bluuebunny/crossref_metadata_2025 huggingface dataset:
A CASE OF HYPOPHOSPHATAEMIC VITAMIN D‐RESISTANT RICKETS TREATED WITH INITIAL MASSIVE DOSES OF 1α‐HYDROXY‐VITAMIN D3 ALONE
Authors: MURAKI K. , NISHI Y. , TSUDA K. , YOSHIMITSU K. , USUI T.
Published: January 2008

ABSTRACT. A 1 5/12‐year‐old girl with hypophosphataemic vitamin D‐resistant rickets was treated with initial massive doses of 1α‐hydroxy‐vitamin D3 (1α‐OH‐D3) alone. A dramatic improvement of bone lesions and growth rate and normalization of the characteristic biochemical defects were noted within four months after the start of massive 1α‐OH‐D3 therapy. The results of this study suggest that early therapy with massive doses of 1α‐OH‐D3 alone improves the radiological findings and restores to normal the biochemical defects and the growth rate as early as possible. This regimen may improve motor strength and endurance and obviate the need for corrective orthopaedic procedures.
MUSCLE SUBSTRATE LEVELS, MUSCLE ENZYME ACTIVITIES AND MUSCLE MORPHOLOGY IN THE VASTUS LATERALIS AND DELTOIDEUS MUSCLES IN NORMAL CHILDREN AND IN CHILDREN WITH COARCTATION OF THE AORTA
Authors: ERIKSSON B. O. , FRIBERG L.‐G. , HANSON E. , MELLGREN G.
Published: January 2008

ABSTRACT. Muscle biopsies from the deltoideus dx and vastus lat. dx muscles were taken in 17 children with coarctation of the aorta, aged 5.0 to 13.8 years, prior to surgery. Higher concentrations of glycogen, ATP and CP were found in the vastus lat. muscle compared to the deltoideus muscle. The same differences between these two muscles were also found in healthy controls. No differences were found between the patients with coarctation of the aorta and the control group. Nor were any differences found for the other variables studied; glucose, glucose‐6‐phosphate, lactate, muscle enzyme activities (SDH, LDH and phosphorylase), muscle fibre composition or fibre sizes. It seems reasonable to assume that the differences in muscle substrate levels found between the vasus lat, and the deltoideus muscles in the two groups were due to a higher degree of activity during daily life for the legs as compared to the arms. Patients with coarctation of the aorta do not seem to be influenced by the altered haemodynamic situation with regard to the studied variables.
KIDNEY LENGTH IN THE NEWBORN MEASURED BY ULTRASOUND
Authors: FITZSIMONS R. B.
Published: January 2008

ABSTRACT. Kidney length was measured in 115 unselected neonates with portable real‐time ultrasound. The left kidney was slightly, but significantly, longer than the right. There was a positive correlation between kidney length and birthweight, but kidney size did not increase significantly after 36 weeks gestation. Further ultrasound studies of the newborn kidney will be of interest.
INCREASED FRACTIONAL EXCRETION OF PHOSPHATE AND BETA2‐MICROGLOBULIN IN UNILATERAL RENAL DISEASE
Authors: APERIA A. , WIKSTAD I. , BROBERGER O.
Published: January 2008

ABSTRACT. Following progressive nephron loss tubular reabsorption in the remaining nephrons will fall to preserve solute and electrolyte excretion. We have examined the fractional excretion (FE) of phosphate, sodium, beta2‐microglobulin (β2M)and tubular glucose reabsorption (Tglucose) in children with unilateral renal disease to find 1) the threshold for this response and 2) whether intrinsic renal mechanisms can elicit this response. Separate renal function studies were performed using unilateral ureteral compression. Total glomerular filtration rate (GFR) was 93.7 ± 2.99 ml/1.73(m2)‐1.min‐1, and 110.25 ± 5.40 in control children. GFR in the scarred kidney (SK) was 22.4 ± 2.46 and in the contralateral kidney (CIK) 67.2 ± 4.60 ml. 1.73 (m2)‐1. min‐1. The kidney area was reduced in proportion to GFR in SK. FE phosphate and β2M were significantly higher in SK than in CIK (sign test), but absolute values for FEphosphate and β2M were not higher in SK than in control kidneys. FEsodium and Tglucose were the same in SK and CIK. Conclusion: Following moderate unilateral reduction of GFR selective depression of tubular reabsorption can occur without extrarenal impulses.
RENAL FUNCTION IN RELATION TO METABOLIC CONTROL IN CHILDREN WITH DIABETES OF DIFFERENT DURATION
Authors: DAHLQUIST G. , APERIA A. , BROBERGER O. , PERSSON B. , WILTON P.
Published: January 2008

ABSTRACT. To evaluate the interpretation of different kidney function tests in diabetic children and teenagers we have studied 47 children with a duration of diabetes up to 5 years, 61 children with a duration of 5.1‐10 years and 49 children with a duration of >10 years. Glomerular filtration rate (GFR) measuerd as inulin clearance or creatinine clearance, clearance PAH (CPAH), filtration fraction (FF), 24‐hour urinary excretion of β2‐microglobulin and albumin were examined and correlated with short‐ and longterm indices of metabolic control. In all groups of duration GFR as measured by inulin clearance was increased compared with reference values from age matched controls. In patients who had had diabetes for 0‐5 years a significant positive correlation was found between inulin clearance and blood glucose during the examination. Inulin clearance was also correlated to HBA1c as well as to 24‐hour urinary glucose (mean of 4‐6 samples during two years). No such correlation was found in the group who had had diabetes for 5‐10 years but in patients with a duration of diabetes >10 years a significant inverse relation was found between GFR and HbA1c. The 24‐hour urinary excretion of albumin was significantly higher in all groups of diabetics compared with controls. The urinary excretion of β2‐microglobulin was similar in diabetics and controls. In the total material no significant correlation could be found between inulin clearance and creatinine clearance. On the other hand significant inverse correlations were found between creatinine clearance and indices of metabolic control. It is concluded that GFR as measured by inulin clearance is related to indices of metabolic control in a different way with different duration of diabetes. As long as the relation between the increased GFR detectable early in the disease to diabetic nephropathy is unknown the predictable value of this kidney function test is low and prospective studies are necessary. Creatinine clearancee assayed by the method of Jaffé is a poor indicator of GFR in diabetics with a poor metabolic control. 24‐hour urinary excretion of albumin measured by sensitive techniques might be predictive for diabetic nephropathy.
Pre‐HbA1c IN CHILDREN WITH INSULIN DEPENDENT DIABETES MELLITUS
Authors: TORNQVIST H. , JEPPSSON J.‐O. , NILSSON K. O.
Published: January 2008

ABSTRACT. Day‐today fluctuations in blood concentration of the glycosylated hemoglobin, HbA1c or HbA1, are mainly due to variations in content of the intermediate aldimide form, preHbA1c, Using electrofocusing we have studied this component adjacent to the HbA1c band, which represents the stable ketoamine form. The fraction of preHbA1c present rapidly increases upon incubation of erythrocytes in 20 mM glucose at +37°C, and the reaction is fully reversible if glucose is removed. In children with insulin‐dependent diabetes mellitus with different degrees of metabolic control, levels of preHbA1c varied between 0.2 and 3.7% of total hemoglobin (median value 1.3%, N=25). A clear correlation was found between preHbA1c and urinary glucose concentrations during the 12 hours preceding blood sampling (r=0.75, p<0.001, df=18). As expected, pre‐HbA1c did not correlate to HbA1c or glycosylated albumin, which reflect long‐ and medium‐term diabetic control.
APLASTIC ANEMIA DURING ETHOSUXIMIDE MEDICATION
Authors: SEIP M.
Published: January 2008

ABSTRACT. A girl, born in 1975, developed severe aplastic anemia in November 1982 while on ethosuximide monotherapy for petit mal epilepsy, about 3 months after starting the ethosuximide medication. She was treated with bolus‐methylprednisolone as described by Bacigalup et al. (13), transfusions and antibiotics. During the third week on this regimen slight improvements in granulocyte and reticulocyte counts were demonstrated, and after approximately 6 weeks she was in stable condition without further need of transfusions. Blood status should be checked regularly during ethosuximide therapy, particularly during the first 6 months.
THE SUCCESSFULL COMPLETION OF THE OSLO MARATHON BY A PATIENT WITH CYSTIC FIBROSIS
Authors: STANGHELLE J. K. , SKYBERG D.
Published: January 2008

ABSTRACT. Metabolic consequences of prolonged, severe exercise were investigated in a well trained 16‐year‐old boy with cystic flbrosis (CF) who completed the Oslo Marathon (42195 m). His CF was diagnosed 6 years earlier. He had minimal radiological lung changes and a maximal oxygen uptake of 63.0 ml/kg/min. Several blood, urine and lung function parameters as well as body weight, fluid intake and rectal temperature were measured. None of the findings differed from those reported in healthy marathoners. Interestingly, no changes were found in the serum concentrations of electrolytes.
DYNAMICS OF PULMONARY WATER BEFORE AND AFTER BIRTH
Authors: BLAND R. D.
Published: January 2008

Bland, R. D. (Cardiovascular Research Institute and Department of Pediatrics, University of California, San Francisco, California). Dynamics of pulmonary water before and after birth. Acta Paediatr Scand, Suppl. 305: 12‐20, 1983.—In fetal life an electrochemical gradient across the pulmonary epithelium causes liquid to flow from the microcirculation of the lungs through the interstitium into potential air spaces. That liquid is rich in chloride (150 meq/l) and almost free of protein (<0.03 g/dl). At birth rapid reversal of the direction of liquid flow is essential for a smooth transition from placental to pulmonary gas exchange. Removal of liquid from the lungs begins even before birth. In fetal rabbits and lambs, a substantial decrease in extravascular lung water occurs late in gestation and during labor. When breathing begins, transpulmonary pressure inflates the lungs and displaces residual liquid from terminal respiratory units into the interstitium. Fluid accumulates in connective tissue spaces surrounding large pulmonary blood vessels, distant from sites of gas exchange. The concentration of protein in the interstitium decreases, thereby increasing the transvascular gradient of protein osmotic pressure. Air entry into the lungs also decreases hydraulic pressure in the pulmonary microcirculation and increases pulmonary blood flow, which expands microvascular surface area for fluid exchange in the lungs. These developments facilitate reabsorption of water into the pulmonary vascular bed. In lambs, the postnatal increase in lung lymph flow is small and transient, accounting for only 10‐15% of the total amount of liquid drained from the lungs after birth. Normally, the pulmonary microcirculation directly absorbs most of the fetal lung liquid that is present at birth.
CENTRAL CONTROL OF VASOPRESSIN RELEASE AND THIRST
Authors: OLSSON K.
Published: January 2008

Olsson, K. (Department of Animal Physiology, University of Agricultural Sciences, Uppsala, Sweden). Central control of vasopressin release and thirst. Acta Paediatr Scand, Suppl. 305: 36–39, 1983.—The effects of changes in the composition and/or the volume of the extracellular fluid on central receptors involved in the regulation of water balance are discussed. A review of results obtained in adults is given, followed by a discussion of possible roles for vasopressin during the neonatal period.
DYNAMICS OF GLOMERULAR ULTRAFILTRATION IN THE NEONATE KIDNEY
Authors: WOLGAST M. , ELINDER G. , KÅLLSKOG Ö.
Published: January 2008

Wolgast, M., Elinder, G. and Källskog, Ö. (Department of Physiology and Medical Biophysics, Uppsala University, Uppsala, Sweden, and Department of Paediatrics, Karolinska Institute, St. Göran's Children's Hospital, Stockholm, Sweden). Dynamics of glomerular ultrafiltration in the neonate kidney. Acta Paediatr Scand, Suppl. 305: 66–69, 1983.—In the neonate kidney the glomerular filtration rate is generally depressed both in absolute terms and when calculated per gram kidney weight. Micropuncture studies have revealed that this phenomenon is due, not to changes in the driving pressures or the hydraulic conductivity of the glomerular capillary membrane, but to a retarded glomerular blood flow. A retarded flow will thus mean a steep rise in the protein concentration in parallel to the filtration of the protein‐free filtrate. The corresponding steep rise of the colloid osmotic pressure will then induce cessation of the filtration in the distal parts of the glomerular capillary. In dehydrated states this phenomenon will be even more aggravated. An extracellular volume expansion with saline induces relaxation of the two arterioies with subsequent rise in the glomerular blood flow. The rise in the colloid osmotic pressure along the capillary is then less and the filtration can proceed along the whole of the glomerulus. Accordingly the glomerular filtration rate will be increased, reaching figures typical of the mature kidney.
Infantile Spasms: Modern Practical Aspects
Authors: RIIKONEN RAILI
Published: January 2008

ABSTRACT. Data on incidence, aetiology, therapy and prognosis of infantile spasms are reviewed. In a large proportion of cases the aetiological factors of infantile spasms can now be established with some certainty. Especially the new neuroradiological and virological investigative methods have enabled a more accurate diagnosis. There have been changes in the aetiologic pattern over the years. The optimal dosage and duration of ACTH or glucocorticoid therapy have not yet been established. In the Finnish study the large ACTH doses (120–160 IE) generally used in many Nordic countries did not carry a better prognosis than the smaller doses (20–40 IE). Side‐effects of ACTH therapy are relatively common. They are more frequent with large doses than with smaller ones. Measures can be taken to prevent or treat part of them. The prognosis and related factors in infantile spasms as well as some recommendations to improve them are reviewed.
Relationship between Protein and Energy in the Feeding of Preterm Infants during the First Month of Life
Authors: MORO G. , MINOLI I. , HEININGER J. , COHEN M. , GAULL G. , RÄIHÄ N.
Published: January 2008

ABSTRACT. Energy and protein quantity and quality in the diet are factors regulating the rate of growth in the preterm infant. In the present study twenty infants 31–36 weeks of gestational age were fed with two identical test formulas which vried only in the content of energy. One formula (F‐81) contained 3.1 g protein (60 bovine whey: 40 bovine caseins) and 81 kcal per dl. The second formula (F‐94) contained the same amount of protein but 94 kcal per dl. At an intake of 150 ml/kg/d the infants received 4.6 g protein/kg/d and either 121 or 141 kcal/kg/d. The infants on F‐94 had a significantly higher rate of weight gain, but growth of length and head circumference was equal in the two groups. Significant differences were found in the plasma concentrations of glutamine and alanine between the two feeding groups. The other plasma amino acids were not statistically different in the two groups of infants. Urine excretion of threonine, serine, glycine, alanine, histidine, tyrosine, glutamine and cystathionine was significantly increased in the high caloric, F‐94‐group. The results indicate that increasing the caloric intake above 120 kcal/kg/d in preterm infants on a relatively high protein intake does not increase linear growth but does produce increased weight gain. The biochemical results provide indirect evidence that this weight increase is the result of increased fat accretion.
A Prospective Study of the Clinical Manifestations of Atopic Disease in Infancy
Authors: VAN ASPEREN PETER P. , KEMP ANDREW S. , MELLIS CRAIG M.
Published: January 2008

ABSTRACT. We prospectively followed a group of infants with a family history of atopy, from birth for up to 20 months of age. All infants were seen every 4 months and a history, physical examination and skin tests obtained. Atopic dermatitis and rhinitis occurred in about half the infants at some time during the study, while wheezing occurred in about a quarter. Both atopic dermatitis and rhinitis were more common in the first 12 months whereas wheezing occurred later and increased in prevalence with age. Defining atopy by the presence of atopic dermatitis or positive skin tests, only immediate food reactions were significantly associated with atopic infants. In contrast, rhinitis, a single episode of wheezing, colic, vomiting and delayed food reactions were not associated with atopy and thus are unlikely to be due to IgE‐related mechanisms during infancy.
Pseudomembranous Colitis with Recurring Diarrhoea and Prolonged Persistence of Clostridium Difficile in A 10‐Year‐Old Girl
Authors: VESIKARI T. , MAKI M. , BAER MÄIJA , GRÖNROOS P.
Published: January 2008

ABSTRACT. A 10‐year‐old girl developed, after treatment with amyxocillin, a clinically and sigmoidoscopi‐cally apparent pseudomembranous colitis with positive Clostridium difficile stool culture. Treatment with vancomycin resulted in rapid clinical cure, but there was a relapse of diarrhoea and reappearance of C. difficile, with no pseudomembranous colitis, within one month. Clinical symptoms subsided spontaneously but C. difficile persisted for 2 more months in the stools. This case reflects three different aspects of C. difficile infection in one child: pseudomembranous colitis, ordinary diarrhoea, and symptomless carrier state.
Complex Chromosomal Rearrangement in a Mentally Retarded Boy without Gross Dysmorphic Stigmata
Authors: FRYNS J. P. , KLECZKOWSKA A. , LEBAS E. , GOFFAUX P. , VAN DEN BERGHE H.
Published: January 2008

ABSTRACT. A boy with severe mental retardation and complex, apparently balanced chromosomal rearrangement (CCR) of autosomes 1, 3 and 5 is described. This complex chromosomal rearrangement involved three translocations and one insertion; five breakpoints were found, at lp31, 3p22, 3p26, 5p14 and 5q23.
Resection of Congenital Stenosis of the Trachea in an Infant
Authors: SØRENSEN H. RAHBEK , HOLSTEEN V.
Published: January 2008

ABSTRACT. A case of congenital stenosis of the distal trachea in a 4‐week‐oId boy with severe respiratory distress was treated with circular resection of the trachea. At follow‐up, more than one year after operation, the condition of the patient was normal.
Body Proportions in Precocious Puberty
Authors: MARTINEZ LETTY , PREECE M. A. , GRANT D. B.
Published: January 2008

ABSTRACT. Sitting height (SH) and sub‐ischial leg length (SLL) were measured in 10 boys and 16 girls with precocious puberty; the patients were aged from 1.5 to 13.4 years at the time. Standard deviation scores (SDS) calculated for chronological age and bone age showed higher scores for SH than for SLL in all but two patients, both girls: the differences between the SDS for SH and SLL were more marked in the boys. The findings indicate that growth of the trunk is usually greater than growth of the legs in precocious puberty, particularly in boys.
Short Mother‐Infant Separation during First Week of Life Influences the Duration of Breastfeeding
Authors: ELANDER G. , LINDBERG T.
Published: January 2008

ABSTRACT. Thirty term infants, who were separated 1–6 days (mean 3.3 days) from their mothers during the first week of life because of minor illnesses, were compared with 116 term non‐separated infants with regard to breastfeeding. At 3 months of age the frequency of entirely breastfed infants was 37 % in the separated group versus 72 % in the non‐separated group, p < 0.001. Thus a few days of separation between mothers and infants during the first week of life seems to decrease the duration of breastfeeding.
Psychosocial Factors Influencing the Duration of Breastfeeding by Primigravidas
Authors: EKWO E. E. , DUSDIEKER L. , BOOTH B. , SEALS B.
Published: January 2008

ABSTRACT. We studied factors which influence the duration of breastfeeding by 81 primigravidas by use of a Likert‐type questionnaire. Three primary independent variables related inversely to the duration of breastfeeding in a multiple regression analysis. The most important of these variables was maternal perception of difficulties in scheduling breastfeeding on her return to work (p < 0.01). Also total family income (p < 0.01) and maternal worries about the demands of breastfeeding (p < 0.01) inversely related to the duration of breastfeeding. Causal analytical technique was used to identify secondary variables relating to the primary independent variables. Maternal worries about the demands of breastfeeding related strongly to her worries about the lack of family psychosocial support. Maternal age and complications of breastfeeding did not relate to the duration of breastfeeding.
Hereditary Renal Adysplasia
Authors: MONN E. , NORDSHUS T.
Published: January 2008

ABSTRACT. A family with unilateral renal “agenesis” through 3 generations is presented. In two of the members, a small tissue bud with a ureteric remnant was observed, compatible with the syndrome of hereditary renal adysplasia. Small kidneys and small compensatory renal hypertrophy appear to be characteristic in this family.
Acute Interstitial Pneumonitis and Carbamazepine Therapy
Authors: SWERT LILIANE F. DE , CEUPPENS J. L. , TEUWEN D. , WIJNDAELE L. , CASAER P. , DAELE M. CASTEELS‐VAN
Published: January 2008

ABSTRACT. A 14‐year‐old girl with skin rash and acute interstitial pneumonitis is presented. She had been taking carbamazepine for two months. Withdrawal of carbamazepine resulted in a prompt improvement of the clinical picture and a normalization of lung function tests. A hypersensitivity reaction to carbamazepine is suggested and the importance of a skin rash as first sign of a generalized reaction is stressed. Lymphocyte‐stimulation‐tests with carbamazepine were strongly positive in the patient and not in healthy persons nor in patients taking carbamazepine without adverse effects.
Environmental Allergens and Morbidity in Atopic and Non‐Atopic Families
Authors: LUOMA R.
Published: January 2008

148 newborns of non‐atopic and 329 newborns of atopic parents were included in a five‐year follow‐up study of atopic diseases. The prevalence of atopic diseases at five years of age is compared to environmental factors, which may be involved in the development of atopic diseases. There was no significant correlation between the development of atopic disease and the following factors: the nature of the immediate environment (industrial, agricultural, rural, urban, arboreal, lake‐district); building materials, heating systems and general state of repair of the houses, including its interior decoration; the presence of pets, plants, humidifiers or cigarette smoke. There was, however, one exception: in both family groups the avoidance of woollen garments and bed clothes before the outbreak of atopic symptoms was associated with the increased prevalence of asthma, allergic rhinitis and atopic dermatitis. The cause of this association remained uncertain. Children with atopic diathesis are known to frequently display skin intolerance to wool. Therefore, wool avoidance in a family may only indicate that the child was potentially atopic. Atopic children suffered from ear infections and vomiting more often than control children. The incidence of ear infections was also increased amongst children with a positive family history of atopy, even if no atopic disease was diagnosed in the child himself. Although breast fed infants tended to have less infectious diseases than those weaned early, ear infections were equally common in all feeding groups. This is further evidence, that in part of the cases of recurrent ear infections, atopy should be considered as a possible etiologic factor.
Phenobarbital Prophylaxis for Hyperbilirubinemia in Preterm Infants
Authors: WALLIN A. , BOREUS L. O.
Published: January 2008

Phenobarbital (PB) has been used at several pediatric centers for prophylaxis against neonatal hyperbilirubinemia. However, few attempts have been made to evaluate this procedure quantitatively, and a variety of dose schedules has been proposed. Therefore, a randomized, controlled clinical trial was performed in which the effects on bilirubin disposition and on neonatal behavior was quantitated. Forty‐three preterm infants were randomized into one of four dose groups and given 0, 4, 8, or 12 mg of PB per kg in a single dose within the first few hours after birth (mean 2.2 h). The total serum bilirubin disappearance rate was found to be significantly increased (p < 0.01) only in the 12 mg/kg group. This effect was not evident until postnatal day 7. The 4 and 8 mg/kg groups were not significantly different from the control group at any time. Infant behavior was monitored by a non‐invasive time‐lapse filming technique. The time spent in quiet sleep was found to be proportional to the plasma PB concentration at one day of age (r= 0.61). The infants in the 12 mg group spent a larger proportion of time in quiet sleep than the other groups (p < 0.05). The plasma half‐lives, plasma clearances and volumes of distribution of PB were similar in the three dose groups. No correlation was found between the pharmacokinetics and the gestational age of the infant. It is concluded that in order to enhance the bilirubin disappearance rate, PB has to be administered in doses that will affect behavior.
Prevention and Control of Neonatal Pyoderma with Chlorhexidine
Authors: SEEBERG S. , BRINKHOFF B. , JOHN E. , KJELLMER I.
Published: January 2008

The extent of staphylococcal colonisation and neonatal pyoderma was studied in 5 220 infants in two large Swedish hospitals in 1979–1982. A method for routine cord care with 4 % chlorhexidine detergent solution was evaluated in one hospital. Nursery colonisation with Staph, aureus and streptococci decreased significantly. The method proved to be clinically efficient for prevention of pyoderma in the nursery as well as for controlling staphylococcal infection after discharge from hospital. The combined use of a quantitative sampling method and phage‐typing showed that most post‐discharge lesions were nursery‐derived. In one of the hospitals, daily cord care with 70 % ethanol failed to prevent streptococcal and staphylococcal omphalitis in the nursery whereas daily cord care with chlorhexidine reduced the incidence of omphalitis from 21 to 1 %.
A Novel Format for a Growth Chart
Authors: SORVA RITVA , PERHEENTUPA JAAKKO , TOLPPANEN ESA‐MATTI
Published: January 2008

A novel format for a growth chart is proposed to facilitate early detection of aberrant growth. Normal growth is shown as a horizontal line and any deviation from this indicates abnormal change in growth. The vertical scales show relative height (height SDS) and relative weight (% deviation of weight from the mean weight for height) directly. Weight is recorded against height rather than age.
Neonatal Screening for Cystic Fibrosis by Dried Blood Spot Trypsin Assay
Authors: CASSIO A. , BERNARDI F. , PIAZZI S. , CAPELLI M. , FREJAVILLE E. , VILLA M. P. , MARTELLI E. , BALSAMO A. , SALARDI S. , MERIGHI R. , CACCIARI E.
Published: January 2008

47127 newborn infants from the Emilia‐Romagna region were screened for cystic fibrosis by dried blood spot trypsin assay. In the initial 12099 subjects screened with a non‐standardized method, two children with cystic fibrosis were observed. Of the remaining 35028 newborn infants, 299 showed high immunoreactive trypsin values; retesting revealed persistent elevation in 11. Sweat testing confirmed cystic fibrosis in 6 subjects and was normal in 5. Clinical monitoring of these 5 children has, as yet, shown no pathological signs. No false‐negative test results have yet been identified. In our region, cystic fibrosis frequency would appear to be 1 case every 5890 newborn infants. Our study confirms that elevated immunoreactive trypsin is characteristic of newborn infants with cystic fibrosis and that screening by determination of immunoreactive trypsin is of great benefit since it allows early diagnosis and a rational approach to therapy.
Simulated Reye's Syndrome and Salicylate Therapy
Authors: YOSHIDA I. , YAMASHITA F. , OKADA S. , HORIKOSHI T.
Published: January 2008

A 4‐year‐old girl with juvenile rheumatoid arthritis developed fever, protracted vomiting, disturbance of consciousness and decorticate posture following the administration of salicylate. There were elevated levels of transaminases in serum, hyperammonemia and a fatty liver. However, the fatty droplets were different electronmicroscopically from that of Reye's syndrome. This observation emphasizes the importance of electronmicroscopic observation of the liver in the differential diagnosis between Reye's syndrome and aspirin‐induced encephalopathy, because the clinico‐pathological findings of intoxication are so similar.
Idiopathic Pulmonary Haemosiderosis in Swedish Children
Authors: KJELLMAN B. , ELINDER G. , GARWICZ S. , SVAN H.
Published: January 2008

During the 3 decades 1950–1979 onset of idiopathic pulmonary haemosiderosis occurred in 10 Swedish children. Complete records were available from the eight children with onset during 1960–1979, which indicates that the yearly risk of onset is 0.24 case per million children. The first symptoms started at the mean age of 5.8 years (range: 10 months‐11 years). From the beginning all children had a severe microcytic, hypochromic, sideropenic anaemia. Pulmonary symptoms were present from the beginning in four children (but haemoptysis in only one) and developed in the remaining children after 11/2–21/2 years. Various therapeutical regimens were tried. Iron therapy seemed of temporary beneficial effect and most children seemed to benefit from prednisone therapy during disease bouts, although the effect of the therapy in the long run could not be determined. The four children with onsets during the 1960s died of their disease after 2–13 years. The four children with onset during the 1970s are still alive. One of them–a 20‐year‐old female, has for two years complete clinical remission and has normalized haematological, X‐ray and pulmonary function data.
A Comparison of the Zinc, Copper and Manganese Status of Very Low Birth Weight Pre‐Term and Full‐Term Infants during the First Twelve Months
Authors: FRIEL J. K. , GIBSON R. S. , BALASSA R. , WATTS J. L.
Published: January 2008

During a longitudinal study, hair samples and dietary intake data were collected from 50 preterm (mean birth weight = 1054 ± 234 g, mean gestational age = 29 ± 2.5 weeks) and 60 full‐term infants (mean birth weight = 3 509 ± 269 g, mean gestational age = 40+1 weeks) at 3, 6 and 12 months of age. Mean daily zinc, copper and manganese intakes were calculated using three‐day dietary records and test‐weight data for the breast‐fed infants. Hair samples were analyzed for these elements by instrumental neutron activation analyses. The medium hair zinc concentration in the pre‐term group at six months (81 μg/g) was lower (p < 0.05) than that of the full‐term group (144 μg/g) and was associated with lower mean dietary zinc intakes at 3 and 6 months. At 12 months, the median hair copper (12.5 μg/g) and manganese (0.18 μg/g) concentrations for the pre‐term were lower (p < 0.05) than those of the full‐term infants (Cu = 16.5 μg/g; Mn = 0.25 μg/g) and were also associated with low dietary copper and manganese intakes
Sympatho‐Adrenal Activity and Metabolic Adjustment during the First 12 Hours after Birth in Infants of Diabetic Mothers
Authors: BROBERGER U. , HANSSON U. , LAGERCRANTZ H. , PERSSON B.
Published: January 2008

Plasma adrenaline and noradrenaline concentrations at birth were the same in infants of diabetic mothers and controls after both vaginal and abdominal delivery. The infants delivered vaginally had significantly higher noradrenaline concentrations than those delivered by caesarean section. During the first 12 postnatal hours, the concentration of noradrenaline decreased to levels similar to those found in newborn infants with minor respiratory problems. No hypoglycemic values were recorded in infants of diabetic mothers at birth nor during the first twelve hours after birth. The C‐peptide concentrations at birth were significantly lower in infants of diabetic mothers delivered vaginally as compared to those delivered by caesarean section. The FFA concentrations increased after birth possibly as a result of the lipolytic action of catecholamines released during labour and delivery. We have not been able to confirm the increased sympatho‐adrenal activity previously reported in infants of diabetic mothers. We suggest that the difference is due to better metabolic control in the diabetic mothers during pregnancy and delivery in this study.
IgG Subclass Concentrations in Preterm Neonates
Authors: OXELIUS V.‐A. , SVENNINGSEN N. W.
Published: January 2008

Serum IgG subclass concentrations were measured in 158 sera from preterm, appropriate for gestational age, infants born between 27 and 37 weeks of gestation, pregnancy, delivery and neonatal period being uncomplicated in all cases. At birth the IgG subclass concentrations were inversely correlated to the degree of prematurity. The IgG subclass concentrations decreased mainly proportionately during the neonatal period. The most immature infants born before the 30th week of gestation had critically low concentrations of all IgG subclasses. All immature infants, already in the first week after birth, showed capacity for IgGl and IgG3 synthesis.
Treatment of Idiopathic Nephrotic Syndrome with Levamisole
Authors: NIAUDET P. , DRACHMAN R. , GAGNADOUX M. F. , BROYER M.
Published: January 2008

Thirty children with frequently relapsing idiopathic nephrotic syndrome (INS) were treated with levamisole (2.5 mg/kg BW) twice a week for a mean period of 9.9 months. A beneficial effect was observed in 16 children in whom corticosteroids could be significantly decreased without relapse. Levamisole was ineffective in 14 patients. There was no difference between the two groups in the duration of INS, the number of relapses and the duration of treatment with levamisole. The mean age at onset of INS was higher in the group of patients where levamisole was effective (5.8 years versus 2.8 years). In 7 patients who responded to levamisole neutrophils decreased below 4×109/l. Transient granulocytopenia was observed in 3. It is concluded that levamisole may be effective in frequently relapsing INS with minimal side effects
Jejunal Mucosa after Leukemia Treatment in Children
Authors: PERKKIO M. , RAJANTIE J. , SAVILAHTI E. , SIIMES M. A.
Published: January 2008

Nine children with acute lymphoblastic leukemia in remission were studied at the end of their three years’maintenance therapy. In the jejunal biopsy specimens significantly fewer intraepithelial lymphocytes and IgA‐cells were observed in the patients than in the controls. However, the crypts were deeper than normal, and the mitotic activity of the crypt cells was markedly increased in all of the patients. Three children presented with decreased epithelial disaccharidase activities. One had abnormal D‐xylose test and two abnormal lactose tolerance test. Although weight gain did not differ from the normal, height increase was retarded in all but one of the patients. We conclude that leukemia treatment leads to changes in the intestinal mucosa that might in part contribute to impairment of growth in the patients and to suppression of mucosal immunity in their jejunum
Diuresis and Urine Concentration during CPAP in Newborn Infants
Authors: SVENNINGSEN N. W. , ANDREASSON B. , LINDROTH M.
Published: January 2008

ABSTRACT. The impact of continuous positive airways pressure (CPAP) on diuresis and urine concentration was studied in newborn preterm infants with respiratory insufficiency with and without pulmonary X‐ray changes. Urine output and osmolality, sodium balance and blood pressure were measured before, during and after CPAP application. In all infants urine osmolality rose and urine output decreased significantly when high CPAP (8 cm H2O) was applied, especially in infants without radiographic pulmonary changes. Three infants also developed hyponatremia at high CPAP levels. The results indicate that high CPAP levels per se may affect fluid balance inadvertently. Therefore fluid intake and urine output should be monitored closely during CPAP treatment.
Premature Thelarche–Natural History and Sex Hormone Secretion in 68 Girls
Authors: ILICKI A. , LEWIN R. PRAGER , KAULI R. , KAUFMAN H. , SCHACHTER A. , LARON Z.
Published: January 2008

ABSTRACT. Data obtained during long‐term follow‐up of 68 girls with premature thelarche were analysed. In 85 % onset was before the age of 2 years, in 30.8 % being present at birth. In 44.1 % there was a regression after 32/12±28/12 12years (SD). Basal levels of plasma FSH and response to LH‐RH were significantly higher than prepubertal controls (1.93± 1.56 vs. 0.8±0.1 mU/ml and peaks 12.3±5.4 vs. 7.9±1.0 mU/ml respectively; p<0.001). Twenty‐seven of 52 patients tested had increased plasma estradiol and in 27 of 40 patients tested, urocytograms or vaginal smear showed estrogenization. Basal levels of LH and response to LH‐RH were prepubertal. The girls with premature thelarche were significantly taller than normal controls of the same age (p<0.001). These results suggest that premature thelarche is an incomplete form of precocious sexual development probably due to derangement in the maturation of the hypothalamo‐pituitary‐gonadal axis which results in a higher than normal secretion of FSH, as well as a defect in the peripheral sensitivity to the sex hormones.
Breast‐milk Antimicrobial Factors of Rural Gambian Mothers: Influence of Season and Prevalence of Infection
Authors: PRENTICE A. , WATKINSON M. , PRENTICE A. M. , COLE T. J. , WHITEHEAD R. G.
Published: January 2008

ABSTRACT. The effects of season and variations in the prevalence of infectious disease on the concentrations and daily production of breast‐milk immunoproteins were studied in 152 rural Gambian mothers and their children up to 26 months post‐partum. IgA, IgG, IgM, C3, C4, lactoferrin, lysozyme and secretory component concentrations and breast‐milk volumes were measured longitudinally over a six month period which encompassed dry and rainy seasons. No increase in the production of any immunoprotein was observed at the time of maximum prevalence of serious infectious diseases, especially diarrhoea, in the children. Enhanced secretion of certain immunoproteins was noted in mothers of children aged 9–18 months at the beginning of the rainy season. There was some evidence that this may have been associated with skin sepsis, particularly impetigo, in the children. The production of most immunoproteins fell during the rainy season. This was not the result of declining maternal food intakes as similar decreases were seen for women receiving a dietary supplement.
Central Nervous System Relapse Surveillance by Serial Beta2‐Microglobulin Measurements in Childhood Acute Lymphoblastic Leukemia
Authors: CLAUSEN N. , IBSEN K. K.
Published: January 2008

ABSTRACT. Beta2‐microglobulin (β2m) is synthesized particularly in lymphocytes. Its value for early detection of central nervous system (CNS) involvement in acute lymphoblastic leukemia in children was tested by serial determinations. Before 9 overt CNS relapses, the mean increase of the cerebrospinal fluid (CSF) β2m concentration was 588 μg/l/month (range: ‐50 to +2020), which was significantly higher than the steady levels during maintenance treatment. Although the absolute value of CSF β2m was increased to 1430 μg/l in the group with overt CNS relapse, individual variations in CSF β2m before a relapse were so great that no difference was seen between samples from CSF with or without lymphoblasts. The ratio between β2m in the CSF and in serum did not increase in serial samples prior to overt relapse, but the ratio was higher in patients with CNS relapse compared with a control group on maintenance therapy. In 9 children without CNS leukemia, the β2m concentration in CSF and serum decreased to a nadir 4 weeks after the start of induction treatment. The subsequent increase of CSF β2m was similar to the increase before a CNS relapse. Mean values of CSF β2m changes differed between groups of children with and without CNS leukemia early in the induction phase and during the maintenance treatment, but the wide range in individual values made serial β2m determinations unsuitable for detecting a CNS relapse.
Growth and Puberty Arrest due to Prolactinoma
Authors: SACK J. , FRIEDMAN E. , TADMOR R. , SAHAR A. , KATZNELSON D.
Published: January 2008

ABSTRACT. A 13‐year‐old male with prolactin secreting pituitary tumor is described. The unusual features were arrested puberty and growth. Previously reported pediatric patients with prolactinoma are reviewed. The importance of serum prolactin measurement and bromocriptine therapy is emphasized.
Evaluation of an Oral Rehydration Solution with Na+ 60 mmol/l in Infants Hospitalized for Acute Diarrhoea or Treated as Outpatients
Authors: ISOLAURI ERIKA
Published: January 2008

ABSTRACT. An oral rehydration solution (ORS) containing 60 mmol/l of Na'(ORS60) was compared in a randomized trial with the ORS of WHO formula (Na+ 90 mmol/l = ORS90) for the treatment of diarrhoeal dehydration in 66 hospitalized infants aged 3 to 34 months. The infants had a 5±3 % dehydration, and received within 6–10 hours 76±32 ml/kg of ORS60 or 74±41 ml/kg of ORS90 corresponding to a sodium input of 4.6±1.9 mmol/kg and 6.6±3.7 mmol/kg, respectively. Both treatments were found adequate and equally effective for the correction of dehydration and sodium deficit. The same ORSM was also compared to a commercial low sodium glucose‐electrolyte solution (sodium 35 mmol/l, glucose 3.5 g/1) for ambulatory treatment of acute diarrhoea in infants. Satisfactory rehydration was achieved within 6 hours in 19 of 23 infants receiving ORS60 as opposed to 6 of 18 infants receiving the commercial solution (p<0.001); the poor result with the latter was in most cases attributed to a refusal by the infant to consume the sweetish solution. It is concluded that ORS60 is suitable for the treatment of isotonic diarrhoeal dehydration in hospitalized children as well as outpatients.
A Comparative Trial of Cholestyramine and Loperamide for acute Diarrhoea in Infants Treated as Outpatients
Authors: VESIKARI TIMO , ISOLAURI ERIKA
Published: January 2008

ABSTRACT. Infants aged 4 to 36 months with acute diarrhoea (rotavirus 66 %) were treated as outpatients with oral fluids and a rapid return to full feedings. In addition, the infants were randomized to receive for 3 days either cholestyramine 2 g twice daily (N= 10), an equivalent placebo 2 g twice daily (N=15), or loperamide 0.10 mg/kg divided in three doses (N=16). The duration of watery diarrhoea from the beginning of treatment was 0.9±1.0 days in the cholestyramine group, 2.5±1.3 days in the loperamide group, and 3.3±1.6 days in the placebo group (P<0.001 cholestyramine vs. placebo, p<0.005 cholestyramine vs. loperamide). The infants receiving cholestyramine also had a better weight gain than those receiving the placebo, and their metabolic acidosis was corrected sooner. There was no hyperchloraemia associated with the cholestyramine treatment. It is concluded that cholestyramine 2 g twice daily for 3 days can be safely used to shorten the course of acute diarrhoea. The use of loperamide in acute infantile diarrhoea does not appear justified.
Changes in the Incidence and Spectrum of Neonatal Septicemia during a Fifteen‐year Period
Authors: BENNET R. , ERIKSSON M. , MELEN B. , ZETTERSTROM R.
Published: January 2008

ABSTRACT. Over a period of 15 years the incidence of neonatal septicemia seen at St Goran's Children's Hospital has increased both per 1000 births and per 100 admitted neonates. The spectrum of causative organisms has changed towards more Gram‐positive organisms and fewer Gram‐negative organisms. In the initial antibiotic treatment an aminoglycoside and ampicillin derivate will still be needed to give full coverage.
Children of Deviant Birthweight: the Influence of Genetic and Other Factors on Size at Seven Years
Authors: OUNSTED M. , MOAR V. A. , SCOTT A.
Published: January 2008

ABSTRACT. 138 small‐for‐gestational age (SGA), 138 average‐for‐gestational age (AGA) and 136 large‐for‐gestational age (LGA) children who had been followed up from birth were measured at the age of seven years. Parental measurements were also obtained. Significant differences for weight, height and head circumference of the children and their parents were found between the three groups. There were highly significant parent‐child correlations for most somatic measures in all groups. Within each group the parental contribution to the variance in children's somatic measures was large; so also was the effect of sex on head circumference. Other biological and pathological factors made only a small contribution in any group.
Immunological Profile in Children with Minimal Change Nephrotic Syndrome
Authors: GUPTA SUDHIR , YUCEOGLU A. M.
Published: January 2008

ABSTRACT. Peripheral blood from patients with active stage of minimal change nephrotic syndrome (MCNS) was examined for concanavalin A (ConA)‐inducible suppressor T cell activity, proliferative response to phytohemagglutinin (PHA) and in the autologous (AMLR) and allogeneic (MLR) mixed lymphocyte reaction, proportions of T cells with receptors for IgM (Tu) or IgG (Tγ) and the levels of serum immunoglobulin M, G and A. Six of 9 patients with MCNS studies showed deficiency of ConA‐induced suppressor cell activity. In the AMLR, only one of 9 patients with MCNS demonstrated depressed proliferative response (p<0.05). In the allogeneic MLR, T cells from 5 of 9 patients with MCNS demonstrated poor proliferative response when stimulated with normal control non‐T cells. Five of 9 patients with MCNS had depressed proliferative response to PHA. The proportion of total T cells, Tu cells and Ty cells in the patient group were comparable to healthy control group. Serum IgG was significantly decreased in 7 of 11 patients. This study demonstrates multiple immunological abnormalities in patients with MCNS that might play a role in its pathogenesis.
Changes in Plasma Lipoproteins from First Day to Third Week of Life in Healthy Breast‐fed Infants
Authors: KIRSTEIN D. , JOHANSEN K. B. , PETERSEN M. B. V. , ANDERSEN G. E.
Published: January 2008

ABSTRACT. Plasma lipoproteins were measured in seven healthy breast‐fed infants three times during the first and on the third, sixth and twenty‐first days of life. Plasma total beta‐lipoprotein, very low density and low density lipoprotein increased three times during the first week of life. Plasma total apolipoprotein A‐I and high density lipoprotein increased twice between the first and third week of life. These dramatic changes in plasma lipoprotein concentrations during the neonatal period can best be explained by the effect of feeding.
Mechanical Power Output in Children Aged 11 and 14 Years
Authors: DAVIES C. T. M. , YOUNG K.
Published: January 2008

ABSTRACT. Short‐term power output in jumping and cycling has been measured in 56 children aged 11 and 14 years. The results showed that the peak power output in cycling (Wb) and jumping (Wp) were closely associated (r=0.91) but in absolute terms Wb was ±34 % greater than Wb. There were no significant differencs in Wb (or Wp) between the 11‐year‐old boys and girls, but the 14‐year‐old boys recorded –25 % higher power output values in cycling and jumping than girls of the same age and were approximately twice as powerful as their younger male counterparts. The velocity of movement in cycling (Vb) and jumping (Vr) for a given age were identical and independent of sex in the younger children. Peak power output in cycling was reached when force and velocity were equivalent to 50 % of their calculated maximal values. When Wb and Wp were related to an anthropometric estimate of leg muscle (plus bone) volume the difference in absolute power output between the children disapppeared. The results suggest that the difference between Wp and Wb and the increase in absolute mechanical power output with age is mainly a function of size and the force which can be exerted at the optimal frequency of movement in children.