bluuebunny/crossref_metadata_2025 huggingface dataset:
PITUITARY‐ADRENAL AND TESTICULAR FUNCTION IN PRETERM INFANTS AFTER PRENATAL DEXAMETHASONE TREATMENT
Authors: HUHTANIEMI ILPO , KOIVISTO MAILA , PAKARINEN ARTO , TUIMALA RISTO , KAUPPILA ANTTI
Published: January 2008

ABSTRACT. Pituitary‐adrenal and testicular function was monitored by plasma ACTH and testosterone (T) measurements in preterm newborns (gestational age below 36 weeks), exposed in utero to dexamethasone treatment for prevention of respiratory distress syndrome. A group of age‐matched premature newborns and full‐term infants served as controls. The cord‐blood ACTH level was high in each group (logarithmic means 65‐75 ng/l), but decreased within the first 2 days of life to mean levels between 20‐30 ng/l on days 3 to 10 inclusive. Dexamethasone treatment had no effect on the postnatal ACTH concentrations when compared with preterm or full‐term controls. Similarly, no differences in plasma ACTH were found between untreated preterm and full‐term infants during the first 10 days of life. T levels in mixed cord blood were on average 2‐3 nmol/l in the preterm male infants. An increase to a mean level of 10 nmol/l was seen in 1 h and 1d samples. Thereafter, the concentration of T decreased to 2‐3 nmol/l on days 3‐10 postnatally. No effect of dexamethasone treatment was seen on the postnatal pattern of plasma T. When preterm male and full‐term male infants were compared, no difference was seen in the T peak in the first day of life. However, the 1‐3, and 60‐90 day concentrations of T were 2‐fold (p <0.01–0.05) higher in the preterm group. It is concluded that prenatal dexamethasone treatment of the mother does not influence the postnatal pituitary‐adrenal function as monitored by ACTH measurements. Likewise, no effect of this treatment was observed on the postnatal testicular activity of preterm male infants. The immediate postnatal peak in plasma T levels persisted longer in the preterm than in the full‐term male infants.
COLONIZATION OF THE UPPER JEJUNUM BY ENTEROPATHOGENIC AND ENTEROTOXIGENIC ESCHERICHIA COLI IN PAEDIATRIC DIARRHOEA
Authors: STINTZING G. , MÖLLBY R.
Published: January 2008

ABSTRACT. Aspirated fluid from the upper jejunum was obtained by intubation of 27 children with diarrhoea and 7 control children without diarrhoea. The aspirated jejunal fluid was analysed for total counts of viable aerobic and anaerobic microorganisms. Gram‐negative aerobic bacteria were typed biochemically and analysed for the production of heat‐labile and heat‐stable enterotoxins. Enteropathogenic Escherichia coli (EPEC) strains of serogroups 0111, 055 and 0127 were detected in the stools of nine patients and the respective strains concomitantly in the uper jejunum (103‐108 bact/ml) in 7 patients with diarrhoea. In 6 patients from whom isolates of enterotoxigenic E. coli (ETEC) were obtained, there were high total viable counts of non‐enterotoxigenic bacteria in the upper jejunum and ETEC were recovered from this location in 3 cases. Enterotoxigenic Klebsiella was recovered from faeces but not from upper jejunum in one case. Compared to the controls, the total number of bacteria in the upper jejunum were 100‐1000 tunes higher in patients with enteropathogenic E. coli (EPEC) or enterotoxigenic E. coli (ETEC). In another 11 cases with diarrhoea caused by Shigella, rotavirus or of unknown aetiology, the total viable counts of bacteria were similar to those of the controls. Five patients with severe EPEC diarrhoea received antibiotics for 5 days. The patients improved clinically, and the EPEC strain had disappeared from the upper jejunum when they were reexamined. In conclusion, in EPEC diarrhoea a colonization of the upper jejunum by the causative organism seemed to take place, while in ETEC diarrhoea, there appeared to be a nonspecific contamination by enteric bacteria.
IMMUNOSUPPRESSIVE TREATMENT OF IDIOPATHIC THROMBOCYTOPENIC PURPURA IN CHILDREN
Authors: JOSEPH ALEYAMMA , EVANS DAVID I. K.
Published: January 2008

ABSTRACT. Eleven children with symptomatic idiopathic thrombocytopenia were treated with immunosuppressive agents. Ten children received cyclophosphamide; I was given azathioprine. Only I child produced a full response, and 6 subsequently needed splenectomy which was curative. It is concluded that immunosuppressive treatment is ineffective in childhood thrombocytopenia and that splenectomy remains the treatment of choice for the rare case which fails to settle spontaneously or respond to corticosteroids.
SLEEP BEHAVIOUR STUDIED LONGITUDINALLY
Authors: KLACKENBERG GUNNAR
Published: January 2008

ABSTRACT. Data on sleep behaviour have been extracted from a prospective longitudinal study of growth in a random sample of, originally, about 200 children, with annual examinations. The purpose was to assess to what extent data at 4 years on duration of sleep, night‐awakening and habitual sharing of the parents’bed can predict conditions in these respects at 8, 12 and 16 years. The predictive power is slight in general concerning the first two variables, while the habit of sharing the parents’bed is rather more difficult to shake off, above all when the child has reached school age (6–7 years in Sweder).
OESOPHAGEAL ULCERATIONS IN TWO CHILDREN TAKING EMEPRONIUM BROMIDE
Authors: FREYSTEINSSON H. , THORSSON Æ. V.
Published: January 2008

ABSTRACT. Two 5 year‐old children developed severe oesophageal ulcerations after a short course of emepronium bromide (Cetiprin®) tablets, prescribed for nocturnal enuresis. They recovered rapidly after stopping the drug. It is suggested that emepronium bromide tablets should not be prescribed for children.
PROTEIN‐LOSING ENTEROPATHY WITH SMALL INTESTINAL STENOSES AND A STAGNANT LOOP IN A NINE‐YEAR‐OLD BOY
Authors: RUDD PETER T.
Published: January 2008

ABSTRACT. This report concerns a 9‐year‐old boy with protein‐losing enteropathy (PLE), small intestinal stenoses and a stagnant loop. The diagnosis of PLE was made after a 51Cr‐labelled albumin study, but that of intestinal stenoses only after repeated barium examinations. All the symptoms disappeared after resection of the lesions. In the investigation of any PLE, surgically treatable lesions must be identified.
DIABETES MELLITUS IN A MONGOLOID CHILD WITH CHRONIC DIPHENYLHYDANTOIN THERAPY
Authors: PAVONE L. , MAZZONE D. , GRASSO S. , PRATO F. , RAITI S.
Published: January 2008

ABSTRACT. A 10‐year‐old epileptic mongoloid child who developed an overt diabetes during chronic treatment with phenytoin in adequate doses is presented. Since mongoloid patients have a genetic predisposition for diabetes and the diabetogenic effect of phenytoin being known, this kind of drug should be used with caution in mongoloid patients.
RESPIRATORY SENSITIVITY BEFORE AND AFTER BIRTH
Authors: PURVES M. J.
Published: January 2008

ABSTRACT. A description is first given of respiratory activity in the fetus and its control. Evidence suggests that when the fetus makes respiratory movements, it is in a state comparable to REM sleep in the newborn and adult and that in the alternating periods of apnoea, it is in quiet sleep. It does not appear that the respiratory movements are normally regulated by chemical or reflex, e. g. Hering Breuer, inputs though they are enhanced by CO2 and depressed by hypoxia. In the apnoeic periods, breathing movements are virtually impossible to elict by chemical or reflex means. Evidence from examination of peripheral inputs indicates that: the carotid body chemoreceptors are inhibited at receptor level, stimulation of the aortic chemoreceptors affects the circulation only and although pulmonary stretch receptors are active and are excited by inflation of the fetal lung, such inflation does not affect discharge in medullary respiratory units or phrenic nerve. Since there is no real evidence of immaturity of the respiratory system in late gestation and since chemical and most reflex inputs appear to provide an adequate stimulus, it is most probable that the periods of apnoea are caused by an inhibitory process, possibly of supra‐pontine origin which acts close to medullary respiratory units and effectively inhibits the operation of the automatic component. This inhibitory process may operate periodically; or continuously and be periodically overridden in REM sleep. After birth, breathing is normally continuous and sensitive to lung inflation, CO2 and after a variable delay, to hypoxia. This may be due to the lifting of the inhibitory process allowing activation of the automatic component. However, there is evidence that even in normal, full term infants, full maturation of the automatic component is not complete until about three months of age and in the meanwhile, breathing tends to be imperfectly regulated and subject to damped oscillations when disturbed.
MAXIMAL OXYGEN UPTAKE IN RELATION TO AGE IN BLIND AND NORMAL BOYS AND GIRLS
Authors: SUNDBERG S.
Published: January 2008

ABSTRACT. Maximal oxygen uptake (VO2 max) was measured in 180 children during exhaustive work on a bicycle ergometer. The material comprised 12 blind boys and 11 blind girls (8–14 years) as well as 82 normal boys and 75 normal girls (8–17 years). VO2 max increased linearly with age in all four groups. In normal girls mature values were reached at the age of 14 years. Normal boys had significantly higher values than normal girls and their VO2 max increased faster with age. No sex differences in VO2 max were found in blind children. Normal children had significantly higher values than the blind. VO2 max/kg was uninfluenced by age in three of the groups: 55, 45 and 37 ml/min/kg in normal boys, blind boys and blind girls, respectively. In normal girls VO2 max/kg decreased with age from 51 to 42 ml/min/kg. Significant sex differences were found in both normal and blind children. VO2 max/kg in blind boys was 82% of that of normal boys, while blind girls had significantly lower values than normal girls. Most of these differences were established already at the age of 8 years. It is concluded that the differences in maximal oxygen uptake between normal and blind children are to a high degree due to different levels of physical activity during early childhood.
CORONARY HEART RISK FACTORS IN 177 CHILDREN AND YOUNG ADULTS WHOSE FATHERS DIED FROM ISCHEMIC HEART DISEASE BEFORE AGE 45
Authors: IBSEN K. K. , LOUS P. , ANDERSEN G. E.
Published: January 2008

ABSTRACT. The occurrence of the classical coronary heart risk factors hypertension, hyperlipemia, tobacco smoking and physical inactivity was investigated in a risk group consisting of 177 children and young adults whose fathers died from ischemic heart disease before age 45 and in randomly selected reference individuals. Only hyperlipemia and especially permanent hypercholesterolemia and familial hypercholesterolemia (FH) was much more common in the risk group than in the reference group. Blood pressure values, smoking habits and physical activity level were almost identical in the two groups. Although FH was about ten times more frequent among risk children it does not explain the majority of early coronary deaths among their fathers.
IMMUNOREACTIVE TRYPSIN SCREENING FOR CYSTIC FIBROSIS
Authors: BORGSTRÖM ANDERS , SVEGER TOMAS , LINDBERG TOR , KOLLBERG HANS , LARSSON AGNE
Published: January 2008

ABSTRACT. Immunoreactive cationic trypsin (irCT) was measured in 22 cystic fibrosis (CF) and 132 control infants. IrCT was analysed with radioimmunoassay of dried blood samples collected for PKU screening around the 5th day of life and stored on filter paper. The mean ± 1 SD level of irCT for the control infants was 42±19 μg/l. Sixteen of the 22 CF children had an irCT level above 100 μg/l (mean + 3 SD) while 6 had a level at or below this cut‐off limit. A specificity of 99%, which gives a sensitivity of 73%, and an approximative noise: signal ratio of 30: 1, suggests that the irCT test may be unsatisfactory as a neonatal screening method for CF.
MYOELECTRICAL ACTIVITY IN EXPERIMENTAL AGANGLIONOSIS OF THE COLON IN THE RAT
Authors: CHANDRAN A. P. , MARYA R. K. , SHARMA L. K.
Published: January 2008

ABSTRACT. Experimental aganglionosis of the colon was produced in rats by an experimental “aganglionosis producing” procedure. Radiological examination of the aganglionic colon showed a narrow segment distal to a dilated megacolon. Histologically, a transverse section of the aganglionic segment showed 3‐4 ganglia in contrast to 32‐40 ganglia per section in the normal colon. The myoelectrical activity of the normal colon presented two fast activities, a fast activity with a frequency of 25‐40 cycles per sec superimposed over a medium‐fast activity of 4‐7 cycles per sec. However the aganglionic colon showed only the fast activity with complete absence of the medium‐fast activity. Thus the experimental aganglionosis produced a characteristic alteration in the myoelectrical activity of colon. This confirms our earlier findings in children with Hirschsprung's disease. It also suggests that the causative mechanism for the production of a narrow segment in Hirschsprung's disease may not be the hyperactivity or the absence of any specific neuronal mechanisms as proposed earlier.
MILK FAT BOLUS OBSTRUCTION IN A PRETERM INFANT
Authors: BROOKE O. G. , GENTNER P. R. , HARZER G. , SPITZ LEWIS
Published: January 2008

ABSTRACT. We describe a preterm infant who developed an intestinal fat bolus obstruction on the 18th day of life. Shortly before the obstruction the infant's feeding had been changed from maternal breast milk to a special formula for preterm infants. Although the fatty acid composition of the bolus resembled breast milk more than the formula, the abrupt change in the feed may have caused the formation of the bolus.
POSTINITIAL REMISSION IN DIABETIC CHILDREN– AN ANALYSIS OF 178 CASES
Authors: KNIP M. , SÄKKINEN A. , HUTTUNEN N. ‐P. , KÄÄR M. ‐L. , LÄNKELÄ S. , MUSTONEN A. , ÅKERBLOM H. K.
Published: January 2008

ABSTRACT. We studied 178 diabetic children and adolescents diagnosed during the period 1962‐79 to find out the occurrence and duration of the postinitial remission, factors favoring a remission and the prognostic value of the remission. A postinitial remission occurred in 113 children (64 %) being complete in only three boys (2 %). The duration ranged from one month to 4.8 years, the mean being 8.4 months. The boys had a remission more often and of longer duration than the girls. The duration of diabetes was longer in the children without remission. The children with remission had lower blood glucose, milder hyperketonemia and ketonuria, higher pH and Pco2 at onset than those without remission. Hemoglobin A1 (HbA1) during 1979 were lower in the children with a positive remission history. The children with a remission lasting more than one year had a subsequently higher glucosuria index, lower HbA1 and higher C‐peptide when compared to those without remission or to those with a short remission. The remission frequency increased from 1962 to 1979. Male sex and mild metabolic derangement at onset favor a postinitial remission, which results in a persisting residual beta‐cell function and better metabolic control beyond the remission.
DIAGNOSIS OF KALLMANN'S SYNDROME IN EARLY INFANCY
Authors: EVAIN‐BRION D. , GENDREL D. , BOZZOLA M. , CHAUSSAIN J. L. , JOB J. C.
Published: January 2008

ABSTRACT. Hypogonadotrophic hypogonadism was suspected in three male newborns on the basis of a very small penis associated with cryptorchidism and a positive familial history of Kallmann's syndrome in one, of isolated anosmia in the two others. It was demonstrated in early infancy by the lack of postnatal rise of LH and testosterone, and by a blunted response to LHRH and HCG stimulation tests. These data suggest that the postnatal follow‐up of plasma LH and testosterone allows the diagnosis of hypogonadotrophic hypogonadism in male infants with micropenis and cryptorchidism and that careful familial investigation may be useful in these cases.
MATERNAL DIET AND FATTY ACID PATTERN OF BREAST MILK
Authors: VUORI E. , KIURU K. , MÄKINEN S. M. , VÄYRYNEN P. , KARA R. , KUITUNEN P.
Published: January 2008

ABSTRACT. The effect of habitual maternal diet on the fatty acid composition of breast milk was evaluated by conducting a dietary survey of lactating mothers and by analyzing their breast milk samples. The mean energy intake of the mothers was 9.8 MJ during the first survey week (20 mothers, 6‐8 weeks post partum) and 8.6 MJ during the second survey week (13 mothers, 17‐22 weeks post partum). Protein, fat and carbohydrate intake comprised 16%, 39% and 45% of the total energy intake, respectively. The breast milk samples contained 3.8% fat. Half of the fatty acids of the diets and breast milk were saturated (S), and one third were monoenoic. Polyunsaturated (P) fatty acids comprised 15% in the diets and 13% in the breast milk. The average P/S ratio was 0.3 both in the diets and breast milk samples. Carbohydrate intake correlated negatively (p<0.05) with arachidic acid of breast milk, and both protein and fat intakes correlated positively (p<0.05) with palmitic acid of breast milk. The maternal diet had no effect on the total fat content of breast milk. A positive correlation was found between the saturated (p<0.05) and polyunsaturated (p<0.01) fatty adds of maternal diet and breast milk. As to the single fatty acids, the only significant correlation was found with linoleic acid (p<0.01). However, the variation of linoleic acid intake explained only about 27% of the variation occurring in the breast milk.
ACTIVATION OF THE KALLIKREIN‐KININ SYSTEM IN PREMATURE INFANTS WITH RESPIRATORY DISTRESS SYNDROME (RDS)
Authors: SAUGSTAD OLA DIDRIK , HARVIE ANN , LANGSLET ASBJØRN
Published: January 2008

ABSTRACT. Plasma prekallikrein levels, kallikrein activity and antikallikrein levels were investigated in nine premature infants with respiratory distress syndrome (RDS) and six premature infants without. Plasma prekallikrein and kallikrein were determined with a chromogenic substrate measuring amidolytic activity. Antikallikrein was measured with a functional assay. In infants with severe RDS, prekallikrein levels were significantly reduced (median 58% of initial values (p<0.01) about 48 hours after onset of symptoms. In infants with moderate RDS prekallikrein level was reduced less, while in babies without RDS there were no significant changes in prekallikrein levels the first 5‐7 days of life. Antikallikrein levels did not change significantly in any babies. The results suggest that the kallikrein‐kinin system might be involved in RDS. This could explain several features of this syndrom such as hypotension and edema. Furthermore the findings show that homeostatic functions are altered in this disease, and they suggest that other cascade systems as the coagulation, fibrinolytic and complement system may be involved as well. The findings emphasize that trauma might be a significant pathogenetical factor for development of this syndrome and indicate that RDS is not simply a biochemical disease with lack of surfactant as the only pathogenetic factor.
LIVER DISEASE IN CHILDREN WITH ALPHA1‐ANTITRYPSIN DEFICIENCY WITHOUT NEONATAL CHOLESTASIS
Authors: NEMETH ANTAL , STRANDVIK BIRGITTA
Published: January 2008

ABSTRACT. Thirteen children with α1‐antitrypsin deficiency (8 PiZ and 5 PiSZ) were investigated at ages ranging from 4 to 6. None had had neonatal cholestasis. Nine, mainly the PiZ individuals, had increased serum concentration of transaminases. Liver biopsy was performed in 7 patients with increased serum levels of transaminases. One of these patients had cirrhosis and 4 had moderate to severe fibrosis. The results indicate that α1‐antitrypsin deficient individuals, also without neonatal cholestasis syndrome run a high risk of developing serious liver disease, already in childhood. The cirrhotic patient was the only one who had increased excretion of bile acids in urine.
THE PATTERN OF REACTIVATED FETAL ERYTHROPOIESIS IN BONE MARROW DISORDERS OF CHILDHOOD1
Authors: GAHR M. , SCHRÖTER W.
Published: January 2008

ABSTRACT. The expression of fetal characteristics of erythropoiesis (haemoglobin F concentration, haemoglobin A2 concentration, haemoglobin F cells, globin chain synthesis, carboanhydrase isoenzyme B, hexokinase isoenzymes, erythrocyte membrane antigens of the iI‐ and the ABH‐system) was examined in red cells of twelve patients with different bone marrow disorders (juvenile chronic myeloid leukaemia (JCML), erythroleukaemia (EL), acute myelogenous leukaemia (AML), aplastic anaemia (AA) and Diamond‐Blackfan anaemia (DB)). In JCML and EL all red cell parameters studied appeared to be fetal including the distribution of hexokinase isoenzymes. No fetal signs could be found in red cells of patients with AML. In two patients with DB who were treated by transfusion no fetal erythropoiesis could be detected. In one patient with DB under cortisone treatment i‐antigen, ABH‐antigens, haemoglobin F concentration, globin chain synthesis and hexokinase isoenzyme distribution were of the fetal or mixed type. In patients with AA only slight elevations of haemoglobin F were detectable. The nearly total reversion to fetal erythropoiesis in JCML and EL seems to be a part of the disorder itself, whereas in the other disorders the reactivation of fetal erythropoiesis could be the result of an erythropoietic stress.
CHLOROMA OF THE MANDIBLE: A PROBLEM OF DIAGNOSIS AND MANAGEMENT
Authors: CONRAN M. J. C. , KEOHANE C. , KEARNEY P. J.
Published: January 2008

ABSTRACT. A 23‐month‐old girl developed a chloroma of the right mandible. Delay in fixation at the initial biopsy confused the histopathology and a second biopsy was required to establish the diagnosis. She was treated with radiotherapy to the local lesion in addition to combination chemotherapy. She is presently maintained on treatment in good health sixteen months after diagnosis.
II Antibacterial Effects of Silver Nitrate as Used for Credé Prophylaxis and of a Colloidal Silver Compound ‐ Hexarginum
Authors: KALLINGS I. MOBERG , WAHLBERG V.
Published: January 2008

Silver nitrate as prophylaxis against gonococcal ophthalmia neonatorum (GON) is still compulsory in many countries, although disputed. In Sweden it is proposed that the use of silver nitrate be discontinued as there is now effective treatment available and because of the present epidemiological situation and good neonatal care. In some communities, however, the socioeconomic situation is such as to justify a continued use of prophylaxis against GON. Therefore it was decided to try Hexarginum (AgNo3+CH3NH2), a colloidal silver compound as an alternative, which is less irritating than silver nitrate. The antibacterial effect in vitro of silver nitrate and Hexarginum on Neisseria gonorrhoeae, Staphylococcus aureus, Streptococcus agalactiae, Diplococcus pneumoniae and Haeomophilus infruenzae was compared. Both compounds were found to be very active in killing gonococci. The effectiveness against other species was varying, H. intluenzae being more rapidly killed than the Gram‐positive cocci. Hexarginum was consistently less active than silver nitrate by 1–4 dilution steps. It was also tested whether silver nitrate and Hexarginum inhibited the adhesion of gonococci to epithelial cells. Some inhibition was found by silver nitrate although the difference was not significant. The effect by which silver nitrate acts as a prophylactic agent against GON is probably more complex than merely depending on the antibacterial effect; any other compound must be evaluated carefully before it can be recommended as an alternative prophylactic agent against GON.
DIETARY PROTEIN FOR LOW BIRTHWEIGHT BABIES Sources and Assessment of Requirements
Authors: WHARTON B. A. , SCOTT P. H. , BERGER H. M.
Published: January 2008

Wharton BA, Scott PH and Berger HM (Sorrento Maternity Hospital, and Biochemistry Department, Selly Oak Hospital, Birmingham, U.K.). Dietary protein for low birthweight babies. Sources and assessment of requirements. Acta Paediatr Scand, Suppl. 296:32, 1982. — Breastmilk is the best food for low birthweight babies for the first critical week(s) of life. In subsequent weeks, during rapid growth, formulas specially designed for this group of infants may be superior to ordinary breast milk substitutes. Modifications comprise the composition of carbohydrates, fats and proteins. Requirements of minerals and vitamins are probably different from those in babies with normal birthweights, A controlled study was done of feeding a formula containing unmodified cow's milk protein (mainly curd) as compared to one containing the same amount of modified cow's milk protein (curd and whey). Using as criteria anthropometry, nitrogen balance studies and plasma amino acid levels certain advantages were found when feeding the low birthweight babies the whey predominant formula.
INFLUENCE OF THERMOREGULATION ON ENERGY METABOLISM OF THE LOW BIRTHWEIGHT INFANT
Authors: PUTET G. , DITTMAR A. , SCHMITT M. , SALLE B.
Published: January 2008

Putet, G, Dittmar, A, Schmitt, M and Salle, B. (Department of Neontology, Hôpital Edouard–Herriot, Lyon, France). Influence of thermoregulation on energy metabolism of the low birthweight infant. Acta Paediatr Scand, Suppl, 296: 62, 1982. — By combining continuous measurements and recordings of (a)O2 consumption and CO2 production, (b) core, mean skin and temperature, (c) “radiative and convective” (R+C) heat loss, we have tried to assess the characteristics and effiency of different heating systems in the usual environment of an intensive care unit. Preliminary results: minimal heat loss is obtained in an incubator with manual temperature control versus servocontrolled incubator on radiant heater; the radiant heater can maintain adequate core temperature but with higher than normal heat loss from the sides of the body and increased warming only of the skin facing the heater; metabolic rate measurements do not show any statistical difference between these various environments; both with an incubator and a radiant heater, a thin plastic sheet (used as heatshield) lowers “R+C” heat loss.
TRACE METAL REQUIREMENTS OF PRETERM INFANTS
Authors: SHAW J.C.L.
Published: January 2008

Shaw, J.C.L. (Department or Paediatrics, University College, London, U.K.). Trace metal requirements of preterm infants. Acta Paediatr Scand, Suppl. 296: 93, 1982. — The elements zinc, copper, manganese, molybdenum, selenium and chromium are considered to be essential nutrients in man. It is known that they cross the placenta because they are all present in fetal bodies where they are presumably necessary for normal growth and development. Though deficiency of copper, zinc, selenium and chromium have been reported in man only copper and zinc deficiency have been described in premature infants. Typically, the deficiency develops late (between 3–6 months of age), at a time when the concentration in breastmilk is falling and before a mixed diet has been introduced.This late onset, together with data on body composition, suggests that preterm infants are born with stores — albeit small — of copper and zinc, as they are with iron. The stores may be depleted to a variable extent following birth by dietary insufficiency (particularly total parenteral nutrition), malabsorption and diarrhoea. This leads to severe deficiency in some infants and possibly less severe deficiency in many more, which may pass unrecognised because of difficulties in diagnosis. Dietary provision of a trace element should have two purposes. It should be sufficient to prevent the development of a deficiency state, and to provide enough to enable stores to be formed so that deficiency does not immediately occur if the diet is temporarily inadequate. No case of manganese, molybdenum, selenium or chromium deficiency has yet been described in preterm infants, but no systematic search for deficiency of these elements has yet been undertaken.
IRON REQUIREMENT IN LOW BIRTHWEIGHT INFANTS
Authors: SIIMES M.A.
Published: January 2008

Siimes, M.A. (Children's Hospital, University of Helsinki, Finland). Iron requirement in low birthweight infants. Acta Paediatr Scand, Suppl. 296: 101, 1982.—Since full‐size newborns have adequate iron stores, severe iron deficiency anaemia rarely develops in these infants. If it develops, it is usually due to intestinal blood loss. Low birthweight infants have reduced iron stores resulting in higher nutritional iron requirements. Despite supplementation preterm infants reach at about two months lower Hb values than full‐term infants, but sebsequent anaemia is prevented. Iron supplementation should at least during the first six weeks be combined with vitamin E supplementation. Different iron dosages are suggested for different birthweights.
THE INFLUENCE OF DIETARY FACTORS ON THE VITAMIN E REQUIREMENTS OF THE LOW BIRTHWEIGHT INFANT
Authors: JANSSON L.
Published: January 2008

Jansson, L. (Department of Paediatrics, University of Lund, Malmö General Hospital, Malmö, Sweden). The influence of dietary factors on the vitamin E requirements of the low birthweight infant. Acta Paediatr Scand, Suppl. 296: 110, 1982.—The vitamin E requirements for the low birthweight (LBW) infant varies with other dietary factors such as iron and polyunsaturated fatty acids (PUFA). This interaction is caused by the influence of iron on the oxidative breakdown of lipids (lipid peroxidation). Thus the need for fortification of infant formulas with vitamin E increases if the formulas are iron fortified or have a high content of PUFA. A vitamin E/linoleic acid ratio of >1 IU/g is currently recommended. The formulas on sale in Sweden satisfies this recommendation. In breastmilk we found a vitamin E/linoleic acid ratio of s>1 IU/g in colostral and transitional milk. In mature breastmilk, however, 9 out of 24 samples showed a ratio < 1 IU/g. Thus it is possible, that the LBW infant fed mature human milk may need a larger supplement of vitamin E than the formula fed infant.
FOOD FOR THE SUCKLING: REVOLUTION AND DEVELOPMENT
Authors: WHARTON B. A.
Published: January 2008

Wharton, B. A. (Sorrento and Birmingham Maternity Hospitls, Birmingham, U.K.). Food for the suckling: revolution and development. Acta Paediatr Scand, Suppl. 299:5, 1982.—The 1970's saw a renaissance in child nutrition, a major revision of infant feeding practice and substantial changes in food for the suckling. Many more babies are breast fed, those who are not receive an infant formula specifically designed for this period of life, and solid foods are no longer introduced in the early weeks. These changes have contributed to the improvement in the suckling's health, particularly the reduction in neonatal tetany, and in deaths from gastroenteritis. Developments in the 1980's should improve our knowledge of breast milk and its properties, advisable intakes of specific nutrients and their interrelationships, and the immunology of infant feeding. Meanwhile, practice will be directed towards the enhancement of successful lactation, the processing of donor human milk, the establishment of standards for infant formulas and the special problems of the low birth weight baby.
IMMUNE COMPLEX MEDIATED TISSUE DAMAGE IN THE LUNGS OF CYSTIC FIBROSIS PATIENTS WITH CHRONIC PSEUDOMONAS AERUGINOSA INFECTION
Authors: HØIBY NIELS , SCHIØTZ PETER OLUF
Published: January 2008

Høiby, N. and Schiøtz, P.O. (Statens Seruminstitut Department of Clinical Microbiology, Rigshospitalet and the Paediatric Department TG, Rigshospitalet, Copenhagen, Denmark). Immune complex mediated tissue damage in the lungs of cystic fibrosis patients with chronic Pseudomonas aeruginosa infection. Acta Paediatr Scand; suppl 301: 63‐73. — Evidence has accumulated which supports the following mechanism of tissue damage in the lungs of cystic fibrosis (CF) patients during chronic P. aeruginosa lung infection:

In CF chronic P. aeruginosa infection with mucoid strains is characterized by persistent presence of P. aeruginosa antigens in the lungs and simultaneous presence of many precipitating antibodies against these antigens in serum and sputum.

Formation of immune complexes in the lungs between these antigens and antibodies are indicated by the detection of immune complex activity in serum and especially in sputum. Immune complex‐mediated activation of complement components in the lungs of such CF patients has been demonstrated. The activation of complement leads to formation of C3a and C5a split products, which lead to liberation of histamine from basophil leukocytes, i.e. inflammation which is also reflected in elevated acute phase proteins in serum. Evidence of this process has also been found as a type I skin test when P. aeruginosa antigens are injected intracutaneously in these patients. Liberation of serotonin from thrombocytes mediated by P. aeruginosa antigens in the presence of antibodies from these CF patients, causing inflammation, has been shown. Attraction of neutrophils to the lungs mediated by immune complex activated complement split products, ingestion of the immune complexes by the neutrophils, and liberation of proteolytic enzymes from the neutrophils, i.e. tissue damage, has been demonstrated, and goes on because immune elimination of the bacteria is not accomplished. The therapeutic consequences are discussed.
PHARMACOKINETICS OF ANTIBIOTICS IN CHILDREN WITH CYSTIC FIBROSIS WITH PARTICULAR REFERENCE TO NETILMICIN
Authors: MICHALSEN HELGE , BERGAN TOM
Published: January 2008

Michalsen, H. and Bergan, T. (Departments of Paediatrics and Microbiology, Aker sykehus and Department of Microbiology, Institute of Pharmacy, University of Oslo, Oslo, Norway). Pharmacokinetics of antibiotics in children with cystic fibrosis with particular reference to netilmicin. Acta Paediatr Scand 1982; suppl 301: 101‐105. — The pharmacokinetics of netilmicin has been studied in 8 children with cystic fibrosis given single doses of 3 and 5 mg/kg body weight as bolus intravenous doses. The serum levels were in proportion to the dose. The serum half‐life was significantly longer (p<0.01) after the higher dose. The apparent distribution volumes were indistinguishable. It is suggested that doses of 4 mg/kg given every 8 h appear suitable in children with cystic fibrosis and that serum levels of antibiotics need to be monitored in patients with cystic fibrosis.
EVALUATION IN YOUNG CHILDREN OF THE URABE AM 9 STRAIN OF LIVE ATTENUATED MUMPS VACCINE IN COMPARISON WITH THE JERYL LYNN STRAIN
Authors: VESIKARI T. , ANDRÉ F. E. , SIMOEN E. , FLORENT G. , ALA‐LAURILA E.‐L. , HEIKKINEN A. , KUUSINEN H. , TERHO A.
Published: January 2008

ABSTRACT. Urabe Am 9, a new strain of mumps vaccine, originally developed in Japan, was evaluated in children 14 to 20 months of age in a comparative trial with the Jeryl Lynn strain. Both vaccines performed well. The antibody responses were measured using a neutralization test and a haemolysis‐in‐gel test. The seroconversion rates at six weeks, as detected with either one or both tests, were 55/58 (94.8%) after the Urabe Am 9 and 58/60 (96.7%) after the Jeryl Lynn vaccine. Only mild infrequent adverse reactions were observed. It is concluded that both strains of live attenuated mumps vaccine are immunogenic and well‐tolerated in this age group.
LEFT VENTRICULAR SYSTOLIC TIME INTERVALS IN PRETERM INFANTS WITH PATENT DUCTUS ARTERIOSUS
Authors: LUNDELL B. P. W. , WALLGREN C. G.
Published: January 2008

ABSTRACT. Left ventricular systolic time intervals were recorded by a non‐invasive technique, from the axillary artery, in 13 preterm infants with patent ductus arteriosus. At the onset of clinical symptoms, consistent with a large left‐to right ductal shunt, the preejection intervals were shorter than in a control group of nine preterm infants without a patent ductus. The most pronounced difference was found in the shortening of the isovolumic contraction time, 10.7 msec in the ductus group compared with 22.4 msec in the control group. Ductal closure normalized the isovolumic contraction time to 22.1 msec. The very short preejection intervals, associated with a large ductal shunt, are suggested to reflect a combination of reduced aortic diastolic pressure and increased left ventricular filling pressure. In spite of increased volume load to the left ventricle there were no detectable changes in the systolic time intervals indicating impaired left ventricular function. The left ventricle seems to be competent to handle increased volume load in the presence of reduced afterload in preterm infants with symptomatic left‐to right ductal shunts.
HIGH SUGAR WORSE THAN HIGH SODIUM IN ORAL REHYDRATION SOLUTIONS
Authors: MEEUWISSE G. W.
Published: January 2008

ABSTRACT. The literature on oral sugar‐electrolyte mixtures for treatment of acute diarrhoea is reviewed. Several trials have shown that the solution proposed by the WHO for developing countries containing inter alia 90 mmol/l of sodium and 111 mmol/1 of glucose is safe for short term oral rehydration. When used in this manner there is no risk for development of hypernatraemia. The surplus base of the solution is not essential and, furthermore, other anions e. g. acetate may be substitute for bicarbonate. Other modifications of the WHO formula have also been successfully tried, e. g. sucrose 4 % (117 mmol/l) in stead of glucose 2%
RELAPSE RATE AFTER CESSATION OF THERAPY IN CHILDHOOD LEUKEMIA
Authors: JOHANSEN O. J. , EILERTSEN M. E. , MOE P. J.
Published: January 2008

ABSTRACT. The experience of four hundred and ninety children from the Nordic countries who had their antileukemic therapy stopped prior to January 1981 is presented. The observation times after stopping therapy were between 1 month and 19 years. One hundred and five children (21.4%) relapsed before January 1981. No children relapsed later than four years after cessation of therapy. The calculated long term relapse rate is 28%.
BLOOD PRESSURE IN CHILDREN WITH DIABETES MELLITUS
Authors: IBSEN K. KAAS , ROTNE H. , HOUGAARD P.
Published: January 2008

ABSTRACT. Blood pressure measurements were evaluated in 151 children aged 2–19 years old with insulin‐dependent diabetes mellitus (DM) of a duration of few months to 15 ½ years. Compared with a reference group, the diabetic children had lower diastolic blood pressure (DBP) shortly after start of DM. There was no difference for the systolic blood pressure (SBP). After duration of diabetes of 5 years there were no significant differences in SBP and only significantly lower DBP in girls (median difference 5 mmHg, p<0.01), while the difference in boys is insignificant (median difference 2 mmHg, p=0.32). In a model describing the intraindividual variation in blood pressure and its dependence on age, weight and height it was found that age was insignificant when weight and height were included. For DBP height was also insignificant when weight was included. For the 9 children with retinal microaneurysms the average SBP was significantly higher than expected for diabetic children of that weight and height.
CONGENITAL HYPOTHYROIDISM: AGE AT START OF TREATMENT VERSUS OUTCOME
Authors: VIRTANEN M. , MÄENPÄÄ J. , SANTAVUORI P. , HIRVONEN E. , PERHEENTUPA J.
Published: January 2008

ABSTRACT. We studied 27 patients with congenital hypothyroidism by neurological and psychometric methods. 7 healthy siblings served as a control group for the psychometric evaluation. In 7 patients treatment had been started before the age of 1 month and in 10 patients after the age of 3 months. Our findings suggest that the progressive loss of intelligence potential starts from birth but if treatment is begun before the age of 1 month, then intelligence remains within normal range. The neurological damage seems to originate partly before birth, but more serious injuries arise if treatment is delayed beyond the age of 3 months.
CARDIAC INVOLVEMENT IN JUVENILE RHEUMATOID ARTHRITIS
Authors: SVANTESSON HELENA , BJÖRKHEM GUDRUN , ELBORGH RENATE
Published: January 2008

ABSTRACT. Cardiac involvement was diagnosed in 15 of 320 cases of JRA (4.7%) and was most frequent in children with active systemic disease. Ten children had pericarditis, 2 had myocarditis, 2 had peri‐myocarditis and 1 had aortic valvulitis. The highest risk of heart involvement was found during the first three years but it could occur at any time. Recurrent episodes were seen in 60% of cases. The prognosis in pericarditis seems to be good since no patient developed cardiac tamponade or constrictive pericarditis and cardiac function evaluated by echocardiography was normal in all patients at follow‐up. In patients with myocarditis and peri‐myocarditis, a dilated left ventricle was found in 2 of 4 patients and 1 patient who died, had severe cardiac changes at autopsy. The prognosis in myocarditis thus seems to be worse. In valvulitis the prognosis depends on which valve is involved. The benefit of early treatment with corticosteroids is discussed.
SERUM LIPIDS AND LIPOPROTEINS IN 157 INSULIN DEPENDENT DIABETIC CHILDREN AND ADOLESCENTS IN RELATION TO METABOLIC REGULATION, OBESITY AND GENETIC HYPERLIPOPROTEINEMIA
Authors: ANDERSEN G. E. , CHRISTIANSEN J. S. , MORTENSEN H. B. , CHRISTIANSEN K. M. , PEDERSEN‐BJERGAARD L. , KASTRUP K. W. , VESTERMARK S.
Published: January 2008

ABSTRACT. Serum lipids and lipoproteins were measured in 157 insulin dependent diabetic children and adolescents (IDDM) and in 350 healthy reference individuals. Serum triglyceride values were lower and total cholesterol and high density lipoprotein cholesterol higher in IDDM. Metabolic regulation reflected by glucosuria, postprandial blood glucose, number of hypoglycemic episodes and hemoglobin AIC all correlated strongly with serum triglyceride and very low density lipoprotein cholesterol but not with serum low density lipoprotein cholesterol or high density lipoprotein cholesterol. Serum lipids and lipoproteins did not correlate with obesity. Three children had genetic hyperlipoproteinemia.

In IDDM measurement of serum lipids and lipoproteins can thus be used to further assess metabolic regulation. Measurement of serum lipids and lipoproteins seems warranted for future evaluation of the risk of cardiovascular disease in IDDM.
HYPOMAGNESEMIA IN DIABETIC CHILDREN
Authors: EWALD U. , GEBRE‐MEDHIN M. , TUVEMO T.
Published: January 2008

ABSTRACT. Serum concentrations of iron, copper, zinc and magnesium were determined in 27 Swedish children with well controlled diabetes without longterm diabetic complications. Thirteen of the diabetic children had age‐ and sex‐matched healthy controls. Significantly lower serum magnesium concentrations were found in the diabetic children than in the matched healthy controls (p <0.01). The levels of iron, copper and zinc did not differ in the diabetic children from those in the controls. A negative correlation between serum magnesium level and duration of diabetes was found (p <0.05). This is seemingly the first report of hypomagnesemia in diabetic children.
INVESTIGATION OF 89 CHILDREN BORN BY DRUG‐DEPENDENT MOTHERS I
Authors: OLOFSSON M. , BUCKLEY W. , ANDERSEN G. E. , FRIIS‐HANSEN B.
Published: January 2008

ABSTRACT. Among 89 infants born by opiate‐ and methadone‐addicted mothers 20% were preterm and 31% were light for gestational age. Mean gestational age. Mean gestational age and birth weight were lower in infants of mothers who had taken mainly opiates compared with infants of mothers who had taken mainly methadone. Preterm labor was more frequent among women who had been acutely withdrawn on methadone within the last month before birth than among women who were maintained on methadone at birth. 85% of the newborns had withdrawal symptoms and 12% had convulsions the severity of which was not correlated with the type of drug abuse. The duration of withdrawal, however, correlated with the amount of methadone taken by the mother at birth. 20% had signs of perinatal asphyxia and had an increased frequency of neonatal convulsions. These babies represent a special high‐risk group of newborns. Prevention, therapy and care demand extraordinary combined efforts by politicians, social welfare personnel, midwives, doctors and nurses.
AMINO ACIDS IN PARENTERAL NUTRITION OF PRETERM INFANTS
Authors: BEGANOVIĆ N. , KOK K. , LEEUW R. DE , VRIES I. J. DE , SCHUTGENS R.
Published: January 2008

ABSTRACT. Parenteral feeding of preterm infants has been accepted as an alternative form of nutrition in those infants unable to accept oral feeding. The amount of amino acid nitrogen and the composition of the amino acid solution to be used, however, have not yet been defined. The amino acid intake and the plasma amino acid concentration of three groups of preterm infants were compared. Twenty‐three infants were fed parenterally. Of these, 16 were studied during the first week of life (group I) and 7 during the second week (group II). A control group of 9 infants fed with oral formula was also studied in the second week (group III). In general, plasma amino acid concentrations in the parenterally fed groups were higher than in the orally fed group, in spite of a lower intake. Comparison of the amino acid intake of groups I and II relative to group III, with the plasma amino acid concentrations of groups I and II relative to group III, revealed a rather constant ratio with the exception of tyrosine and aspartic acid, where higher values were found. It is concluded that further increase in the amino acid nitrogen in parenteral feeding of preterm infants requires a more adapted preparation.
ADOLESCENTS WITH CYSTIC FIBROSIS IN THE NETHERLANDS
Authors: SINNEMA G. , BONARIUS J. C. J. , STOOP J. W. , LAAG J. VAN DER
Published: January 2008

ABSTRACT. In a survey‐study of all living Dutch patients with cystic fibrosis (CF) born before 1971 data have been gathered on sex, age, age at diagnosis; height and weight; treatment and social development. The group consists of 102 schoolchildren (8–11 years), 179 adolescents (12–21 years) and 28 young adults (22–40 years). Males are in the majority, especially in the 12 to 17 age group (61 %). In 51% of all patients CF was diagnosed before the age of 2, and in 75% before the age of 5. Male CF patients are on average 6 cm (0.84 SD) shorter than normal and female patients 3 cm (0.48 SD). As far as weight for height is concerned, 54 % of the CF patients fall below the 10th percentile. Weight for height is slightly lower in females than in males. CF patients usually leave primary school at an older age than their healthy peers. In comparison to healthy adolescents of the same age, adolescents with CF attend full‐time day‐school for a longer time, more of them receive general education and fewer take vocational training. Adolescents and young adults with CF do not stay longer than normal in the protective environment of their parental home.
DIAGNOSTIC AND THERAPEUTIC ASPECTS OF DIHYDROBIOPTERIN DEFICIENCY
Authors: BECK B. , BRANDT N. J. , CHRISTENSEN E. , NIEDERWIESER A. , PEDERSEN P. S.
Published: January 2008

ABSTRACT. The first Scandinavian hyperphenyialaninaemic patient with a cofactor deficiency is described. By neonatal screening the Guthrie test showed a serum phenylalanine of 302 μmol/I (5 mg/dl), which at age 6 weeks had fallen to high normal values. At age 5 months the serum phenylalanine was around 2000 μmol/l and the child presented with severe neurological symptoms. The diagnosis of defect dihydrobiopterin biosynthesis was made by high performance liquid chromatography of the urine. Loading tests followed by daily treatment of the missing cofactor was able to keep the serum phenylalanine in the normal level. Because of persisting, yet diminishing neurological symptoms neurotransmitter treatment was started. Breast feeding as the cause of the low neonatal levels of serum phenylalanine and the late start of clinical symptoms is proposed and the importance of screening all hyperphenylalaninaemic newborns for defect biopterin metabolism is stressed.
THE McCUNE‐ALBRIGHT SYNDROME WITHOUT TYPICAL SKIN PIGMENTATION
Authors: GRANT D. B. , MARTINEZ L.
Published: January 2008

ABSTRACT. This paper describes three girls with an incomplete form of the McCune‐Albright syndrome. Polyostotic fibrous dysplasia and precocious puberty were present but the typical abnormal skin pigmentation was absent.