bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimation of Glomerular Filtration Rate in Children Using 99m‐Technetium DTPA
Authors: YAP H. K. , SUNDRAM F. X. , YIP W. C. L. , TAY J. S. H. , ANG E. S. , TOH H. J. , JOSEPH V. T. , SAW A. H.
Published: January 2008

ABSTRACT. The usefulness of radionuclide imaging studies with 99m‐technetium diethylenetriaminepen‐taacetic acid (Tc‐DTPA) for quantitating the glomerular filtration rate (GFR) in children was studied. This was compared to the conventional methods for measuring GFR using 51‐chromium‐EDTA clearance (Cr‐EDTA), creatinine clearance and a height/plasma creatinine formula. In the 22 children studied, the correlation coefficient between renal uptake of DTPA and Cr‐EDTA was 0.90 (p<0.001). In contrast, there was a poorer correlation between Cr‐EDTA and creatinine clearance (r=0.69) or the derived GFR using height/creatinine formula (r=0.83). The regression line between Tc‐DTPA uptake and Cr‐EDTA clearance was used to derive a formula for calculating the predicted GFR. This was tested in 10 additional children, and the correlation between the predicted GFR and measured GFR (using Cr‐EDTA clearance studies) was 0.92 (p<0.001). Quantitative estimation of the GFR during renal imaging studies is a feasible and convenient method of assessing renal function.
Pseudohypoaldosteronism in a Female Infant and Her Family: Diversity of Clinical Expression and Mode of Inheritance
Authors: CHITAYAT D. , SPIRER Z. , AYALON D. , GOLANDER A.
Published: January 2008

ABSTRACT. Pseudohypoaldosteronism was diagnosed in an infant that clinically presented severe failure to thrive and vomiting. Evaluation of her extended family revealed many other affected family members with a vast range of clinical expression. The mode of inheritance is most likely autosomal dominant. Salt supplementation during infancy was effective in restoring normal growth, weight gain and serum electrolytes.
Acute Infectious Lymphocytosis: Phenotype of the Proliferating Cell
Authors: BERTOTTO A. , ARCANGELI C. DE FELICIS , SPINOZZI F. , GERLI R. , FABIETTI G. , GERMINI G. , VACCARO R.
Published: January 2008

ABSTRACT. A case of acute infectious lymphocytosis in an otherwise healthy 2‐year‐old child is reported. Marker analysis of the expanded blood lymphocytes showed that they were predominantly T cells and that there was a considerable increase in the helper/inducer phenotype (OKT4+) population. However, the lymphocyte response to polyclonal T‐cell activators was low. This is the first report on T‐cell subset distribution in acute infectious lymphocytosis.
Bile Acid Metabolism in Children with Cystic Fibrosis
Authors: WEBER ANDRÉE M. , ROY CLAUDE C.
Published: January 2008

ABSTRACT. Recycling of bile acids through the enterohepatic cycle is very efficacious. Bile acids contribute to bile formation and, by forming micelles, participate in lipid solubilization and absorption. The small fraction which escapes in the feces, is synthesized daily by the liver to compensate for losses. In CF, bile acid malabsorption has been documented; these large losses are accompanied by an interruption in the enterohepatic circulation with concomitant reduction in bile acid pool and disturbances in biliary composition. The various intraluminal factors implicated in bile acid malabsorption include: unhydrolysed triglycerides and phospholipids, precipitation of bile acids in acidic duodenal content, adsorption to residues and modification of colonic microflora. A defect in bile acid ileal uptake has also been advocated. These disturbances in bile acid metabolism associated with CF might lead to aggravation of diarrhea and steatorrhea, cholelithiasis and perhaps liver disease.
Two Geographically Defined Populations with Different Organization of Medical Care
Authors: EKSMYR R.
Published: January 2008

ABSTRACT. In a previous study, a difference in early neonatal mortality was found between two geographically defined populations with different perinatal health services. The mortality was lower in districts served by hospitals with specialized obstetric service but lacking neonatal wards than in districts with both these facilities. This unexpected finding was not explained by population‐related differences in perinatal risk factors. In the present cause‐specific analysis of the early neonatal deaths, it was shown, after exclusion of lethal malformations, that the observed difference remained. It was most pronounced in full‐term non‐malformed infants, possibly indicating that it was more related to antenatal/obstetric care factors than to the pediatric care facilities available.
Endomyocardial Biopsy in Children with Cardiac Hypertrophy
Authors: MORTENSEN S. A. , BAANDRUP U. , WENNEVOLD A.
Published: January 2008

ABSTRACT. Transvascular right ventricular endomyocardial biopsy was carried out on three boys with severe hypertrophic hearts. There were no complications, but technically the use of the thin‐walled, long introducer‐sheath (available for the child‐size bioptome) was rather troublesome because of its tendency to kink. Light‐microscopy was helpful in diagnosing hypertrophic cardiomyopathy and possible endocardial fibroelastosis in two cases and in excluding eosinophilic myocarditis in the third case. Concealed storage disease (amyloidosis) was excluded and therefore the use of experimental cytotoxic thrapy‐with potential adverse effects‐was avoided. A more stable sheath material ought to be developed to prevent untoward incidents during biopsy procedures in children.
Home Blood Glucose Monitoring in Diabetic Children and Adolescents
Authors: HERMANSSON GÖRAN , LUDVIGSSON JOHNNY , LARSSON YNGVE
Published: January 2008

ABSTRACT. In order to elucidate the question whether blood glucose monitoring should replace glucosuria testing in childhood diabetes 160 diabetic children and adolescents were invited to participate in a feasibility study on home blood glucose testing. Seventeen girls and 15 boys with an age of 4–21 years and duration of diabetes for 0.3‐18.7 years accepted, thus a selection of motivated patients. They performed 20–22 diurnal blood glucose profiles, each consisting of 7 blood samples, during a 3 month period. Thereafter, all patients were encouraged to continue blood glucose self‐control and the actual performance of the 32 patients was evaluated 3 years later. Daily glucosuria tests were also made and HbA1 was analysed. Patients’attitudes were evaluated through 2 questionnaires. The study shows that blood glucose monitoring is feasible in the actual age groups. Most patients were positive towards blood tests, particularly because it gave an immediate answer to an actual problem, but its introduction did not change the metabolic control. However, pain restricted its daily use and only 6.4% of the patients preferred blood testing to urinalysis for long term use. Furthermore, the correlation between home glucosuria and HbA1 was as good as between home blood glucose and HbA1. It is concluded, that blood glucose self‐monitoring is a valuable tool in the management of childhood diabetes, but that it should be regarded as a complement to and not a substitute for daily home urinalysis.
Determinants of Plasma Arginine‐Vasopressin in Children
Authors: RASCHER W. , RAUH W. , BRANDEIS W. E. , HUBER K.‐H. , SCHÄRER K.
Published: January 2008

ABSTRACT. Plasma concentration of arginine‐vasopressin (AVP) was measured in 145 healthy subjects aged one day to 18 years of age. AVP decreased with age immediately after birth. Above one year of age values of children did not significantly differ from those in adults. AVP significantly correlated with plasma and urine osmolality after water deprivation during 16 h. Plasma AVP rose during exercise and fell after volume expansion. Nausea and vomiting are potent nonosmotic determinants of AVP release in children. Nonosmotic factors of AVP release should be controlled when sampling blood for measuring AVP in children for diagnostic and investigational purposes.
Aldosterone in Cystic Fibrosis: Measurement in Saliva and Correlation with Disease Severity
Authors: FERGUSSON R. J. , ATHERDEN S. M. , McCRAE W. M. , EDWARDS C. R. W.
Published: January 2008

ABSTRACT. Aldosterone was measured in the saliva of 20 patients with cystic fibrosis and a group of 20 normal children matched for age and sex. Mean levels were higher in the patient group but overall differences were small and statistically not significant. For the first time a link between aldosterone level and disease severity in patients with cystic fibrosis was established using a simple scoring system to assess disease activity. Urinary and salivary electrolytes were similar in the two groups. The results do not support the proposed hypothesis that the salivary glands of patients with cystic fibrosis are insensitive to aldosterone.
Abnormal Pancreatic Electrolyte Secretion in Cystic Fibrosis
Authors: DAVIDSON G. P. , KIRUBAKARAN C. P. , RATCLIFFE G. , COOPER D. M. , ROBB T. A.
Published: January 2008

ABSTRACT. We performed pancreatic function tests on sixty‐five cystic fibrosis (CF), and eleven control children. The technique used continuous IV infusion of cholecystokinin and secretin, with duodenal juice collection over a 90 min period, and was made quantitative by continuous duodenal infusion and distal collection of an unabsorbable marker (bromosulphthalein). Some CF patients had near normal pancreatic enzyme outputs, some had impaired but measurable levels, but most (79 %) had almost absent trypsin secretion. CF children with better pancreatic function, were younger and more likely to be male. All controls showed a large increase in bicarbonate concentration and secretion rate per kilogram body weight during the test, but most children with CF (96.5 %) did not. Because two of our CF patients had water and bicarbonate secretion within the control range, this finding does not exclude the diagnosis of CF. Sodium, potassium and chloride ion secretion in CF patients was lower than controls but overlap occurred. We found a linear correlation between acinar and tubular secretion in CF patients which indicates that there is probably not a primary genetic defect in pancreatic bicarbonate secretion in CF.
Incomplete Lactose Absorption from Breast Milk during Acute Gastroenteritis
Authors: TOLBOOM J. J. M. , MOTEETE M. , KABIR H. , MOLATSELI P. , FERNANDES J.
Published: January 2008

ABSTRACT. The incidence and degree of incomplete lactose absorption was investigated in breast fed infants and children up to two years of age during acute gastroenteritis (GE). Lactose absorption was assessed in 50 patients by means of the hydrogen breath test (HBT), approximately 5.5 days after admission to hospital. HBT detected incomplete lactose absorption of marked (lactose malabsorption) and probably mild degree in 8 and 6 patients respectively. Incomplete lactose absorption appeared to be transient in all 5 patients retested after discharge. HBT failed to identify 8 cases of lactose intolerance which were detected by investigation of the stools. In 31 breast fed controls of a similar age range incomplete lactose absorption of only mild degree was probably present in 2 and lactose intolerance in 1, which too was only detected by investigation of stools. During acute GE the use of HBT is appropriate to detect milder forms of incomplete lactose absorption than lactose intolerance. For the detection of lactose intolerance the measurement of pH and reducing substances in the stools remains the method of choice. The findings are in favour of the continuation of breast feeding during acute GE.
Long‐term Treatment with Corticosteroids/ACTH in Asthmatic Children
Authors: OBERGER E. , THORÉN M. , ENGSTRÖM I.
Published: January 2008

ABSTRACTS

Hypothalamic‐pituitary‐adrenal (HPA) function was studied in 23 children with severe bronchial asthma during and after long‐term treatment with prednisolone and/or ACTH1‐24 (depot tetracosactrin) by means of ACTH stimulation test and insulin tolerance test. In the 14 children primarily treated with depot tetracosactrin, the Cortisol levels in insulin tests were within normal limits both during and after treatment. An enhanced response to ACTH stimulation was found during the treatment period. During treatment with prednisolone a marked impairment of the adrenocortical function was found, with low basal plasma Cortisol levels and subnormal response to ACTH stimulation, more marked the lower the age at the start of treatment and the higher the dose per kg body weight. After substitution with depot tetracosactrin the HPA‐function was restituted, with plasma Cortisol levels within normal limits. Growth hormone levels after insulin induced hypoglycemia were ±7 ng/ml during and after treatment with depot tetracosactrin. As long‐term treatment with depot tetracosactrin has little side‐effects in terms of suppression of the HPA‐axis it is a useful alternative to oral prednisolone in severe asthma in children.
Neonatal Primary Hyperparathyroidism: Total Parathyroidectomy with Autotransplantation of Cryopreserved Parathyroid Tissue
Authors: LUTZ P. , KANE O. , PFERSDORFF A. , SEILLER F. , SAUVAGE P. , LEVY J. M.
Published: January 2008

ABSTRACT. Primary neonatal hyperparathyroidism is a life threatening disease because of severe hypercalcemia. The best therapy is early total parathyroidectomy which requires permanent replacement therapy. We describe the first case treated by total parathyroidectomy and late allotransplantation of cryopreserved parathyroid tissue. Twenty months after transplantation, serum calcium and phosphate levels are normal in the absence of any supplementary treatment.
A Prospective Study of Rotavirus Infections in Neonatal and Maternity Wards
Authors: TUFVESSON B. , POLBERGER S. , SVANBERG L. , SVEGER T.
Published: January 2008

ABSTRACT. The occurrence and symptomatology of rotavirus infections was studied at three maternity wards and one neonatal unit. Rotavirus was identified in 12.7% of 553 infants and 1.3% of 542 mothers at the maternity wards. Infections were more frequent in a mixed obstetric/ gynecology ward than in the pure obstetric wards. Only 10% of the infants had symptomatic infections. Subgroups of rotavirus was determined in 41 infants: 22 of subgroup I and 19 of subgroup II, which is the subgroup accounting for the majority of childhood gastroenteritis. Rotavirus was found in faecal samples from 37% of the infants at the neonatal unit during an eight‐month survey. A seasonal variation with most infections during colder months was seen. Subgroup determination was possible in 29 cases, 14 subgroup I and 15 subgroup II. Fifteen per cent of the infections demonstrated diarrheal symptoms. No significant difference among other clinical data registered was seen among rotavirus infected compared to the non‐infected infants. We conclude that neonatal rotavirus infections occur as an endemic infection at our maternity wards possibly combined with infections due to external sources of virus in mixed wards and neonatal units
The Functional Residual Capacity of Infants with Respiratory Distress Syndrome
Authors: RICHARDSON PETER , BOSE CARL L. , CARLSTROM JEFFREY R.
Published: January 2008

ABSTRACT. Positive end‐expiratory pressure (PEEP) is used in the treatment of infants with respiratory distress syndrome (RDS) to prevent atelectasis, recruit alveolar space and return the functional residual capacity (FRC) toward normal volumes. This study determined the FRC range of 15 prematurely bom infants with RDS receiving PEEP. Ventilator settings were controlled clinically using predominantly results of arterial blood‐gas analyses. Measurements of arterial blood‐gases and FRC (N2 washout) were made during the infants' second day of life. The FRC of the infants on a PEEP of 4.5 ± 1.3 cmH2O ranged widely from 3 to 33 ml/kg with a mean of 14.5 ml/kg; 17 ± 2 ml/kg was considered normal. The FRC was within one SD of the mean in only three of the 15 infants (20%) and outside of two SD of normal in seven (47%). A linear regression of calculated alveolar‐arterial oxygen gradient (AaDo2) with FRC yielded a correlation coefficient r=0.825. The AaDo2 values could be used to identify six of the seven infants having FRC outside of 2SD from normal. We conclude that convential methods of PEEP selection for infants with RDS seldom result in a normalization of FRC. Calculated AaDo2 values may be used to identify most RDS infants with FRC widely divergent from normal values.
Umbilical Cord Dehydroepiandrosterone Sulfate and Cortisol Levels in Preterm Infants Born to Pre‐Eclamptic Mothers
Authors: PROCIANOY RENATO S. , CECIN SANDRA K. G.
Published: January 2008

ABSTRACT. The influence of early‐onset pre‐eclampsia upon the umbilical cord serum levels of Cortisol and dehydroepiandrosterone sulfate was studied in fifty‐one preterm infants not exposed prenatally to corticosteroids. Preterm infants born to pre‐eclamptic mothers (group A) presented lower dehydroepiandrosterone sulfate levels than preterm infants born to non‐pre‐eclamptic mothers (group B). The umbilical cord serum levels of Cortisol were similar between both groups. It is suggested that the decrease in the cord serum levels of dehydroepiandrosterone sulfate in preterm infants of pre‐eclamptic mothers plays an important role in the pathogenesis of the subnormal maternal urinary estriol excretion, and that the accelerated pulmonary and cerebral maturation of preterm infants born to pre‐eclamptic mothers is not explained by an increased fetal serum Cortisol concentration.
Plasma Amino Acids in Supplementary Parenteral Nutrition of Preterm Infants
Authors: SCHRÖDER H. , PAUST H.
Published: January 2008

ABSTRACT. The present investigation aims to determine quantity and quality of the amino acid (AA) solution to be used in supplementary parenteral nutrition (SPN). We established the plasma AA concentrations of preterm infants (birthweight 1160‐1940 g, mean 1540; gestational age 29‐30 weeks, mean 32) divided into three groups. Group I (n=11) and group II (n=12) were put on a standardised SPN regimen starting with an intravenous supply of 2.5 resp. 1.5 g A A/kg/day. Infants of group III were formula‐fed, and served as controls. A total of 231 aminograms was obtained during the first two weeks of age. Comparison of groups I and II to group HI revealed plasma accumulation of six AA in group I. Supplementation in group II resulted in a normal pattern, except alanine, proline, and methionine. However, only deviations of proline and methionine may be judged as imbalances, and lowering in composition may be considered. We conclude that the low intravenous AA intake employed in group II may be preferred in SPN of preterm infants.
Late Mucosal Relapse in a Boy with Coeliac Disease and Cow's Milk Allergy
Authors: KUITUNEN PEKKA , SAVILAHTI ERKKI , VERKASALO MATTI
Published: January 2008

ABSTRACT. A case of coeliac disease where exceptionally long gluten challenge was needed to produce mucosal relapse is presented. An initial diagnosis of intestinal cow's milk allergy with total villous atrophy was made at the age of 3.5 months. The lesion healed after the child was put on a diet free of cow's milk and gluten. After 4.3 years on a normal diet his jejunal structure was still normal but at the age of 10.9 years, after 8.7 years of gluten ingestion, total villous atrophy was again observed. On a gluten‐free diet the small intestinal structure is completely normal at the age of 17.1 years.
Advances in Perinatal Care and Declining Regional Neonatal Mortality in Finland, 1968‐82
Authors: TENOVUO A. , KERO P. , PIEKKALA P. , SILLANPAA M. , ERKKOLA R.
Published: January 2008

ABSTRACT. Neonatal mortality (NNM) was investigated in the region of the University Central Hospital of Turku (UCHT), Finland, during a 15‐year period from 1968 till 1982. During the study period 81620 livebom infants were born. The NNM rate declined from 13.5 in 1968 to 3.0 in 1982 during the study period. Significant declines occurred in NNM due to respiratory distress syndrome (RDS) and asphyxia. The decline in NNM was more obvious during the early neonatal period (0‐6 days after birth) and in the low birth weight (LBVV) group (BW less than 2500 g). We believe that centralization of obstetric and neonatal services in risk cases and the new neonatal intensive care accounted for the decline in NNM.
Acute Oliguria in Preterm Infants with Hyaline Membrane Disease:
Authors: TULASSAY T. , SERI I.
Published: January 2008

ABSTRACT. Ten premature infants with hyaline membrane disease and with acute oliguria were treated with furosemide or furosemide and dopamine. Furosemide alone did not increase diuresis. Furosemide when combined with dopamine, however, caused significant increases in urine output, sodium excretion, fractional sodium excretion and creatinine clearance. These data suggest that the increase in the sodium excretion was due not only to a reduction in the tubular sodium reabsorption but also to an increase in the glomerular filtration rate. Since in premature neonates the creatinine clearance is not a very precise index of the glomerular filtration rate, the extent of contribution of the increase in the glomerular filtration rate to the enhanced sodium excretion cannot be determined. Despite the increase in the sodium excretion, the serum sodium concentration did not fall significantly. We conclude that the combined treatment with dopamine and furosemide is useful for treating furosemide‐resistant, severe functional renal failure in preterm infants with hyaline membrane disease.
Hyperkalemic Distal Renal Tubular Acidosis in Salt‐Losing Congenital Adrenal Hyperplasia
Authors: RODRIGUEZ‐SORIANO JUAN , VALLO ALFREDO , CASTILLO GONZALO , OLIVEROS ROBERTO , FERNANDEZ‐GARNICA JOSE MIGUEL
Published: January 2008

ABSTRACT. Functional indices of distal urinary acidification were assessed in two male infants, aged 1 and 3 months, with salt‐losing congenital adrenal hyperplasia. In both cases the diagnosis was sustained by the presence of elevated plasma levels of 17‐hydroxyprogesterone, hyponatremia, hyperkalemia, metabolic acidosis and increased plasma renin activity. Both patients were unable to lower urinary pH below 5.9 either during acute ammonium chloride‐induced acidosis or after i.v. administration of furosemide. One patient also failed to decrease urine pH below 5.5 and to increase urinary potassium excretion during sodium sulfate infusion. Oral sodium bicarbonate loading was given to both patients but failed to induce a significant increase in the urine minus blood Pco2 gradient. This gradient remained low also after neutral phosphate administration. Repeated studies after acute administration of fludrocortisone in one case or after prolonged administration of hydrocortisone in the other resulted in complete normalization of all functional studies. We conclude that salt‐losing congenital adrenal hyperplasia can lead to hyperkalemic distal renal tubular acidosis in early infancy. The defective renal secretion of hydrogen ion and potassium is probably related to the abolishment of the negative potential difference in the cortical collecting tubule induced by the impaired reabsorption of sodium.
Estimation of Digoxin Dosage in VLBW Infants Using Serum Creatinine Concentrations
Authors: GORTNER L. , HELLENBRECHT D.
Published: January 2008

ABSTRACT. Digoxin steady state plasma concentrations (Css) and the corresponding serum creatinine concentrations were studied in 17 VLBW infants. Birth weight was in the range of 760‐1500 g (mean 1068 g), gestational age ranged from 26 to 32 weeks (mean 28.7 weeks). Digoxin steady state plasma concentrations were found in the range of 0.5‐6.5 μg/ml (mean 1.88 μg/ ml) during maintenance therapy with 1.6‐8.4 μg/kg BW/24 h (mean 4.4 μg/kg BW724 h) given in two divided doses intravenously. No digoxin‐like immunoreactive substance could be detected in the plasma of 18 infants (10 patients with a birth weight <1500 g, 8 patients with a birth weight of 2100‐4 730 g) that were not treated with digoxin. The calculated digoxin clearance ranged from 0.38‐4.03 ml/min/kg BW. Serum creatinine concentrations were found in the range of 35‐274 μmol/l (0.4‐3.1 mg/100 ml). A hyperbolic correlation may be derived from the digoxin clearance and the corresponding serum creatinine concentration. A linear relationship was observed between the dose normalized digoxin concentrations (y=Css/dose in 24 h) and the respective creatinine concentrations x (v=0.52x‐0.05; n=17; 5=0.24; r=0.86; p<0.01). According to this equation we suggest a dosing schedule for digoxin in VLBW infants with impaired renal function. Digoxin maintenance dose is derived from the digoxin target and the creatinine serum concentration. This dose recommendation proved reliable on four VLBW infants (birth weight 770‐1260 g) with decreased renal function.
IgG and IgM Antibody Responses to Pneumococcal Vaccination in Splenectomized Children and in Children Who Had Non‐Operative Management of Splenic Rupture
Authors: KALIN M. , LINNÉ T. , ERIKSSON M. , LÄNNERGREN K. , TORDAI P. , JAKOBSSON B. , LUNDMARK K.‐M.
Published: January 2008

ABSTRACT. The IgG and IgM type specific anticapsular pneumococcal antibody titres were studied with ELISA during one year following vaccination with a 14‐valent pneumococcal polysaccharide vaccine in four different patient groups: 41 children splenectomized after a traumatic rupture, 16 splenectomized because of disease, 15 non‐surgically managed after splenic rupture, and 19 healthy controls. Serum samples were obtained before vaccination and after 14, 60, 180, and 360 days. The IgG antibody responses were equally good in all of the patient groups, while the IgM antibody responses were less pronounced in the splenectomized. In the non‐surgically managed patients, the IgM antibody titres after vaccination, as well as antibody responses per se, were significantly higher for all 12 pneumococcal types studied than in the patients who were splenectomized. Both the IgG and the IgM antibody titres were highest at 14 days after vaccination. However, while the IgG titres for most pneumococcal types remained elevated at 360 days, the IgM titres soon fell to prevaccination levels. The antibody response was less good for the types 3 and 6 A. The results indicate that the IgG antibody response to pneumococcal polysaccharide vaccination is unaffected in splenectomized individuals, but the IgM antibody response is decreased. In patients with a healed traumatically damaged spleen, both the IgG and IgM responses seem to be normal.
Effects of Delivery by Caesarean Section on Lung Function in Healthy Newborn Infants
Authors: SANDBERG K. , SJÖQVIST B. A. , HJALMARSON O. , OLSSON T.
Published: January 2008

ABSTRACT. With the aim of extending previous studies showing differences in lung function after birth between infants delivered vaginally (VD) and by Caesarean section (CS) we investigated lung volumes, ventilation, efficiency of ventilation, and lung mechanics in 24 healthy, full term infants with no clinical signs of respiratory disease, 12 after VD and 12 after CS. Measurements were made on two occasions: 2 and 26 hours after birth. At 2 hours no differences in any measured quantity were found between the groups. The only difference found 24 hours later was that the average thoracic gas volume (TGV), was lower in infants after CS than after VD. The difference in functional residual capacity was, however, not significant. This means that the difference in TGV, previously also found by other workers, did not affect the ventilated air space. Our results do not support the theory of general inferiority in lung performance after birth in healthy, full term infants without respiratory disease delivered by CS.
Oral Rehydration Therapy in Malnourished Infants with Infectious Diarrhoea
Authors: MARIN L. , GÜNOZ H. , SÖKÜCÜ S. , SANER G. , APERIA A. , NEYZI O. , ZETTERSTRÖM R.
Published: January 2008

ABSTRACT. The clinical response and changes in water and salt homeostasis was studied for 36 hours during oral rehydration therapy with a rehydration solution containing 60 mmol sodium/1 (ORSffl) in 14 malnourished 3‐ to 15‐month‐oId Turkish infants with acute infectious diarrhoea. All patients were successfully rehydrated with this treatment. Sodium was efficiently absorbed from the gut and water balance was rapidly restored. Because of excess fluid retention following the initial rehydration period about 50% of the patients became oedematous. Urine volume and urinary sodium excretion were found to be much lower than in well‐nourished patients of the same age with acute diarrhoea who were treated in the same way. In all of the malnourished infants the serum sodium level remained within the normal range during treatment. The results show that malnourished infants retain much more fluid and sodium than infants who are in a normal nutritional state. Excessive retention of water and salt seem to be due to an inability of the kidneys to control sodium and fluid homeostasis while orally administered sodium and fluid are being absorbed from the gut. The results show that ORT is safe and efficient in the treatment of malnourished infants with acute diarrhoea. But since these infants run a high risk of developing a severe retention of fluid and salt, and consequently may develop circulatory failure due to hypervolemia during oral rehydration therapy, it is important to carefully monitor the volume of fluid that is given.
An Infant with Simultaneous β‐Lactamase‐Positive Haemophilus influenzae Meningitis and β‐Lactamase‐Negative H. influenzae Septicemia, Escherichia coli Pyelonephritis, and Herpes Encephalitis
Authors: PELTOLA H. , TURPEINEN M. , KOSKINIEMI M.
Published: January 2008

ABSTRACT. We describe an infant with meningitis and septicemia due to infection with two different strains of Haemophilus infitenzae, with a urinary tract infection due to Escherichia coli and in whom herpes virus encephalitis was diagnosed within three days. Acinetobacter cal‐coaceticus septicemia developed three weeks later. No immunological deficiency could be demonstrated in the patient who recovered finally, albeit with sequelae due to encephalitis.
Hypercalcemia:
Authors: SADEGHI‐NEJAD A. , SENIOR B.
Published: January 2008

ABSTRACT. Although well known in adults the association of hypercalcemia with hyperthyroidism has not been reported in children. We describe how its occurrence in a hyperthyroid child obscured the manifestations of hyperthyroidism and discuss the factors that led to its appearance and regression.
Malformations in 10000 Consecutive Births in Tunis
Authors: KHROUF N. , SPÅNG R. , PODGORNA T. , MILED S. B. , MOUSSAOUI M. , CHIBANI M.
Published: January 2008

ABSTRACT. Malformations were assessed in 10000 consecutively born infants, dead or alive, at the Wassila Bourgiba Maternity Hospital in Tunis. The medical and social history including the rate of consanguinity was studied in the malformed group as well as in a control group of 229 infants. Three hundred and ninety‐six infants were malformed; 248 had major malformations and 148 had minor ones. Thirteen per cent of the stillborn were malformed compared to 3.7% of the liveborn. The rates of most specific malformations were comparable to those in other studies but a relatively high rate of neural tube defects, 2.2/1000, can be noted. There is a significant overrepresentation of consanguinity (65%) in parents of nonsyndromic mul‐timalformed infants.
Free and Erythrocyte‐Bound Bilirubin in Neonatal Jaundice
Authors: MALIK G. K. , GOEL G. K. , VISHWANATHAN P. N. , MISRA P. K. , SHARMA B.
Published: January 2008

ABSTRACT. Serum free bilirubin and erythrocyte‐bound bilirubin concentrations were estimated in 53 jaundiced neonates with a total serum bilirubin concentration of 227.4 ± 80.4 μmol/1. The serum free bilirubin and erythrocyte‐bound bilirubin concentrations were 8.7 ± 5.6 μmol/1 and 23.8 ± 6.0 μmol/1, respectively. Both, the serum free bilirubin (r=+0.741, p<0.001) and erythrocyte‐bound bilirubin (r=+0.754, p<0.001) correlated directly with bUirubin‐albumin molar ratio. There was a direct correlation between free and erythrocyte‐bound bilirubin concentration (r=+0.657, p<0.001). The prediction of serum free bilirubin concentrations from the known erythrocyte‐bound bilirubin value was unreliable.
Plastic Blankets and Heat Shields Decrease Transmission of Phototherapy Light
Authors: KARSDON J. , SCHOTHORST A. A. , RUYS J. H. , BERGER H. M.
Published: January 2008

ABSTRACT. An in vitro study showed that the use of transparent plastic insulation to decrease heat loss from newborn infants substantially decreases the transmission of phototherapy light. The decrease is proportional to the number of plastic layers between the light source and the baby because of reflection from the surface of the plastic. This increases if the surface is irregular. Thickness and the type of plastic used had no effect.
Breastfeeding and Socioeconomic Status in Southern Brazil
Authors: BARROS F. C. , VICTORA C. G. , VAUGHAN J. P.
Published: January 2008

ABSTRACT. Patterns of breastfeeding were studied in a cohort of 5 914 infants followed from birth in Pelotas, Southern Brazil. Overall, 92% of the babies commenced breastfeeding and 54% were still breastfed by 3 months of age. This proportion dropped to 30% by 6 months, 20% by 9 months, and 16% by 12 months. The prevalence of breastfeeding soon after birth, and at 3, 6, 9 and 12 months of age was studied according to socioeconomic status as measured by family income. Children from the poorest families were less likely to be breastfed from birth than those from the richest families (89% and 97%, respectively), and also showed lower prevalence of breastfeeding at 3 and 6 months. By the age of 12 months poor children showed the highest prevalence of breastfeeding.
Serum Steroids and Success of Corticotropin Therapy in Infantile Spasms
Authors: RIIKONEN R. , PERHEENTUPA J.
Published: January 2008

ABSTRACT. Serum levels of 8 steroids and urinary Cortisol excretion were determined in 10 infants before and during corticotropin therapy for infantile spasms. High serum dehydroepiandrosterone‐androstenedione concentration ratio distinguished the 6 infants with good therapeutic response from the 4 with poor response (p=0.001). No such distinction was obtained directly by any of the serum steroid levels, 24‐hour urinary Cortisol, or serum pregnenolone‐proges‐terone concentration ratio. This suggests that the therapeutic effect of corticotropin may be mediated by steroid factors other than Cortisol. Inhibition of the 3 β‐hydroxysteroid dehydrogenase system in zona reticularis might be beneficial during the corticotropin therapy.
The Daytime Breath Hydrogen Profile in Children with Abdominal Symptoms and Diarrhoea
Authors: KNEEPKENS C. M. F. , BIJLEVELD C. M. A. , VONK R. J. , FERNANDES J.
Published: January 2008

ABSTRACT. The daytime breath hydrogen profile (DBHP) enables the study of breath hydrogen (BH) excretion in children under normal dietary and environmental circumstances. We studied the DBHP in 43 children with abdominal pain and (or) diarrhoea in order to evaluate its use in the detection of carbohydrate malabsorption (CHM). The results were compared to those of the lactose BH test. The DBHP was abnormal in 16 patients (37%), 8 of whom also had an abnormal lactose BH test. Five other patients with an abnormal lactose BH test had a normal DBHP. In 7 out of 10 children with an abnormal DBHP, the recorded abdominal symptoms coincided with a sharp increase in BH excretion. Abnormal DBHPs were most frequently found in children with functional abdominal complaints and with giardiasis. Our findings indicate that CHM is more frequently encountered in children with abdominal symptoms than can be detected by the lactose BH test. The DBHP offers new possibilities in the investigation of gastrointestinal conditions by correlating the symptoms directly to the effect induced by CHM.
Acute Diarrhoea and Asymptomatic Infection in Chilean Preschoolers of Low and High Socio‐economic Strata
Authors: ARAYA M. , FIGUEROA G. , ESPINOZA J. , ZARUR X. , BRUNSER O.
Published: January 2008

ABSTRACT. Preschoolers who belonged to the high (Group I, n= 112) or the low (Group II, n=90) socioeconomic stratum were followed prospectively for six months. Mean monthly incidence of diarrhoea was 3 and 7 episodes per 100 children for Group I and Group II respectively (p<0.001). Episodes were shorter and affected a smaller proportion of children in Group I (p<0.002 and p<0.05), respectively). Bacterial enteropathogens were recovered in 12.6% and 13.5% of the episodes in Group I and Group II and parasites in 15.4% and 62.8%, respectively. Rotavirus was detected once in each group. Asymptomatic carrier rates for en‐teropathogenic bacteria were 12.0% in Group I and 7.2% in Group II. The corresponding figures for parasites were 28.2% and 62.8% (p<0.001). Nutritional status was normal in all children. These results suggest that socioeconomic stratum plays an important role in the characteristics of diarrhoea! illness in the groups which conform the population of the less developed countries. Acute diarrhoea is less frequent in preschoolers living in Santiago than in other developing areas. Rates of asymptomatic infection are high.
Hospital Routines in Infants with Hyperbilirubinemia Influence the Duration of Breast Feeding
Authors: ELANDER G. , LINDBERG T.
Published: January 2008

ABSTRACT. Twenty‐nine infants undergoing phototherapy to treat hyperbilirubinemia were divided into two groups. One group of mothers (non‐separated) were transferred with their infants to the paediatric ward and remained as the primary care provider. The other group of mothers (separated) remained on the maternity ward and went to the paediatric unit to care for their infants at feeding times. A third group of healthy mothers and infants served as controls. Mothers in the non‐separated group were more satisfied with the care than mothers in the separated group. The duration of breast feeding in the separated group was significantly shorter than in the other groups. The urine Cortisol levels in the separated mothers were the same at one week and three months after delivery. The mothers in the other two groups had significantly higher urine Cortisol levels during the first week postpartum than three months postpartum. We conclude that routine phototherapy for jaundiced infants should not separate mothers and infants.
Long‐term Treatment with Corticosteroids/ACTH in Asthmatic Children
Authors: OBERGER E. , TARANGER J. , BRUNING B. , ENGSTROM I. , KARLBERG J.
Published: January 2008

ABSTRACT. Skeletal maturation in severe bronchial asthma was studied in 15 children during and after treatment with depot tetracosactrin and in 6 children during treatment with prednisolone. Attained skeletal maturity before treatment was below the reference mean in the majority of children. Skeletal maturation was enhanced during treatment with depot tetracosactrin, which led to more advanced attained skeletal maturity at withdrawal than at start of treatment. There was a tendency towards larger increases of skeletal maturity than of height. The influence of adrenal androgens, released by ACTH‐stimulation and good control of the disease are probably relevant factors for the acceleration of skeletal maturation. After withdrawal of depot tetracosactrin the rate of skeletal maturation normalized. During prednisolone treatment there was a delay of skeletal maturation leading to a progressive relative decrease of attained skeletal maturity, and closely related to a delay in linear growth. Treatment with depot tetracosactrin may thus induce enhancement of skeletal maturation, but with the treatment regimen found to be efficacious in bronchial asthma, the effect is not very pronounced and does not perceptibly affect the ultimate outcome of growth.
Maternal TSH‐Receptor Antibodies and TSH Antibodies in Screening for Congenital Hypothyroidism
Authors: KARLSSON F. A. , DAHLBERG P. A. , ALM J. , LARSSON A. , FELDING I.
Published: January 2008

ABSTRACT. Serum samples from 30 mothers who had given birth to at least one child with a positive neonatal thyrotropin (TSH) screening test were analysed for TSH‐receptor antibodies. One mother with hypothyroidism after thyroiditis who had two sons who had had transient congenital hypothyroidism, showed significantly elevated concentrations of TSH receptor blocking IgG antibodies in her serum. The three daughters of another mother had neonatal hyper‐thyrotropinaemia but normal thyroid hormone levels. This woman had elevated serum levels of TSH but was clinically and biochemically euthyroid. The apparent hyperthyrotropinaemia in this family was due to an artifact in the TSH radioimmunoassay caused by maternal anti‐TSH IgG antibodies. It is obvious that placental transfer of maternal IgG antibodies to the thyroid TSH receptor is one cause of transient congenital hypothyroidism. Likewise, maternal IgG directed against TSH interferes with radioimmunoassays of TSH and the results may be falsely interpreted as hyperthyrotropinaemia. It is concluded that in neonatal hyperthyrotropinaemia analysis of the mother's serum is indicated, and that maternal TSH receptor blocking antibodies must be considered as a cause of congenital hypothyroidism, especially if the mother has a history of thyroid dysfunction.
High Resolution CT Scanning of the Pituitary Gland in Growth Disorders
Authors: STANHOPE R. , HINDMARSH P. , KENDALL B. , BROOK C. G. D.
Published: January 2008

ABSTRACT. We have performed 217 GEC 8800 CT scans of the hypothalamus and pituitary glands of 202 children with disorders of growth and development. Pituitary morphological abnormalities were common. Intrapituitary low density lesions were found in 17 % of the whole series and in 58% of children with tall stature. Seventy‐seven children with idiopathic growth hormone deficiency could be divided on the basis of pituitary morphology seen on CT scan into pituitary aplasia (n = 11) and pituitary hypoplasia (n = 53). Patients with pituitary aplasia had an absent adenohypophysis which probably dated from early intrauterine life and therefore could not be related to birth trauma. We have found a high incidence of evolving endocrinopathy in children with pituitary insufficiency: thus, if a short child is investigated the initial endocrine findings need to be repeated as the pattern of pituitary insufficiency changes with time. An evolving endocrinopathy starting in later childhood is suggestive of the presence of a cerebral tumour. Children with subnormal growth velocities and a normal growth hormone response to pharmacological tests have a wide spectrum of pituitary morphological abnormalities which may be associated with growth hormone neurosecretory dysfunction.
Testosterone Regulates the Haemoglobin Concentration in Male Puberty
Authors: THOMSEN K. , RIIS B. , KRABBE S. , CHRISTIANSEN C.
Published: January 2008

ABSTRACT. In a longitudinal study of male puberty 20 boys were examined every three months for at least two years. Haemoglobin concentration was determined and related to changes in serum testosterone concentrations. The data show a steep increase in serum testosterone during puberty (p<0.001) followed with a five months delay, by a significant increase in haemoglobin concentration (p<0.001). It is concluded that the steep increase in serum testosterone during puberty produces an acute stimulation of erythropoietin leading to an increase in erythrocyte production and thereby to a detectable increase in haemoglobin concentration a few months thereafter. The present study supports the idea that the selection of the relevant reference range for haemoglobin in boys should depend on the state of physical developments as expressed by serum testosterone.
Large Interindividual Variations in the Pharmacokinetics of Oral 6‐Mercaptopurine in Maintenance Therapy of Children with Acute Leukaemia and Non‐Hodgkin Lymphoma
Authors: LAFOLIE P. , HAYDER S. , BJÖRK O. , ÅHSTRÖM L. , LILIEMARK J. , PETERSON C.
Published: January 2008

ABSTRACT. The concentrations of 6‐mercaptopurine were studied in plasma and red blood cells from 10 children with acute leukaemia or non‐Hodgkin lymphoma receiving oral maintenance therapy. The doses varied between 25 and 79 mg/m2 body surface once daily. Large interindividual differences were found in the concentrations both in plasma and in red blood cells. There was no clear relationship between the dose administered and the concentrations obtained. However, in each patient the concentrations in plasma and in red blood cells were very similar. In most patients, the peak concentrations were reached 1‐2 hours after dose intake and the concentrations then declined with half‐lives less than 1 hour. Further studies are necessary to evaluate the potential value of drug level monitoring in optimizing treatment with oral 6‐mercaptopurine.
Longterm Follow‐up of Ventilator Treated Low Birthweight Infants
Authors: BLENNOW G. , PLEVEN H. , LINDROTH M. , JOHANSSON G.
Published: January 2008

Forty‐five of 47 low birthweight infants (<2.5 kg b.w.) from a 21/2‐year period surviving after ventilator treatment in the neonatal period were studied. The children were assessed at the age of 6‐7 years by neurological examination and Griffith's test. There were 2 children with diplegia, and one with a descrete hemiplegia. Eleven other children had minor motor disturbances. Fifteen children had short attention span. In the Griffith's test 8 had a general quotient below 3; most often because of low scores in the Locomotor scale and the Performance scales. Eight children had minor motor difficulties and short attention span in combination. These eight children together with the three patients with cerebral palsy, another four patients with low Griffith test and one girl with severe retrolental fibroplasia, and one girl with neurogenic hearing reduction could be at risk for later school difficulties (38%). Finally, one boy was successfully shunted for hydrocephalus. The abnormalities found did not correlate with birthweight or duration of ventilator treatment.
Conjugating Ability of Bile Acids in Hepatic Failure
Authors: ARISAKA M. , ARISAKA O. , NITTONO H. , OBINATA K. , NIIJIMA S. , YABUTA K. , SUZUKI F. , YANAGAWA S.
Published: January 2008

ABSTRACT. A 5‐month‐old boy with giant cell hepatitis died of hepatic failure. Analysis of serum bile acids by high pressure liquid chromatography revealed a marked increase in total bile acid concentration and a decrease in the cholate to chenodeoxycholate ratio. However, contrary to expectation, the conjugating ability of bile acids with taurine or glycine was well preserved. This suggests that the amino acid conjugation can occur despite the presence of severe hepatocellular damage.
Milk Protein intake in the Term infant
Authors: RÄIHÄ N. , MINOLI I. , MORO G.
Published: January 2008

ABSTRACT. Thirty healthy term infants were studied during the three first months of life. The infants were divided into three feeding groups consisting of 10 infants in each. The feeding regimens were: human milk by breast feeding, a formula (F‐I) containing 1.2 g/100 ml of protein and a control formula (F‐II) containing 1.6 g protein/100 ml. Both formulas were whey predominant and isocaloric. Protein intake was significantly higher with formula F‐II when compared to the human milk group and to formula F‐I. No significant differences with respect to weight, length and head circumference were found among the groups, but the rate of growth between 2 to 12 weeks was higher in the control formula (F‐II) group. Serum albumin concentrations were normal and similar in all feeding groups. Blood urea nitrogen and urine total nitrogen concentration was significantly lower in the low protein formula I group when compared to the control formula II. After the fourth week of life the low protein formula infants had similar blood urea nitrogen and urine nitrogen concentrations as those of the breast‐fed infants. The results indicate that current formulas in use provide excessive protein intakes after the first months of life.