bluuebunny/crossref_metadata_2025 huggingface dataset:
5. MIGRAINE IN CHILDREN AND ADOLESCENTS
Authors: RIGG C. ANDREW
Published: January 2008

ABSTRACT

Although migraine has been considered in the past to be uncommon in children and adolescents, there is mounting evidence that it is not, and that it produces significant childhood morbidity. However, the clinical picture varies from case to case, and often from attack to attack in the same patient. Stress plays a most important role in triggering attacks of this familial disease, and the physician must be aware of this if his treatment is to be successful. In adolescent girls, falling estradiol plasma levels are apparently important in triggering attacks of migraine associated with menstruation. In an attack, the initial vasoconstrictive phase, mainly intracranial gives way to a vasodilative phase, mainly extracranial, which results from withdrawal of the vasoconstrictive support from the extracranial arteries which is normally provided by serotonin. The plasma level of the latter drops sharply during an attack, and its excretion product, 5‐hydroxy‐indole acetic acid, appeals in increased amounts in the urine.

Laboratory investigations, after a most careful, detailed history, and physical examination, should include an EEG, skull films and possibly a brain scan. Management includes prophylactic measures, both environmental and pharmacologic, and treatment of the attack itself, where promptness is the watchword.
10. THE IMPACT OF ILLNESS IN ADOLESCENCE AND COPING BEHAVIOR
Authors: HOFMANN A DELE D.
Published: January 2008

ABSTRACT

The emotional impact of serious illness or injury bears just as much potential for being disabling to an adolescent as does the condition itself. It is also these concerns and the possibilities for difficult behavior on the part of teenagers on the ward which frequently cause staff members to feel at a loss when caring for this reputedly difficult age group. But if one carefully examines the specific developmental stresses of illness and the various coping mechanisms by which the youth may counter them, a logical management approach emerges.

To a large degree this approach depends on compensation, intellectualization, displacement and constructive denial but also recognizes that destructive denial, regression and projection do normally and naturally occur at various points in the course of illness and hospitalization and that panic and acting out may also readily occur, but less frequently. The deterence of the more deleterious responses and promotion of the more felicitous depends on a ward setting which provides for the adolescent's growing need for independence and self‐determination; for continued reassurance about body image integrity, for resumption of mastery and control; and for the maintenance or restoration of his sense of self‐worth. These goals are achieved by encouraging the youth to be an active partner in his own care; to share in decisions made about his condition; to pursue just as much independent self‐management as he can; to actively engage in establishing a peer group with other adolescents in the ward; to continue with his education, socialization, personal interests and outside peer contacts as much as possible; and to feel that the staff respects his dignity and privacy, likes him as a person and appreciates the courage and effort with which he is facing a difficult time.
CONSIDERATIONS ON TREATMENT OF NEPHROBLASTOMA
Authors: JEREB B. , SANDSTEDT B. , ÅHSTRÖM L. , ERICSSON N. O.
Published: January 2008

Abstract. Thirty‐six patients with nephroblastoma in Stages I, II and III treated at Radiumhemmet between 1966 and 1973, were analysed. The tumours were classified into three different histological types. All 10 patients in Stage III have developed metastases. All patients in Stages I and II (5 out of 26) who developed metastases had poorly differentiated (histological Type III) tumours. The indications for postoperative irradiation and chemotherapy for the different stages and histological types of the tumour are discussed.
THE OSTEODYSTROPHY OF PROLONGED OBSTRUCTIVE LIVER DISEASE IN CHILDHOOD
Authors: GLASGOW J. F. T. , THOMAS P. S.
Published: January 2008

Abstract. Ten infants with obstructive jaundice who developed varying degrees of metabolic bone disease were studied biochemically and radiologically. Mild rickets was present in 7, and 3 others with severe bone disease developed widespread skeletal demineralization and multiple fractures. The intake of vitamin D was apparently loosely related to the severity of the osteodystrophy. The latter however, was closely linked to both the serum inorganic phosphate and the calcium × phosphate product. The serum calcium was directly related to the infant's gestational maturity, hypocalcaemia being present in those born before 35 weeks. Pathogenetic factors have probably included reactive hyperparathyroidism and nutritional deprivation associated with preterm delivery. Five of the infants who had biliary atresia developed radiological evidence of osteoporosis from about twelve months of age. This may be related to protracted calcium malabsorption, but its true nature remains to be elucidated.
THE PERIURETHRAL AEROBIC BACTERIAL FLORA IN HEALTHY BOYS AND GIRLS
Authors: BOLLGREN I. , WINBERG J.
Published: January 2008

Abstract. The present study was undertaken to provide information about the presence of bacterial flora in the periurethral region of healthy children and its variation with age and sex. It was intended as a basis for subsequent studies in individuals prone to urinary tract infection. Quantitative methods were used for bacteria sampling and culture. The study included 394 girls and 305 boys from birth to 16 years. During the first few weeks of life a massive aerobic bacterial flora (E. coli, enterococci, staphylococci) was established in the periurethral region of both sexes. The colonization with E. coli and enterococci began to diminish already during the first year of life and became very scanty after the age of 5 years. In newborns E. coli colonization was dense in boys and scanty in girls. Later E. coli was the dominating gram‐negative species in girls of all age groups. In boys E. coli dominated during the first half year of life, later Proteus was as common as E. coli; staphylococci did not change very much. Urine samples from healthy school‐children contained very few gram‐negative bacteria, even when collected without preceding cleansing. The results suggest that there might be a local defence mechanism maturing during the first year of life, eventually protecting the exposed area from colonization with gram‐negatives and enterococci.
THE PERIURETHRAL AEROBIC FLORA IN GIRLS HIGHLY SUSCEPTIBLE TO URINARY INFECTIONS
Authors: BOLLGREN I. , WINBERG J.
Published: January 2008

Abstract. After the age of 5 years, normal children have but few aerobic gram‐negative rods periurethrally. This study examines whether there is an abnormal periurethral colonization in urinary tract infection‐prone girls during infection‐free intervals, indicating a defective local defence. In 13 girls with a history of recurrent infection, daily bacterial samples were obtained from the periurethral area and from urine. Sampling continued until an infection eventually occurred. Seven girls contracted a urinary tract infection within 3–30 days. All were heavily colonized with gram‐negative rods, often several species, before infection appeared. Serotyping of E. coli confirmed that it was the colonizing strain which later invaded the bladder. The findings suggest a local defect in the antibacterial defence of infection‐prone individuals and gives strong evidence for ascending infection. Six girls remained uninfected during an observation period of 9–123 days. They all had a normal periurethral flora. A reasonable hypothesis would be that the same factor counteracted colonization and infection. Since abnormal periurethral colonization was not a constant phenomenon the postulated defect may vary. This might explain the fact that urinary tract infections often appear in quick succession, often followed by long infection‐free intervals.
THE ROLE OF HAEMOLYSIS IN NEONATAL HYPERBILIRUBINAEMIA AS REFLECTED IN CARBOXYHAEMOGLOBIN LEVELS
Authors: NECHELES THOMAS F. , RAI UMA S. , VALAES TIMOS
Published: January 2008

Abstract. Carboxyhaemoglobin levels were measured in 250 consecutive, normal, term newborns and in a group of 75 severely jaundiced infants in an effort to assess the role of haemolysis in non‐specific neonatal hyperbilirubinaemia—“Physiologic jaundice”—as well as in severe jaundice of various etiologies. In normal newborns a significant correlation (r=0.3293, p<0.001) was found between third‐day carboxyhaemoglobin and serum bilirubin levels. Significant correlations were also found between the cord and third day values for carboxyhaemoglobin (infants of non‐smoking mothers) for reticulocyte count, and for serum bilirubin. Third day haemoglobin showed no correlation with any of the other parameters including cord haemoglobin. Of the infants with third day carboxyhaemoglobin up to 0.75%, 1.7% had third day serum bilirubin values above 16.0 mg/100 ml. The corresponding percentage for the infants with carboxyhaemoglobin above 0.75% was 6.1%. It is concluded that increased rates of haemolysis due to as yet unspecified causes play an important role in the non‐specific hyperbilirubinaemia of normal term newborns. As expected, high levels of carboxyhaemoglobin were found in infants with severe jaundice due to Rhesus and ABO haemolytic disease and glucose‐6‐phosphate dehydrogenase deficiency but also in jaundiced prematures and in Greek infants with severe jaundice of unknown cause.
CONGENITAL HYPERPARATHYROIDISM AND VITAMIN D DEFICIENCY SECONDARY TO MATERNAL HYPOPARATHYROIDISM
Authors: SANN L. , DAVID L. , THOMAS A. , FREDERICH A. , CHAPUY M. C. , FRANCOIS R.
Published: January 2008

Abstract. A new case of congenital hyperparathyroidism secondary to maternal hypoparathyroidism is described. Neonatal roentgenograms of the skeleton showed severe bone demineralisation and the distal metaphyses of the long bones were spread, frayed and cupped. Elevated levels of serum immunoreactive parathormone (iPTH) were found at the age of 41 days=270 μlEq/ml (Normal: <50 μlEq/ml). A very low plasma 25‐OH‐D concentration (<4 ng/ml) was found at the same time in spite of previous administration of 600 units of vitamin D every day for 18 days and in spite of healing of the bone lesions. At the age of 3 months, 15 mg of vitamin D was given orally: iPTH levels which remainded high 3 weeks before (210 μlEq/ml) were found to be normal one week after this vitamin D load (37 μlEq/ml). It is suggested that in congenital hyperparathyroidism secondary to maternal hypoparathyroidism, hyperparathyroidism increases the infants needs for vitamin D. This could result in a state of vitamin D deficiency which in turn would maintain the parathyroid hyperactivity.
ESCHERICHIA COLI O ANTIBODY CONTENT IN MILK FROM HEALTHY SWEDISH MOTHERS AND MOTHERS FROM A VERY LOW SOCIO‐ECONOMIC GROUP OF A DEVELOPING COUNTRY
Authors: CARLSSON B. , AHLSTEDT S. , HANSON L. Å. , LIDIN‐JANSON G. , LINDBLAD B. S. , SULTANA R.
Published: January 2008

Abstract. The antibody content of milk from healthy Swedish mothers was compared with that of milk from mothers of a very low socio‐economic group in a developing country. Antibodies of various immunoglobulin classes against E. coti O antigens were determined with the enzyme‐linked immunosorbent assay (ELISA). The milk antibodies which mainly belonged to the secretory IgA class appeared in similar concentrations in milk from the two groups using E. coli antigens of Swedish as well as Pakistani origin. The secretory IgA antibodies could be demonstrated in the stool of the breast‐fed infants of the undernourished mothers. Also the concentration of serum IgG and IgA antibodies to E. coli O antigens were similar in the Pakistani and Swedish mothers. The serum IgM antibody levels of the Pakistani mothers were higher, however, presumably due to a higher frequency of infections. It was noted that the milk production decreased considerably upon the hospitalization of the healthy and well‐to‐do Swedish mothers. The small milk volumes of the undernourished Pakistani mothers suggest that the lactation failure observed was mainly due to inadequate milk flow and not to decreased milk quality. The results indicate the necessity of studying the nutritional, psychological and social factors responsible for low milk yield and add yet another reason to stimulate prolonged breastfeeding.
B, T AND NULL LYMPHOCYTES IN NEWBORN INFANTS AND THEIR MOTHERS
Authors: CHRISTIANSEN J. SANDAHL , OSTHER K. , PEITERSEN B. , BACH‐MORTENSEN N.
Published: January 2008

Abstract. Estimation of B, T and null cells were performed on 29 newborn healthy babies and 16 mothers. The lymphocytes were isolated from peripheral venous blood, which is considered to be more representative of the immune state in the newborn than the cord blood. B lymphocytes were estimated by cytofluorometric measurements, T lymphocytes by sheep red blood cell rosette technique, (SRBC‐R). Combined immunofluorescence and SRBC‐R technique revealed the null cells. In the newborn babies the amount of B and T cells were found to be diminished. In the mothers the amount of B lymphocytes were low compared with normal adults. The rather high null cell percentage found in the babies might represent immature precursor cells. Mothers seem to be immuno‐depressed as reflected in the low amount of B cells.
RENAL FUNCTION AS A MARKER OF HUMAN FETAL MATURATION
Authors: SIEGEL SHARON R. , OH WILLIAM
Published: January 2008

Abstract. Sixty clinically well infants of various gestational ages (27 to 40 weeks) were studied from 24–40 hours after birth to evaluate glomerular filtration rate and renal excretion rate of sodium at various stages of fetal maturation. Creatinine clearance was directly related to gestational age (r=0.643). Fractional sodium excretion was inversely related to gestational age (r=‐0.755). The renal functions of small for gestational age infants were similar to those of full‐term infants whose birth weights were appropriate for gestational age. The data showed that the glomerular functions of an infant below 32 weeks of gestation were more predominant than the tubular function resulting in a greater fractional sodium excretion rate and higher urinary Na loss in infants of this gestational age, when compared with the more mature infants.
UMBILICAL VEIN CATHETERIZATION AND PORTAL HYPERTENSION
Authors: JUNKER P. , EGEBLAD M. , NIELSEN O. , KAMPER J.
Published: January 2008

Abstract. Portal hypertension is a rarely encountered late complication of umbilical vein catheterization. A survey of the 38 cases previously published is presented together with an additional Case Report. It is concluded that catheterization for more than 2 days carries an increased risk of thrombosis, and that umbilical artery catheterization should be preferred in the majority of cases due to a reduced risk of complications. The correct position of the catheter tip must always be controlled by fluoroscopy or X‐ray. Infusion of hypertonic solutions with unphysiological pH should be restricted and umbilical vessel catheterization should only be carried out in severe cases. Pretreatment of the catheters with heparin possibly reduces the hazards.
DEFECTIVE NEUTROPHIL CHEMOTAXIS AND HYPERIMMUNOGLOBULINEMIA E—A REVERSIBLE DEFECT?
Authors: FONTAN G. , LORENTE F. , RODRIGUEZ M. C. GARCIA , OJEDA J. A.
Published: January 2008

Abstract. An eleven‐month‐old boy is presented with chronic atopic dermatitis and recurrent infections of the skin and respiratory tract, including subcutaneous abscesses. Immunological studies disclosed a neutrophil chemotactic defect, blood eosinophilia and serum hyper IgE. The clinical and analytical data are similar to those of patients previously described by Hill & Quie. A diet free of the allergens which were responsible for the atopic dermatitis reversed the chemotactic defect, the blood eosinophilia and the clinical symptoms.
PRIMARY HYPOTHYROIDISM, GROWTH HORMONE DEFICIENCY AND CONGENITAL MALFORMATIONS IN A CHILD WITH THE KARYOTYPE 46, XY, del(l)(q25q32)
Authors: KOIVISTO M. , ÅKERBLOM H. K. , REMES M. , CHAPELLE A. DE LA
Published: January 2008

Abstract. Primary thyroidal hypothyroidism, growth hormone deficiency, congenital malformations and mental retardation occurred in a child with an interstitial deletion of one of the No. 1 chromosomes. Two bands were missing, so that the karyotype could be written: del(l)(pter→q25::q32→qter). The possible relationship between the clinical features and chromosomal deletion are discussed.
PLEURAL EMPYEMA IN A NEWBORN INFANT An Unusual Cause of Respiratory Distress
Authors: PETERSEN STEN , ASTVAD KENNETH
Published: January 2008

Abstract. In a 2‐day‐old baby with symptoms of respiratory distress a right‐sided pleural empyema caused by haemolytic streptococci was found. Possible sources of infection are discussed. The mother had purulent discharge from a tooth a few weeks before delivery, and this may have been the focus. The baby was treated with pleural drainage and ampicillin with good result.
INTRAEPITHELIAL LYMPHOCYTE COUNTS IN SMALL INTESTINAL BIOPSIES FROM CHILDREN WITH DIARRHOEA
Authors: FERGUSON ANNE , McCLURE J. P. , TOWNLEY R. R. W.
Published: January 2008

Abstract. We have investigated small intestinal biopsies from children with coeliac disease, acute gastroenteritis, failure to thrive and giardiasis, to find out if a high intraepithelial lymphocyte count is a feature specific to coeliac disease, or whether it is always associated with partial or subtotal villous atrophy. The results indicate that the normal range for childrens' intraepithelial lymphocyte counts is similar to that for adults (around 6–40 lymphocytes per 100 epithelial cells); that counts are high in coeliac disease, but also in some children with giardiasis or with failure to thrive in whom the jejunal biopsy appears otherwise normal; and that intraepithelial lymphocyte counts are normal in acute gastroenteritis even when there is partial villous atrophy with increased lamina propria lymphoid cell infiltrate. Thus, this measurement of small intestinal lymphocyte infiltration may be of diagnostic value in differentiating the diarrhoea of food intolerance from infectious diarrhoeas in young children.
GROWTH HORMONE AND SOMATOMEDIN A IN GIRLS WITH ADOLESCENT IDIOPATHIC SCOLIOSIS
Authors: WILLNER S. , NILSSON K. O. , KASTRUP K. , BERGSTRAND C. G.
Published: January 2008

Abstract. Girls with adolescent idiopathic scoliosis are taller than nonscoliotic girls of the same age. This observation may be related to factors regulating longitudinal growth. Plasma growth hormone was determined in a group of scoliotic girls by double antibody radioimmunoassay under the following conditions: 1) Insulin induced hypoglycemia, 2) glucose tolerance test, 3) exercise. Somatomedin A was determined by a method based on the ability of serum to stimulate the incorporation of radioactive sulphate in embryonic chick cartilage. The results were compared with those obtained in a control group of healthy nonscoliotic girls of comparable age. After overnight fasting and after at least one hour's rest the basal growth hormone level was 9.8 ± 11.1 (±S.D.) ng/ml in the scoliotic girls (n=48) and 2.2 ± 1.1 ng/ml in the controls (n=15). This difference is significant. In the hypoglycemia test the peak growth hormone level tended to be higher in the scoliotic girls but the difference is not significant. In the exercise test the maximal value was reached at different times in the two groups: at 20 min after start of the exercise in the scoliotic girls (n=14, 17.3±11.8 ng/ml) and at 40 min in the controls (n=9, 16.0±6.6 ng/ml). In the glucose tolerance test the growth hormone level was suppressed in both groups but the mean values tended to be higher during the first 120 min in the scoliotic girls. The serum somatomedin levels were higher in the group of scoliotic girls (n=19, 1.13±0.17 U/ml) than in the controls (n=14, 0.88±0.16 U/ml) and the difference is significant. The results obtained are difficult to interpret but suggest that growth hormone secretion is higher in girls with adolescent idiopathic scoliosis than in healthy girls of comparable age.
SIGNIFICANCE OF OBSTETRIC FACTORS IN PROGNOSIS OF LOW BIRTHWEIGHT CHILDREN
Authors: BJERRE B. , BJERRE I.
Published: January 2008

Abstract. Obstetric factors were studied in ah unselected series of mothers of LBW‐children and compared with those in a corresponding control series. Both groups consisted of 161 women with single pregnancies and 16 with twin pregnancies. Of the 188 LBW‐children, 14% were twins. Of the single infants, 42% were appropriate for gestational age (AGA), i.e. within the 10th to 90th percentile according to Swedish curves for intrauterine growth, and 58% small for gestational age (SGA). The commonest causes of low birthweight (LBW) in the AGA‐group were bleeding (34%) and premature rupture of the membranes (28%). In the SGA‐group toxaemia was found in 15%, but in 50% of the SGA‐group no cause of LBW was demonstrable. In this latter group the average placental weight was low. The mortality was noted and 89% of the living children were examined neurologically at 5 years of age. The prognosis of the child depended on the duration of pregnancy. Bleeding during pregnancy was a prognostically unfavourable sign, but even serious bleeding complications did not exclude a normal development of the child. The prognosis was best for those infants in whom no cause of LBW was demonstrable.
ANTIBODY‐COATED BACTERIA IN THE URINE OF CHILDREN WITH URINARY TRACT INFECTIONS
Authors: FORSUM U. , HJELM E. , JONSELL G.
Published: January 2008

Abstract. The test for antibody‐coated bacteria in urine for the diagnosis of the anatomical level of urinary tract infections was evaluated in children with UTI. The ability of the test to differentiate between an upper and lower infection is influenced by the antiglobulin preparation used, since too sensitive an antiglobulin probably detects nonspecifically bound antibodies. Staphylococcal protein A seems to be well suited for use as an antiglobulin in this test. Using staphylococcal protein A all children with X‐ray findings suggesting renal damage had antibody‐coated bacteria in the urine, however, nine infants and 5 children with clinical symptoms of pyelonephritis had a negative test. Of 28 children with clinical symptoms of cystitis only one had a positive test. Of 50 children with asymptomatic bacteriuria 9 had antibody‐coated bacteria in the urine; 41 had not. The findings indicate that the method might be useful in establishing the anatomical level of urinary tract infection and might also be useful for screening children with asymptomatic bacteriuria who risk developing kidney infections.
LYCOPERDONOSIS
Authors: HENRIKSEN N. T.
Published: January 2008

Abstract. Inhalation of large quantities of spores from the puffball (lycoperdon), which has been widely used in folk medicine, can cause a respiratory disease with symptoms of pneumonia and widespread densities in the lungs. The course is rather protracted, but the final outcome seems good. Steroids probably shorten the disease. A typical case is reported.
MYOCARDITIS ASSOCIATED WITH ECHO TYPE 7 INFECTION IN A LEUKEMIC CHILD
Authors: MIDULLA M. , MARZETTI G. , BORRA G. , SABATINO G.
Published: January 2008

Abstract. A 31/2‐year‐old boy, during the course of acute lymphocytic leukemia presented clinical, roentgenological and ECG signs of myocarditis, which disappeared completely within 1 1/2 month. ECHO type 7 virus was isolated from the faeces during the acute stage of the disease and rise in ECHO 7 neutralizing antibodies was demonstrated in paired sera of the patient. This unusual pathogenicity of ECHO 7 virus could be explained with the impairment of the host resistance induced by leukemia and immunosuppressive therapy.
Case Report INTESTINAL ENTEROKINASE DEFICIENCY
Authors: FOLLETT G. F. , MACDONALD T. H.
Published: January 2008

Abstract. Deficiency of intestinal enterokinase results in failure to thrive, diarrhoea, anaemia, hypoproteinaemia and oedema. A case arising in the neonatal period is described, in which several of the characteristic features were lacking. Difficulties encountered in the diagnosis and methods of assay are discussed.
SERUM GAMMA‐GLUTAMYL TRANSPEPTIDASE ACTIVITY AND URINARY D‐GLUCARIC ACID EXCRETION IN NEWBORNS IN THE FIRST WEEK OF LIFE Effects of phenobarbital and nicethamide combination
Authors: TALAFANT E. , HOšKOVÁ A. , POJEROVÁ A.
Published: January 2008

Abstract. High serum γ‐glutamyl transpeptidase activity was found in cord blood of newborn boys. This activity decreased to lower values on the 4th and 7th days. In newborns treated for 3 days following the birth with a combination of phenobarbital and nicethamide an increase of γ‐glutamyl transpeptidase activity occurred from the 4th to the 7th days. The 7th day levels were significantly higher when compared with the controls. Simultaneous determination of urinary glucaric acid excretion confirmed the induction of hepatic microsomal enzymes in glucuronic acid pathway. This could also be demonstrated by a pronounced decrease of serum bilirubin levels in groups receiving the enzyme inducers whether phenobarbital was administered intramuscularly or orally as sodium salt solution.
AN EPIDEMIOLOGICAL STUDY OF A DANISH SCHOOL POPULATION I. Reference Values for Serum Lipids Based on a Clinical and Biochemical Study of 284 Girls and 268 Boys
Authors: STRUNGE P. , TROSTMANN AA. F.
Published: January 2008

Abstract. A study was performed on a Danish school population to obtain reference values of the following serum lipids: total lipid, phospholipid, cholesterol, glycerol and triglyceride. 92% of 630 children participated, but 23 were excluded following clinical examination. Thus values are given for 301 girls and 274 boys aged 8 to 17 years.
ERYTHROCYTE GLUCOSE 6‐PHOSPHATE DEHYDROGENASE DEFICIENCY (G6PD TYPE A‐) AND NEONATAL JAUNDICE
Authors: BIENZLE U. , EFFIONG C. , LUZZATTO L.
Published: January 2008

Abstract. The association of erythrocyte G6PD deficiency (type A‐) and hyperbilirubinaemia in two groups of Nigerian male newborns has been examined. The results provide evidence that the enzyme deficiency is the single most important factor in the pathogenesis of severe neonatal jaundice in this West African population.
INTRARENAL REFLUX
Authors: ULDALL P. , FRØKJÆR O. , IBSEN K. KAAS
Published: January 2008

Abstract. Seventy‐six children with a total of 123 ureters showing vesico‐ureteric reflux were reviewed in order to detect intrarenal reflux (pyelotubular backflow) occuring during micturating cystourethrography. This was found in 7 patients (9.2%). Five patients had unilateral and two bilateral intrarenal reflux. In only 7 out of the 9 kidneys with intrarenal reflux was it possible to outline the kidney contour precisely on excretion urography. In 3 cases renal damage corresponded exactly to the areas with intrarenal reflux. One kidney showed damage which did not correspond to the location of intrarenal reflux and 3 were without signs of damage. Renal damage of varying localization was found in 54 of the 123 kidneys with vesico‐ureteric reflux and intrarenal reflux was present in 6 of these (11%). The significance of intrarenal reflux as a cause of renal damage and whether intrarenal reflux might be primary or secondary to the renal damage are discussed, and it is concluded that presence of intrarenal reflux is a definite indication for operation.
TONE AUDIOMETRY CONTROL OF CHILDREN TREATED FOR MENINGITIS WITH LARGE INTRAVENOUS DOSES OF AMPICILLIN
Authors: DAHNSJÖ H. , ANDERSSON H. , HALLANDER H. O. , RUDBERG R. D.
Published: January 2008

Abstract. Thirty‐seven children treated for bacterial meningitis with ampicillin in high doses were followed up with audiometric control. Defects were recorded in 6 cases. Two of these were ascribed to chronic otosalpingitis. In 4 patients with sensorineural hearing loss, 3 were unilateral, and in only one case was the damage bilateral. Even here there was a previous history of hearing loss. A suggested ototoxicity of ampicillin could not be confirmed.
HAEMOPHILIA PROPHYLAXIS IN SWEDEN
Authors: NILSSON INGA MARIE , HEDNER ULLA , AHLBERG ÅKE
Published: January 2008

ABSTRACT. 29 boys (4–18 years old) with severe haemophilia A were given prophylactic infusions of AHF concentrate (human fraction I–0) for 2 to 13 years in an attempt to change the haemophilia from a severe to a moderate form and thereby prevent arthropathy and severe bleeding episodes. The sizes of the doses and the intervals at which the doses were given were titrated by AHF survival studies. As a rule, the patients received AHF in amounts sufficient to raise the AHF level to 30–45% at 5–12 day intervals. In about 50% of the infusions the AHF content was not below 1% before the next infusion. During such prophylaxis all patients except one have been in a good general condition. They have had bleeding episodes, which have, however, been much less severe and less frequent. The children have been able to live an almost normal life. The number and duration of stays in hospital have been markedly reduced. 17 of the patients had only minor or no joint defects before the start of the treatment. In this group the joint function was identical with that found in moderate haemophilia in the same age groups. Two patients developed anticoagulants. No other side effects were seen.

The prophylactic regimen in Sweden thus reduced severe haemophilia to moderate.
INFLUENCE OF FAT AND CARBOHYDRATE CONTENT OF DIET ON FOOD INTAKE AND GROWTH OF MALE INFANTS
Authors: FOMON SAMUEL J. , THOMAS LORA N. , FILER L. J. , ANDERSON THOMAS A. , NELSON STEVEN E.
Published: January 2008

ABSTRACT. Two groups of normal fullterm infants were studied from 8 to 112 days of age while receiving formulas of the same caloric density and prepared from the same ingredients. A limited selection of strained foods was permitted. From the combination of formula and strained foods, one group received 29% of calories from fat and 62% from carbohydrate whereas the other received 57% from fat and 34% from carbohydrate. Fifteen infants in each group completed the study as planned. Energy intakes per kilogram and rates of gain in length and weight were similar in the two feeding groups.
CONGENITALLY CORRECTED TRANSPOSITION OF THE GREAT ARTERIES A Clinical Study of 101 Cases
Authors: BJARKE B. B. , KIDD B. S. L.
Published: January 2008

ABSTRACT. The anatomy, natural history, clinical features and symptomatology of 101 cases of congenitally corrected transposition of the great arteries (C‐TGA) diagnosed over a 20‐year period at Hospital for Sick Children, Toronto, Ontario, is reported. Only 1 patient had no associated lesion and only 14 an intact ventricular septum. Pulmonary stenosis was present in a little more than half of the patients. Left A‐V valve involvement existed in 21 patients. In spite of the hich incidence of associated lesions the prognosis was better than expected. Seventy‐six patients were alive at the end of the study, no one being critically ill. No death occurred among the patients with intact ventricular septum. Patients with pulmonary stenosis as a group developed symptoms later, were less handicapped and had a better prognosis than those without a pulmonary stenosis. One third of the patients had dysrhythmias. Eight patients having a 3rd degree AV‐block. Auscultatory findings were not of too great a help when diagnosing C‐TGA. Forty‐seven patients had a single second sound, of these 37 had pulmonary stenosis. In 60 % of the patients, where information was available, the second sound was reported to be of normal intensity. Our surgical experience is documented and discussed. Palliative procedures were done with successful results and low mortality. Totally corrective procedures were performed in 9 patients with 4 deaths.
HEALTH SCREENING OF FOUR‐YEAR‐OLDS IN A SWEDISH COUNTY
Authors: SUNDELIN C. , VUILLE J.‐C.
Published: January 2008

ABSTRACT. The data gathered in connection with a routine health screening program for 4‐year‐olds were used in order to test a number of hypotheses concerning factors which might have influenced the effectiveness of the program, as well as concerning the quality of preventive care delivered to the children before the age of 4 years. It was found that preventive care of relatively high quality delivered to children 0–3 years of age had not reduced the prevalence of previously undetected health problems at 4 years of age. Furthermore, the analysis demonstrated substantial differences between physicians in the rates of correct and unnecessary referrals. Only a small part of these differences could be attributed to professional status or specific experience with the program. They consisted essentially in varying thresholds for what was perceived as a health problem needing treatment, and were considered as a matter of personal temperament. True differences of quality did occur but were less prominent. The implications of these findings with regard to the continuation of the program are discussed.
TWO CASES OF PHOSPHOENOLPYRUVATE CARBOXYKINASE DEFICIENCY
Authors: HOMMES F. A. , BENDIEN K. , ELEMA J. D. , BREMER H. J. , LOMBECK I.
Published: January 2008

ABSTRACT. Two children are described who suffered from hypoglycemia and liver impairment. Assays of gluconeogenic enzymes in liver samples taken immediately after death demonstrated a deficiency of phosphoenolpyruvate carboxykinase, a key enzyme of gluconeogenesis. Post mortem examination demonstrated massive fat deposition in liver and kidney and to a lesser extent in other tissues. The fatty changes in liver and kidney could be explained by the absence of phosphoenolpyruvate carboxykinase, which would cause an alteration in the mitochondrial‐cytosolic processes related to gluconeogenesis.
CONCENTRATIONS OF TRIGLYCERIDES, FREE FATTY ACIDS AND GLYCEROL IN CORD BLOOD OF NEWBORN INFANTS WITH A BIRTH WEIGHT OF ≤2700 GRAMS
Authors: CHRISTENSEN NIELS CHRISTIAN
Published: January 2008

Abstract Concentrations of triglycerides, free fatty acids (FFA) and glycerol were measured in umbilical venous blood from 99 infants with a birth weight of between 1100–2700 g and a gestational age of 27–41 weeks. Thirty infants were small for gestational age (SGA), 58 were appropriate (AGA) and 11 were of uncertain gestational age. In AGA infants with a gestational age of ≥35 weeks, FFA values were lower than in those with a gestational age of>35 weeks; otherwise concentrations of triglycerides, FFA and glycerol were independent of birth weight and gestational age in AGA infants. In SGA infants, higher FFA values were found compared with both AGA and term infants of normal birth weight. Triglyceride values were higher in SGA than in AGA infants. In SGA infants, a significant positive correlation was found between gestational age and concentrations of both FFA and triglycerides. No differences in FFA, glycerol and triglyceride concentrations were seen between asphyxiated and non‐asphyxiated AGA infants.
SEASONAL INCIDENCE OF SOME CONGENITAL MALFORMATIONS IN THE CENTRAL NERVOUS SYSTEM IN SWEDEN, 1965–1972
Authors: SANDAHL BJÖRN
Published: January 2008

Abstract Seasonal trends of some congenital CNS malformations in infants born in Sweden during the years 1965 to 1972 were investigated. The study is based on reports to the Swedish Register of Congenital Malformations, statistics from the National Board of Health, and records from Malmö General Hospital and the Hospital of Lund. The malformations analysed in this study are anencephaly, spina bifida aperta (with or without hydrocephalus) and isolated hydrocephalus. Variations in incidence of months of birth and last menstrual period (LMP) were tested statistically in three different ways: standard χ2‐test for heterogeneity between recorded numbers of infants each calender month, Edwards' method, and a squared sinus function, all with or without correction for variations in genera) monthly birth rates. Statistical significant seasonal variations were found for anencephaly with an LMP maximum in March and for spina bifida aperta with a maximum in July. Factors which can explain such seasonality are briefly discussed.
THE EFFECT OF L‐DOPA WITH AND WITHOUT DECARBOXYLASE INHIBITOR ON GROWTH HORMONE SECRETION IN CHILDREN WITH SHORT STATURE
Authors: FEVANG F. Ø. , STØA K. F. , THORSEN T. , AARSKOG D.
Published: January 2008

Abstract The efficiency of L‐dopa alone and L‐dopa plus a dopa‐decarboxylase inhibitor (carbidopa) in provoking growth hormone (GH) secretion was studied in 40 children with short stature. By preventing the extracerebral metabolism, carbidopa increases the availability of L‐dopa to the brain. The study was designed as paired series of growth hormone stimulation tests in which the effect of L‐dopa alone, in different dosage schedules, was compared with the same dose level of L‐dopa plus carbidopa. When L‐dopa was given in full dose (125–500 mg), there was no significant difference in the serum GH concentrations at any time of sampling. In the lower dose level, the stimulant effect of L‐dopa alone tended to be exceeded by the combination of L‐dopa and carbidopa. The serum GH responses to the different schedules indicate that an optimal hypothalamic dopamine concentration for GH release could be achieved with a considerably lower dose of L‐dopa than those employed in previously reported studies. When L‐dopa is combined with a dopa decarboxylase inhibitor, the children have the advantage of less side effects in the form of nausea and vomiting.
INSULIN AND GLUCAGON RESPONSE TO ARGININE INFUSION IN CYSTIC FIBROSIS
Authors: REDMOND AILEEN O. B. , BUCHANAN K. D. , TRIMBLE ELIZABETH R.
Published: January 2008

Abstract Redmond, A. O. B., Buchanan, K. D. and Trimble, E. R. (The Royal Belfast Hospital for Sick Children, Belfast, and The Department of Medicine, Queen's University, Belfast). Insulin and glucagon response to arginine infusion in cystic fibrosis. Acta Paediatr Scand, 66:199, 1977.—The glucagon and insulin responses to intravenous arginine were studied in 17 children with cystic fibrosis and in 9 control children. It was found that the overall secretion of insulin was diminished; however, four of the CF children did have a normal output. The glucagon responses did not parallel those of insulin. The glucagon output varied in the CF children—seven had normal, four excessively high and six low output. Three of the four children with extremely high output had more severe disease and were below the third centile on the weight chart. These four had a fasting hypoglycaemia and also a very low glucose and insulin response. We have confirmed diminished insulin secretion in cystic fibrosis, but diminished glucagon secretion was only noted when some insulin secretion was preserved. The high levels of glucagon seen in the most insulin deficient subjects may be derived from extrapancreatic sources, or may be associated with ‘stress‘ reaction in these patients who also had most severe pulmonary involvement. The data would be consistent with diminished glucagon and insulin secretion from the pancreas but as the disease progresses an excessive secretion of extra pancreatic glucagon results.
LEARNING DISORDERS Some Medical Aspects
Authors: GORDON NEIL
Published: January 2008

Abstract Gordon, N. (The Royal Manchester Children's Hospital and Booth Hall Children's Hospital, Manchester, England). Learning disorders—some medical aspects. Acta Paediatr Scand, 66:247, 1977.—The first skills are motor ones and these depend on perceptual development and the organisation of movement. If development is deviant the child will be clumsy. The clinical picture is considered, and the effects this may have in the school situation. Disorders of language development may be secondary to other factors such as deafness or brain injury, or may be a specific disability. The various grades of the latter are described. Both perceptual and language disorders can underlie reading retardation and the analysis of a particular child's difficulties is stressed. The etiology of these conditions is discussed with particular reference to the failure of integration. Intracerebral connections may not form, be destroyed, or not used. The role of the Doctor is an important one, and this includes not only diagnosis and assessment but also helping the child in the home and school, especially when emotional and behaviour complications occur. The doctor must also act as a questioner and co‐ordinator.
FACTOR XIII (FIBRIN STABILISING FACTOR) IN HENOCH‐SCHÖNLEIN'S PURPURA
Authors: HENRIKSSON PER , HEDNER ULLA , NILSSON INGA MARIE
Published: January 2008

Abstract.In 13 out of 17 consecutive children with Henoch‐Schönlein's purpura the factor XIII determined with the dansyl cadaverine method was found to be decreased during the acute phase. The decrease is assumed to be due to a specific degradation by proteolytic enzymes liberated from inflammatory cells, with defective local haemostasis as a result. This assumption is strengthened by the observation that treatment with factor XIII combined with an antifibrinolytic drug controlled life‐threatening gastro‐intestinal bleeding in one of the patients. It would therefore appear that such treatment might offer a new possibility of controlling severe haemorrhages in Henoch‐Schönlein's purpura.
CONGENITAL IMMUNODEFICIENCY AND AGRANULOCYTOSIS (RETICULAR DYSGENESIA)
Authors: HAAS R. J. , NIETHAMMER D. , GOLDMANN S. F. , HEIT W. , BIENZLE U. , KLEIHAUER E.
Published: January 2008

Abstract. A patient is presented who manifested the typical clinical and pathological features of congenital immunodeficiency and agranulocytosis (reticular dysgenesia). Treatment under gnotobiotic conditions enabled the measurement of immunological parameters up to the 17th week of life with the following results: negative skin tests, low response to phytohaemagglutinin, weak response in the mixed leukocyte culture and very few E rosettes. Peripheral lymphocytes and lymphocytes in the lymphatic tissues were markedly decreased. Humoral immunoglobulins and plasma cells in the organs were decreased. The in vitro culture of hemopoietic cells showed a diminished content of myelopoietic progenitor cells (“committed stem cells”). It is concluded that the disease may be primarily a defect of stem cells with regard to differentiation in myelopoiesis or lymphopoiesis.
PHYSICAL HEALTH OF 7‐YEAR‐OLD CHILDREN An Epidemiological Study of School Entrants and a Comparison with Their Preschool Health
Authors: KÖHLER LENNART
Published: January 2008

Abstract. At 7 years of age, all 649 7‐year‐old children in a school district underwent a physical examination, a vision screening and an auditory screening. 210 of the children were previously examined in an extensive health control at 4 years of age. The purpose of the present study was to describe the children's health situation and to evaluate the special health control performed at 4 years of age. In 15% of the children, functionally important health problems were found. Visual defects were most common, comprising 7.5%, then came physical health problems such as motor disturbances, obesity, bacteriuria in 6.5%, and hearing defects in 1%. About half of the important health problems were previously known. Children who had passed the special health control at 4 years of age had fewer newly detected important health problems and more previously known ones than other children, which means that many children with above all visual defects but also motor disturbances, bacteriuria and testis retention, were detected and treated earlier than would have happened without the special control at 4 years. It is concluded that the “ordinary” preschool Child Health Services did fulfill their purpose to detect handicapping disorders in an acceptable way; by the introduction of the special health control at 4 years of age, this function was further improved.
PHYSICAL MASS EXAMINATIONS IN THE SCHOOL HEALTH SERVICE
Authors: KÖHLER LENNART
Published: January 2008

Abstract. At 7 years of age, all 649 children in a school district underwent a physical examination, a vision screening and an auditory screening. The purpose of the present study was to analyse the value of the routine physical examination within the school health services. In 15% of the children functionally important health problems were found. Visual defects were most common, comprising 7.5%, then came physical health problems such as motor disturbances, obesity, bacteriuria in 6.5%, and hearing defects in 1%. About half of the important health problems were previously known. Most disorders of importance were detected by the nurse's screening examination and rather few by the doctor's physical examination. It seems advisable to introduce screening procedures in the hands of nurses also for the physical examination. The role of the school physician in the general health surveillance would then be mainly to control and verify specific observations or suspicions of disease or handicap noted by the school nurse. His time and attention could instead be directed towards important tasks, which are now often neglected, e.g. health education, and care of sick and handicapped children in the school setting.
SISOMICIN TREATMENT OF SERIOUS NEONATAL INFECTIONS A Clinical and Pharmacokinetic Study
Authors: HENRIKSSON P. , SVENNINGSEN N. , KAHLMETER G. , HAEGER K.
Published: January 2008

Abstract. 23 infants, 20 of which had verified or clinically highly suspected serious infections in the neonatal period, were treated with a new antibiotic aminoglycoside, sisomicin, i.m. in doses from 2.8 to 6.6 mg/kg/24 h. Clinical cure was obtained in 18 of 20 cases, and marked improvement in one case. Adverse effects were only observed in two infants with tenderness at the injection sites. Serum concentrations and half‐life estimations showed that the concentrations were similar to those obtained for gentamicin, and that half‐life was independent of postnatal age, but highly correlated to the gestational age and to body weight. Consideration should therefore be given to the prolonged half–life of the drug in immature and low birth weight infants.
CONGENITAL RICKETS Study of the Evolution of Secondary Hyperparathyroidism
Authors: SANN L. , DAVID L. , FREDERICH A. , BOVIER‐LAPIERRE M. , BOURGEOIS J. , ROMAND‐MONIER M. , BETHENOD M.
Published: January 2008

Abstract. A case of congenital rickets of nutritional origin is described in a light‐for‐date premature infant (gestational age 34 weeks, birthweight 1100 g). X‐rays of the long bones showed spread, frayed and cupped metaphyses at birth and at the age of 16 days. Serum calcium was 8.2 mg/100 ml, phosphorus 3.4 mg/100 ml and alkaline phosphatase (A.P.): 323 IU/ml (N≤200) at the age of 3 days. Very high level of serum immunoreactive parathyroid hormone (iPTH) was found at the age of 16 days=295 μlEq/ml (N≤50). Evidence of maternal vitamin D deficiency was demonstrated by low plasma 25‐hydroxycholecalciferol (25‐OH‐CC): 1.0 ng/ml (N: 13.2±4.2) soon after delivery; it was found to be normal (10.2 ng/ml) six months later. Ca infusion (15 mg/kg/3 h) resulted in a marked fall of serum iPTH (280 to 84 μlEq/ml). Administration of vitamin D2 (2400 IU/day for 10 days) induced some healing of the metaphyses; A. P. remained elevated (400 IU/ml); plasma 25‐OH‐CC was normal 10.2 ng/ml and serum iPTH was 115 μlEq/ml. When 25‐OH‐CC was given orally for ten days (15 μg/day), plasma 25‐OH‐CC rose to 64.5 ng/ml with a minor change of serum iPTH (94 μlEq/ml); X‐rays of the bones showed osteoporosis. These results suggest a reduced conversion of 25‐OH‐CC into 1–25‐(OH)2‐CC.