bluuebunny/crossref_metadata_2025 huggingface dataset:
Regulation of Serum Sodium in Dehydrated and Orally Rehydrated Infants
Authors: MURTAZA ASIFA , ZULFIQAR IMTIAZ , RAZAKHAN SHAUKAT , LINDBLAD BO S. , APERIA ANITA
Published: January 2008

ABSTRACT. We have examined the control of serum sodium concentration (S‐Na) in 60 male infants with acute diarrheal disease, moderate dehydration, but without the presence of fever, vomiting or other conditions. The infants were studied on admission and during oral rehydration therapy (ORT). We examined the effect of rapid reduction of the purging rate on the control of S‐Na by adding pulverized rice and pulses (dal moong) to the rehydration solution. On admission S‐Na was significantly inversely related to age. This correlation could not only be attributed to difference in stool sodium losses. Changes in S‐Na and urinary K/Na ratio during oral rehydration therapy (ORT), were analyzed seperately in infants below and above 4 month of age. During the first six hours of ORT, there was an increase in S‐Na in all groups. During the following 18 hours, S‐Na tended to normalize around 138 mmol/1. Normalization occrred faster if purging rate was reduced. In all groups urinary K/Na ratio (index of aldosterone production and, inversely, of sodium balance), was high at admission and fell during ORT. In the youngest infants (below 4 month of age) the fall was significantly more pronounced if the purging was reduced. We conclude that it is important to consider age when prescribing ORT. The capacity to correct distrubances in S‐Na becomes more efficient during maintenance stage of ORT. Correction of S‐Na and sodium balance is enhanced by rapid reduction of abnormal intestinal losses.
Passage of Gliadin into Human Breast Milk
Authors: TRONCONE RICCARDO , SCARCELLA ALDA , DONATIELLO ANNA , CANNATARO IERO , TARABUSO ANNA , AURICCHIO SALVATORE
Published: January 2008

ABSTRACT. Samples of breast milk were taken from 53 women following the ingestion of 20 g of gluten. The samples were analysed for the presence of gliadin by a double‐antibody sandwich enzyme immunoassay. Gliadin (5–95 ng/ml) was detected in 54/80 samples collected at various stages of lactation. Maximum levels in milk were found 2–4 hours after ingestion; gliadin could not be detected in serum. The transfer of gliadin from mother to infant might be critical for the development of an appropriate specific immune response to gliadin later in life.
Chronic Growth Retardation with Normal Growth Hormone Response to Provocative Stimuli and Low Somatomedin Activity
Authors: CARRASCOSA A. , VICENS‐CALVET E. , AUDI L. , GUSINYE M. , ALBISU M. , POTAU N.
Published: January 2008

ABSTRACT. Four prepubertal children with chronic growth retardation (growth velocities ≤4 cm/yr), normal growth hormone (GH) response to provocative stimuli and low basal but increased somatomedin activity values after GH administration, received continuous GH‐therapy (4 IU/three times a week) for an 18–24‐month period. Growth velocity doubled during the first 12 months of therapy and remained 4–6 cm/yr until the end. Bone age progressed according to chronological age and adult height predictions improved. No thyroid function or carbohydrate and lipid metabolism anomalies were observed. After completion of this GH‐therapy period, patients remained off treatment during the following six months. Growth velocities were similar to pre‐GH‐treatment values in two patients, lower in the third and higher in the fourth, who was by then pubertal. Thus, in these patients, long‐term GH‐therapy promoted growth and improved adult height prediction.
Increased Vigilance and Dopamine Synthesis by Large Doses of Tyrosine or Phenylalanine Restriction in Phenylketonuria
Authors: LOU H. C. , LYKKELUND C. , GERDES A.‐M. , UDESEN H. , BRUHN P.
Published: January 2008

ABSTRACT. In a group of 9 patients with classical phenylketonuria (PKU) aged 15–24 years we examined the effect of phenylalanine restricted diet on vigilance, as judged by the continuous visual reaction times, and neurotransmitter synthesis, as judged by cerebrospinal fluid (CSF) homovanillic acid (HVA) and 5‐hydroxyindole acetic acid (5‐HIAA) levels. HVA and 5‐HIAA levels decreased significantly with increase in plasma phenylalanine concentration on free diet (p<0.01 and p<0.0005 respectively). Vigilance improved on phenylalanine restricted diet in 6 of the 7 patients with abnormally long reaction times on free diet. Addition of tyrosine (160 mg/kg/24 h) to the free diet resulted in an increased HVA/5‐HIAA ratio in CSF in the six patients examined. In 14 patients on free diet supplemented with tyrosine, an improvement in vigilance (reaction times at the 90 percentile) was seen in all 12 patients with values longer than the normal mean (264 msec) (p<0.001). Tyrosine treatment may be a therapeutical alternative when phenylalanine restriction is impractical.
Gastric Suction in Healthy Newborn Infants Effects on Circulation and Developing Feeding Behaviour
Authors: WIDSTRÖM A.‐M. , RANSJÖ‐ARVIDSON A. B. , CHRISTENSSON K. , MATTHIESEN A.‐S. , WINBERG J. , UVNÄS‐MOBERG K.
Published: January 2008

ABSTRACT. Gastric emptying of newborn infants is a procedure performed to prevent aspiration of gastric contents. The present investigation was conducted to study the effects of gastric suction on circulatory and behavioural parameters in 21 healthy newborn children (11 cases, 10 controls). A small elevation in mean arterial blood pressure was observed during gastric suction. The incidence of retching was also increased. In all children spontaneous sucking and rooting movements, as well as state of sleep and wakefulness were recorded. In the control group spontaneous sucking and rooting movements started to occur 15 min after birth and reached a maximum at 45 and 60 min, respectively. The first hand to mouth movement was observed after a mean of 34 min and the infants found the nipple and started to suckle at about 55 min. This sequence of prefeeding behaviour was disrupted in children who had undergone gastric suction. The physiological side‐effects induced by gastric suction are minor, but it seemed to be unpleasant for the child and no clear advantages are gained by the procedure.
The Effect of Non‐Nutritive Sucking on Plasma Insulin, Gastrin, and Somatostatin Levels in Infants
Authors: MARCHINI GIOVANNA , LAGERCRANTZ HUGO , FEUERBERG YVETTE , WINBERG JAN , UVNÄS‐MOBERG KERSTIN
Published: January 2008

ABSTRACT. The aim of the present investigation was to study the effect of non‐nutritive sucking on plasma levels of insulin, gastrin, and somatostatin in infants. These hormones were measured with radioimmunoassay in plasma collected from fullterm and preterm infants sucking a pacifier. In fullterm infants, sucking caused a significant increase of insulin levels from 13 ± 10 μU/ml to 40 ± 36 μU/ml and 21 ± 17 μU/ml after 45 sec and 5 min respectively, from when the infants started sucking. A similar pattern was seen in preterm infants. In contrast, gastrin and somatostatin levels were not significantly affected. We suggest that sucking causes an activation of the vagal nerve, which results in the release of insulin. We also suggest that in infants, oral feeding is superior to bolus feeding, since in the latter case no vagal activation and consequently no release of hormones with anabolic properties occurs.
Zinc and Copper Status of Allergic Children
Authors: TORO R. DI , CAPOTORTI M. GALDO , GIALANELLA G. , del GIUDICE M. MIRAGLIA , MORO R. , PERRONE L.
Published: January 2008

ABSTRACT. Zinc and copper status was examined in 19 healthy and 43 atopic children (22 asthmatics and 21 eczematous) 2–14 years old. Dietary intakes for energy, protein, zinc and copper and some nutritional indices (height, weight, serum protein, albumin, ceruloplasmin) were similar in the allergic and in the control group. The proton‐induced X‐ray fluorescence technique was used to assess zinc and copper concentrations in serum and hair. No difference was detected in serum zinc concentration between allergic and healthy children. In contrast, mean hair zinc level was lower (p<0.05) in allergic than in healthy children (99±6 vs. 147±9 μg/g). Mean serum copper content was higher in asthmatic than in control children while mean hair copper was higher (p<0.05) in asthmatic and eczematous children than in the control group. These findings suggest a different zinc and copper nutritional status between allergic and healthy subjects. Allergic children, in particular, seem to be a risk of zinc deficiency.
Growth of 519 Small for Gestational Age Infants during the First Two Years of Life
Authors: TENOVUO A. , KERO P. , PIEKKALA P. , KORVENRANTA H. , SILLANPÄÄ M. , ERKKOLA R.
Published: January 2008

ABSTRACT. The physical growth of 519 small for gestational age infants (SGA), with a birth weight below the 10th percentile on our own growth curve, born in the region of University Central Hospital of Turku during the period June 1,1981‐May 31, 1982, was studied. The study population consists of 4 517 term, appropriate for gestational age (AGA) infants, 488 term SGA infants, 320 preterm AGA infants and 31 preterm SGA infants. The degree of intrauterine growth retardation (IUGR) seemed to have an effect on physical growth in term SGA infants. Those term SGA infants with a low Ponderal Index (PI) (type II) were taller and had a larger head circumference at the age of 24 months than term SGA infants with adequate PI (type I). Among the preterm SGA infants the degree of IUGR seemed to have no effect on later growth. Smoking is still one of the main risk factors associated with poor intrauterine growth. In this study we also found that smoking has an effect on later growth; the children of smoking mothers were smaller than those of non‐smoking mothers in the AGA group. Among the SGA infants the infants of non‐smoking mothers were bigger than those of smoking mothers. This difference could be explained by other factors associated with SGA. We found that in spite of the catch‐up growth during the first months, 26% of the severely SGA infants (birth weight below the 2.5th percentile) still had a weight below the 2.5th percentile at the age of 24 months.
Severe Neonatal Respiratory Distress Syndrome Treated with the Isolated Phospholipid Fraction of Natural Surfactant
Authors: NOACK G. , BERGGREN P. , CURSTEDT T. , GROSSMANN G. , HERIN P. , MORTENSSON W. , NILSSON R. , ROBERTSON B.
Published: January 2008

Ten newborn infants (795–1680 g) with severe respiratory distress syndrome (RDS) were treated with the isolated phospholipid fraction of bovine or porcine surfactant, which was administered via the airways (dose 200 mg/kg), at a median age of 10.5 h. Before receiving surfactant, all the infants were on artificial ventilation (FiO2 0.6–1.0). Within 2 h after surfactant replacement, the arterial‐to‐alveolar PO2 ratio increased from 0.1 to 0.35. There was a concomitant improvement in lung aeration on the chest roentgenograms and a significant reduction in the right‐to‐left shunt. Four patients died of cerebral hemorrhage; two of them also had a patent ductus arteriosus. One surviving infant developed bronchopulmonary dysplasia, and another succumbed 8 months later to the sudden infant death syndrome. No antibodies against surfactant were detected in the sera of the survivors. Since our results show a significant improvement in lung function after replacement therapy, the efficacy of this new surfactant preparation should be further tested in randomized clinical trials.
Persistence of Human Milk Proteins in the Breast‐Fed Infant
Authors: DAVIDSON LAURIE A. , LÖNNERDAL BO
Published: January 2008

Several proteins in human milk are postulated to have physiological functions in the breastfed infant. Therefore, survival of human milk proteins after passage through the gastrointestinal tract of the breast‐fed infant was investigated. Fecal samples were collected from exclusively breast‐fed term infants and milk samples from their mothers. Soluble proteins in the feces were extracted and analyzed for total protein, nitrogen, lactoferrin, secretory IgA, serum albumin and lysozyme. Significant amounts of lactoferrin and secretory IgA were excreted by the infants and this excretion decreased throughout the study period in a trend similar to the decreasing milk concentrations of these proteins. Gel filtration demonstrated excreted lactoferrin and secretory IgA to be intact. No serum albumin or lysozyme was detected in the fecal extracts. Crossed Immunoelectrophoresis showed three human milk proteins to be present in the feces—the third was identified as α1‐antitrypsin. Excretion of these proteins indicates the total protein content of human milk is an over‐estimation of the protein nutritionally available to the infant.
Production of Authentic Recombinant Somatropin
Authors: FRYKLUND LINDA
Published: January 2008

Further developments in recombinant DNA technology, exploiting a natural mechanism for export using a signal peptide in E. coli, have enabled the production of recombinant somatropin, with full biological activity and extremely high purity. The secretion of the protein into the periplasmic space has simplified purification procedures, providing a unique and simple process and a pure and active product.
Results from the First 2 Years of a Clinical Trial with Recombinant DNA‐derived Human Growth Hormone (Somatrem) in Turner's Syndrome
Authors: ROSENFELD RON G. , HINTZ RAYMOND L. , JOHANSON ANN J. , SHERMAN BARRY
Published: January 2008

A total of 70 subjects with Turner's syndrome from 11 centres were enrolled in a study of somatrem. After an initial observation period, they were randomly assigned to one of four groups, receiving no treatment (Group 1, control); oxandrolone, 0.125 mg/kg/day (Group 2); somatrem, 0.125 mg/kg 3 times/week (Group 3); or a combination of somatrem and oxandrolone on the above dose regimens (Group 4). After 12–20 months, Groups 1 (control), 2 (oxandrolone) and 4 (combination) were treated with somatrem, 0.125 mg/kg 3 times/week, and oxandrolone, 0.0625 mg/kg/day; Group 3 remained on somatrem, 0.125 mg/kg 3 times/week. All three treatment groups showed a statistically significant increase during year 1 in growth velocity over both their pretreatment growth rates and the control group growth rate. These increases were slightly less in year 2 for the somatrem and combination therapy groups, but remained significantly higher than the year 1 control group growth rate. Plasma IGF‐1 levels were elevated in years 1 and 2 in the somatrem and combination groups. Adverse events were few with the somatrem group, though mild virilization occurred with oxandrolone, alone or in combination. Bone age advancement was observed with all treatments but was greater with combination therapy; it was accompanied by height age advancement. The effect of this therapy on predicted adult height was also evaluated.
Analysis of Linear Growth Using a Mathematical Model. II. From 3 to 21 Years of Age
Authors: KARLBERG J. , FRYER J. G. , ENGSTRÖM I. , KARLBERG P.
Published: January 2008

Karlberg, J., Fryer, J. G., Engström, I. and Karlherg, P. (Departments of Anatomy and Paediatrics I, University of Gothenburg, Sweden and the Department of Biostatistics, School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA). Analysis of linear growth using a mathematical model. II. From 3 to 21 years of age. Acta Paediatr Scand [Suppl] 337:12, 1987.

The‘ICP growth model’(ICP = Infancy, Childhood and Puberty components) represents linear growth from 3 years of age to maturity by a combination of a slowly decelerating childhood component together with a sigmoid puberty component, the latter acting only during adolescence. Linear growth is analysed for 157 longitudinally followed healthy infants using this model. The main aim is to assess the ability of the ICP model to describe and evaluate individual growth patterns in healthy children with particular emphasis on the considerable individual variation in the timing of puberty and the shape of the pubertal growth spurt. The use of the model to evaluate growth longitudinally over both short and long periods is also outlined.

Reference values based on the ICP approach, the ICP Standard, seem to have a number of advantages in comparison with cross‐sectional standards. In the‘Prepubertal ICP Standard’, the contribution of the puberty component is omitted. The standard can be applied on an individual basis to evaluate prepubertal growth and pubertal onset, independently of the timing of puberty. By using the‘Pubertal ICP Standard’both the difference in pubertal maturation and the negative relationship between the size of the pubertal gain and the timing of puberty are taken into account. The fact that the gain in the puberty component is time‐invariant, and can thus be aligned with the timing of puberty for an individual child, forms the basis of this approach. The analyses have also revealed a new predictor for final height, which is termed HAPO (height adjusted for pubertal onset). This predictor is based on age and attained size at onset of puberty‐the‘onset’regression line.
The Effect of Human Growth Hormone Injection Frequency on Linear Growth Rate
Authors: ALBERTSSON‐WIKLAND KERSTIN
Published: January 2008

Albertsson‐Wikland, K. (Departments of Paediatrics II and Physiology, University of Gothenburg, Gothenburg, Sweden). The effect of injection frequency on linear growth rate. Acta Paediatr Scand [Suppl] 337:110, 1987.

hGH has been used in the treatment of hGH deficient children for nearly 30 years. The optimum treatment regimen is, however, still unknown. Generally, administration has been by 2 or 3 intramuscular injectiodweek and the total weekly dose has been 0.3–0.5 IU/kg. Many factors are known to influence the effect of treatment, such as the dose and the age of the child. In animal studies, the optimum growth rate occurs when the physiological pulse frequency of growth hormone is simulated (i.e. intravenous infusions of growth hormone every 3 hours in the rat). In humans, optimal growth rates occur in children in whom the spontaneous secretion of hGH is associated with many peaks (pulses) of high amplitude. In hGH deficient children, growth rate increases when the weekly dose of hGH is administered daily rather than 2–3 times/week, thereby optimizing the body's utilization of the hormone. The hGH plasma profile after daily subcutaneous hGH injections is, however, different from the hGH plasma profiles of children growing normally, in whom hGH secretion is episodic with many sharp pulses during the day and night. Whether simulation of normal hGH plasma profiles will increase the growth rate in hGH deficient children and normalize their adult height requires further investigation.
Bioequivalence of Genotropin and Somatonorm
Authors: WILTON PATRICK , WIDLUND LARS , GUILBAUD OLIVIER
Published: January 2008

Wilton, P., Widlund, L. and Guilbaud O. (Medical Department, KabiVitrum Peptide Hormones AB, Departments of Pharmacology and of Statistics and Computer Services, Research and Development, KabiVitrum AB, Stockholm, Sweden). Bioequivalence of Genotropin and Somatonorm. Acta Paediatr Scand [Suppl] 337:118, 1987.

The bioequivalence parameters, AUC, Cmax and Tmax were calculated from serum hGH concentration‐time curves after subcutaneous injections of Genotropin (recombinant somatropin) and Somatonorm (somatrem) in a two‐period crossover study in 11 healthy men aged 21–35 years. Cmax was 53.4 and 62.9 mIU/litre and Tmax was 5.3 and 4.0 hours for Genotropin and Somatonorm, respectively. Criteria for bioequivalence were fulfilled for AUC. The bioavailability of Genotropin given subcutaneously was determined from the data obtained in the study above, and after an intravenous injection of Genotropin in the same dose (0.1 IUkg body weight). The measured bioavailability of 71% could be an overestimate due to interference by endogenous hGH.
Clinical Experience with Genotropin Worldwide: An Update March 1987
Authors: GUNNARSSON ROLF , WILTON PATRICK
Published: January 2008

Gunnarsson, R., and Wilton, P. (Medical Department, KabiVitrum Peptide Hormones, Stockholm, Sweden). Clinical experience with Genotropin worldwide: an update March 1987. Acta Paediatr Scand [Suppl] 337:147, 1987.

The efficacy and safety of Genotropin (recombinant somatropin, KabiVitrum AB, Sweden) was analysed in 199 children with hGH deficiency, comprising a combined series of four current multicentre trials. Stimulation of linear growth from pretreatment height velocities of 3–4 cm/year to about 10 cm/year was observed after 6 and 9 months of treatment. Statistical analysis revealed significantly greater height velocities (by 2–3 cm/year) when the weekly dose of the hormone was given in 6–7 injections rather than in 3 injections. Immunogenicity seems to be very low, with only about 2% of the children having detectable antibodies during treatment.
Release of GI Hormones in Mother and Infant by Sensory Stimulation
Authors: UVNÄS‐MOBERG KERSTIN , WIDSTRÖM ANNE MARIE , MARCHINI GIOVANNA , WINBERG JAN
Published: January 2008

ABSTRACT. It is well established that sensory stimulation is of great importance for the growth of and for the physiological and psychological development of infants. Supplementary sensory stimulation such as non‐nutritive sucking and tactile stimulation has been shown to increase the growth rate and the maturation of premature infants. In human neonates non‐nutritive sucking has a vagally mediated influence on the levels of some gastrointestinal hormones. In animal experiments afferent electrical stimulations of the sciatic nerves at low intensity leads to an activation of the vagal nerves and to a consequent release of vagally controlled gastrointestinal hormones such as gastrin and cholecystokinin. We therefore assume that both nonnutritive sucking and tactile stimulation trigger the activity of sensory nerves which leads to a release of vagally regulated gut hormones. Since gut hormones stimulate gastrointestinal motor and secretory activity and the growth of the gastrointestinal tract, and enhance the glucose‐induced insulin release, they may contribute to the beneficial effects on maturation and growth caused by sensory stimulation. In the breast‐feeding situation, the sucking of the child elicits similar reflexes in the mother leading to an activation of the maternal gut endocrine system and a consequent increase in energy uptake. These data indicate that many types of neurogenic reflexes induced in mother‐infant interactions are of importance for the energy economy of both mother and child.
Early Feeding Problems in an Affluent Society
Authors: DAHL M. , KRISTIANSSON B.
Published: January 2008

ABSTRACT. A study was undertaken to investigate growth in children with different types of early feeding problems without any obvious medical explanation. Altogether 42 children were studied and followed up to the age of two years. Twenty‐five children refused to eat (RTE), nine had colic, seven had vomiting and one child displayed hyperirritability at mealtimes. Comparisons were made with controls matched for sex, age and residential area. Attained weight and length were measured frequently; rates of gain were calculated und the growth variables were transformed to standard deviation scores (SD scores). After the onset of the symptoms the SD scores of attained weight and length decreased significantly in the children with RTE and in those with vomiting (p <0.05), and the rate of weight gain was significantly lower in the RTE group than in the control group (p <0.001). At two years of age the children with vomiting had recovered and showed a complete catch–up growth, while the RTE group had attained significantly lower SD scores of attained weight (p <0.001) and length (p <0.001) than the control group. It was found that the risk of growth impairment was greatest in children who refused all food or all food except breast milk.
A Longitudinal Study on Growth and Spontaneous Growth Hormone (GH) Secretion in Children with Irradiated Brain Tumors
Authors: ALBERTSSON‐WIKLAND KERSTIN , LANNERING BIRGITTA , MÁRKY ILDIKÓ , MELLANDER LOTTA , WANNHOLT ULLA
Published: January 2008

ABSTRACT. Longitudinal growth was studied in 27 children after radiotherapy for a brain tumor. Growth deviation (1 SD) was found in 56% of the children after 2 years and was most profound in prepubertal children aged between 3 and 8 years at the time of irradiation. In this group growth velocity was markedly reduced and no catch up was seen. In all children studied growth hormone (GH) secretion, measured as the spontaneous secretion over 24 hours, was found to be severely disturbed. Our conclusion is that all children with a growth deviation 1 SD after radiotherapy (40 Gy) to the hypothalamo–hypophyseal region should be considered GH deficient. In such children GH treatment can be initiated without further testing.
IgG4 in Human Colostrum and Human Milk: Continued Local Production or Selective Transport from Serum
Authors: KELLER MARGARET A. , GENDREAU‐REID LILIANE , HEINER DOUGLAS C. , RODRIGUEZ ANNETTE , SHORT JEFFREY A.
Published: January 2008

ABSTRACT. Colostrum, mature milk, and paired plasma samples were obtained from 10 postpartum women who had not been previously studied. The geometric mean concentration of IgG4 in colostrum (3.3 μg/ml) was similar to the mean concentration in mature milk (3.0 μg/ml). The arithmetic mean for the percent of IgG = IgG4 was 10.3±3.3% for colostrum, 10.3±3.1% for mature milk, 2.6±0.3% for early plasma, and 1.7±0.3% for later plasma. Local mammary production of immunoglobulin was determined by subtracting the estimated serum contribution from the measured concentration in colostrum or milk. Evidence for local mammary production of IgG4 was found in 5 of 10 colostrum samples and 8 of 10 mature milk samples. These observations indicate that the previously observed selective enrichment of IgG4 in colostrum is also true for mature milk. These are the first studies suggesting continued local production of any immunoglobulin other than IgA in mature human breast milk.
Concentrations of Human Atrial Natriuretic Peptide in the Cord Blood and the Plasma of the Newborn
Authors: ITO Y. , MATSUMOTO T. , OHBU K. , KIMURA Y. , HAYASHI M. , MATSUO H. , KATO H. , YAMASHITA F.
Published: January 2008

ABSTRACT. Concentrations of human atrial natriuretic peptide (hANP) in the cord blood and the plasma were measured in 25 newborns. The level of hANP in 0 to 1 post‐natal days (212.8±118.1 pg/ml; mean±SD) was significantly higher than that in cord blood (69.7±53.2 pg/ml) (p < 0.005). There were no significant differences in the levels of hANP at the ages of 0 to 1, 4 and 6 post‐natal days. The level of hANP did not show any significant correlation with urinary excretion of Na, urinary Na/Cr or Na/K ratios. Further evaluations should be made in order to clarify the role of hANP during the early post‐natal period.
Zinc and Vitamin A in Liver of Foetuses and Infants
Authors: DÓREA JOSÉ G. , ARAÚJO MARIA OPHELIA G. DE
Published: January 2008

ABSTRACT. The association of zinc and vitamin A levels was studied in liver of foetuses and infants which were stillborn or died of various causes between the age of 26 weeks of gestation up to 16 weeks post‐partum. No correlation between zinc and vitamin A was observed (r=0.07). Although smaller infants had more hepatic vitamin A than larger infants no significant difference was observed between these groups for liver zinc values.
Double Blind Study on the Need for Vitamin D Supplementation in Prepubertal Children
Authors: ALA‐HOUHALA MARJA , KOSKINEN T. , KOSKINEN M. , VISAKORPI J. K.
Published: January 2008

ABSTRACT. Fifty‐one healthy prepubertal schoolchildren were followed for 13 months in a double blind study. Twenty‐four of them were supplemented with 400 IU of vitamin D2 5–7 times weekly, while 27 received a placebo. The children were examined in winter both at the beginning and at the end of the study, and in the middle of the study in autumn. Mean 25‐hydroxyvitamin D levels in the supplemented group were significantly higher than those in the placebo group both in autumn and in winter, when the study ended. The vitamin D supplementation did not, however, affect other vitamin D metabolites, serum calcium, albumin, inorganic phosphorus, parathyroid hormone concentrations or alkaline phosphatase activity. Moreover, the supplementation caused no alterations in the weight or height gain or bone mineral content of the distal radius of the children, and thus subclinical rickets could not be shown.
Serum Albumin, Retinol‐binding Protein, Thyroxin‐binding Prealbumin and Acute Phase Reactants as Indicators of Undernutrition in Children with Undue Susceptibility to Acute Infections
Authors: BONDESTAM MARGARETA , FOUCARD TONY , GEBRE‐MEDHIN MEHARI
Published: January 2008

ABSTRACT. This study was conducted in order to test the usefulness of measuring the concentrations of selected serum proteins and acute phase reactants in assessing the nutritional status of children with undue susceptibility to acute infections. The concentrations of serum proteins were determined by an immunodiffusion technique in 28 children with undue susceptibility to infections and were compared with those in healthy children. The patients were grouped according to the clinical pattern, i.e. into children with mainly upper respiratory tract infections, with frequent middle ear infections and with lower respiratory tract infections. The total group and all three subgroups of patients had not only significantly lower (p < 0.001 or p < 0.01) mean serum levels of albumin and retinol‐binding protein, but also of the acute phase reactants α2‐macroglobulin and ceruloplasmin (p < 0.01) than the controls. No differences were observed between the patients and the controls in respect of the acute phase reactant orosomucoid. This study indicates that the concentrations of albumin and RBP along with selected acute phase reactants are rapidly influenced by altered nutritional status in children with undue susceptibility to acute infections.
Neonatal Jaundice
Authors: LEVINE RODNEY L.
Published: January 2008

In 1956 Rolf Zetterström & Lars Ernster published their seminal observations demonstrating that bilirubin uncoupled oxidative phosphorylation in isolated mitochondria (1). On the other side of the Atlantic, Richard Day had found that bilirubin inhibited the uptake of oxygen by slices or homogenates of rat brain (2). These novel discoveries appeared to lead the way to understanding the unique toxicity of bilirubin in the newborn. The decades which followed the publication of these papers have seen thousands of additional publications concerning bilirubin and neonatal jaundice, but we do not seem that much closer to a convincing demonstration of the basis for kernicterus nor lesser forms of bilirubin toxicity (3). The neurotoxicity of bilirubin was recently reviewed here by Hansen & Bratlid (4); their article provides an excellent, balanced summary of the field. In contrast, this article offers a particular perspective of evolving work on the toxicity of bilirubin.
Incidence of Childhood Diabetes Mellitus in Austria 1979–1984
Authors: SCHOBER E. , FRISCH H.
Published: January 2008

ABSTRACT. The mean annual incidence of childhood diabetes mellitus in Austria was 7.22 cases per 100 000 with a year to year variation of 6.09–8.67 per 100 000. A seasonal variation of onset, with peaks in autumn and winter and with lower rates in summer in children older than 4 years, could be observed. The peak incidence in girls occurred at 11–12 years and preceeded the highest incidence in boys by 1–2 years. Both sexes showed a small peak around 6 years of age. The male to female ratio was 1.2/1. Compared to epidemiologic studies in north‐west‐ern Europe the incidence of childhood diabetes in Austria is low, however higher than in France or Italy.
Contrasting Features of Insulin Dependent Diabetes Mellitus Associated with Neuroectodermal Defects and Classical Insulin Dependent Diabetes Mellitus
Authors: GARCIA‐LUNA P. P. , VILLECHENOUS E. , LEAL‐CERRO A. , DURAN S. , JORGE S. , WICHMANN I. , NUNEZ‐ROLDAN A. , ASTORGA R.
Published: January 2008

ABSTRACT. The Wolfram, or DIDMOAD, syndrome is a rare congenital disease that is associated with diabetes insipidus, insulin dependent diabetes mellitus of an early onset, bilateral optic atrophy and deafness. Urological disorders are usually present as well. We have studied nine patients belonging to five different families. All of the family members were HLA typed (including DR), and islet cell as well as antinuclear antibody determinations were carried out. Although individuals with insulin dependent diabetes mellitus are very prone to have either HLA‐DR3 or ‐DR4 antigens, none of our patients had DR3 antigens and only one was DR4 positive. On the other hand, three of our patients were typed as HLA‐DR2 positive. This antigen is uncommon in classical insulin dependent diabetes. In one of the families, the affected siblings did not share the same HLA haplotype. Islet cell and antinuclear antibodies were not found in any of the cases and six of the patients had a small, but significant, insulin secretory reserve. On the basis of some of the clinical features it was also possible to further distinguish between the DIDMOAD syndrome and the classical insulin dependent diabetes mellitus. The differences encountered between classical and DIDMOAD insulin dependent diabetes mellitus—the presence/absence of HLA linkage, HLA‐DR2, ‐DR3 and ‐DR4 associations, islet cell or antinuclear antibodies, the tendency to ketosis and diabetic retinopathy—indicate that their etiopathogenies are triggered by distinct mechanisms.
Cyclosporine in Steroid‐Resistant Diamond‐Blackfan Anaemia
Authors: SEIP M. , ZANUSSI G. F.
Published: January 2008

ABSTRACT. Two siblings with Diamond‐Blackfan anaemia (DBA) and several congenital malformations were first treated with corticosteroids and blood transfusions. High steroid doses were needed, but in spite of this haemoglobin values periodically fell below acceptable levels. Cyclosporine was then given in addition to prednisolone. A slow increase in haemoglobin levels was observed over 2–3 months, and the prednisolone doses could be reduced gradually. Two short communications in the literature report similar experiences (1, 2). Cyclosporine could be tried in DBA when reasonable corticosteroid doses do not give a satisfactory response. Since the main effect of cyclosporine is a specific inhibition of T‐lymphocytes, the observed therapeutic effect in DBA indicates that T‐lymphocytes may play an important role in the pathogenesis of this disease.
Heparin Cofactor II, Antithrombin and Protein C in Plasma from Term and Preterm Infants
Authors: ANDERSSON T. R. , BANGSTAD H. , LARSEN M. L.
Published: January 2008

ABSTRACT. The coagulation inhibitors heparin cofactor II (HCII), antithrombin (AT) and protein C (PC) were measured in healthy term and preterm infants in order to establish reference standards. The mean value for HCII in term infants was found to be about half of the adult values. Values below 25% in healthy infants may suggest hereditary deficiency states. One girl with congenital HC II deficiency was detected. Mean AT and PC levels were somewhat higher than HC II. Healthy preterm infants have significantly lower HC II and AT values than healthy term infants. Serial AT measurements have been used in monitoring seriously ill infants and used as a prognostic indicator. In a small number of unhealthy neonates HC II was reduced to an even greater extent than AT, and on recovery normalized more rapidly than AT.
Growth, Growth Hormone and Sex Steroid Secretion in Girls with Central Precocious Puberty Treated with a Gonadotrophin Releasing Hormone (GnRH) Analogue
Authors: STANHOPE R. , PRINGLE P. J. , BROOK C. G. D.
Published: January 2008

ABSTRACT. We have treated 14 girls with central precocious puberty for a mean period of 2.3 years (range, 0.5–3.9) with intranasal (D‐Ser6) GnRH analogue administered in a mean dose of 28 μg/kg/day (range, 15–56). With the onset of treatment there was an initial increase in sitting height compared to subischial leg length, but overall there was no significant change in height standard deviation score for bone age. In this respect our results were indistinguishable from untreated children with central precocious puberty. There was a decrease in physiological GH secretion, associated with decreased sex steroid secretion, which probably accounts for the growth deceleration which has been described during GnRH analogue therapy. The effect of this growth deceleration combined with slowing of the rate of epiphyseal maturation may explain the absence of alteration in height prognosis.
Metabolic Differences between AGA‐ and SGA‐Infants of Very Low Birthweight
Authors: BOEHM G. , SENGER H. , MÜLLER D. , BEYREISS K. , RÄIHÄ N. C. R.
Published: January 2008

ABSTRACT. The metabolic response to different levels of human milk protein intake was studied in 23 appropriate (AGA) and 19 small for gestational age (SGA) infants of very low birthweight (VLBW) on the eighth day of life. The infants received from birth, either fresh preterm human milk or human milk fortified with lyophilized human milk (6 g per 100 ml). Thus, the protein intake ranged from 1.98 to 3.28 g/kg/d in the AGA‐ and from 1.94 to 3.34 g/kg/d in the SGA‐infants. Alpha‐amino‐nitrogen and bile acid concentrations in serum and total‐ as well as alpha‐amino‐nitrogen excretion in the urine were measured. When the protein intake was less than 2.5 g/kg/d no differences between the groups could be found in any of the parameters directly related to nitrogen metabolism, but a significantly higher concentration of bile acids in serum was found in the SGA‐infants. On protein intakes of more than 2.5 g/kg/d the SGA‐infants responded with higher alpha‐amino‐nitrogen as well as total bile acids concentrations in the serum and also with higher excretions of total‐ as well as alpha‐amino‐nitrogen in the urine when compared to the AGA‐infants. The differences between the groups became more pronounced with an increasing protein intake. The data suggest that on the eighth day of life SGA‐infants are more sensitive to an excessive protein intake than AGA‐infants. Hepatocellular dysfunctions as a result of intrauterine growth retardation seems to be an important factor in this special metabolic situation. Bile acid concentration in the serum can be used as a good marker to detect this. The observed differences in the metabolic capacity to handle protein between AGA‐ and SGA‐infants on the eighth day of life have to be considered in the nutritional management of VLBW‐infants.
Fetal and Neonatal Cortical Adrenal Function in Birth Asphyxia
Authors: PROCIANOY RENATO S. , GIACOMINI CLARICE B. , OLIVEIRA MARIA LIÉGE B.
Published: January 2008

ABSTRACT. Eighteen newborn infants, gestational age between 36 and 42 weeks with birth asphyxia were compared with 23 normal newborn infants to determine serum cortisol and dehydroepiandrosterone sulfate levels in cord blood and in venous blood samples collected 12–18 hours after birth. Both groups were similar in gestational age, birthweight, proportion of small for gestational age and large for gestational age infants, proportion of infants delivered by cesarean section with and without labor, and proportion of mothers with pre‐eclampsia. There was no antenatal exposure to corticosteroid. The asphyxiated newborn infants had a significantly higher mean cord serum level of cortisol, and a significantly lower mean cord serum level of dehydroepiandrosterone sulfate than the control group. Mean serum cortisol and dehydroepiandrosterone sulfate levels collected 12–18 hours after birth were similar between both groups. It is suggested that elevated cord serum level of cortisol is related to birth asphyxia stress stimulating the adrenal definitive zone, and the low cord serum level of dehydroepiandrosterone sulfate is secondary to a transient hypoxemic‐ischemic insult to the adrenal fetal zone.
Adherence of Alpha‐Hemolytic Streptococci to Human Endocardial, Endothelial and Buccal Cells
Authors: SCHOLLIN J.
Published: January 2008

ABSTRACT. Human buccal, endothelial and endocardial cells were prepared and the adherence of different bacteria to these cells was tested in vitro. Buccal cells were scraped off immediately before use in the adherence tests. Endothelial and endocardial cells were prepared from human umbilical vein and human heart valves by using collagenase, and cultured in cell culture medium. Seventeen different bacteria were used in the adherence tests; ten strains of alpha‐hemolytic streptococci, five from children with infective endocarditis (IE) and five from healthy carriers, two S. aureus, two N. meningitidis, two N. gonorrhoeae and one E. coli. The five alpha‐hemolytic streptococcal strains from patients with IE showed significantly higher adherence values than those from healthy carriers as well as in comparison with the remaining seven bacteria. The difference in adherence might be an expression for different bacterial surface properties. These differences might be important in explaining the infective mechanism in infective endocarditis.
Sensitization of Children in the Stockholm Area to House Dust Mites
Authors: NORDVALL S. L. , ERIKSSON M. , RYLANDER E. , SCHWARTZ B.
Published: January 2008

ABSTRACT. Atopic sensitization of children in the Stockholm area to house dust mites (HDM) was investigated in a case‐control study. Sixty children with and 60 without positive skin prick tests for HDM were matched for age and sex. HDM‐sensitized children had previously more often lived in other areas known to be mite infested than the control children. Sensitization to mites was related to dampness in the homes, but no significant relationship was found to the type of residence, frequent visits to a summer house in the archipelago or parental smoking. Dust samples from mattresses of the children with the strongest positive reactions to miles in skin prick tests and the respective controls were subjected to an enzyme immunoassay, to measure the content of the major allergens of the Dermatophagoides (D.) species D. pterinyssinus, D. farinae and D. microceras. Mattress dust samples from the beds of HDM‐sensitized children contained significantly higher HDM antigen concentrations than those from the beds of controls. Private houses contained significantly more HDM antigens than flats and 10 of 11 homes in which a dampness problem was recognized contained mite antigens. It is postulated that mite infestation is increasing in the area, energy‐saving measures creating improved conditions for HDM survival.
Venous Thrombosis Associated with Lupus Anticoagulant and Anticardiolipin Antibodies
Authors: PELKONEN P. , SIMELL O. , RASI V. , VAARALA O.
Published: January 2008

ABSTRACT. We describe deep vein thrombosis associated with lupus anticoagulant and anticardiolipin antibodies in three children aged 10 to 14 years. One of them also had arterial thromboses. None of the patients had systemic lupus erythematosus when the thrombosis first occurred, but one fulfilled the criteria for systemic lupus erythematosus 3 years later. At presentation all had symptoms suggestive of pulmonary embolism and evidence of an autoimmune disease: Addison's disease in one, anti‐DNA or antinuclear antibodies in all three, and a positive Coombs' test in two. Two of the three gave a false‐positive test for syphilis. In the patient with systemic lupus erythematosus recurrent thrombocytopenia and severe haemolytic anaemia necessitated splenectomy. A child should be tested for lupus anticoagulant or anticardiolipin antibody if venous or arterial occlusion occurs without a known predisposing cause, or if there is pulmonary embolism or symptoms or laboratory findings suggestive of a connective tissue disease.
Brain Atrophy with Intracranial Calcification Following Congenital HIV Infection
Authors: TOVO P. A. , GABIANO C. , FAVRO‐PARIS S. , PALOMBA E. , GAJNO G.
Published: January 2008

ABSTRACT. An 18‐month‐old girl with AIDS related complex following congenital HIV infection suffered since the first days of life from severe neurological disturbances. The extensive congenital brain atrophy and the diffuse intracranial calcification which were found were strongly reminescent of intrauterine infection. Since the agents usually responsible for congenital infections were excluded an HIV embryopathy appears likely.
Transcutaneous Bilirubinometry in Preterm Very Low Birth weight Infants
Authors: TAN K. L. , MYLVAGANAM A.
Published: January 2008

ABSTRACT. Transcutaneous bilirubinometry using the Minolta Airshield TcB was performed on 40 preterm VLBW Chinese infants during the first 7 days of life; altogether 614 observations were made on the forehead and sternum, respectively. A positive correlation between the TcB index and plasma bilirubin concentration was obtained on the forehead and sternum. Positive plasma bilirubin‐TcB index correlations were also observed for each individual day. The plasma bilirubin‐TcB index (forehead) regressions were fairly similar for the individual days and the combined overall regression except for 2 days (days 5 and 7). A slight improvement was observed when only bilirubin concentrations ≤200 μmol/l were evaluated. The intercepts were however different for individual days requiring correction factors to the combined overall regression intercept if the regression is to be used for the respective days. However, the plasma bilirubin‐TcB index (sternum) regression for the individual days were significantly different one from another, and from the overall combined plasma bilirubin‐TcB index (sternum) regression. This significant difference was still observed when only plasma bilirubin concentrations ≤200 μmol/l were evaluated. Hence, transcutaneous bilirubinometry has major limitations in preterm VLBW infants.
Retarded Skeletal Maturation in Weaver Syndrome
Authors: FRETZAYAS A. , PAPANICOLAOU A. , TZANETAKOS K. , THEODORIDIS C. , KARPATHIOS T.
Published: January 2008

ABSTRACT. A male infant with primordial overgrowth and morphological characteristics of Weaver syndrome is presented. Unexpectedly his osseous maturation was retarded.
FATHER'S INFLUENCE IN THE DEVELOPMENT OF INFANT'S RELATIONSHIPS
Authors: PRUETT KYLE D.
Published: January 2008

Abstract. Recent research on the father infant interaction has challenged the long held belief that the “most important thing a father can do for his children is to love their mother”. Fathers have significant influences on the development of the infant's relationships both directly and indirectly. Certainly his greatest indirect influence is through supporting, protecting, and facilitating the maternal infant dyad when it is the primary nurturing relationship.

New research from a variety of perspectives in Europe and the United States have begun to document the powerful impact that fathers have on their children directly, and not just mediated through the maternal infant dyad. The Nordic family study in Europe, and clinical research by Parke, Lamb, Yogman, and Pruett in the United States have all documented the impact on the infant of increased paternal involvement in the early years, thanks to a variety of influences. Evidence now suggests that infants are able to make direct use of the father's unique contribution to their growth and development. This contribution not only increases the repertoire of available to the infant, but appears to have its own unique meaning to the infant, who often seeks it out quite directly and aggressively.

Stylistic differences between paternal and maternal nurturing appear to be of great interest and use to the child. The close contact between father and infant does not appear to threaten maternal infant attachment.

Data from an ongoing longitudinal study of primary care giving fathers in the intact families will be presented. The impact of such a rare but theoretically highly interesting phenomenon on the capacity of the infant to develop useful relationships will be highlighted with clinical materials.

Finally, we shall conclude with a discussion of the question in reverse, i.e., how does the infant influence the development of the father's relationships?