bluuebunny/crossref_metadata_2025 huggingface dataset:
Knemometry as a Predictor of Response to Somatrem in Turner's Syndrome
Authors: WALES J. K. H. , MILNER R. D. G.
Published: January 2008

Wales, J. K. H. and Milner, R. D. G. (Department of Paediatrics, University of Sheffield, Sheffield, UK). Knemometry as a predictor of response to somatrem in Turner's syndrome. Acta Paediatr Scand [Suppl] 337:37, 1987.

The response of 13 children with Turner's syndrome to somatrem, 2 IU/day, has been determined for a 4‐week period of treatment using knemometric measurements, and compared to 6 months of treatment assessed by conventional auxology. In this small series, knemometry was able to predict those children in whom hGH therapy was not beneficial.
An Attempt to Assess the Replacement Dose of Human Growth Hormone in the Treatment of Growth Hormone Deficient Children
Authors: HIBI ITSURO , TANAKA TOSHIAKI , YANO HISAKO , UMEZAWA SACHIKO , KAGAWA JIRO , TANAE AYAKO , ISHIKAWA EIJI
Published: January 2008

Hibi, I., Tanaka, T., Yano, H., Umezawa, S., Kagawa, J., Tanae, A. and Ishikawa, E. (National Children's Medical Research Center, Tokyo, the National Children's Hospital, Tokyo and the Department of Biochemistry, Miyazaki Medical College, Miyazaki, Japan). Acta Paediatr Scand [Suppl] 337:87, 1987.

In 25 patients with hGH deficiency, who had been treated long‐term with hGH, the mode of hGH administration was switched from the conventional method (0.3–0.5 IU/kg/week, in two or three divided doses, intramuscularly) to daily subcutaneous injection at 1900–2100 hours with a dose of 0.46 ± 0.07 IU/kg/week (equivalent to 14.7 ± 2.0 IU/m2/week). After 1–3 months of this new mode of hGH administration, blood and urine were sampled at 0900 hours after overnight fasting. Blood glucose, plasma insulin, plasma IGF‐1 and plasma total IGF (after extraction) were analysed in blood samples. IGF‐1 and hGH were measured in urine samples. These measurements indicated that the dose studied was close to a replacement one, but might be slightly higher than the exact replacement dose.
Early Feeding Problems in an Affluent Society
Authors: DAHL M.
Published: January 2008

ABSTRACT. The aim of this study was to investigate the natural course of later problems and their prevalence in children with early feeding difficulties. Forty‐two children with feeding problems without any obvious medical reason during the first year of life were followed up prospectively to the age of two years. Comparisons were made with 42 age‐ and sex‐matched controls. Information was obtained from parental interviews, medical records and assessments of psychomotor development. In 21 (50%) of the children with feeding problems the problems persisted at the age of two years. There were significantly higher frequencies of infections and behavioural problems among the children with early feeding problems than among the controls. No differences in psychomotor development were found. Recurrent infections, behaviour problems and psycho‐social problems were significantly correlated with severe persistent feeding problems at the age of two years.
Respiratory Water Loss in Relation to Activity in Fullterm Infants on Their First Day after Birth
Authors: RIESENFELD T. , HAMMARLUND K. , SEDIN G.
Published: January 2008

ABSTRACT. Respiratory water loss (RWL), oxygen consumption and carbon dioxide production were measured in ten fullterm infants on their first day after birth, using an open flow‐through system with a mass spectrometer, specially equipped with a water channel, for analysis of gas concentrations. Measurements were made both with the infant asleep and during different levels of motor activity. The ambient temperature was maintained at approximately 32.5°C and the ambient relative humidity at 50%. RWL increased from 4.2±0.7 (SD) mg/kg min when the infant was asleep to 6.3±1.0 mg/kg min when he or she was awake but calm; with increasing activity there was a further increase in RWL. The oxygen consumption increased from 5.4±0.9 (SD) ml/kg min during sleep to 6.9±0.8 (SD) ml/kg min when awake, and also increased further with increasing activity.
Is Oxygen Supply the Only Regulator of Erythropoietin Levels?Serum Immunoreactive Erythropoietin during the First 4 Months of Life in Term Infants with Different Levels of Arterial Oxygenation
Authors: HÅGÅ P. , COTES P. M. , TILL J. A. , SHINEBOURNE S. A. , HALVORSEN S.
Published: January 2008

ABSTRACT. Serum immunoreactive erythropoietin (siEp) levels were measured in 35 full‐term infants aged 0–13 weeks, 31 of whom had congenital heart disease. The infants displayed a wide range in arterial oxygen tension (Pao2) and oxygen saturation (Sao2). During the first days of life siEp varied widely with a range from less than 3 to more than 10000 mIU/ml. The wide variation is consistent with findings in cord blood at term. The siEp levels did not correlate significantly with haemoglobin, haematocrit, Pao2, Sao2, or arterial oxygen content in the total sample, nor when the cohort was split up into different age groups. Cyanotic infants aged 2–13 weeks had significantly higher siEp concentrations than normal adults (p <0.001) and than children with cyanotic congenital heart disease, aged 4 months‐10 years (p <0.001). The raised siEp levels in cyanotic children aged 2–13 weeks found in this study and the normal levels found in their older counterparts (4 months‐10 years) (reported elsewhere) are consistent with the pattern observed in man and animals exposed to prolonged hypobaric hypoxia, in which after an initial rise in erythropoietin concentrations the levels fall to normal while increased erythropoiesis is sustained.
Disseminated Intravascular Coagulation in Post‐Dysenteric Haemolytic Uraemic Syndrome
Authors: BADAMI K. G. , SRIVASTAVA R. N. , KUMAR RAJIVE , SARAYA A. K.
Published: January 2008

ABSTRACT. Coagulation studies were carried out in 14 children with haemolytic araemic syndrome that followed acute dysentery. Stool cultures showed Shigella dysenteriae in 3 cases and were sterile in the remainder. Prolongation of the prothrombin time, activated partial thromboplastin time and thrombin time and raised levels of fibrinogen degradation products were found in 12 cases, indicating the presence of disseminated intravascular coagulation. Renal histologic examination showed cortical necrosis in 7 cases, which was extensive in S and patchy in 2. Disseminated intravascular coagulation may have a role in the pathogenesis of haemolytic uraemic syndrome associated with acute dysentery.
Management of Pseudomonas Aeruginosa Lung Infection in Danish Cystic Fibrosis Patients
Authors: PEDERSEN SVEND STENVANG , JENSEN TIM , HØIBY NIELS , KOCH CHRISTIAN , FLENSBORG ERHARD W.
Published: January 2008

ABSTRACT. The annual mortality rate of cystic fibrosis patients with chronic Pseudomonas aeruginosa lung infection at the Danish CF‐centre ranged from 10 to 20% in the years 1970–1975. In this period the patients received antipseudomonal chemotherapy only during acute exacerbations of infection. From 1976 99 patients acquired chronic P. aeruginosa infection and were given regular and intensive antipseudomonal treatment 3–4 times per year. The patients were followed for 612 patient‐years; 7 died and the 10‐year survival rate after onset of P. aeruginosa infection was 90%±4%. The annual mortality rate is now 1–2%. Although precipitating antibodies against P. aeruginosa increased significantly, pulmonary function did not deteriorate with duration of infection. Cross‐infection between patients caused an increased incidence of chronic P. aeruginosa infection which was reduced by hygienic measures.
Determinants of Serum Vitamin D Levels in Preadolescent Cystic Fibrosis Children
Authors: THOMPSON G. N.
Published: January 2008

ABSTRACT. The effects of liver disease, fat malabsorption and sunlight exposure on serum vitamin D levels were determined in 21 optimally treated preadolescent cystic fibrosis (CF) children over a 12‐month period. Manifest liver disease and fat malabsorption appeared not to affect the vitamin D level. However, the level fell significantly in winter, although not below the normal range, suggesting that sunlight exposure is a more important determinant of vitamin D levels in preadolescent CF children than liver disease and fat malabsorption.
The Alcohol Intoxicated Child and Its Prognosis
Authors: THUNSTRÖM M.
Published: January 2008

ABSTRACT. This article is a review of Swedish and international literature concerning children apprehended for drunkenness. The need for a thorough psychosocial investigation before deciding how to interpret the episode is stressed. A high‐risk group of children, in whom the drunkenness is to be looked upon as a warning signal of developing alcoholism, is described. Increased co‐operation between the Department of Paediatrics and of Child and Youth Psychiatry, Social Welfare Authorities and School Health Care regarding the treatment of these children is recommended.
Salt and Water Homeostasis during Oral Rehydration Therapy in Neonates and Young Infants with Acute Diarrhoea
Authors: MARIN L. , SÖKÜCÜ S. , GÜNOZ H. , SANÉR G. , NEYZI O. , ZETTERSTRÖM R.
Published: January 2008

ABSTRACT. The clinical response and changes in water and salt homeostasis were studied daring oral rehydration therapy (ORT) with a solution containing 90 mmol sodium per I (ORS90) in 9 infants less than 2 months old (range 2–60 days). Two infants were still dehydrated 36 hours after starting ORT and were excluded from the study. Fluid was retained more rapidly and also to a larger extent than in infants of the same age treated with a solution with a sodium concentration of 60 mmol/l (ORS60). The stool sodium output was higher than that found previously in infants of the same age treated with ORS60. We conclude that during ORT the gut plays an active role in the regulation of salt homeostasis. When the sodium intake is high the percentage of sodium remaining unabsorbed is higher than when the intake is low. This mechanism reduces the risk of hypematremia in young infants treated with ORS90. The study thus demonstrates that ORS90 is effective and also seems to be safe in the treatment of neonates and young infants with dehydration secondary to diarrhoea if fluid intake is kept around 200 ml/kg/day during the rehydration period.
Atrial Natriuretic Peptide and Atrial Pressures in Newborns with Transposition of the Great Arteries
Authors: ANDERSSON S. , TIKKANEN I. , PESONEN E. , WALLGREN E. I. , FYHRQUIST F.
Published: January 2008

ABSTRACT. The relation of atrial pressure to atrial plasma concentration of atrial natriuretic peptide (ANP) was studied in four newborns undergoing catheterization because of transposition of the great arteries. In three patients, mean left atrial pressure clearly exceeded right atrial pressure (12±7 vs. 2±3 mmHg; mean ±SD). In one patient mean atrial pressures were identical (4 mmHg). In all patients the ANP concentration in the left atrium exceeded that of the right (833±464 vs. 415±366 pg/ml; mean ±SD). There was a significant (r=0.97; p < 0.01) correlation between pressure and ANP concentration in the left atria. In the right atria, no linear correlation existed between pressure and ANP concentration. ANP concentration in the left atrium decreased after a lowering of the left atrial pressure by atrial septostomy. In these patients, the left atrium seems to be the main source of circulating ANP.
A Randomized Double‐Blind, Placebo‐Controlled Trial of Dexamethasone and Racemic Epinephrine in the Treatment of Croup
Authors: KUUSELA ANNA‐LEENA , VESIKARI TIMO
Published: January 2008

ABSTRACT. Seventy‐two children hospitalized for croup received on admission a single dose of either 0.6 mg/kg dexamethasone or an equivalent placebo intramuscularly from randomized ampules; subsequently the same patients were randomized to receive either nebulized racemic epinephrine or saline by intermittent positive pressure breathing. Of the four treatment groups those receiving a placebo injection and nebulized saline had the slowest recovery by all criteria. Dexamethasone and nebulized epinephrine reduced the symptoms and hastened recovery, but dexamethasone was more effective by clinical evaluation at 6 and 12 hours post admission. The patients given dexamethasone had a significantly shorter hospital stay than those receiving placebo. We conclude that a single injection of a potent corticosteroid is beneficial in acute spasmodic croup. Nebulized racemic epinephrine given with an appropriate device is also effective, but the effect of epinephrine is less remarkable in patients treated with dexamethasone.
Treatment with Probucol of Children with Familial Hypercholesterolemia
Authors: SANJURJO P. , MARTUL P. , SASIETA M. , LAFUENTE P. , ARIZA F. , CABEZA I.
Published: January 2008

ABSTRACT. Nine children with familial hypercholesterolaemia, age range 2 to 12 years, were treated with a low cholesterol diet and probucol (10 mg/kg/day). The year before, the children received, as only treatment, a low fat‐cholesterol diet. During this period their mean plasma total cholesterol level fell from 8.2±1.45 mmol/l to 7.17±0.84 mmol/l (12.6%). This level was further reduced to 5.92±0.63 mmol/l (17.1%) after the addition of probucol. Plasma high density lipoprotein cholesterol levels were lowered in absolute terms but not in relation to total cholesterol. No apparent side effects were observed. However, the use of probucol should be restricted for the moment to severe cases of hypercholesterolaemia as the long‐term excretion of the drug in children is not yet known.
Familial Pseudohypoaldosteronism
Authors: POPOW C. , HERKNER A. POLLAK. K. , SCHEIBENREITER S. , SWOBODA W.
Published: January 2008

ABSTRACT. The clinical course of two siblings with a severe form of pseudohypoaldosteronism was followed over a period of seven and five years respectively. Both children persistently had a high sodium‐potassium excretion ratio in the urine, sweat, saliva, and stools as well as high serum concentrations of aldosterone and renin and an increased urinary excretion of tetrahydroaldosterone. Despite sustained treatment with sodium chloride (10–40 mmol/kg/d) and cation exchange resin (sodium polystyrole sulfonate 0.5–2 g/kg/d) they repeatedly developed episodes of salt wasting and hyperkalemia which occurred mainly during uncomplicated respiratory tract infections. Aldosterone receptor characteristics were studied in the cytosol of the rectal mucosa at ages 2.5 years and 6 months respectively. Compared to age matched controls there was a decreased affinity for aldosterone at the low affinity binding site. Among the members of the family, the father and one of his sisters had high concentrations of sodium in the sweat and an increased urinary excretion of tetrahydroaldosterone.
Psychomotor Development of Children with Congenital Hypothyroidism Diagnosed by Neonatal Screening
Authors: ILICKI A. , LARSSON A.
Published: January 2008

ABSTRACT. The psychomotor development in 68 children with congenital hypothyroidism diagnosed during the first two years of a nationwide neonatal screening programme in Sweden was assessed during their first three years of life. Replacement therapy with thyroxine was initiated at the age of 15±7 days (mean ± SD). Griffiths tests were performed in 15 patients at the age of 18 months and in 51 patients at 30–47 months. Their developmental quotients did not differ from those of control children, indicating that the psychomotor development in the children with congenital hypothyroidism was normal. In earlier studies of Swedish children with congenital hypothyroidism, diagnosed clinically before the age of three and a half years, the psychomotor development was found to be impaired. In contrast, the patients diagnosed by neonatal screening and given early therapy displayed normal results in Griffiths tests. This indicates that the age at the start of treatment is an important determinant for the prognosis.
Serum Vitamin A Levels in Mothers and Their Breast‐Fed Term Infants with or without Supplemental Vitamin A
Authors: ALA‐HOUHALA MARJA , KOSKINEN T. , MÄKI RITVA , RINKARI SIRPA
Published: January 2008

ABSTRACT. Serum concentrations of vitamin A were measured in term infants (n=72) and their mothers at delivery and after 20 weeks of breast‐feeding (n=48). During the 20 weeks the infants received either no supplemental vitamin A (but the mothers were given 3000 IU vitamin A daily) (n=16) or a daily vitamin A supplementation of 600 (n=17) or 1500 IU (n=15). After 20 weeks of breast‐feeding the vitamin A levels in the unsupplemented infants were similar to those at birth. The infants supplemented either with 600 or 1500 IU had higher vitamin A serum levels than at birth (p<0.01), however, there was no difference between the two supplemented groups. During lactation, the serum vitamin A concentrations of the mothers increased significantly in all groups with or without vitamin A supplementation.
A Comparison of the Mid‐Arm Circumference/Head Circumference Ratio and Ponderal Index for the Evaluation of Newborn Infants after Abnormal Intrauterine Growth
Authors: GEORGIEFF M. K. , SASANOW S. R. , CHOCKALINGAM U. M. , PEREIRA G. R.
Published: January 2008

ABSTRACT. We studied the accuracy of the ponderal index and the mid‐arm circumference/head circumference ratio for detecting newborn infants who were likely to be symptomatic because of aberrant intrauterine growth. Sixty infants were evaluated because of suspected intrauterine growth retardation; both the mean ponderal index and mid‐arm circumference/head circumference ratio were significantly lower in the group of 30 symptomatic infants than in the group of 30 asymptomatic infants (p<0.05). However, the mid‐arm circumference/head circumference ratio identified a significantly higher percentage of the symptomatic infants than the ponderal index (80% vs. 47%; p=0.007). An additional 60 infants were evaluated because of suspected abnormal intrauterine growth acceleration. The mean mid‐arm circumference/head circumference ratio, but not the ponderal index, was significantly higher in the group of 30 symptomatic infants than in the group of 30 asymptomatic infants (p<0.005). Again, the mid‐arm circumference/head circumference ratio identified a significantly higher percentage of the symptomatic infants than the ponderal index (79% vs. 33%; p<0.001). The mid‐arm circumference/head circumference ratio is more accurate than the ponderal index for the evaluation of potentially symptomatic newborn infants who suffered abnormal fetal growth. The ponderal index is not useful for the detection of symptomatic large‐for‐dates infants.
Neonatal Screening: Life‐Stress Scores in Families Given a False‐Positive Result
Authors: FYRÖ KARIN
Published: January 2008

ABSTRACT. In a previous study the psychological reactions to a false‐positive result of a neonatal screening test were studied in 102 families. The present study deals with life‐stress factors in the same families at the time of screening. The number of factors are used to denote a life‐stress score and the families have been divided into two groups: those with high and those with low scores. The children's physical health during the first year and the changes in the families during the five years after the screening have also been investigated. There were no large differences between the two groups of families; however, the mothers in families with high scores more often breastfed their children for less than two months, more frequently required medical care during the infants’first year of life and were more often separated during the first five years.
Children of Mentally ill Mothers: Mortality and Utilization of Paediatric Health Services
Authors: BÅGEDAHL‐STRINDEUND M. , TUNELL R. , NILSSON B.
Published: January 2008

ABSTRACT. A two‐year cohort of children of parapartum mentally ill mothers, born in Stockholm during the mid‐1970s, was studied with regard to mortality, hospitalization rate and Well Baby Clinic (WBC) care consumption during the pre‐school‐age period. The findings were compared with those of matched controls. The index children—especially those of addicts and neurotic or temporarily insufficient mothers—had a higher admission rate and had spent more days in hospital than the controls. The index children tended to have a higher mortality rate than the controls. No significant difference was found in the WBC attendance rates of the index children and the controls. Socially disadvantaged families tended, however, to pay more visits to the WBC than those who were better off. Home visits by the WBC nurse were made more frequently to the index families than to the controls. Failure to appear for regular health checks of the child correlated better with social dysfunction than with mental illness per se in the mother. An adverse social environment, including addiction, seemed to be a separate factor of significant importance, apart from mental illness per se in the mothers, for the morbidity of the children.
Hypocalcemia and Hyperphosphatemia in Severely Dehydrated Children with and without Convulsions
Authors: MURTAZA A. , KHAN S. R. , BUTT K. S. , LINDBLAD B. S. , APERIA A.
Published: January 2008

ABSTRACT. Tetanic convulsions are not uncommon among severely dehydrated children in the developing countries. This raises the question whether these children have disturbances in the homeostasis of divalent ions. Serum values are reported of calcium, magnesium, phosphorus, sodium and potassium, as well as blood pH in children below 3 years of age with acute watery diarrhoea and with an estimated weight loss of about 10%. The study was performed on dehydrated children with (DC) or without (D) convulsions. Values were obtained on admission and following rehydration therapy (RT). On admission serum calcium was low in both D and DC children. Serum phosphorus was likewise elevated in both D and DC children. Serum magnesium was slightly elevated in the DC but not in the D group. No patient had Hypernatremia. During RT, serum calcium increased significantly and serum phosphorus decreased significantly in D and DC children. Serum calcium showed a significant inverse correlation with serum phosphorus and a significant direct correlation with blood pH. Treatment of DC children with i.v. calcium and i.m. magnesium had no immediate effect on the convulsions. Our conclusion is that severely dehydrated children will develop hypocalcemia. The cause may be a redistribution of calcium into the cells, parallelled by a redistribution of phosphorus from the intra‐ to the extracellular space.
Natural Killer Cell Function in Atopic Dermatitis
Authors: CHIARELLI F. , CANFORA G. , VERROTTI A. , AMERIO P. , MORGESE G.
Published: January 2008

ABSTRACT. The natural killer cell activity was studied in 41 children with mild, moderate and severe atopic dermatitis (AD) and in 37 controls. The natural killer cell function of lymphocytes was reduced in atopic children (mean ± SD 21.92±6.18% vs. 43.87±5.80%; p<0.0001). This decrease was not related to the IgE serum level. A negative correlation was found between natural killer cell activity and the clinical severity of AD (r=0.73; p<0.001). Natural killer cell function was re‐evaluated after 9 months in 27 children during a quiescent phase of AD; it was still low, but to a lesser degree (27.66±5.42%, in the quiescent phase, vs. 43.87±5.80, controls; p<0,0001). The reduced natural killer cell activity seems related to the disease activity.
Renal Function and Albumin Excretion during Exercise in Children during Remission of the Minimal Change Nephrotic Syndrome
Authors: BERG U. , BOHLIN A.‐B. , FREYSCHUSS U. , JOHANSSON B.‐L. , LEFVERT A.‐K.
Published: January 2008

ABSTRACT. Six patients with the minimal change nephrotic syndrome in remission and seven healthy controls were investigated with regard to renal haemodynamics and albumin excretion before, during and after exercise. The glomerular filtration rate and effective renal plasma flow were determined by a standard clearance method, employing continuous infusion of inulin and para‐aminohippuric acid. Microalbuminuria was measured by an immunoturbidimetric method. The work load was standardized at 70% of the maximal working capacity and was applied for 20 min. During exercise there was a significant fall in the glomerular filtration rate and effective renal plasma flow and a significant rise in the filtration fraction. The pattern of renal haemodynamic changes did not differ between the groups. Nor was there any statistically significant difference in urinary albumin excretion, although the exercise‐induced increase in albumin excretion of the controls did not reach statistical significance. It is concluded that the renal haemodynamics and urinary albumin excretion of children having long remissions of the minimal change nephrotic syndrome are normal at rest as well as during and after a submaximal exercise test.
Faecal Concentrations and Production Rates of Short Chain Fatty Acids in Normal Neonates
Authors: RASMUSSEN HENRIK SANDVAD , HOLTUG KLAUS , YNGGÅRD CHARLOTTE , MORTENSEN PER BRØBECH
Published: January 2008

ABSTRACT. Changes in intestinal microbial flora are reflected in the faecal concentrations and production rates of short chain fatty acids. However, since no data on the latter are available in neonates, the aim of this study is to provide information on short chain fatty acids in faeces from normal neonates. Faecal samples were collected immediately after birth (meconium) and on the 4th day of life in 13 healthy, full‐term neonates. The production capacity was evaluated by a faecal incubation system. Concentrations of short chain fatty acids were low in meconium (11.2+3.9 mmol/l (mean±SD)), equivalent to about 10% of the adult level (p<0.01), but increased significantly during the first 4 days of life to 28.4±20.1 mmol/l (p<0.05). The fermentation pattern (i.e. relative composition of different acids) showed differences between adults and neonates, primarily due to a higher proportion of acetate found in the latter. The ratio acetate/propionate/butyrate/other acids was 89/5/5/1 in 4‐day‐old neonates compared to 65/18/11/6 in adults (p<0.001). Our findings correlate well with the postnatal microbial colonization of neonatal colon.
Plasma Atrial Natriuretic Polypeptide Concentration in Healthy Children from Birth to Adolescence
Authors: KIKUCHI K. , SHIOMI M. , HORIE K. , OHIE T. , NAKAO K. , IMURA H. , MIKAWA H.
Published: January 2008

ABSTRACT. We measured plasma atrial natriuretic polypeptide concentrations in the umbilical artery and vein, and peripheral veins of healthy children from birth to adolescence to establish the normal range. The plasma atrial natriuretic polypeptide concentration in the umbilical artery (mean±SD, 51.0±21.4 fmol/ml) was significantly higher than that in the umbilical vein (18.1±13.5 fmol/ml) in neonates after vaginal delivery. Also neonates aged 5 days or less had a significantly high concentration in the peripheral vein (60.7±29.4 fmol/ml). There was no significant difference in atrial natriuretic polypeptide concentrations in the peripheral veins between older children and adults. The concentrations in children aged more than 5 days and adults aged 20–34 years were 14.4±7.4 fmol/ml and 10.0±4.8 fmol/ml, respectively. However, the atrial natriuretic polypeptide concentration in the umbilical artery was not increased in three neonates delivered by caesarean section although they had a high concentration in the peripheral vein 24 hours after birth.
Infancy Growth Pattern Related to Growth Hormone Deficiency
Authors: KARLBERG J. , ALBERTSSON‐WIKLAND K.
Published: January 2008

ABSTRACT. Linear growth during the first three years of life can be represented mathematically in terms of the “ICP‐growth model”, using a combination of a quickly decelerating Infancy component with the addition of a slowly decelerating Childhood component, the latter acting from the second half of the first postnatal year. The growth pattern for supine length of four children with growth hormone (GH) deficiency is related here to the first two components of this growth model. Basically, all four infants displayed a pattern in line with the exponential shape of the Infancy component to the age when GH therapy was initiated. This observation indicates the existence of the Infancy component as it has been adopted for the ICP‐model, and also that it represents the part of postnatal linear growth which seems to be independent of GH. The onset of the Childhood component in healthy subjects has been observed as an abrupt increase in growth rate during the second half of the first year of life. A similar abrupt increase was observed in this study at the time of the initiation of GH therapy (16–27 months). This observation gives some further empirical support to the hypothesis that the child's age at onset of the Childhood component defines the as yet undetermined age at which GH begins to exert a significant influence on linear growth. ICP‐based growth charts provide an improved instrument for early detection of GH deficiency.
Injuries at School
Authors: BREMBERG S. , GERBER C.
Published: January 2008

ABSTRACT. One quarter of all injuries in children of school age occur at school. In order to analyse the importance of schoolmate interactions and unsatisfactory schoolmate relationships for the occurrence of injuries at school a case‐control study was carried out in 1986 in the comprehensive schools of Linköping. Fifty injured students and 50 controls, matched by grade and sex, were interviewed. Sixty‐six percent of all injuries occurred during time not organized by the teachers. In 36% the situation was characterized by brawling or chasing. Injured students demonstrated significantly more often unsatisfactory relationships with schoolmates. In the age group at highest risk (11–13 years) differences between injured and controls were most apparent. Student proposals to prevent injuries most commonly concerned brawling during breaks. The study indicates that interaction between schoolmates and unsatisfactory schoolmate relationships are important determinants of risk of injury at school.
Probable Homozygotic Form of the Marfan Syndrome in a Newborn Child
Authors: SCHOLLIN J. , BJARKE B. , GUSTAVSON K.‐H.
Published: January 2008

ABSTRACT. A case of Marfan's syndrome diagnosed in a newborn boy is described. Both parents were affected by the disease but none of them was aware of it. The boy had cardiac, skeletal and ocular manifestations from birth. He suffered early from severe congestive heart failure due to mitral insufficiency and died at four months of age of pneumonia. The family history is described in this report.
Dynamic Aspects in Transient Hyperphosphatasaemia of Infancy
Authors: RASMUSSEN K. T. , CARSTENSEN H.
Published: January 2008

ABSTRACT. A 20‐month‐old boy with absence epilepsy was found to have a strikingly elevated serum alkaline phopshatase (AP) at start of treatment with valproic acid. The monitoring of this therapy made it possible to follow the elimination of AP which was shown to be a first order kinetic with a half‐life of 6.1 days. A concurrent adenovirus infection was diagnosed.
Proximal Renal Tubular Acidosis Associated with Glycogen Storage Disease, Type 9
Authors: NAGAI TOSHIRO , MATSUO NOBUTAKE , TSUCHIYA YUTAKA , CHO HIDEO , HASEGAWA YUKIHIRO , IGARASHI YUTAKA
Published: January 2008

ABSTRACT. A 21/2‐year‐old Japanese boy with glycogen storage disease, type 9, developed proximal renal tubular acidosis (RTA). The RTA significantly improved in response to cornstarch therapy, implying a direct causal relationship between subtle metabolic derangements in glycogen storage disease, type 9, and proximal RTA.
Post‐Concussion Syndrome
Authors: NYLANDER I. , RYDELIUS P.‐A.
Published: January 2008

ABSTRACT. A 9‐year‐old boy was referred for child‐psychiatric examination because of failure in school, restlessness, impulsiveness and concentration difficulties. The symptomatology was ascribed to a previous severe head injury and defined as a post‐concussion syndrome. During the examination it was found that he had an identical twin brother without a history of brain‐damage. A comparison of the patient and his twin brother with the same examination methods at the age of 9 and 18 gave similar results. These indicate that factors other than brain damage also could explain a clinical picture with school failure, restlessness, impulsiveness and concentration difficulties in a schoolboy. The question arises whether a clinical picture of this kind are the symptoms of stress among vulnerable boys in reaction to excessive demands from their psychosocial environment.
Bilirubin Binding and Acid‐Base Equilibrium in Newborn Infants with Low Birthweight
Authors: MEISEL P. , JÄHRIG D. , BEYERSDORFF E. , JÄHRIG K.
Published: January 2008

ABSTRACT. Acidosis is known as a risk factor for the development of bilirubin encephalopathy in neonatal jaundice. However, few attempts have been made to evaluate the influence of acid‐base state on bilirubin‐albumin binding state in blood of newborn infants. Therefore, in 171 appropriate and 83 small for gestational age newborns (birthweight less than 2500 g) the acid‐base state in blood and bilirubin (BR) binding state in serum was measured at the ages of 3, 4, 5, and 8 days. There is a weak but significant correlation between standard base deficit and the ratio BR/reserve albumin as well as the toxic potential of serum BR. The results suggest that the higher risk in acidosis is not only caused by increased tissue binding of BR but also—at least partially—attributable to decreased BR binding in serum.
Examination of Infant Brain Maturation Using Ultra Low Field MRI
Authors: SUHONEN‐POLVI HANNA , MÄÄTTÄNEN HELI , ALANEN ANU , KATEVUO KALEVI , TENOVUO ARJA , KERO PENTTI , KORMANO MARTTI
Published: January 2008

ABSTRACT. The brains of 42 newborn infants were examined with MRI at 0.02 T field, and regional variations of T1 relaxation time were measured from the images. There were three groups: 1. full term infants (9), 2. preterm infants (10) and 3. SGA (= small for gestational age) infants (20). Relaxation times showed a correlation to myelination of the brain. The brain of SGA infants showed a large variation in their T1 values.
Estrogen Treatment of Excessively Tall Girls with Marfan Syndrome
Authors: KNUDTZON J. , AARSKOG D.
Published: January 2008

ABSTRACT. Five girls with Marfan syndrome were treated with estrogens for reduction of their final heights. Treatment was started at a chronological age of 12.0±0.5 years and height of 173.0±3.1 cm (means ±SEM). Skeletal age was 12.4±0.2 years and Bayley‐Pinneau final height prediction 186.3±1.4 cm. Estrogen treatment for 2.0±0.4 years resulted in final height of 184.1±0.2 cm (p<0.05). The weight increased with 7.8±2.7 kg during the treatment period. The present results indicate that estrogen treatment may be effective in reducing adult height in girls with Marfan syndrome, but that the effect is probably less than that observed in normally tall girls. This may probably be explained by the rather late start of treatment. No immediate effects on aortic root diameters were observed. Estrogen treatment in Marfan syndrome is discussed with regard to beneficial effects, possible side‐effects and optimal age for starting treatment.
Hypoglycaemia in Childhood Diabetes II.
Authors: ÅMAN J. , WRANNE L.
Published: January 2008

ABSTRACT. Hypoglycaemia (blood glucose 1.3–2.5 mmol/1) was induced in thirty diabetic children by reduction of their morning meal. Glucagon, 10 or 20 μg/kg was then given by intramuscular or subcutaneous injection. Ten min later, all signs of hypoglycaemia had disappeared and blood glucose concentrations increased by 0.7–3.3 mmol/1. Glucagon plasma concentrations at glucose nadir were low, 23±8 pmol/l, rose to 300±42 ten min after the injection and reached peak values after another ten min. Later, a slow decrease was noted. No significant difference of blood glucose or plasma glucagon concentrations were found after subcutaneous or intramuscular injections of 20 μg/kg. After 10 μg/kg, slightly lower increase of blood glucose was seen, but the clinical effect was equally good. Nausea occurred in four children given 20 μg/kg. The rise of blood glucose did not correlate to the peak glucagon concentration obtained after the injection but showed significant correlations to the lowest glucose concentration and, inversely, to the concentration of free insulin in blood at glucose nadir. It is concluded that glucagon injections are effective in hypoglycaemia in insulin‐treated diabetic children and that the injection of 10–20 μg/kg gives long‐standing supraphysiological concentrations which make repeated injections unnecessary.
Compliance with a Dietary Manipulation Programme in Families with Infants Prone to Atopy
Authors: PÖYSÄ L. , REMES K. , KORPPI M. , LAUNIALA K.
Published: January 2008

ABSTRACT. The success of familial compliance with a dietary manipulation programme was studied prospectively in 91 newborn babies from atopic families for up to 12 months. The control group consisted of 72 infants from non‐atopic families. The percentages of infants breast‐fed at the age of six months were 58% and 38% in the study group and control group, respectively. The introduction of cow's milk based formulas was postponed until the age of three months in 63% of the infants in the study group and 47% of the infants in the control group. Solid food was avoided during the first three months in 76% and 45% of the infants in the study group and control group, respectively. Maternal age, smoking and low social class were associated with poor compliance. The existence of atopic dermatitis in any member of the family was associated with good compliance. The main advantages of our programme were the increased number of children breast‐fed until the age of six months, and the reduced number of infants introduced to cow's milk based formulas or solid food before three months of age.
Congenital Hypothyroid Goiter and Amiodarone
Authors: WOLF D. De , SCHEPPER J. De , VERHAAREN H. , DENEYER M. , SMITZ J. , SACRE‐SMITS L.
Published: January 2008

ABSTRACT. Amiodarone is an anti‐arrhythmic drug with a content of 39% Iodine. No adverse effects on fetal thyroid function have previously been observed with maternal ingestion of Amiodarone during pregnancy. A case of severe congenital hypothyroidism with goiter, associated with maternal ingestion of 200 mg Amiodarone daily from the 13th week of pregnancy, is described here. No other environmental causes of goiter, nor a congenital organic thyroid disorder could be demonstrated.
Neurologic Sequelae Following Interferon Therapy of Juvenile Laryngeal Papilloma
Authors: VESIKARI TIMO , NUUTILA AULI , CANTELL KARI
Published: January 2008

ABSTRACT. Human leukocyte interferon at doses from 2 million units every two days to 3 million units daily was given to a 2‐year‐old boy for the treatment of recurrent juvenile laryngeal papilloma. After 7 months of treatment the child developed spastic diplegia, which persisted despite the discontinuation of interferon therapy. The clinical picture was consistent with an upper motor neuron lesion; no evidence of peripheral neuropathy was found.
Serial Measurements of Cerebral Blood Flow Velocity in Preterm Infants during the First 72 Hours of Life
Authors: CALVERT S. A. , OHLSSON A. , HOSKING M. C. , ERSKINE L. , FONG K. , SHENNAN A. T.
Published: January 2008

ABSTRACT. Serial measurements of cerebral blood flow velocity (CBFV) were made in 29 preterm infants, using continuous wave Doppler ultrasound. CBFV was measured in both anterior cerebral arteries and quantitative measurements of CBFV were determined using the area under the velocity curve. In all ventilated infants, CBFV increased significantly during the first 6 hours of life and continued to increase until 16 hours of age. Thereafter, CBFV remained relatively constant. This increase in CBFV was primarily the result of increased diastolic flow. Three infants who had evidence of intraventricular haemorrhage on cranial ultrasound, had similar CBFV compared with the infants with no evidence of haemorrhage. Two infants died and both demonstrated areas of periventricular leukomalacia at autopsy. These infants had a prolonged period of low CBFV. These measurements provide normal data for ventilated, preterm infants. As previously suggested in term infants, the initial rise in CBFV may be secondary to closure of the ductus although a generalized decrease in peripheral vascular resistance could also be a contributing factor. Fluctuations in CBFV rather than individual readings are probably more important in the genesis of IVH. An episode of significantly reduced CBFV is a poor prognostic sign.
Immunological and Endocrinological Response to Growth Hormone Therapy in Short Children
Authors: BOZZOLA M. , MACCARIO R. , CISTERNINO M. , DE AMICI M. , VALTORTA A. , MORETTA A. , BISCALDI I. , SCHIMPFF R. M.
Published: January 2008

ABSTRACT. We investigated the influence of human growth hormone (hGH) on mitogen‐stimulated lymphoproliferation, in vitro IgM production, serum levels of immunoglobulins, somatomedin‐C (Sm‐C) values and serum growth‐promoting activity (Thymidine Activity, TA) in 18 short children, aged between 6.6–14.5 years, undergoing a 3‐month course of hGH therapy. Blood was collected the day before treatment (Group A), on the 5th day after patients were administered hGH daily (0.1 U/kg) i.m. for 4 days (Group B), after a 3‐month course of hGH injected three times weekly, and finally before (Group C) and 24 h after an extra injection (Group D). In vitro IgM production from the patients' unstimulated lymphocytes decreased from 277±41 (Group A) to 168±38 (Group B), to 119±43 (Group C) and then to 119±28 ng/ml (Group D) (p<0.05). Using PWM‐stimulated lymphocytes in vitro IgM production decreased from 2015±464 (Group A) to 1116±316 (Group B), then to 511±170 (Group C) and 968±295 ng/ml (Group D) (p<0.02). The variation of this decrease could be correlated with the variation of growth velocity during treatment (r=0.619, p<0.05). In contrast, no significant changes were found following therapy either in serum levels of IgA, IgE, IgG, IgM, Sm‐C and TA, or in phytohemagglutinin, concanavalin A and pokeweed mitogen‐stimulated lymphoproliferation. Our data suggest that there is some relationship between growth hormone, growth and immunity.
Risk Factors for Occasional and Recurrent Wheezing after RSV Infection in Infancy
Authors: RYLANDER EMMA , ERIKSSON MARGARETA , FREYSCHUSS ULLA
Published: January 2008

ABSTRACT. Sixty‐seven children who were hospitalized with a verified RSV infection were reexamined after 4 years at the age of 4 to 7 years. Twenty‐four children had had no subsequent respiratory symptoms, 22 had wheezed 1–3 times and 21 had recurrent wheezing. A family history of atopy and a personal history of neonatal respiratory problems were more common in the group with recurrent wheezing, whereas paternal smoking was more frequent in the group with occasional wheezing. RSV infection in early infancy was more related to occasional wheezing than recurrent episodes. The spirometric data obtained from the forced expirograms were normal, compared to the predicted normal values. In the children with recurrent wheezing, however, the values for PEF and the MEF25 were significantly lower in comparison with all the other children showing a mild obstruction.
Immunoregulation with Levamisole in Children with Frequently Relapsing Steroid Responsive Nephrotic Syndrome
Authors: DRACHMAN R. , SCHLESINGER M. , ALON U. , MOR J. , ETZIONI A. , SHAPIRA H. , OHALI M. , DRUKKER A.
Published: January 2008

ABSTRACT. The immunological and clinical effects of levamisole were studied in 10 children with frequently relapsing steroid responsive nephrotic syndrome (SRNS). The efficacy of the drug was tested during remission of the disease with all patients on alternate day steroid therapy. The lymphocyte proliferative response to phytohemagglutinin (PHA), concanavalin‐A (Con‐A) and pokeweed mitogen (PWM) were normal. The Con‐A induced suppressor T‐lymphocyte activity of 7 patients was low before treatment with levamisole 8±3.7% and increased to normal values during therapy 34±6%; p<0.001 (control 32±5%). In these 7 children prednisolone dosage could be decreased significantly or discontinued altogether (44.1±5.3%). Patients without immunoregulatory abnormalities did not respond to levamisole. In 3 out of 4 children tested the percentage of OKT8+ cells rose during levamisole therapy from 19.7±2.1 to 37±2.3 (p<0.001), thus correcting the elevated pre‐treatment OKT4+/OKT8+ ratio from 3.1±0.2 to 1.5±0.2; p<0.001 (control 1.47±0.2). These data support the hypothesis that abnormal immunoregulation may play a role in the pathogenesis of SRNS. Treatment with levamisole can be useful in some patients with the frequently relapsing form of the disease.
Poor Reversibility of EEG Abnormality in Hypotensive, Preterm Neonates
Authors: GREISEN GORM , PRYDS OLE , ROSÉN INGMAR , LOU HANS
Published: January 2008

ABSTRACT. Twenty‐four infants, 32 weeks of gestation or less, were studied with continuous recording of amplitude integrated electroencephalogram (aEEG) and repeated Doppler ultrasound determination of the mean blood flow velocity in the internal carotid artery (cMFV). The recording was started after the initiation of mechanical ventilation for respiratory distress. Of twelve infants receiving blood or albumin transfusion to expand the intravascular volume and in whom adequate data were available, both mean arterial blood pressure and cMFV increased in eight, and cMFV but not blood pressure in further two. In the present circumstances we consider the cMFV increases to represent true increases in cerebral blood flow. aEEG burst rate increased distinctly in five of the twelve infants during or immediately following transfusion, but did only approach the level of the four non‐transfused infants after several hours, indicating a dysfunction of neural tissue not readily reversible by improved blood flow.
Sister Chromatid Exchanges in Peripheral Lymphocytes of Children Vaccinated against Rubella and Measles–Mumps–Rubella
Authors: KITSIOU S. , SAXONI‐PAPAGEORGIOU P. , HAIDEMENAKI T. , GALA A. , KOUKOUTSAKIS P. , STAVRINADIS C. , PLASSARA M. , SINANIOTIS C.
Published: January 2008

ABSTRACT. This study was undertaken in order to evaluate the cytogenetic and immunological responses to the effective, harmless and world‐wide used vaccines of I. rubella and II. Measles–mumps–rubella (M‐M‐RII). In one group (A) of five girls vaccinated against rubella and in another group (B) of four boys and two girls vaccinated against measles–mumps–rubella, the following parameters were studied before and repeatedly after vaccination: (a) SCE frequency, in peripheral lymphocytes, (b) DNA‐synthesis, in peripheral mononuclear cells, and (c) antibody titres. The mononuclear cell proliferation rate was elevated between the 3rd and 7th day, preceeding the humoral immunological reactions, which began after the 25th day (group A) and the 28th day (group B). The latter findings coincided with a significant increase of SCE frequency in group A (one child) and in group B (all six children); in no case did the highest SCE/cell ratio exceed the normal value.
CHARGE‐Association with Pulmonary Stenosis
Authors: Ivarsson S. A. , Johansson Ö. , Neiderud J. , Lindberg T.
Published: January 2008

CHARGE‐association was proposed by Pagon et al. (1) as an acronym for a malformation syndrome including Coloboma, Heart disease, Atresia choanae, Retarded growth and development and/or CNS anomalies, Genital anomalies and/or hypogonadism and Ear anomalies and/or deafness. More than 60 cases have been reported with four or more of the seven defects (2). Associated anomalies may appear but many of the features are midline facial or central nervous system defects. At least two separate genetic forms may exist even if sporadic cases are most frequent. This report concerns a boy with heart defects not previously described in the complete CHARGE‐association.