008

ABSTRACT. During a 5‐month period, 513 stool samples submitted to the enteric laboratory at the University Hospital of the West Indies were examined for Cryptosporidium. Oocysts were detected in 4.9% of all stools, 7.3% of diarrhoeal stools, 19.5% of stools from malnourished children and 23.7% of stools from malnourished children with diarrhoea, Cryptosporidium was the sole pathogen detected in all 25 positive stools, and was the second most frequent enteric isolate. All cases of cryptosporidiosis occurred in children less than 2.5 years of age. All 15 malnourished children were admitted to hospital where they presented with dehydration (87%), vomiting (93%), fever (100%) and diarrhoea which lasted an average of 15.3 days. Two of these children died. In contrast, dehydration (20%), vomiting (40%) and fever (50%) were less common and diarrhoea less protracted in well‐nourished children, four of whom were admitted to hospital. This preliminary report suggests that Cryptosporidial gastroenteritis presents with increased frequency and severity in malnourished compared with well‐nourished Jamaican children.
Maternal Occupation and Delivery Outcome: A Study Using Central Registry Data
Authors: ERICSON ANDERS , ERIKSSON MARGARETA , KÄLLÉN BENGT , ZETTERSTRÖM ROLF
Published: January 2008

ABSTRACT. The outcome of all deliveries in Sweden in 1981 has been studied. The occupation of each mother was obtained by record linkage using census data from November 1980. Rates of perinatal deaths or congenital malformations did not vary according to maternal occupation, more than might be expected to happen by chance, which indicated that maternal occupation is not a major factor in the outcome of these deliveries. There was variation in the rates of low birth weight infants, according to maternal occupation, which may have been an effect of socioeconomic factors associated with the occupation. Within occupational groups, working situations may exist which entail an increased teratogenic risk, but in order to reveal such risks, studies with a different design must be carried out.
Clinical and Radiological Features of Osteogenesis Imperfecta Type IVA
Authors: PATERSON C. R. , McALLION S. J. , SHAW J. W.
Published: January 2008

ABSTRACT. This paper reports a survey of 78 patients with osteogenesis imperfecta (OI) type IVA, the variant that causes the greatest difficulties in differential diagnosis. A subgroup of children aged between five and eleven were compared with a control group from local schools. Among the OI children there were, apart from the high number of fractures, also significantly increased incidences of bruising, nosebleeds, excessive sweating and hypermobility of joints. Although none of the children with OI type IV had the dark blue or grey sclerae of the type I disease, an appreciable number had pale blue sclerae in early childhood. Radiologically normal bone texture was seen at the time of the first fracture in 10 out of 17 patients. Hypertrophic callus was seen in five patients and metaphyseal fractures in four. We hope that the information on this large group of patients will assist in the prevention of diagnostic difficulties.
Prediction of Symptomatic Patent Ductus Arteriosus in Preterm Infants Using Doppler and M‐mode Echocardiography
Authors: MELLANDER M. , LARSSON L. E. , EKSTRÖM‐JODAL B. , SABEL K.‐G.
Published: January 2008

ABSTRACT. To investigate whether the development of symptomatic patent ductus arteriosus could be predicted, 26 preterm infants dependent on mechanical ventilation were examined daily with Doppler and M‐mode echocardiography until 3 days after birth. The presence or absence of a hemodynamically significant ductus shunt, as judged from echocardiographic criteria, was tested for predictive power in terms of sensitivity, specificity and total error rate. Out of the 26 infants 13 developed symptomatic patent ductus arteriosus at a median age of 5 days (range 2–8). These 13 infants developed echocardiographic evidence of a large shunt at a median age of 2 days (range 1–3). The sensitivity of prediction was 18, 46 and 100% at 1, 2 and 3 days after birth. The specificity was 80, 92 and 85% and the total error rate was 52, 32 and 8%. Thus, accurate prediction was possible 3 days after birth.
Hypothyroidism in Children with Filter Paper TSH of 30 to 50 μU/ml at Initial Screening Implication of the TSH Cut‐off Point for Recalling of Infants at Risk
Authors: LEGER J. , LEMERRER M. , BRIARD M. L. , CZERNICHOW P.
Published: January 2008

ABSTRACT. In a systematic screening of newborns in France daring the period from 1979 to 1983, 959 infants with hypothyroidism were detected. In 16 cases of confirmed hypothyroidism the initial filter paper TSH (FP‐TSH) was between 30 and 50 μU/ml. These cases emphasize the necessity of keeping a Y“security zone” for FP‐TSH value between 30 and 50 (μU/ml and of recalling these patients for a second test filter paper TSH.
Urinary C‐Peptide Excretion at Onset of Insulin Dependent Diabetes Mellitus in Children
Authors: IVARSSON S. A. , JOHANSSON E. , NILSSON K. O. , THORELL J. I.
Published: January 2008

ABSTRACT. The 24‐hour urinary excretion of C‐peptide and the plasma C‐peptide concentration were measured at the onset of insulin dependent diabetes mellitus (IDDM) in children. The excretion of C‐peptide was twice as high as that found in normal control subjects, whereas the plasma C‐peptide values were markedly lower, indicating increased urinary leakage of C‐peptide in this phase of the disease. In the diabetic children under seven years of age the mean value of C‐peptide excretion was clearly lower than in the older children.
Respiratory Water Loss in Fullterm Infants on Their First Day after Birth
Authors: RIESENFELD T. , HAMMARLUND K. , SEDIN G.
Published: January 2008

ABSTRACT. Measurements of water loss from the airways, oxygen consumption and carbon dioxide production were made in 12 fullterm, newborn infants on their first day after birth, using an open flow‐through system. The system includes a mass spectrometer, specially equipped with a water channel, for analysis of gas concentrations. To avoid condensation of water vapour, the tubing in the flow‐through system is heated. Respiratory water loss was 4.9±1.2 (SD) mg/kg min, which meant an insensible water loss from the respiratory tract of 25.4±6.9 (SD) g per infant and 24 h at rest, at an ambient temperature of 32.2°C and with an ambient humidity of 50%. Oxygen consumption was 6.0±0.8 (SD) ml/kg min. An inverse relationship was found between respiratory water loss and ambient humidity, with higher losses at a low than at a high humidity. Oxygen consumption did not change very much with ambient humidity.
Improving Prospects for Surgery in Infants of Birthweight Less than 1 200 Grams
Authors: RYAN ROWENA M. , KEOGH ANN , WHITELAW A. G. L. , ZIDEMAN D. A. , SINGH M. P.
Published: January 2008

ABSTRACT. Over a six‐year period seventeen infants of birthweight less than 1200 grams (including nine of birthweight less than 1000 grams) underwent major gastrointestinal surgery. Fourteen of the seventeen (82%) survived, a higher rate than previously reported. Nine infants had necrotising enterocolitis, three had oesophageal atresia and five had other types of intestinal obstruction. Six infants who were unfit to be transferred to the operating theatre underwent surgery on the neonatal unit: of these, four survived. We feel the outlook is optimised by conservative surgical intervention and by maximal medical support with intensive care monitoring, post‐operative mechanical ventilation and intravenous alimentation. Survival after surgery is now very much the rule in the extremely low birthweight infant, even in those who are too sick to be transferred to the operating theatre.
Circulating Autoantibodies to Thyroid Hormones: A Diagnostic Pitfall
Authors: PRYDS O. , HADBERG A. , KASTRUP K. W.
Published: January 2008

ABSTRACT. Circulating autoantibodies to thyroid hormones are occasionally detected and may cause confusion, because symptoms and signs are inconsistent with the measured thyroid hormone values. We present a 5 1/2 year old girl with Hashimoto's thyroiditis and false high concentrations of free thyroxine and total triiodothyronine.
Acute Gastroenteritis in Children Attending Day‐Care Centres with Special Reference to Rotavirus Infections
Authors: HJELT K. , PÆRREGAARD A. , NIELSEN O. H. , GRAUBALLE P. C. , GAARSLEV K. , HOLTEN‐ANDERSEN W. , TVEDE M. , ØRSKOV F. , KRASILNIKOFF P. A.
Published: January 2008

Acute gastroenteritis (GE) among 214 children (aged 6 months – 7 years) attending day‐care centres (DDCs) in the Copenhagen County was studied during a 12‐month period. A total of 197 cases of GE was observed in 109 children (i.e. 51% of the participants). The aetiology was as follows: rotavirus (n=48) (24%), pathogenic bacteria (n=11) (6%), Giardia lamblia (n=3) (2%), while the aetiology of 68% remains unknown. The pathogenic bacteria included Yersinia enterocolitica, thermophilic Campylobacter, Clostridium difficile (±toxin) and enteropathogenic E. coli. In 4% of the GE the infections were multiple and Cryptosporidium was seen in one of these cases. The rate of GE declined with age from 1.35 GE per child per year (age group 1.0– <2.0 years) to 0.36 (6.0 – <8.0 years). Serum sampled at the start of the study period showed that the frequency of detectable rotavirus IgG increased with age from 48% in the 6 months – <1.0 year group to 96% in the 4.0 – <7.0 year group. The highest rates of rotavirus GE occurred from January to April (i.e. the rotavirus season). Moreover, rotavirus GE was almost absent after the age of 4. Hence, the rates of rotavirus GE per rotavirus season per child were 0.80 (age group 6 months–<1.0 year), 0.32 (1.0–<2.0), 0.14 (2.0–<3.0), 0.16 (3.0–<4.0), 0.06 (4.0–<5.0) and 0.04 (5.0–<6.0). Only 2 out of the 48 rotavirus GE were reinfections. The 32 children with asymptomatic rotavirus infections and those with rotavirus GE showed a similar distribution of age and season. A cross‐sectional study of the prevalence of rotavirus excretion during the rotavirus season revealed only a single true asymptomatic excretor.