bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychosocial Factors and Physical Health during the First Year of Life Children in a New Stockholm Suburb. A Prospective Longitudinal Study. III
Authors: AURELIUS G. , NYLANDER I. , ZETTERSTRÖM R.
Published: January 2008

The study is part of a longitudinal research project of a cohort of 501 children in a Stockholm suburb. The aim of the project is to clarify the relation between the children's health and development and their home environment. The present work deals with the children's physical health during their first year of life and comparisons were made between infants in families suffering or not suffering from psychosocial stress. Indications of psychosocial stress in the homes include reports of alcohol abuse, mental disease or criminality in one or both of the parents. Judging by reports from child welfare centres and hospital records, children from homes with psychosocial stress do not have a higher rate of somatic illnesses, retarded psychomotor development and psychosomatic problems than the control children.
Clinical Growth Standards for Irish Children
Authors: HOEY HILARY M. C. V. , TANNER JAMES M. , COX LESLIE A.
Published: January 2008

A cross‐sectional study, measuring height and weight, was performed on a representative sample of 3 509 Irish children aged from 5 to 19 years inclusive. Comparison with other countries showed a significantly later pubertal growth spurt than either the U.K. or the U.S. However, the final adult height and weight are similar to other countries as in the weight‐for‐height of children aged 5 to 9 years. The urban children are taller than the rural and the higher socio‐economic groups are taller than the lower at all ages, but all achieved the same final adult height. Longitudinal tempo‐conditional growth standards were constructed based on the Irish cross‐sectional and menarche data together with all the available information from longitudinal studies. These charts are similar to those of the U.K., but the use of colours allows more information to be put on the charts, thus making them more suitable for clinical use.
A Prospective study of children as car passengers in road traffic accidents with respect to restraint effectiveness.
Authors: ALDMAN B. , GUSTAFSSON H. , NYGREN Å. , TINGVALL C.
Published: January 2008

Out of all accidents involving cars, irrespective of the outcome, and reported to the Folksam Insurance Company, accidents to private caps in which children were passengers were collected. In all, 2,763 such children were found during a period of 19 months. All injuries were coded according to the Abbreviated Injury Scale (AIS). The Injury Severity Score (ISS) and the risk of death or disability by RSC was also calculated.

The use of restraints among all children was used as a basis for estimating the effectiveness of restraint use.

Restraint systems were divided into rearward‐ and forward‐facing, the forward‐facing restraints consisting of both child seats and adult seat belts alone. The injury frequency and effects of restraint use were also linked to car weight.

It was found that restraint use, especially rearward‐facing seats, were effective in reducing injuries.
Quality of data on injured child car passengers in road traffic accidents
Authors: ALEXANDERSSON S. , GUSTAFSSON H , NYGREN A. , TINGVALL C.
Published: January 2008

In the present study injuries to children as car passengers reported by the police to the National Bureau of Statistics were compared with corresponding injuries reported to an insurance company. Both coverage errors and errors in reported data were investigated.

Injuries reported to the insurance company were coded according to Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS) was calculated. It was found that police reports on such injuries contain a number of errors but that the data can be used under some conditions.
Misuse of child restraints cars and potential hazards from such misuse
Authors: NYGRE A. , TINGVALL C. , TURBELL T.
Published: January 2008

By observational studies in which cars were stopped at random by the police, misuse of child restraints in private cars was investigated. Misuse of several types among different kinds of child restraint systems was found to occur in Sweden.

Some selected types of improper use were tested in barrier sled collisions with dummies arranged according to European child restraint regulations and were found to alter the dummy kinematics.

It is concluded that misuse should be decreased in order to reduce potential risks af lowering the efficacy of otherwise effective child restraints.
Growth Hormone Releasing Hormone in the Assessment and Long‐term Treatment of Growth Hormone Deficiency
Authors: ROSS R.J.M. , GROSSMAN A. , PREECE M.A. , SAVAGE M.O. , BESSER G.M.
Published: January 2008

The secretion of hGH after the administration of the analogue of growth hormone releasing hormone, GHRH (1–29)NH2, to 8 normal adults and 41 short children has been studied. The children were classified on the basis of their hGH response to insulin‐induced hypoglycaemia; 28 had severe hGH deficiency (peak serum hGH less than 7 mIU/litre) and 13 had simple short stature (peak serum hGH greater than 15 mIU/litre). The hGH response to GHRH was similar in normal adults and short stature children, but significantly lower in the hGH deficient children. In 23 (82%) of the hGH deficient children the peak serum hGH in response to GHRH was greater than 7 mIU/litre (the maximum value seen during hypoglycaemia), and in 14 (50%) the peak serum hGH in response to GHRH was greater than 15 mIU/litre. This suggests that in the majority of hGH deficient children the defect in hGH secretion results from hypothalamic GHRH deficiency. The hGH responses of the short stature children to insulin‐induced hypoglycaemia were mainly in the low range of normal, and the majority showed normal hGH responses to GHRH. Eighteen prepubertal children with definite hGH deficiency have been treated for 3–18 months with twice daily, subcutaneous injections of GHRH. This has promoted linear growth in 12 children, of whom 8 showed an increment in height velocity of 2–11 cm/year. GHRH provides a valuable method for the assessment of hGH secretion, but by itself it cannot be used to establish deficient hGH secretion; this requires a stimulation test that promotes hypothalamic GHRH secretion, such as insulin‐induced hypoglycaemia. GHRH is a practical alternative therapy to hGH for some hGH‐deficient children.
Growth Hormone Deficiency in Adults ‐ an Indication for Therapy?
Authors: PREECE M.A. , ROUND J.M. , JONES D.A.
Published: January 2008

Case studies are presented for two patients, one with isolated hGH deficiency and one with multiple hormone deficiencies. The patients were studied 3 months before, and 3 and 9 months after discontinuing hGH therapy, at 19 and 18 years of age, respectively. Strength in the quadriceps femoris, cross‐sectional area of the quadriceps muscles and cross‐sectional muscle fibre area were measured. In the patient with multiple hormone deficiencies, clear decreases in all three parameters were evident after discontinuing hGH treatment. There were no significant changes in the other patient. Reasons for these differences are discussed.
Abstract
Authors: BARDO ALICJA
Published: January 2008

Cystic fibrosis (CF) is a chronic genetic disease mainly affecting the exocrine glands. Its main clinical symptoms are: abnormal production of mucus which blocks the airways, pancreatic insufficiency and increased sweat electrolytes.

In the present investigation a series of enzymes and metabolites—mainly of carbohydrate metabolism—was investigated in biological fluids from CF homozygotes, CF heterozygotes and healthy controls under different conditions.

CF homozygotes—and to a lesser degree CF heterozygotes—had increased activity of ribonuclease, and increased concentrations of electrolytes and lactate in their saliva and urine at rest. Saliva of CF patients also had augmented levels of protein.

When healthy persons were submitted to anaerobic effort, the activity of ribonuclease and the concentrations of protein, electrolytes and lactate increased in their saliva, and thereby, mimicked the values found in the saliva of cystic fibrosis patients at rest.

An abnormal response to a sucrose load was found in both CF‐homozygotes and CF‐heterozygotes. Greater increase in both glucose and lactate concentrations in the blood as well as a more rapid clearance of these metabolites was observed after the sucrose intake.

A possible cause for these findings could be a disturbed carbohydrate metabolism in CF.

Therefore, enzymes and metabolites connected to the metabolic pathway of glucose were investigated in CF fibroblasts and in animal models for CF.

An increased activity of glycolytic enzymes in CF fibroblast were shown. Similar increases in activities of glycolytic enzymes were found in cells of submandibular glands of rats that were killed in a state of induced metabolic acidosis. These cells also showed increased protein and mucus contents, and elemental changes similar to those observed in fibroblasts of cystic fibrosis patients.

Contrary to this, decreased activities of the enzymes of the glycolytic pathway were found in the submandibular gland of chronically reserpinized rats. The end‐products of glycolysis, pyruvate and lactate, were also decreased, whereas the concentration of phosphoenolo‐pyruvate and creatinphosphate were increased, possibly causing acidosis in the gland.

Thus a disturbed glycolytic pathway in CF cells and a decreased intracellular pH might play an important role in the pathogenesis of this disease.
The Chronically Reserpinized Rat Disturbed Energy Metabolism in the Submandibular Gland
Authors: BARDO A. , MÜLLER R. M. , CEDER O. , ROOMANS G. M. , KOLLBERG H.
Published: January 2008

Some of the enzymes and metabolites of the glyconeogenetic pathway, ATP and creatine phosphate were investigated in the submandibular gland of reserpinized rats, and compared to those of control rats. Decreased activities of malic enzyme (p<0.005) and glucose‐6‐phosphatase (p<0.001) were found, while the activities of fructose‐1,6‐diphosphatase and malate dehydrogenase were not significantly changed. No activity of pyruvate carboxylase or phosphoenolpyruvate carboxylase was detected. Oxaloacetate (p<0.01), malate (p<0.005) and citrate (p<0.005) were found in decreased concentrations and fructose‐6‐phosphate in increased concentration in the submandibular glands of reserpinized rats. Decreased concentration of ATP (p<0.01) was found whereas the concentration of creatine phosphate was increased (p<0.05). The activity of creatinephosphokinase was decreased (p<0.005). These findings show a disturbance of high‐energy phosphate compounds content and a possible acidosis in the submandibular gland of this animal model for cystic fibrosis.
Reduced Activity of Glyceraldehyde 3‐Phosphate Dehydrogenase in Pancreas of Two Patients with Cystic Fibrosis
Authors: BARDO ALICJA
Published: January 2008

Post‐mortem studies of some enzymes connected to glucose metabolism were performed on pancreas, liver and adipose tissue from two patients with cystic fibrosis and from two age‐matched controls. The activity of glyceraldehyde 3‐phosphate dehydrogenase in the cystic fibrosis patients was markedly reduced in the pancreas, reduced to a lesser extent in the liver and increased in the adipose tissue. The activity of α‐glycerophosphate dehydrogenase was extremely high in cystic fibrosis pancreas, moderately higher in adipose tissue and considerably lower in the liver. Pyruvate kinase was decreased in CF pancreas and liver and increased in the adipose tissue. Glucose‐6‐phosphate dehydrogenase activity was detectable in cystic fibrosis pancreas, not detectable in the controls and lower in CF‐liver. All enzyme activities were compared with activities from organs of matched controls.
Physiological Role of Growth Hormone in Adult Life
Authors: SALOMON F. , SÖNKSEN P. H.
Published: January 2008

Salomon, F. and Sonksen, P. H. (Department of Medicine, St Thomas's Hospital, London, UK). Physiological role of growth hormone in adult life. Acta Paediatr Scand [Suppl] 337:158, 1987.

Some historical background on the physiological effects of pituitary gland extract and later of purified hGH in experimental animals is given, and the regulatory role of hGH in the human adult is reviewed. The effects of hGH on Carbohydrate, protein and lipid metabolism are complex and closely linked to the action of other hormones, particularly insulin.
Substitution Therapy with Recombinant Growth Hormone (Somatrem) in Adults with Growth Hormone Deficiency
Authors: DEGERBLAD M. , GRUNDITZ R. , HALL K. , SJÖBERG H‐E. , SÄÄF M. , THORÉN M.
Published: January 2008

Degerhlad, M., Grunditz, R., Hail, K., Sjöberg, H. E., Sääf, M. and Thorén, M. (Department of Endocrinology, Karolinska Hospital, Stockholm, Sweden). Substitution therapy with recombinant growth hormone (somatrem) in adults with growth hormone deficiency. Acta Paediatr Scand [Suppl] 337:170, 1987.

The effects of a 12‐week period of substitution therapy with somatrem have been investigated in six adults with confirmed hGH deficiency. Five of the six patients experienced a subjective improvement, mentally and physically, but these improvements were not demonstrated when the patients were assessed objectively. No side‐effects were reported. Serum procollagen III peptide increased in all patients and serum IGF‐1 increased in five of the six patients.
Serum CPK–BB Isoenzyme in the Assessment of Brain Damage in Asphyctic Term Infants
Authors: FERNANDEZ F. , VERDU A. , QUERO J. , PEREZ‐HIGUERAS A.
Published: January 2008

ABSTRACT. Serum creatine phosphokinase‐BB activities were measured at 4 and at 10 hours of life in 33 asphyctic full‐term infants. The infants were followed for a mean period of 16 months. Enzyme activities at 4 hours of life were significantly higher in those neonates who died of severe hypoxic‐ischemic encephalopathy or developed neurological sequelae than in those who did not present neurological abnormalities during the follow‐up time. The specificity of the enzyme assay in order to predict the neurological outcome was inferior to that of cranial computed tomography or a combined clinical‐electroencephalographic evaluation. It appears that the presence of elevated serum creatine phosphokinase‐BB activity can be a sensitive indicator of conspicuous brain damage, but it is of limited value to predict the neurological outcome after neonatal asphyxia.
The Long‐term Prognosis of Childhood Asthma in a Predominantly Rural Swedish County
Authors: JÖNSSON J.‐Å. , BOE J. , BERLIN E.
Published: January 2008

ABSTRACT. In 1985 a survey questionnaire was sent to 119 individuals who had been hospitalized as children (aged 5–15) because of asthma over a ten‐year period (1953–1962). Four patients out of 123 had died, three of them because of asthma. The response rate was 98% and the follow‐up covered a time range from 23 to 31 years. The mean age at follow‐up was 33 (range 26–43) and sixty‐four individuals (55%) were free from symptoms. The severity of asthma was evaluated by means of a symptom‐score divided into 5 degrees (no symptoms to continuous asthma). Symptom onset under the age of 4, the occurrence of atopic eczema and increased sensitivity to pollen, furry animals and respiratory tract infections correlated significantly (p<0.05, p<0.05 and p<0.01, respectively) with the occurrence of continuous adult asthma. A factor which appears to predict the development of adult asthma is a high level of medical care, expressed as the number of days of hospitalization during childhood.
Post‐Obstructive Urinary Concentrating DefectA Case Study in the Role of Prostaglandins
Authors: DAVIDAI G. , ALON U. , JAFFE M. , HOCHBERG Z.
Published: January 2008

ABSTRACT. A child with post‐obstructive urinary concentrating defect was studied for the possible pathophysiological role of prostaglandins and an eventual therapeutic approach. Increased urinary excretion of prostaglandins was corrected by indomethacin, with resultant increased nephrogenous cyclic AMP and partial improvement in the concentrating defect. The addition of a thiazide restored urinary concentration. These results add clinical support to the conception of the important role of prostaglandins in the mechanism of post‐obstructive hyposthenuria. This therapeutic regimen is advocated for prolonged post‐obstructive concentrating defect.
Gaucher Disease: Treatment of Hypersplenism with Splenic Embolization
Authors: THANOPOULOS B. D. , FRIMAS C. A. , MANTAGOS S. P. , BERATIS N. G.
Published: January 2008

ABSTRACT. Hypersplenism is a frequent complication of Gaucher disease requiring splenectomy. A patient with Gaucher disease and severe hypersplenism was treated with partial splenic embolization to avoid the increased risk of serious infectious complications and deterioration of the disease associated with splenectomy. A first embolization (25% ablation) was performed at 4 years. Because of persisting abdominal discomfort, failure to thrive and signs of hypersplenism a second embolization (40–50% ablation) was performed 18 months later. Subsequently, the patient's health improved remarkably and 4 years later he achieved normal growth, maintains normal haematologic parameters, is free of symptoms and has no skeletal abnormalities. No serious infections have occurred. The size of the liver and the spleen has not changed appreciably. It appears that partial splenic embolization may be preferable to splenectomy in patients with Gaucher disease, especially in those of young age.
Mortality, Morbidity, Growth and Development of Babies Weighing 501–1000 Grams and 1001–1500 Grams at Birth
Authors: BROTHWOOD M. , WOLKE D. , GAMSU H. , COOPER D.
Published: January 2008

ABSTRACT. During the five‐year period, January 1980 to December 1984, 149 babies of extremely low birthweight (ELBVV; 501–1000 g) and 296 of very low birthweight (VLBVV; 1001–1500 g) were admitted to King's College Hospital, Neonatal Intensive Care Unit. The survival rates were 51.7 % and 82.8 % respectively. There were more peri‐ and postnatal problems in the ELBVV babies than the VLBW babies and these differences were highly significant. All surviving babies born between January 1980 and December 1982 were followed up until aged two. The ELBW children had a higher incidence of neuro‐developmental sequelae than those of VLBW especially when both major and minor problems were considered. Their developmental quotients were lower at one and two years. Significantly more ELBW children were of short stature and low weight (<3rd centile). By two years of age the differences between ELBW and VLBW children in stature and mean DQ had lessened.
Glucose Tolerance and Insulin Receptor Binding to Monocytes and Erythrocytes in Patients with Cystic Fibrosis
Authors: ANDERSEN O. , GARNE S. , HEILMANN C. , PETERSEN K. E. , PETERSEN W. , KOCH C.
Published: January 2008

ABSTRACT. Cystic fibrosis (CF) is the most frequent life threatening hereditary disease in the Western World with an incidence of approximately 1:2000. Due to increasing survival rates the high frequency of abnormal glucose tolerance has become an important problem. We compared insulin concentrations during oral glucose tolerance test and insulin receptor binding to both monocytes and erythrocytes from 9 patients with CF, with results from 10 healthy controls of similar body weight. The insulin: glucose ratio was increased in the fasting state (p < 0.05) in patients with CF compared to controls, indicating an increased insulin resistance in CF‐patients. The total insulin secretion during oral glucose tolerance test as judged by the area beneath the insulin curve was similar in the two groups, but insulin secretion was significantly delayed in patients with CF. Insulin receptor binding to monocytes and the number of receptors were significantly increased (p < 0.01 and 0.02, respectively) in patients with CF whereas the dissociation constant was similar in patients with CF and controls. No difference was observed in insulin receptor binding to erythrocytes between the two groups. No correlations were found between insulin receptor binding to monocytes or erythrocytes and glucose tolerance or insulin concentrations.
The Role of Parainfluenza Viruses in Inspiratory Difficulties in Children
Authors: KORPPI M. , HALONEN P. , KLEEMOLA M. , LAUNIALA K.
Published: January 2008

ABSTRACT. Viral findings were prospectively studied in middle and lower respiratory tract infections in 449 hospitalized children during a 12‐month follow‐up period. A viral aetiology was found in 30 of the 65 children (46%) with inspiratory difficulties. Parainfluenza viruses were the infective agents in 24 of the 30 cases with viral diagnoses (80%), type 2 being the most prominent. There were 38 cases of parainfluenza infections, type 2 being the infective agent in 58% of the 24 cases of parainfluenza infections with inspiratory difficulties but in only 21% of the 14 cases of parainfluenza infections without inspiratory difficulties. Type 2 parainfluenza virus produced inspiratory difficulties in 82% of the cases as opposed to 56 and 50% of the cases for type 1 and 3, respectively. It is concluded that the type 2 parainfluenza virus has a particular association with inspiratory difficulties in children. Viral diagnosis was reached using direct antigen detection in nasopharyngeal specimens by radioimmunoassay in 59% and using complement fixation serology in 76% of parainfluenza infections. Ditect antigen detection was especially useful in infants. We suggest that direct antigen detection should be used as a primary virological diagnostic method in small children with middle and lower respiratory tract infections.
A Prospective Study on Non‐IgE‐Mediated Asthma in Children
Authors: ØSTERGAARD P. A. A.
Published: January 2008

ABSTRACT. From 1977 to 1980, seventy‐two children were found to have intrinsic (non‐IgE‐mediated) asthma. Except for five patients, 4 boys and one girl, who apparently grew out of their asthma, the remaining 67 patients were followed for six years. During the study period, 12 patients, 10 boys and 2 girls, developed extrinsic (IgE‐mediated) asthma. Nine of them (75%) had a positive family history of atopic disease, which was only the case in 12 (22%) of the patients who did not develop extrinsic disease. Hence, a change from intrinsic into extrinsic asthma is apparently common in boys, but seems to be rare in girls. In addition, in girls with intrinsic asthma, fixed or declining lung function tests followed by signs of pulmonary hyperinflation and lung fibrosis is common. Further, in the present series of children with intrinsic asthma, 5 patients, 4 girls and 1 boy, developed severe bronchiectasis. The majority of patients, who on repeated chest X‐rays showed persistent hyperinflation of the lungs associated with fixed FEV1/FVC levels and a marked increase of serum IgG‐concentrations were those at risk to develop severe lung disease.
Enuresis in Seven‐Year‐Old Children
Authors: JÄRVELIN M. R. , VIKEVÄINEN‐TERVONEN L. , MOILANEN I. , HUTTUNEN N.‐P.
Published: January 2008

ABSTRACT. A random sample of 3 206 seven‐year‐old children was studied in order to examine the prevalence of enuresis and associated somatic and genetic risk factors. The overall prevalence of enuresis was 9.8% and the figures for nightwetting, day wetting and mixed day and night wetting 6.4%, 1.8% and 1.6% respectively. The prevalence was 9.5% among primary school children, 24.8% among children whose entry to school had been postponed and 26.6% among handicapped and mentally retarded children. If the father had been enuretic after 4 years of age the risk of the child being enuretic was 7.1 times greater than otherwise (95% confidence limits of the risk ratio 5.1–9.8, p < 0.001), the corresponding risk ratio when the mother had been enuretic being 5.2 (3.9–7.0, p < 0.001). Low birth‐weight children were enuretic more often than children of normal birth‐weight. It seems that there are at least two aetiologically significant groups of enuretic children: cases with neurological damage and mixed day and night wetting and cases with delayed maturation, with nightwetting which shows a clear sex and genetic dependency.
Childhood Mortality in Relation to Nutritional Status and Water Supply—a Prospective Study from Rural Malawi
Authors: LINDSKOG U. , LINDSKOG P. , CARSTENSEN J. , LARSSON Y. , GEBRE‐MEDHIN M.
Published: January 2008

ABSTRACT. In connection with the introduction of an improved method of water supply in rural Malawi, the nutritional status, morbidity, and mortality among 1178 children under five were studied during three rainy and three dry seasons. Data were collected at fortnightly home interviews. Nutritional assessment was made twice a year. One hundred and thirty‐seven of the children died during the study period, and the probability of dying before the age of five was estimated to 270 per 1000 children. The mortality risk was related to weight for height (p<0.001) and height for age (p<0.01) as well as to upper arm circumference (p<0.001) and triceps skinfold (p<0.05). Mortality among children living in households using the new, piped‐water supply tended to be lower than mortality for those using traditional water sources, although the difference was not statistically significant (relative risk 0.4, 95% confidence interval 0.1–1.3).
The Effect of Reduction of Maintenance Treatment on Circadian Variation in Peak Expiratory Flow Rate Values in Asthmatic Children
Authors: AALDEREN W. M. C. VAN , POSTMA D. S. , KOËTER G. H. , KNOL K.
Published: January 2008

ABSTRACT. We investigated in well controlled asthmatic children whether it is possible to predict by measuring daytime forced expiratory volume in one second, the decline in nocturnal peak expiratory flow rate values after withdrawal of maintenance medication. Forced expiratory volume in one second and peak expiratory flow rate were measured in the outpatient clinic, on the last day with medication. Peak expiratory flow rates were then measured every four hours on days 4, 5 and 6 without medication. Seventeen children showed an amplitude in circadian peak expiratory flow rate values of more than 20% (group I) and nine children showed an amplitude of 20% or less on the three study days (group II). Mean values ± SEM were 34.7±2.1% and 10.5±1.5%, respectively. Forced expiratory volume in one second values were comparable in both groups. Daytime peak expiratory flow rate values before and after withdrawal, remained on the same level in both groups. In group I peak expiratory flow rate values of 24.00 and 08.00 hours on day 6 were significantly lower (p<0.05) than on day 4. The results indicate that history and daytime pulmonary function measurements alone, are insufficient to assess the clinical situation and suggest that a decrease in early morning peak expiratory flow rate value (08.00 hours) is an early sign of deterioration of the disease state, after reduction of medication.
Blood Pressure and Body Size in Precocious Puberty
Authors: LIKER H. R. , BARNES K. M. , COMITE F. , HENCH K. D. , LORIAUX D. L. , CUTLER G. B. , PESCOVITZ O. H.
Published: January 2008

ABSTRACT. Blood pressure increases with age in normal children. This increase appears to be related to body size. To assess the role of body size as a determinant of blood pressure in precocious puberty, we compared the Mood pressure of 81 children with precocious puberty with the blood pressure standards for normal children from the NHLBI Task Force on Blood Pressure Control in Children. Children with precocious puberty had significantly increased blood pressure for chronologic age (p<0.05) but generally appropriate Mood pressure for height age or weight age. These data are consistent with the hypothesis that increased body size causes the increased blood pressure for chronologic age in children with precocious puberty. Physicians who evaluate such children should assess whether blood pressure is appropriate for height age rather than chronologic age.
Neonatal Parenteral Nutrition with a Fat Emulsion Containing Medium Chain Triglycerides
Authors: LIMA L. A. M. , MURPHY J. F. , STANSBIE D. , ROWLANDSON P. , GRAY O. P.
Published: January 2008

ABSTRACT. Fifty‐one newborn infants requiring parenteral nutrition were randomly assigned to receive a 50% medium chain triglyceride/50% long chain triglyceride lipid emulsion or the conventional 100% long chain triglyceride emulsion. Fat was administered daily for 20 hours, to a maximum of 3 g/kg/day. Plasma triglycerides, cholesterol, free fatty acids, ketones, glucose and capillary blood gases were monitored daily up to the sixth day of fat infusion. There were no significant differences in mean plasma triglycerides and free fatty acids between the two groups. No cases of hyperketonaemia were detected in the infants studied. Hyperglycaemic episodes were detected with similar frequency in both groups. The group who received the emulsion containing medium chain triglycerides had significantly lower mean plasma cholesterol values during the study. After 6 days of intravenous fat administration mean plasma cholesterol was more than 100% higher in the group which received the conventional emulsion. Differences in cholesterol content between the emulsions and a cholesterol lowering effect of medium chain triglycerides are possible explanations for these findings.
Cause and Effect of Obstetric (Neonatal) Brachial Plexus Palsy
Authors: SJÖBERG I. , ERICHS K. , BJERRE I.
Published: January 2008

ABSTRACT. We have studied the causes and outcome of obstetric brachial plexus palsy in all children born in Malmö during the 10‐year period 1973–1982. Forty‐eight of 25736 live‐bom children (0.19%) were neonatally diagnosed as having a brachial plexus paresis. Twenty‐five percent of these, i.e., one child in 2000 liveborn, had a persistent palsy. The obstetric history was characterized by high birthweight, vertex presentation with shoulder dystocia and multiparity; and in two cases the mother had two children with brachial palsy. The children who recovered totally did so during the first few months. The prognosis for the more common upper brachial plexus, or Erb's, was more favorable than that for entire brachial plexus palsy. All the children with persistent palsy were afflicted with considerable reduction in arm function, resulting in varying degrees of handicap, such as not being able to use the palsied arm at all or not being able to perform certain tasks—writing properly, playing a musical instrument, doing the hair, wearing clothing with shoulder straps, etc. We wish to point out that, in several cases, obstetric brachial plexus palsy results in a lifelong handicap and that prevention and therapy are essential both in obstetric and in pediatric management.
Changing Pattern of Childhood Coeliac Disease in Finland
Authors: MÄKI M. , KALLONEN K. , LÄHDEAHO M.‐L. , VISAKORPI J. K.
Published: January 2008

ABSTRACT. In the Tampere region in Finland, the incidence of childhood coeliac disease was 1:1096 between 1964 and 1973 and 1:3214 from 1974 to 1983. The clinical picture of coeliac disease had changed to milder forms, resulting in an upward shift of age at diagnosis. Coeliac disease was found in older children and adolescents, manifesting itself mostly in minor abdominal symptoms, short stature, delayed puberty, anaemia and joint complaints, and in children with diabetes mellitus. Long breast‐feeding seemed to postpone the symptoms but the introduction of gluten was of no significance. The low incidence for 1974 to 1983 was thought to be due to the estimated 20 cases born in 1979 to 1983 who were not detected. We do not believe that coeliac disease has disappeared but that it will be found during the next decade in the patients who were not diagnosed in school age and adolescence.
Hyperphenylalaninemia in Malignant Histiocytosis and Virus‐Associated Hemophagocytic Syndrome
Authors: Imashuku S. , Kodo N. , Esumi N. , Morioka Y. , Todo S. , Furukawa N. , Kinueasa A.
Published: January 2008

It has been known for more than 2 decades that amino acid changes accompany various forms of infectious diseases. In some of these infections, an elevation in the phenylalanine/tyrosine ratio has been reported (1–4). Similar amino acid changes have also been described in protein calorie malnutrition (5) and chronic renal insufficiency (6). So far, however, such changes have not been clearly described in patients with hematologic neoplasias, especially for proliferative disorders of mononuclear macrophages. Nor has the actual occurrence of hyperphenylalaninemia in association with infectious or neoplastic disorders been reported. Recently, we encountered 2 patients with malignant histiocytosis (MH) (7) and a case of virus‐associated hemophagocytic syndrome (VAHS) (8). In all three patients the disease took a very rapid and fatal course with multiple organ dysfunction associated with hyperphenylalaninemia (>400 μmol/l) and an increased serum phenylalanine/tyrosine (Phe/Tyr) ratio (>4.00) (Table 1).
Gastric Aspirates of Newborn Infants: pH, Volume and Levels of Gastrin‐ and Somatostatin‐Like Immunoreactivity
Authors: WIDSTRÖM A.‐M. , CHRISTENSSON K. , RANSJÖ‐ARVIDSON A.‐B. , MATTHIESEN A.‐S. , WINBERG J. , UVNÄS‐MOBERG K.
Published: January 2008

ABSTRACT. The aim of the present investigation was to study volume, pH and the levels of gastrin‐ and somatostatin‐like immunoreactivity in gastric aspirates obtained immediately after birth from 25 healthy infants. In addition, the same parameters were measured in amniotic fluid collected from 11 of the mothers. The median volume of the gastric contents was 4 ml (range 0–11) and median pH was 6.96 (range 2.77–9.58). Gastrin and somatostatin median concentrations were 8 pM (range 0–52) and 67 pM (range 15–>1000), respectively. The corresponding levels in amniotic fluid were 8.2±3.6 pM and 28.4±5.3 pM, median pH was 9.22 (range 8.05–9.58). There was a significant correlation between volume and pH of gastric contents. The pH of the gastric aspirate was inversely correlated with the somatostatin levels. No correlation could be demonstrated as regards levels in amniotic fluid and gastric content. Gastric content and amniotic fluid were not correlated regarding pH, gastrin and somatostatin. It is suggested that the foetus drinks about 10 ml portions of amniotic fluid which are gradually emptied from the stomach and that these drinking episodes are associated with gastric exocrine and endocrine secretion normally seen following feeding after birth.
Longitudinal Analysis of Infantile Growth in Children with Celiac Disease
Authors: KARLBERG J. , HENTER J.‐I. , TASSIN E. , LINDBLAD B. S.
Published: January 2008

ABSTRACT. The aim of the present study was to describe linear growth of infants with celiac disease, using the “ICP‐growth model”. Supine length during the first three years of life was studied longitudinally in 63 infants with diagnosed celiac disease. “Undisturbed” linear growth was seen during the first six postnatal months followed by reduced growth during the second half of the first year. After 1.5 years of age a pattern of catch‐up growth was observed, leading to an average attained length at 3 years of age similar to that of the controls. According to the “ICP‐growth model”, normal linear growth can mathematically be represented during the first 3 years of life by an Infancy component with the addition of a Childhood component, the latter acting from the second half of the first postnatal year. The onset of the Childhood component (assumed to represent the age at which growth hormone begins to influence linear growth significantly) was delayed by about an average of 3 months, which is in agreement with the observed reduction in gain during the second half of the first year of life. Children suffering from celiac disease and with “late” onset of the Childhood component were shorter at 1, 2 and 3 years of age than those with “normal” onset. The results of this investigation show that ICP‐based growth charts are helpful in detecting and monitoring growth for children with celiac disease, and indicate a possible mechanism whereby malabsorption (and perhaps secondary malnutrition) leads to reduced growth velocity.
Plasma Lipid and Apolipoprotein Levels in Children Hereditarily Predisposed to Coronary Heart Disease
Authors: PEROVA N. , AINGORN H. , METELSKAYA V. , DOROFEEVA T. , BELOKONJ N.
Published: January 2008

ABSTRACT. Plasma lipids and apoproteins A‐I, A‐II and B levels were measured in 125 children whose fathers had coronary atherosclerosis (paternal coronary heart disease group), in 172 children with blood pressure lability and in 154 children selected at random from a representative subsample (reference). The paternal coronary heart disease group had, compared with the reference group, lower levels of high density lipoprotein cholesterol and apoprotein A‐I, higher levels of low density lipoprotein cholesterol, triglycerides and apoprotein B, and also a higher ratio of apoprotein B to apoprotein A‐I. The paternal coronary heart disease group subjects with blood pressure lability had the most pronounced changes in the lipoprotein spectrum, which were similar to atherogenic changes in the lipoprotein profile, characteristic of patients with coronary atherosclerosis.
Pulmonary Resection for Localized Bronchiectasis in Cystic Fibrosis
Authors: STEINKAMP G. , von der HARDT H. , ZIMMERMANN H. J.
Published: January 2008

ABSTRACT. Three children with cystic fibrosis and localized bronchiectasis were treated by surgical removal of the affected lobe, after attempts to clear the obstructed bronchus by medical therapy and bronchoscopy with suction and lavage had been unsuccessful. Three to six years after surgery, the results are excellent. Pulmonary disease is mild in all patients, shown by chest radiographs and pulmonary function tests. A review of 102 cases reported in the literature demonstrates that pulmonary surgery is effective and can be performed safely in selected patients.
Increased IgG2 and IgG3 Concentration Is Associated with Advanced Pseudomonas Aeruginosa Infection and Poor Pulmonary Function in Cystic Fibrosis
Authors: PRESSLER T. , MANSA B. , JENSEN T. , PEDERSEN S. S. , HØIBY N. , KOCH C.
Published: January 2008

ABSTRACT. The concentrations of IgG subclass immunoglobulins were determined by radial immunodiffusion in serum from 126 patients with cystic fibrosis (CF). The results were compared to values from age‐matched healthy children and adults and correlated to patients age, duration of chronic Pseudomonas aeruginosa infection and lung function parameters. Fifty‐two percent of the patients had an elevated concentration of at least one of the IgG subclasses; IgG1 28%, IgG2 16%, IgG3 18% and IgG4 48%. There was significant correlation between elevated serum levels of IgG2, and to a lesser extent IgG3, with decreased lung function (for FEV1; p=0.0001, and p=0.001 respectively) and high levels of antipseudomonas precipitins (p=0.008, and p=0.002). A similar correlation was not found for IgG1 and IgG4. IgG subclasses vary in their ability to promote phagocytosis and to activate complement and it is possible that individual differences in the IgG subclass pattern could explain the variable course of this disease.
Orocoecal Transit Time in Healthy and Constipated Children
Authors: VAJRO P. , SILANO G. , LONGO D. , STAIANO A. , FONTANELLA A.
Published: January 2008

ABSTRACT. Orocoecal transit time (OCTT), assessed by means of H2 breath test after lactulose and/or after a semisolid standard meal, was studied in normal and constipated children. Both control subjects and patients with constipation showed a significantly longer OCTT after a standard meal than after lactulose ingestion (p<0.01). Whereas the OCTT after lactulose did not differ in the two groups, the constipated patients had a significantly longer transit time after a standard meal when compared to controls (p<0.05). No correlation was observed within each group between the OCTT after a standard meal or after lactulose ingestion (r=‐0.077; p>0.1). These findings suggest that 1) measurement of the transit of a standard meal instead of a lactulose solution may offer more direct insight into the role of small intestinal transit of food, both in physiological and pathological conditions, 2) gastrointestinal segments other than colon may play a role in chronic non organic constipation of childhood.
Compensatory Increase of CBF in Preterm Infants during Hypoglycaemia
Authors: PRYDS O. , GREISEN G. , FRIIS‐HANSEN B.
Published: January 2008

ABSTRACT. Cerebral blood flow (CBF00) was investigated in 24 preterm infants (mean 30.8 weeks of gestational age) by use of intravenous 133‐Xe clearance technique while screening simultaneously for low blood glucose after birth (mean 3 hours). CBF was significantly increased in 10 infants with blood glucose lower than 1.7 mmol/l compared to normoglycaemic infants and tended to decrease rapidly after treatment. Nine of the 10 hypoglycaemic infants were monitored for cerebral function. Well defined visual evoked cortical potentials were elicit‐able in all and the aEEG was not less active during the hypoglycaemic episode. Therefore, it is suggested that compensatory increase of CBF may have supported the cerebral metabolism during uncomplicated hypoglycaemia.
Vaginally Born Low‐Risk Preterm Infants: Fetal Acidosis and Outcome at 6 Years of Age
Authors: HOLMQVIST P. , PLEVÉN H. , SVENNINGSEN N. W.
Published: January 2008

ABSTRACT. In a population of vaginally born low‐risk preterm infants fetal acidosis (scalp pH <7.20) was found in 50% (6 out of 12) of infants of 29–33 weeks' gestational age (Group I) and in 9% (2 of 22) infants of 34–36 weeks' gestational age (Group II). At 6–7 years of age the children underwent a neurodevelopmental examination including a Griffith test. Five out of 6 Group I infants with fetal acidosis and 10 out of 20 Group II infants without fetal acidosis had minor or moderate neurodevelopmental problems. On the Griffith test Group II infants scored below Group I with more coordination and fine motor problems on the tested subscales. Fetal acidosis was more common in very preterm infants but cannot be used per se as a reliable indicator of long‐term outcome.
Growth Hormone Response to Growth Hormone‐Releasing Hormone (hp GHRH‐1‐44) as an Index of Growth Hormone Secretory Dysfunction after Prophylactic Cranial Irradiation for Acute Lymphoblastic Leukemia (24 Grays)
Authors: CROSNIER H. , BRAUNER R. , RAPPAPORT R.
Published: January 2008

ABSTRACT. The growth hormone response to growth hormone releasing hormone hp GHRH1‐14 (2 μg/kg i.v.) was studied in 19 prepubertal children who had been irradiated with 24 Gy for acute lymphoblastic leukemia (ALL) or lymphosarcoma (LS) at a mean chronological age of 410/12 years (limits 10/12 to 9 years). They were evaluated after a mean time interval of 4 8/12±3/12 years and compared to 14 prepubertal children with constitutional short stature (CSS). The individual responses to GHRH were decreased in all but three of the irradiated children. The mean GH response was 16.7±2.5 ng/ml as compared to 52.6±8.5 ng/ml in the control group (p<0.001). The GH response to GHRH was not correlated with the GH response to arginine‐insulin tolerance test (AITT). A decreased response to GHRH with values between 12.5 and 19.4 ng/ml was observed in four cases with normal growth rates and normal GH responses to AITT. These results suggest that an impaired GH response to GHRH is a frequent finding after cranial irradiation for ALL or LS and may be the only sign of GH secretory dysfunction. It is probably indicative of early hypothalamic impairment of GH secretion.
Thrombocytopenic Purpura and Coeliac Disease
Authors: STENHAMMAR L. , LJUNGGREN C. G.
Published: January 2008

ABSTRACT. In a child with immune thrombocytopenic purpura (ITP) the findings of circulating reticulin antibodies and IgA and IgG gliadin antibodies suggested the diagnosis of coeliac disease. This was verified by small intestinal biopsy. In spite of a gluten‐free diet the thrombocytopenia persisted. The association of ITP and coeliac disease was previously described in adults but to our knowledge this is the first report of the coexistence of ITP and coeliac disease in a child.
Cutis Marmorata Telangiectatica Congenita with Terminal Transverse Limb Defects
Authors: BJÖRNSDOTTIR UNNUR STEINA , LAXDAL THRÖSTUR , BJÖRNSSON JOHANNES
Published: January 2008

ABSTRACT. We describe a girl with clinical and histopathological manifestations characteristic of Cutis Marmorata Telangiectatica Congenita (CMTC) associated with Terminal Transverse Limb Defects (TTLD). In contrast to previous reports on this rare syndrome, no cutaneous atrophy or aplasia was evident in our patient.
Measurement of Small Intestinal Transit Time in Children
Authors: MURPHY M. S. , NELSON R. , EASTHAM E. J.
Published: January 2008

ABSTRACT. The lactulose hydrogen breath‐test provides a non‐invasive measure of mouth to caecum transit‐time. Its use, particularly in children has not been thoroughly investigated. We have studied the effects on transit time of altering the lactulose concentration of the test solution, and of administering it in a liquid nutrient preparation. Concentration markedly affected transit‐time; studies with an isotonic solution may be least affected by delayed gastric emptying, and so may reflect small bowel transit‐time. Day‐to‐day variation was large, and was not reduced by altering lactulose concentration, or by using the liquid nutrient based test solution. There was no correlation between age and transit‐time.
Children with Tonsillar Obstruction: Indications for and Efficacy of Tonsillectomy
Authors: AHLQVIST‐RASTAD J. , HULTCRANTZ E. , SVANHOLM H.
Published: January 2008

ABSTRACT. One hundred and twenty‐two children between 1 1/2 and 14 years of age with symptoms suggesting tonsillar obstruction have been investigated. Each patient's history was analysed and the symptoms scored according to their incidence and severity. In addition, the size of the tonsils was evaluated. Eighty‐five patients were chosen for tonsillectomy. The children with signs and symptoms of tonsillar obstruction improved greatly immediately after tonsillectomy. Severe symptoms of obstruction were observed in children with nearly normal tonsil size, as well as in those with very large tonsils. It is therefore just as important to obtain a careful history as it is to evaluate the size of the tonsils before deciding about surgery.
Epidemiology of Absence Epilepsy
Authors: OLSSON I.
Published: January 2008

ABSTRACT. An epidemiological study of absence epilepsy is presented. The study comprised a series of cases from a Swedish population, aged 0–15 years, selected on the basis of EEG criteria. All children with regular and symmetrical 3 (2–4) Hz spike‐and‐slow‐wave complexes, recorded for the first time during the period 1978–1982, were included. A total of 134 children fulfilled the inclusion criteria, and of these, 108 (80.6%) had absences alone or in combination with general tonic‐clonic seizures (GTCS); 11 (8.2%) had absences combined with other seizures; 15 (11.2%) had other types of seizures only. The mean annual incidence of absence epilepsy was 7/100 000 for children aged 0–15 years. Of these, 6.3/100 000 had absences alone or in combination with GTCS. The cumulative incidence of absence epilepsy was 98/100 000. The mean age of onset was 7 years.