bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic Value of Growth Hormone‐Releasing Hormone Tests in Short Children
Authors: BUTENANDT O.
Published: January 2008

Butenandt O. (Department of Paediatric Endocrinology, Children's Hospital, University of Munich, Munich, West Germany). Diagnostic value of growth hormone‐releasing hormone tests in short children. Acta Paediatr Scand [Suppl] 349 93, 1989.

The growth hormone‐releasing hormone (GHRH) test was applied to more than 230 children. Twenty‐five out of 61 patients with proven growth hormone (GH) deficiency responded to GHRH with a GH increase of greater than 10 ng/ml. In most of the patients with idiopathic GH deficiency, a priming procedure using daily injections of GHRH improved the secretory response to GHRH. Nearly all children with familial shortness of stature showed a prompt increase in GH levels, with a mean peak level of 34.9 ng/ml (range 0.5–144 ng/ml). A second test was performed in five children with familial short stature because of failure to respond to the first test. Children with constitutional delay of growth and development did not differ in their GH response from patients with familial shortness of stature. Ten girls with Ullrich‐Turner's syndrome responded with a mean increase of 22 ng/ml GH (range 10.1–34.0 nglml). Therapy with glucocorticoids, as well as endogenous hypersecretion of cortisol, suppressed the responsiveness of the pituitary gland to GHRH. Suppression was also observed following a single dose of dexamethasone during the steroid‐suppression test in eight obese children. Low responsiveness of the pituitary gland was also seen in patients with thalassaemia and transfusion‐induced haemosiderosis. It is concluded that it is not possible to detect GH deficiency with a single GHRH test. A full endo‐crinological evaluation is necessary to prove the diagnosis.
Normal Pattern of the Cerebral Function Monitor Trace in Term and Preterm Neonates
Authors: THORNBERG E. , THIRINGER K.
Published: January 2008

ABSTRACT. Cerebral Function Monitor (CFM) recordings were performed on 10 term and 19 preterm healthy infants. Term infants were monitored once, while preterm infants were followed serially. Forty‐six recordings were made on 7, 14, 16 and 9 occasions in the age groups 30–31, 32–33, 34–35 and 36–37 weeks. All infants were examined clinically at 18 months of age and found healthy. By drawing weighted lines derived from the lower and upper limits of the CFM traces, mean values of minimum and maximum cerebral activity were calculated for the different age groups. In the term infants different CFM traces were identified corresponding to quiet sleep and active sleep. In the preterm infants a similar cyclic variability of the CFM trace was noted. A gradual increase in the minimum cerebral activity was found with increasing gestational age, resulting in a gradual narrowing of the trace.
The Physiological and Biological Significances of Human Atrial Natriuretic Peptide in Neonates
Authors: ITO Y. , MARUMO F. , ANDO K. , HAYASHI M. , YAMASHITA F.
Published: January 2008

ABSTRACT. The purpose of our study was to analyze the physiological and biological significances of the high human atrial natriuretic peptide (hANP) levels during early post‐natal period. The absolute values or changes of plasma hANP concentrations did not correlate with the absolute values or changes of body weight, blood pressure, urinary sodium/creatinine and urinary aldosterone/creatinine ratios. Gel permeation chromatography of samples from two neonates revealed the presence of two molecular forms of hANP, α and β, both in the plasma and urine. In the plasma, the β‐hANP was predominant on the 3rd day of life and the α‐hANP on the 6th day of life. The change from one form to another was independent of the absolute value of hANP. We obtained no evidence suggestive of a physiological role of the high plasma hANP concentration during the early post‐natal period. However, because of biological differences between these two fractions, their distribution must be taken into account when attempting to interpret the high hANP values observed in neonates.
Predictive Value of Short‐Term Growth Using Knemometry in a Large Population of Healthy Children
Authors: DEAN H. J. , SCHENTAG C. T. , WINTER J. S. D.
Published: January 2008

ABSTRACT. We have analyzed the lower leg growth using a knemometer and the height growth using a stadiometer of 90 healthy children aged 3‐16 years, for one year. The intra‐ and interindividual monthly lower leg growth varied up to 4‐fold, which was not accounted for by age or sex. The correlation between short term and annual lower leg growth rates increased with longer observation periods. There was no month‐to‐month consistency in the ratio of lower leg growth and height growth. There was no correlation between 1 month lower leg growth and annual height growth. The correlation increased with time. The 6‐month observation interval was the interval with the highest predictive value for annual lower leg growth (R2=0.727) and annual height growth (R2=0.732). We conclude that growth of different parts of the skeleton and variable interval growth rates limits the ability of knemometry to predict long term growth.
Oxygen Toxicity in the Neonatal Period
Authors: SAUGSTAD OLA DIDRIK
Published: January 2008

ABSTRACT. Oxygen is toxic because it produces oxygen radicals. One important oxygen radical generating system is hypoxanthine‐xanthine oxidase. Hypoxic newborn babies who have elevated concentrations of hypoxanthine in tissues and body fluids and simultaneously are treated with supplementary oxygen, may therefore produce oxygen radicals in excess overwhelming the body's natural defence systems against free radicals. Further, the capacity of many of these defence systems are probably reduced in the preterm baby. A series of conditions in neonates may, at least partly, be caused by oxygen radicals, e. g. bronchopulmonary dysplasia, retinopathy of prematurity, necro‐tising enterocolitis and patent ductus arteriosus. These conditions may be different facets of one disease; the “Oxygen radical disease in neonatology”. It is speculated that oxygen radicals play a role in regulating the perinatal circulation. This new insight concerning the role of oxygen radicals may have fundamental consequences for treatment and handling of sick newborn babies.
The Impact of Gluten on Haematological Status, Dietary Intakes of Haemopoietic Nutrients and Vitamin B12 and Folic Acid Absorption in Children with Coeliac Disease
Authors: HJELT K. , KRASILNIKOFF P. A.
Published: January 2008

ABSTRACT. The haematological status, as well as the fractional absorptions of folic acid‐and of vitamin B12 (FAFol and FAB12) were studied longitudinally in 20 coeliac children aged 1.2‐16.6 yr (mean 7.5 yr) during periods of gluten‐free and gluten containing diets. The absorption methods were specially adapted to use in children, and age‐related reference limits were established. Also, dietary intakes of iron, folate and B12 were registered. The haemoglobin concentrations did not show any significant differences in relation to shifts in diet. A few had mild anaemia while the haemoglobin concentrations in the other patients remained within normal range. The iron status, as judged from mean corpuscular volume (MCV), serum (S)‐iron, S‐transferrin and saturation %, appeared to be generally insufficient. However, the only significant change related to shifts in diet was an increase of S‐iron during the first period of gluten‐free diet. Dietary intakes of iron proved to be insufficient, regardless of the type of diet. Plasma (P)‐B12 concentrations demonstrated a wide range of values above the lower normal limit, whereas the level in a single patient was within the “intermediate range” of B12 insufficiency (150‐200 pmol/l). The folate status (erythrocyte‐folate) showed significant variations related to dietary changes. However, few patients were folate depleted. FAFol and FAB12 demonstrated rapidly occurring, and significant decreases and increases in relation to gluten challenge and gluten‐free diet, respectively. Bacterial overgrowth of the small intestinal tract was not found to be a plausible cause of the B12 malabsorption in the case of 5 patients observed. In conclusion, it is recommended that the dietary management of coeliac patients with regard to haemopoietic nutrients focus on an appropriate iron intake. While a few patients failing to keep a strict gluten‐free diet risk folate depletion due to malabsorption and to inadequate intake, these patients are, on the other hand, unlikely to develop vitamin B12 deficiency.
Serum Carnitine Level in Phenylketonuric Children under Dietary Control in Greece
Authors: SCHULPIS K. H. , NOUNOPOULOS C. , SCARPALEZOU A. , BOULOUKOS A. , MISSIOU‐TSAGARAKIS S.
Published: January 2008

ABSTRACT. Although total, free and esterified carnitine blood levels were found to be low (p < 0.001) in phenylketonuric patients under dietary treatment compared to controls, no clinical signs of carnitine deficiency were noticed. Exclusion from the PKU diet of nutrients rich in carnitine has been suggested. Supplementation of the diets with carnitine or preferably enrichment of the PKU formulas with carnitine will rectify the restriction of extrinsic carnitine in PKU dietary treatment.
Use of a Test Diet in Screening for Neuroblastoma Reduces False‐Positives Attributable to Food Intake
Authors: SAITO T. , NIKKAWA T. , USUGANE T. , OKAMOTO T. , KOMIYA H.
Published: January 2008

ABSTRACT. We attempted to reduce false‐positives during screening for neuroblastoma using a qualitative urine test by introducing a test diet without foodstuffs known to cause false‐positive results. In preliminary in‐vivo experiments, intake of contra‐indicated foods such as orange juice or banana was shown to result in high percentages of false‐positive results several hours after food intake. False‐positive results were obtained even after 24 hours among breast‐fed infants whose mothers received orange juice. In a controlled field trial the false‐positive rate was reduced to 2.84% among 540 infants taking the test diet compared with 5.05% among 9844 control infants following conventional guidance on contra‐indicated foods (p < 0.05). For comparison, a questionnaire survey of nationwide screening in Japan in 1987 revealed that 66% of the screening centres employed qualitative urine tests, either a Spot or Dip method. False‐positive rates, including those due to inappropriate urine collection, ranged from 0.4 % to 33.7% (mean 7.1%). Rates ranged from 0.2% to 18.7% (mean 3.4%) in the remaining 34% of screening centres employing a quantitative method with high performance liquid chromatography.
Incidence and Etiology of Neonatal Septicaemia and Meningitis in Western Sweden 1975‐1986
Authors: TESSIN I. , TROLLFORS B. , THIRINGER K.
Published: January 2008

ABSTRACT. In a retrospective study of neonatal septicaemia and meningitis in a defined region of western Sweden 1975‐1986, 231 cases were identified. The incidence was 2.8/1000 live births. The case‐fatality rate was 15%. Thirty‐three patients had meningitis. Only 55 patients (24 %) had no known risk factors. Preterm delivery was a most important risk factor for both morbidity and mortality. The most common causative organisms were group B streptococci, Staphylococcus aureus and aerobic Gramnegative rods, together isolated from 82 % of the patients. The cases were approximately equally divided between very early, early and late onset infections. Group B streptococci were over‐represented in very early onset infections in all birthweight groups and aerobic Gram‐negative rods were the most common isolates from low birthweight infants with late onset infections. However, group B streptococci, Staphylococcus aureus and Gram‐negative rods were found in all birthweight and gestational age groups. Thus, initial antimicrobial therapy must be equally broad in all neonates with suspected septicaemia.
Delayed‐Onset Dyskinetic' Cerebral Palsy'–a Late Effect of Perinatal Asphyxia?
Authors: ARVIDSSON J. , HAGBERG B.
Published: January 2008

ABSTRACT. A 12‐year‐old girl, born full term after severe pre‐ and peripartal asphyxia, with transient abnormal newborn neurology and slight motor developmental deviations but no cerebral palsy syndrome, is described. At the age of 5, she developed a slowly progressive dyskinetic hemisyndrome, initially uncoordinated hyperkinetic movements in her left arm, dystonic posturing then supervened. Since the age of 11, her right side had also slowly become involved. As extensive examinations excluded other causes, it is concluded that this case represents a delayed onset dyskinetic ‘CP‐syndrome’ subsequent to a postanoxic non‐progressive insult to the basal ganglia, but with a wellcompensated functional integrity before the age of 5.
Somatosensory Evoked Potentials in Neonatal Jaundice
Authors: BONGERS‐SCHOKKING J. J. , COLON E. J. , HOOGLAND R. A. , BRANDE J. L. V. VAN DEN , GROOT C. J. DE
Published: January 2008

ABSTRACT. Somatosensory evoked potentials (SEPs) were studied in jaundiced and normal neonates on the day the highest bilirubin values were reached, 2‐3 days later, and at five weeks. During the first week three groups were formed according to peak bilirubin values: A: 250 μmol/I (n=20), B: 125‐250 μmol/I (n=6), C: <125 μmol/I or no jaundice (n=19). At five weeks 10 infants of group A were reinvestigated, together with 17 controls. Cervical (N13) and scalp SEPs (N19) were recorded with a variable number of stimuli. The SEPs of group B and C did not differ from each other. In group A the N13 peak latencies were within the range of group C at the first investigation, but prolonged at the second and third. The cortical components were prolonged at the first investigation, improved but still prolonged at the second, while the N19 peak latency was still prolonged at the third investigation. The central conduction time (CCT) correlated positively with the bilirubin level. Since a rapid decrease in the N19 amplitude was found for all groups from 25 to 100 stimuli, recordings should be done with a low number of stimuli (less than 100). Our findings indicate that both the periferal and the central components of the SEPs in the neonatal period are delayed by jaundice and that full recovery is not obtained at five weeks. The non‐invasive SEP technique can be used as a daily monitor of the effect of bilirubin on the CNS.
Aetiology of lcteric Hepatitis and Fulminant Hepatic Failure in Children and the Possible Predisposition to Hepatic Failure by Sickle Cell Disease
Authors: YOHANNAN M. D. , ARIF M. , RAMIA S.
Published: January 2008

ABSTRACT. The aetiological agents of acute icteric hepatitis and fulminant hepatic failure were investigated in 47 children less than 12 years of age presenting at our hospital during the period January to December 1987. Hepatitis A virus was the aetiological agent in 72 %, hepatitis B virus in 11 %, cytomegalovirus in 2 % and non A non B in 15 %. These results confirm the endemicity of these viruses in the Saudi population and that they can be contracted in early life and could lead to severe hepatitis. Three of the patients who had hepatitis A virus infection developed fulminant hepatic failure and two of them died. Two of the patients who developed fulminant hepatic failure were also suffering from sickle cell disease. This raises the question of a possible predisposition to hepatic failure in sickle cell disease upon infection with hepatitis A virus.
Incidence of Clostridium difficile in Hospitalized Children A Prospective Study
Authors: TVEDE M. , SCHIØTZ P. O. , KRASILNIKOFF P. A.
Published: January 2008

Abstract. A total of 394 children, aged 0‐14 years, referred to a paediatric department were investigated for the occurrence of Clostridium difficile, its cytotoxin in faeces, and its clinical significance in a prospective study over one year. Of the children in the investigation, 337 suffered from gastrointestinal diseases or had been treated with antibiotics prior to the investigation. Twenty‐four percent of these children had Cl. difficile in one or more faecal samples and toxin was demonstrated in half of these patients. In 18/148 (12%) of the patients with acute gastroenteritis Cl. difficile was isolated as the only pathogen. In contrast, among 57 control children with no gastrointestinal symptoms and no prior antibiotic treatment significantly fewer harboured Cl. difficile (p<0.01). Cl. difficile was isolated with similar frequency in children with or without prior antibiotic treatment. Isolation of Cl. difficile was significantly higher in patients under one year of age p<0.001). In 78% of the patients with Cl. difficile the bacteria were found in faeces during the initial two days of hospitalization indicating that most of the cases were community acquired. The occurrence of Cl. difficile was not influenced by seasonal variation and the distribution between sexes was equal.
Comparison of Different Regimens of Prednisone Therapy in Frequently Relapsing Nephrotic Syndrome
Authors: WINGEN ANNE‐MARGRET , MÜLLER‐WIEFEL DIRK E. , SCHÄRER KARL
Published: January 2008

Abstract. The long‐term results of four different regimens of prednisone therapy were compared in 32 children with steroid sensitive, frequently relapsing idiopathic nephrotic syndrome with minimal glomerular lesions on renal biopsy. Prednisone was adminstered according to the following dosage schedules: 1) long‐term daily, 2) standard intermittent, 3) standard alternate‐day, and 4) short‐term daily. Over a mean observation period of 7 years patients without steroid dependency received a cumulative dosage of prednisone of 10 mg/m2/day and those with steroid dependency received 19 mg/m2/day. Relapse free intervals were the longest with long‐term daily prednisone therapy compared to the other three regimens. In frequently relapsing patients without steroid dependency the relapse free intervals were similar with either intermittent or alternate‐day prednisone therapy (median 75 d); however, they were significantly shorter with short‐term prednisone therapy (median 33 d). In frequently relapsing patients with steroid dependency the time of remission was generally shorter than in patients without steroid dependency (median 25d vs. 69d) with no benefit of any of the different forms of short‐term treatment.
Relation of Serum and Erythrocyte Magnesium Levels to Blood Pressure and a Family History of Hypertension A Follow‐up Study in Japanese Children, 12‐14 Years Old
Authors: SHIBUTANI Y. , SAKAMOTO K. , KATSUNO S. , YOSHIMOTO S. , MATSUURA T.
Published: January 2008

Abstract. Serum and erythrocyte magnesium concentrations (S‐Mg, E‐Mg) were measured in 122 junior high school students followed up for two years from 12 to 14 years of age, and the relationship to blood pressure and a family history of hypertension were investigated. The subjects who had high S‐Mg and E‐Mg levels at the first examination two years prior tended to show high levels after this follow‐up. There were significant positive correlations between two intraindividual values of S‐Mg and E‐Mg. A similar tendency was found for blood pressure. Tracking phenomena were observed with these measures. The subjects who had high E‐Mg levels at the first examination showed no blood pressure elevation during the two‐ year period. The subjects with a family history of hypertension [FH(+)] showed a higher degree of blood pressure rise during two years than those with no family history [FH(‐)], with a significant difference in systolic blood pressure at the age of 14. E‐Mg tended to be lower in the FH(+) group than in the FH(‐) group with a significant difference in 14‐year‐old girls. These results suggest that a hereditary predisposition to hypertension is related to magnesium metabolism and that intracellular magnesium deficiency may influence blood pressure elevation in the FH(+) children.
Learning Disabilities in Children: Significance of Low‐Level Lead‐Exposure and Confounding Factors
Authors: LYNGBYE TROELS , HANSEN OLE NOERBY , TRILLINGSGAARD ANEGEN , BEESE INGE , GRANDJEAN PHILIPPE
Published: January 2008

Abstract. The hypothesis that low‐level lead absorption is a risk factor for learning disabilities in school children was examined in the municipality of Aarhus, Denmark. During 1982‐1983, a total of 1302 children in the first grade (54 % of the eligible population) delivered shed deciduous teeth. The lead concentration in the circumpulpal dentin was used as an indicator of the cumulated lead absorption, and 200 cases (high‐lead) and controls (low‐lead) were selected, and matched for socioeconomic group and gender. The parents were interviewed regarding the child's development and past medical history. Possible confounders were identified and controlled for in a logistic multivariate model. The influence of lead absorption became statistically signincant only after exclusion of the children with proven medical risk factors, thereby the adjusted odds ratio in the weighted analysis was changed from 2.2 to 4.3. Thus, in a Scandinavian low‐level lead‐polluted area, lead absorption appears to be a risk factor for learning disabilities.
Acylcarnitine is Low in Cord Blood in Cystic Fibrosis
Authors: LLOYD‐STILL J. D. , BOHAN T. , HUGHES S. , WESSEL H. U.
Published: January 2008

ABSTRACT. Carnitine metabolites (total, free, short and long chain) were analyzed in cord blood of cystic fibrosis (n=5), non‐CF siblings (n=7), and controls (n=8). Total acylcarnitine (short and long chain combined) was significantly lower (<0.001) in CF compared to both control groups. Total and free carnitine showed no significant differences between the three groups. These findings are compatible with disturbed fatty acid metabolism in utero and may be related to the increased energy expenditure characteristic of CF infants.
Respiratory Infections and Vascular Rings
Authors: VAN AALDEREN W. M. C. , HOEKSTRA M. O. , HESS J. , GERRITSEN J. , KNOL K.
Published: January 2008

ABSTRACT. Recurrent respiratory infections after the first years of life are not easily related to vascular rings as the cause of these infections. Therefore six cases of older children are presented in whom a vascular ring was the cause of their respiratory problems. None of them ever had stridor or swallowing problems in early infancy, and recurrent respiratory infections occurred later in life as a symptom of a vascular ring. Unfamil iarity with this association caused a delay in diagnosis and treatment in two patients and persistent lung damage in one child. Five of the 6 children recovered well after operation. The diagnosis can be made at an early stage if close inspection of the outline of the trachea on the chest radiograph shows an impression from the right side.
Breast‐Milk Calcium Concentrations during Prolonged Lactation in British and Rural Gambian Mothers
Authors: LASKEY M. A. , PRENTICE A. , SHAW J. , ZACHOU T. , CEESAY S. M. , VASQUEZ‐VELASQUEZ L. , FRASER D. R.
Published: January 2008

ABSTRACT. Detailed investigations of breast‐milk calcium concentrations during 2 years of lactation have been conducted in Cambridge, UK, and rural Gambia. Mature milk concentrations remained steady for 3 months but declined during months 4‐12 by over 25% (p< 0.001). The pattern was identical in both communities despite differences in breast‐feeding practices. Calcium concentrations were not related to feed frequency or breast‐milk sodium concentrations, suggesting that breast involution is not responsible for the decrease after 3 months. Breast‐milk calcium concentrations were characteristic of the individual, varied twofold between mothers and were independent of maternal age, parity and milk output. Gambian breast‐milk contained 19% less calcium than Cambridge milk, throughout lactation (p< 0.001). The extent to which this reflected the lower calcium intakes of Gambian mothers is unknown. Further studies are required to determine factors regulating breast‐milk calcium secretion.
Changes in Plasma Concentrations of Atrial Natriuretic Peptide during Exchange Transfusion in Premature Infants
Authors: KHOÓR A. , TULASSAY T. , BALD M. , RASCHER W.
Published: January 2008

ABSTRACT. Plasma concentrations of atrial natriuretic peptide (ANP) and hemodynamic parameters were investigated in five premature infants undergoing exchange transfusion. Baseline values of ANP were 51.7 ± 21.2 fmol/ml. Volume depletion by withdrawal of 10 ml blood did not cause changes in systolic blood pressure (79.4 ± 4.3 vs. 71.4 ± 5.6 mmHg) and heart rate (115 ± 5.2 vs. 115 ± 2.4 b/min). ANP levels in plasma remained unaltered (53.4 ± 24.9 fmol/ml). Replacement of 10 ml blood increased central venous pressure by 33% and ANP concentration in the plasma by nearly 30%, while heart rate and blood pressure remained unchanged. Our data indicate that the heart of the premature infant responded to acute blood replacement with increased ANP‐release, while blood removal appeared not to influence hormone regulation.
Disseminated Adenovirus (Type 19) Infection in a Neonate Rapid Detection of the Infection by Immunofluorescence
Authors: MATSUOKA T. , NAITO T. , KUBOTA Y. , MORITA Y. , TAKEI J. , AKIYAMA K. , HATA J. , HASEGAWA A. , SATA T. , KURATA T.
Published: January 2008

ABSTRACT. A case of fatal disseminated adenovirus infection in a neonate who suffered from severe keratoconjunctivitis and pneumonitis is reported. The diagnosis was made seven days after the onset of illness based on the detection of adenovirus antigen in the smears of the tracheal suction and conjunctival swab by immunofluorescence. Viral antigen was detected in the frozen or formalin‐fixed autopsy specimens of the lungs, kidneys, spleen, liver and lymph nodes. Typical crystal arrangement of adenovirus virions was observed in the alveolar epithelial cells by electron microscopy. The isolated virus was identified to be of type 19 by a neutralization test. The IF examination using adenovirus group specific immune reagents on the smears of clinical specimens appears to be useful for rapid diagnosis of viral infections.
Immunoglobulin G Subclasses and Lymphocyte Subpopulations and Function in Osteomyelitis and Septic Arthritis
Authors: BEARD LORRAINE J. , FERRIS LINDA , FERRANTE A.
Published: January 2008

ABSTRACT. We investigated serum IgA, IgG, IgM and IgG subclass concentrations, complement activity, lymphocyte subpopulations, Iymphocyte responses to mitogens and natural killer cell cytotoxicity in 15 children who had had osteomyelitis and septic arthritis and in a group of control subjects. IgG subclass concentrations below the fifth percentile for age occurred in 4 patients. We found isolated deficiencies of IgGI and IgC3 and combined deficiencies of IgG2/IgG3/IgC4 and IgG2/IgG4. Concentrations of IgA and of IgG tended to be below the mean for age. The percentage of Leu‐11 + cells was reduced in patients. Other immunological parameters studied were normal. These findings suggest that although most patients who have had osteomyelitis and septic arthritis do not have low immunoglobulin concentrations, impaired antibody production may be a predisposing factor in at least a few such children.
Psychological Aspects in Children and Adolescents with Hypopituitarism
Authors: FRISCH H. , HÄUSLER G. , LINDENBAUER S. , SINGER S.
Published: January 2008

ABSTRACT. Psychological studies in children with stanted growth have partly shown inconsistent results due to heterogeneity of samples and the use of non‐standardized test procedures. We have examined patients with proven hypopituitarism using a selection of standardized and age‐related psychological tests. Forty‐eight patients, 32 male, 16 female, age 6 to 26 years with isolated growth hormone deficiency (n = 22) and multiple pituitary deficiencies (n = 26) were investigated. The patients had had hormonal substitution therapy for 0.1‐16.8 years. Test procedures included evaluation of intelligence and various personality parameters. Full score IQ was in the average range. Despite these findings a high percentage of patients had delayed schooling or had to repeat a class. They were normal regarding emotional balance and frustration tolerance and did not show any tendency towards depression or psychosomatic disorders. Social behavior was characterized by an infantile attitude toward their personal environment. The patients showed a tendency to avoid aggressiveness in frustrating situations. In contrast to the results of these tests, a non‐standarized interview demonstrated that the majority of patients had serious problems because of their short stature, including difficulties in finding social contacts. Continuous medical and psychological guidance is therefore recommended.
Atopy and Coeliac Disease: Bias or True Relation?
Authors: GRECO L. , SETA L. DE , D'ADAMO G. , BALDASSARRE C. , MAYER M. , SIANI P. , LOJODICE D.
Published: January 2008

ABSTRACT. Several reports have suggested a relationship between atopy and coeliac disease and atopy has also been linked to the pathogenesis of the mucosal damage. Conclusive epidemiological evidence of the relationship has not been satisfactorily established. The case‐control study reported here was undertaken to test the hypothesis that coeliac disease is linked to atopy. Eighty‐two coeliac disease cases and a group of 180 age matched controls and all their first degree relatives were investigated for atopy. Siblings of cases reported an increased prevalence of food intolerance, compared to siblings of controls. No increase in asthma, eczema, rhinitis, conjunctivitis, cow's milk protein allergy (CMPA) were detected in relatives of cases, compared to those of controls. When each index case and each control were investigated no increased prevalence of atopic conditions was found. Skin prick testing to major allergens was positive in a similar proportion of cases and controls. Serum total IgE of a random sample of cases and controls showed no difference in mean values. This study supports the null hypothesis: there is no difference in the prevalence of atopy in cases affected by coeliac disease and their relatives, compared to controls and their relatives. The sources of possible bias in previous reports are discussed.
Immediate Effects on Lung Function of Instilled Human Surfactant in Mechanically Ventilated Newborn Infants with IRDS
Authors: EDBERG K. E. , EKSTRÖM‐JODAL B. , HALLMAN M. , HJALMARSON O. , SANDBERG K. , SILBERBERG A.
Published: January 2008

ABSTRACT. We have studied the effects on lung volume, respiratory mechanics and ventilation during the first hours after instillation of 60 mg/kg of human surfactant into the trachea of 4 very preterm, newborn infants with severe IRDS under mechanical ventilation. Measurements were made with a “face‐out” body plethysmograph and a modified nitrogen wash‐out method. In addition to a transient decrease in total and alveolar ventilation immediately after the instillation we found an immediate rise in lung volume, but respiratory compliance decreased. These changes lasted less than two hours. Oxygen requirements fell in 3 out of 4 infants. The changes in lung volume and compliance are explained in terms of changes in the shape of the static recoil pressure characteristics of the diseased lungs after treatment. Mechanisms behind the short duration are sought in mode of instillation, dosage, age at treatment, and severity of disease.
Neurosecretory Dysfunction of Growth Hormone Secretion in Thalassemia Major
Authors: SHEHADEH NAIM , HAZANI ANNA , RUDOLF MARY C. J. , PELEG ISRAELA , BENDERLY ABRAHAM , HOCHBERG ZEEV
Published: January 2008

ABSTRACT. The growth retardation of children with thalassemia major is multifactorial. Along the endocrine axis of growth hormone (GH), serum somatomedin has been shown to be deficient and GH response to GH‐relasing hormone impaired, while GH response to provocative stimuli is normal. We studied the spontaneous secretion of GH in seven patients with thalassemia major and growth retardation. Three of the patients were hypothyroid, and the other four were euthyroid. Spontaneous secretion of GH in all seven patients was subnormal: the number of pulses, the mean pulse amplitude, and the integrated concentration of GH were all lower than in 14 age‐ and sex‐matched (10 pubertal and 4 prepubertal) control subjects. GH response to provocative stimuli was normal in the euthyroid patients. This pattern of response corresponds with the definition of neurosecretory dysfunction of GH secretion. It is concluded that the growth retardation of patients with thalassemia major is partly due to neurosecretory dysfunction of GH secretion.
Use of Medical Care and Antibiotics among Preschool Children in Different Day Care Settings
Authors: RASMUSSEN F. , SUNDELIN C.
Published: January 2008

ABSTRACT. The use of medical care among 880 1‐5 year olds in different day care settings was studied using register information on physician visits, purchases of antibiotics and municipal day care in 1984. The unit of analysis was months in the different day care settings and not children. The rates of physician visits were 1.4 to 1.8 times higher for acute upper respiratory tract infections and all acute infections and 2 to 3 times higher for secretory otitis media during day care centre months and family day care months as compared to home care months. The rate of visits for bronchial asthma was 5 times higher during day care centre months than during home care months. No differences were found between day care centre months and family day care months with respect to the rates of physician visits for acute upper respiratory tract infections, acute otitis media and all acute infections. Among children in family day care, the daily number of hours in day care, and size, average age and age homogeneity of the groups were not significantly associated with rates of visits for all acute infections or purchases of antibiotics.
Effects of Short‐Term Growth Hormone Therapy in Short Children without Growth Hormone Deficiency
Authors: TAKANO K. , HIZUKA N. , ASAKAWA K. , SUKEGAWA I. , HORIKAWA R. , SHIZUME K.
Published: January 2008

ABSTRACT. Evaluation of 24‐hour endogenous growth hormone (GH) secretion was carried out in 62 children, aged 7‐16 years, who did not have classic GH deficiency (GHD). The mean 24‐hour GH concentration, determined at 20‐minute intervals over 24 hours, was variable, ranging from 1.28 to 11.39 μg/l with a mean of 4.95 ± 2.55 μl (± SD). There was a positive correlation between mean 24‐hour GH concentration and plasma insulin‐like growth factor I (IGF‐I) values (r= 0.54; p < 0.01). Recombinant human GH, 0.1 IU/kg/day was administered to 30 of the 62 children for 6 months followed by 6 months’observation without treatment. Thereafter, GH was administered at the same dose for a further 6 months to 16 children. The mean height velocities before, during, and after the first treatment period were 4.3 ± 0.9, 7.3 ± 1.9 and 4.9 ± 2.0 cm/year (mean ± SD), respectively. The height velocity during treatment was greater than pre‐ and post‐treatment values (p < 0.001). The height velocity Increased again during the second treatment period to a mean of 8.5 ± 2.0 cm/year (p < 0.001). Nine other children were treated continuously in a similar manner for 1 year and their height velocity increased significantly from 4.1 ± 1.4 to 6.0 ± 1.9 cm/year (p < 0.001). According to our criteria, 29 of the 39 children (74.4%) who were treated for 6‐12 months showed a GH‐dependent height increase during therapy. There were no differences between the children who responded to GH treatment and those who did not in terms of Chronological age, bone age, plasma IGF‐I level, maximal GH level to insulin‐induced hypoglycaemia, or mean 24‐hour plasma GH concentration. These data indicate that some short children without GHD respond to GH treatment with an increased height velocity. Further investigations are required to determine the effect of GH on final height.
Response to Growth Hormone in Children with Idiopathic Short Stature
Authors: GROUP A
Published: January 2008

ABSTRACT. A multicentre randomized trial of human growth hormone (GH) treatment was carried out in 121 children with short stature who did not meet the classic criteria for GH deficiency. In the first year of the trial, half of the children received treatment with recombinant somatropin 0.1 mg/kg (0.27 IU/kg) three times weekly and showed a significant increase in mean growth velocity from a pretreatment value of 4.6 ± 1.1 to 7.5 ± 1.2 cm/year (mean ± SD). The growth velocity of the untreated children did not change significantly. The growth velocity of the control group (including 10 pubertal children) increased from 4.2 ± 1.3 to 5.0 ± 1.4 cm/year. In the second year, half of the control group received treatment with somatropin, 0.1 mg/kg (0.27 IU/kg) three times weekly. while the remainder received the same weekly dose on a once‐daily basis. The mean growth velocity increased in both cases to 8.2 ± 1.4 and 9.0 ± 1.6 cm/year, respectively. The group treated during the first year was also divided into two groups in the second year. One group continued with the original treatment regimen, resulting in a mean growth velocity of 6.8 ± 1.8 cm/year. The other group changed to once‐daily treatment at the same weekly dose and the mean growth velocity for this group in the second year was 7.8 ± 1.4 cm/year. The gain in height age in both of these groups exceeded the bone age in both the first and second years of treatment, suggesting a gain in predicted adult height. The major indicators of an improved growth velocity in the second year of treatment were, in declining order, first treatment year growth velocity, Tanner stage, daily dosage regimen, and pretreatment insulin‐like growth factor I levels. The results show that improved growth rates and predicted adult stature are observed in children with idiopathic short stature after treatment with GH. Daily treatment was found to be superior to the same overall dose given three times weekly.
Separation and Identification of Growth Hormone Variants with High Performance Liquid Chromatography Techniques
Authors: GELLERFORS P. , PAVLU B. , AXELSSON K. , NYHLÉN C. , JOHANSSON S.
Published: January 2008

ABSTRACT. Liquid chromatography techniques were used to separate and identify human growth hormone (hGH) variants. N‐terminal modified forms, such as des‐Phe (2‐191) and methionyl‐hGH (met‐1‐191), were separated from recombinant human growth hormone (rhGH (1‐191)) by hydrophobic interaction chromatography (HIC). A proteolytically cleaved (‘clip’) form of rhGH which has a break in the polypeptide chain between Thr(142) and Tyr(143), also proved to be separable from rhGH by HIC. In addition, a mutated form of rhGH with only two amino acid substitutions, Glu(65) to Val(65) and Glu(66) to Lys(66), on a random coil domain of the molecule, was separated from rhGH by HIC, indicating that these substitutions altered the hydrophobicity of the molecule. Treatment of rhGH with hydrogen peroxide led to sulphoxide formation in two methionine residues Met(14) and Met(125); it was not possible to oxidize Met(170). The oxidized forms of rhGH were readily separated from rhGH(1‐191) by reversed‐phase chromatography. Analyses of rhGH batches showed very low levels (< 0.3%) of oxidized rhGH, indicating that rhGH is highly resistant to oxidative reactions. Deamidations were induced in rhGH by heat treatment. The primary deamidation site was found to be Asn(149). Monodesamido rhGH and didesamido rhGH were efficiently separated from rhGH(1‐191) by anion‐exchange chromatography.
The Utility of Infancy Weight Curves for the Prediction of Linear Growth Retardation in Preschool Children
Authors: SIMONDON K. B. , SIMONDON F. , CORNU A. , DELPEUCH F.
Published: January 2008

ABSTRACT. Routine weight measurements, recorded on health cards of 95 Congolese infants, were collected during a cross‐sectional survey as the children were aged 1 to 5 years. The subjects were divided into two groups according to height‐for‐age (more or less than – 2 SD of NCHS reference) at the time of the survey. Adjustment of a mathematical function to the infancy weight curves allowed comparison of groups using the means of the function's parameters: The stunted children had been significantly lighter than the healthy group during infancy. Predictive values of estimated weights and quarterly weight gains were assessed by discriminant analysis and cut‐off points were computed. The weight gain between 3 and 6 months of age predicted stunting just as well as weight at age 1 year did. Sensitivity and specificity were at 77 % and 74 %, respectively. These results suggest that good prediction of stunting is possible from first‐year weight measurements.
Physiological Effects of Mental Stress and Orthostasis in Young Insulin‐Dependent Diabetic Patients
Authors: JOHANSSON B.‐L. , FREYSCHUSS U.
Published: January 2008

ABSTRACT. The effects of procedures which stimulate sympathetic activity, viz. mental stress induced by a colour‐word conflict test (CWT) for 20 min, and orthostasis (ORT) for 8 min were studied in 8 young (16‐20 yr) insulin‐dependent diabetes mellitus (IDDM) patients and 9 age and sex‐matched healthy controls. The IDDM patients showed no signs of neuropathy or retinopathy and their mean HbA1c value was 8.4 ±0.6% (normal value < 5.0 %). Blood pressure and heart rate increased significantly during CWT and ORT in both groups. The changes in systolic blood pressure and heart rate were comparable in both groups during CWT; the IDDM group showed a higher (p < 0.05) heart rate after 8 min of orthostasis, however. CWT and ORT elicited equivalent increases in noradrenaline in venous plasma in both groups (p < 0.05), but the IDDM patients had 50% lower values (p < 0.01) at rest, during CWT and at rest after CWT than controls. CWT and ORT evoked equivalent plasma adrenaline increases in both groups. The lipolysis marker, plasma glycerol, was about 40 % lower (p < 0.05) in the IDDM group before and after CWT. Yet, mental stress evoked equivalent increases in glycerol levels (p < 0.01) in both groups. These findings indicate that sympathetic activity in the young diabetic patients without signs of neuropathy may be blunted.
The Diagnosis of Syndromes by Use of a Dysmorphology Database
Authors: STRØMME P.
Published: January 2008

ABSTRACT. A dysmorphology data base can be useful for the clinician in the task of diagnosing multiple malformation syndromes in children. In this article the database POSSUM is described. Four patients with multiple anomalies referred for diagnostic syndrome evaluation are presented. They serve as examples on how POSSUM efficiently can be applied to obtain a short list of appropriate alternative syndromes, subsequently followed by a discussion on the differential diagnosis in each case. A specific, rare syndrome was diagnosed with the aid of POSSUM in all four cases. POSSUM appears to be useful for the diagnosis of dysmorphic syndromes.
Basal Energy Expenditure in Obese and Normal Weight Schoolchildren
Authors: MAFFEIS C. , MICCIOLO R. , ZOCCANTE L. , ZAFFANELLO M. , PINELLI L.
Published: January 2008

ABSTRACT. The present study was performed using indirect calorimetry to test the hypothesis of a reduction of the basal energy expenditure in obese prepubertal children. The obese and control children studied were comparable regarding age, height and fat‐free mass (FFM). Total weight and body fat percentage were significantly greater in the obese children. Plasma insulin and glucagon concentrations were significantly higher in obese than in control children. In the two groups of children the basal metabolic rates (BMRs) were comparable in both absolute values and values adjusted for FFM, age and gender utilizing the multiple regression analysis. The most important variable to predict BMR was FFM, followed by age. BMR was significantly correlated with FFM, both for obese and control children, and also when the two groups were combined. In conclusion, our data do not support the idea that a child's obesity is maintained by increased metabolic efficiency at least in basal conditions.
Intrauterine Intussusception and Ileal Atresia Presenting as Acute Perforation
Authors: KELLY S. B. , SINGH M. P.
Published: January 2008

ABSTRACT. A case is reported of a girl born by caesarean section at 28 weeks gestation who developed an acute perforation of the ileum due to intussusception 11 days after birth. This was treated successfully by resection of the affected segment of ileum and by performing a temporary ileostomy followed by end‐to‐end anastomosis. She made a complete recovery. This case also demonstrates the difficulty of early diagnosis of intussusception in the neonatal period.
Acute C‐Peptide, Insulin and Branched Chain Amino Acid Response to Feeding in Formula and Breast Fed Infants
Authors: WALLENSTEEN M. , LINDBLAD B. S. , ZETTERSTRÖM R. , PERSSON B.
Published: January 2008

ABSTRACT. The response of C‐peptide in serum and urine and of glucose and branched chain amino acids in blood to formula and breast feeding was assessed in six breast‐fed and six formula‐fed infants 3–6 months of age. We analysed serum C‐peptide, branched chain amino acids (BCAA) in blood, and blood glucose in the fasting state at 90′ and 180′ after regular meal. The excretion of urinary C‐peptide and creatinine was also determined. The formula‐fed infants received formula in current use, containing 15–16 g protein/l and with casein/whey ratio of 40/60. In the fasting state, no significant inter‐group difference was found in the level of serum C‐peptide or the valine/glycine ratio. Postprandially, the formula‐fed infants had significantly higher serum C‐peptide values and valine/glycine ratio than the breast‐fed infants, p≤0.05. No significant inter‐group difference was found for blood glucose. The urinary C‐pep‐tide/creatinine ratio was significantly lower in the breast‐fed group, p=0.02, and significantly correlated both to the valine/glycine ratio at 90′, rs=0.75, p=0.02 and to the serum C‐peptide value at 90′, rs=0.66, p=0.03. These results confirm that in formula‐fed infants the insulin response to meal is enhanced compared to that in breast‐fed infants. The finding of similar blood glucose values in the two groups may also indicate an insulin resistance in the formula‐fed infants following meal.
Iron Availability from an Infant Formula Supplemented with Bovine Lactoferrin
Authors: SCHULZ‐LELL G. , DÖRNER K. , OLDIGS H.‐D. , SIEVERS E. , SCHAUB J.
Published: January 2008

ABSTRACT. Iron balance studies were performed in 16 term infants from their 3rd until their 17th week of life. The balance studies were performed at home and comprised five periods with an interval of 3 to 4 weeks, each consisting of three 24‐hour collections of milk and stool samples. Seven infants were fed an adapted infant formula supplemented with bovine lactoferrin (100 mg/100 ml) and nine received the same formula without lactoferrin. The lactoferrin supplemented group received 169 μg iron/kg b.w. × day and retained 63 μg/kg b.w. × day. The mean iron intake of infants fed with the adapted formula without supplementation of lactoferrin was 118 μg/kg b.w. × day. The retention of iron was 43 μg/kg b.w. × day. Mean percentage retention of iron in the supplemented group was 36%, in the non‐supplemented group 28%.
The Role of Commercial Latex Agglutination Test in the Diagnosis of Group B Streptococcal Infection in Neonates
Authors: THORE M. , FAXELIUS G. , HEDIN G. , JOHNSSON H. , RINGERTZ S. , SCHRÖDER S. , SCHWAN A. , THID S. , ÖHRNER Y.
Published: January 2008

ABSTRACT. An open prospective multicenter study was conducted in order to evaluate the Wellcogen Strep B latex agglutination test in the diagnosis of group B streptococcal (GBS) infections in neonates. Twenty‐three (5.9%) of 391 urine specimens and 5 (1.2%) of 404 sera assayed were positive. The results of the urine tests corresponded to sensitivity of 0.78 for bacteremic, 0.50 for non‐bacteremic and 0.53 for all GBS associated (bacteremic, non‐bacteremic and suspected) infections. After 20–25‐fold concentration of urine specimens the sensitivity increased to 1.0 for bacteremic, 0.67 for non‐bacteremic and 0.78 for all GBS associated infections. The specificity of the test was high (0.93 for concentrated urines), and the predictive value of positive test (Pvpos) was 0.68. A positive latex test was highly predictive of positive surface cultures for GBS (Pv pos = 0.83 after concentration).