bluuebunny/crossref_metadata_2025 huggingface dataset:
ARTERIAL BLOOD PRESSURE SERUM LIPIDS AND CARDIOVASCULAR COMPLICATIONS IN FAMILIES OF HYPERTENSIVE CHILDREN
Authors: CASSIMOS CHR. , AIVAZIS V. , KARAMPERIS S. , VARLAMIS G. , KATSOUYANNOPOULOS V.
Published: January 2008

ABSTRACT. The arterial blood pressure (B. P.), the cardiovascular complications and the type of hyperlipoproteinemia were studied in 98 families of hypertensive children (group A) and in 100 families of normotensive children (group B). In group A, hypertension was found in 27% of the parents and 47.4% of grandparents, whereas in group B in 7.5% and 22.5% respectively. In siblings of hypertensive children hypertension was found in 13.5% as apposed to 5.4% of those of normotensive children. Cardiovascular complications were recorded in 27.5% in the parents and grandparents of group A and in 12% in group B. Hyperlipoproteinemia with obvious preponderance of type II (IIa, IIb) and IV was found in 58.5% of parents in group A and 21.1% in group B.
CLOSTRIDIUM DIFFICILE TOXIN IN FAECAL SPECIMENS OF HEALTHY CHILDREN AND CHILDREN WITH DIARRHOEA
Authors: MÅRDH P.‐A. , HELIN I. , COLLEEN I. , ÖBERG M. , HOLST E.
Published: January 2008

ABSTRACT. Presence of cytopathogenic effect (CPE) that could be inhibited by an antitoxin to Clostridium sordelli, known to cross‐react with Clostridium difficile toxin, was sought in faecal specimens from 101 infants. Of the children, 45 were healthy, while 56 had been hospitalized because of diarrhoea. CPE was found in 12 of the healthy infants and in 5 of those hospitalized. Faecal specimens of these 5 gave a CPE at titres of 103‐4, whereas in the 12 healthy infants the titres were 101‐2. Studies on consecutive samples showed that the CPE could persist for between 7‐11 weeks up to 9 months and more. Of the 45 healthy infants, 11 harboured C. difficile compared with 6 of the 56 with diarrhoea. In both groups, 3 CPE‐positive infants were culture‐negative for C. difficile. Four of those hospitalized had recently been given antibiotics; all were negative in both culture and CPE tests. The present study demonstrates that care should be exercised when interpreting the results of cultures for C. difficile and tests for CPE made on faecal specimens in order to establish a diagnosis of antibiotic‐associated enterocolitis in infants and children.
FAILURE OF PNEUMOCOCCAL VACCINATION IN A SPLENECTOMIZED CHILD
Authors: NIELSEN J. LANNG , PEDERSEN F. KARUP , ELLEGAARD J.
Published: January 2008

ABSTRACT. Recurrent Streptococcus pneumoniae septicaemia occurred in a splenectomized child with idiopathic thrombocytopenic purpura. Fatal infection took place 1 year after pneumococcal vaccination and was caused by sero‐type 18C which was included in the vaccine. The efficacy of pneumococcal vaccination is discussed in relation to specific pneumococcal polysaccharide antibody titers, and it is concluded that vaccination alone is insufflcient in preventing overwehlming infections in splenectomized Individuals.
AUTOIMMUNITY TO INSULIN IN A CHILD WITH HYPOGLYCEMIA
Authors: ROVIRA A. , VALVERDE I. , ESCORIHUELA R. , LOPEZ‐LINARES M.
Published: January 2008

ABSTRACT. Plasma insulin antibodies were present in a 5‐year‐old boy who had been suffering from frequent hypoglycemic episodes during a year without exogenous insulin administration. The antibodies were of low titre one month after the last hypoglycemic episode, although a possible previous higher titre could have been responsible for the child's symptoms. After 17 months, during which the child remained asymptomatic, insulin antibodies could not be detected in his plasma. This is a new case of insulin autoimmunity associated with hypoglycemia.
NATURAL KILLER CELL ACTIVITY AND ANTIBODY‐DEPENDENT CELLULAR CYTOTOXICITY IN NEWBORN INFANTS
Authors: HALLBERG A. , MALMSTRÖM P.
Published: January 2008

ABSTRACT. The ability of lymphocytes from the peripheral blood of preterm and term infants and adult women and men to mediate natural killing (NK) and K cell activity (antibody‐dependent cellular cytotoxicity) was analysed in 4 hours 51Cr‐release assays. K 562 cells were targets for NK activity. K cell activity was assayed on antibody‐coated rat thymocytes. Lymphocytes from adult male donors were significantly more cytotoxic to K 562 cells than were lymphocytes from adult female donors. Lymphocytes from both preterm and term infants had significantly lower NK and K cell activity than lymphocytes from adult donors. During the first month of life no increase in NK activity or K cell activity occurred in 7 infants who were re‐examined. It is concluded that neither NK nor K cell activities are fully developed during the first month of life.
HEMOSTATIC BALANCE ALTERATIONS IN OBESE CHILDREN
Authors: CACCIARI E. , COCCHERI S. , BERGAMASCHI R. , FORTUNATO G. , BALSAMO A. , POGGI M. , CICOGNANI A. , PIRAZZOLI P. , ZAPPULLA F.
Published: January 2008

ABSTRACT. Fibrinolytic response to venous occlusion and other clotting parameters were studied in 34 obese children and 16 controls. The obese children (mean age 9 2/12 years) had a mean overweight of 51.8%± 15.6, higher blood glucose and cholesterol levels, and increased baseline and glucoseinduced insulinemia. However, baseline ELT did not differ significantly; ELT after 5 min venous occlusion was 203.2 ± 110.9 min in the obese children and 114.7 ± 67.9 min in the control group (p<0.01) with a mean percent decrease respectively of 14.9% and 29.2%. Poor fibrinolytic responders did not correlate with age, overweight, or metabolic indices. Lower levels of ATm (p<0.01) and no changes in F VIII: C and F VIII: R Ag were also found in the obese. Furthermore, in a larger group of 84 prepubertal obese children (mean age 10 years; mean overweight 48.2%) and in 39 normal prepubertal children (mean age 10 4/12 years) we also studied platelet aggregation capacity according to Breddin. This parameter was altered in a high proportion of the obese children (p<0.05). The obese children were also poor fibrinolytic responders, similarly to obese adults, and exhibited early alteration of the clotting balance.
INHIBITION OF THE INSULIN RESPONSE TO GLUCOSE AFTER TREATMENT WITH CYPROHEPTADINE
Authors: GOLANDER A. , SPIRER Z.
Published: January 2008

ABSTRACT. The effect of cyproheptadine treatment on the glucose‐induced insulin response was studied on a group of 8 children. The insulin response to a glucose load either i. v. or orally was found to be blunted after one month of treatment with a low dose of cyproheptadine. These results suggest that cyproheptadine administered to our patients reduced their insulin reserves.
GONADOTROPIN RESPONSIVENESS TO LUTEINIZING HORMONE RELEASING HORMONE IN PREPUBERTAL AND PUBERTAL PATIENTS WITH GROWTH HORMONE DEFICIENCY
Authors: FRISCH H. , WALDHAUSER F. , HAVELEC L. , SCHOBER E. , SWOBODA W. , SPONA J. , SCHERNTHANER G.
Published: January 2008

ABSTRACT. Gonadotropin response to 100 μg/m2 LHRH was determined in 31 patients with growth hormone deficiency. According to their bone ages the patients were divided into a “prepubertal” (n=18) and a “pubertal” (n=13) group. The results were compared with the LHRH tests from 16 healthy prepubertal boys and girls and 32 healthy adult probands, respectively. The maximum increment of LH and FSH was evaluated. In the “prepubertal” group five patients had an insufficient rise of LH and FSH, four of them having additional anterior pituitary hormone deficiencies. In the “pubertal” group nine patients were found to be gonadotropin deficient, all of them had additional hormone deficiencies, TSH being the most frequently affected hormone. Only one of 14 gonadotropin‐deficient patients had no other than growth hormone deficiency in addition. An isolated decreased FSH increment without LH deficiency was found in 6 male and 2 female patients and is not thought to be of diagnostic value. No influence of growth hormone treatment or growth velocity on the gonadotropin responsiveness was found. Patients with an additional thyreotropic defect could be classified as pituitary or hypothalamic disorder due to their reaction in the TRH test. These groups could not be differentiated by a single bolus LHRH test, indicating the need of prolonged stimulation to recover the pituitary hyporesponsiveness. Due to methodological problems the diagnosis of gonadotropin deficiency in an individual patient of the prepubertal age group might be questioned. However, a normal gonadotropin response to LHRH can be expected in prepubertal patients with growth hormone deficiency and may indicate a normal gonadotropin function.
TRANSCUTANEOUS BILIRUBINOMETRY IN FULLTERM CHINESE AND MALAY INFANTS
Authors: TAN K. L.
Published: January 2008

ABSTRACT. An evaluation of the Minolta/Airshields transcutaneous bilirubin meter (TcB) was made in 68 Chinese and 28 Malay fullterm infants and 9 infants undergoing phototherapy. A close correlation between the TcB index and bilirubin values was achieved at all three sites measured–forehead, sternum and back. The accuracy of the TcB was reduced by phototherapy. A high degree of reproducibility was demonstrated. The TcB is a useful screening device for neonatal jaundice.
THE PROTEIN TOLERANCE OF VERY LOW BIRTH WEIGHT INFANTS FED HUMAN MILK PROTEIN ENRICHED MOTHER'S MILK
Authors: HAGELBERG S. , LINDBLAD B. S. , LUNDSJÖ A. , CARLSSON B. , FONDÉN R. , FUJITA H. , LASSFOLK G. , LINDQVIST B.
Published: January 2008

ABSTRACT. Pooled breast milk was ultra‐filtrated and freeze‐dried to give a product with a protein content of 60 g/100 g powder. More than half of the secretory IgA activity against E. coli O antigen was preserved. This concentrated protein was added to the mother's fresh milk providing a protein supply of 3.0‐3.5 g/kg/24 hours in four VLBW infants, at a calorie supply of 110 kca/kg/24 hours. Growth followed the intrauterine rate. Free amino acid levels, acid‐base balance and urea concentrations of peripheral whole blood indicated tolerance of the increased supply of human milk protein.
LATE PROGNOSIS IN UNTREATED NEONATAL POLYCYTHAEMIA WITH MINOR OR NO SYMPTOMS
Authors: HØST A. , ULRICH M.
Published: January 2008

ABSTRACT. In a series of 635 single non‐malformed newborn infants with a gestational age ranging from 35 to 43 weeks we found venous haematocrit values of 60% or greater (range 60‐72%) in 117 (18%); 30 neonates (4.7%) had haematocrits above 65%, and of these, 7 had values above 70%. Only 13 developed symptoms, all minor, which might be ascribed to polycythaemia, and all 117 survived. Haemodilution was not performed in any case. Ninety‐eight children were followed up at the age of 2.5 years with a physical examination and a Denver Developmental Screening Test. At the age of 6 years an interval story concerning development and health was obtained from a questionnaire in 92 children; 4 children were lost to both follow‐up investigations. Of the 113 children, 104 (92%) were classified as normal. The remaining children suffered from febrile convulsions (one case), nocturnal enuresis (five cases), speech defect (one case), gross motor clumsiness (two cases) and hyperkinetic behaviour (one case). None had epilepsy or cerebral palsy. The findings were minor and showed no association to haematocrit levels or possible polycythaemic symptoms in the neonatal period. Hence we do not consider preventive haemodilution to be indicated in neonatal polycythaemia with minor or no symptoms within the studied range.
MODIFIED HUMAN IMMUNE SERUM GLOBULIN FOR INTRAVENOUS ADMINISTRATION: IN VITRO OPSONIC ACTIVITY AND IN VIVO PROTECTION AGAINST GROUP B STREPTOCOCCAL DISEASE IN SUCKLING RATS
Authors: FISCHER GERALD W. , HUNTER KENNETH W. , WILSON SAMUEL R.
Published: January 2008

ABSTRACT. Human immune serum globulin (ISG) preparations were tested in an in vivo suckling rat protection assay and an in vitro opsonophagocytic assay against various types and strains of Group B streptococci (GBS). Standard ISG provided minimal protection in suckling rats against type III GBS sepsis, whereas preparations of ISG modified for intravenous administration (MISG) provided significant protection against all strains of type III, type II and type Ia GBS tested. Although less protection was obtained against type la strains, the survival in suckling rats challenged with all types of GBS varied from 73 % to 91% with MISG therapy, as compared with 5% to 12% survival in untreated animals. In this in vivo model, MISG was protective even when administered after bacterial challenge, but had to be administered within 5 h of infection. MISG also had high in vitro opsonic activity against GBS types III and II, but was less effective with some type Ia strains. Just as MISG was more protective than ISG in vivo, it also was more opsonic in vitro. A detailed comparison of one lot of MISG with its parent ISG revealed that the modified preparation actually contained less IgG. When equivalent concentrations of affinity‐purified IgG from both preparations were tested, the IgG from MISG was significantly more opsonic. Since the affinity purification procedure eliminated the possibility that IgM or substances introduced in the modification process were actually responsible for the enhanced bactericidal activity, it appears that the individual IgG molecules in MISG may be more effective. These studies suggest that MISG which has been modified by reduction and alkylation for intravenous administration may provide a valuable adjunct to chemotherapy in the treatment of GBS disease in the neonate.
GROWTH IN EARLY CHILDHOOD OF NEWBORNS AFFECTED BY DISPROPORTIONATE INTRAUTERINE GROWTH RETARDATION
Authors: WALTHER F. J. , RAMAEKERS L. H. J.
Published: January 2008

ABSTRACT. A group of term newborns affected by disproportionate intrauterine growth retardation as expressed by a small ponderal index (100 × W/L3), was followed‐up with appropriate normally grown controls matched for age, sex, birth rank and social class. Despite catch‐up growth during the first 6 months after birth the study group was still underweight‐for‐length with lower mean skinfold measures at the age of 3 years in comparison with the controls. This indicates that, despite its late onset in pregnancy, disproportionate intrauterine growth retardation continues to influence growth in early childhood.
GROWTH AND DEVELOPMENT IN A GIRL WITH PSEUDOHYPOPARATHYROIDISM AND HYPOTHYROIDISM
Authors: de WIJN E. M. , STEENDIJK R.
Published: January 2008

ABSTRACT. Statural growth, physical and skeletal development of a girl with pseudohypoparathyroidism and primary hypothyroidism were analysed in a longitudinal study, which lasted for 12 years from the age of 0.8 years. Growth in height, which slowed down when thyroid therapy was withheld, was within the normal range. Still, as a result of early puberty, the girl became a small adult. Skeletal age was advanced over chronological years by an average of 2.7 years. This rapid skeletal development was more pronounced in the tubular bones than in the round bones of the hand. Two of the five metacarpals of the left hand grew more slowly than the others. This became clinically apparent at the age of 5.6 years. In all five metacarpals growth ceased at the same time, indicating that the abnormally short size of the two metacarpals did not result from early epiphyseal closure.
TRANSIENT ERYTHROBLASTOPENIA IN SIBLINGS
Authors: SEIP M.
Published: January 2008

ABSTRACT. A brother and sister with an age difference of 23 months developed transient erythroblastopenia of childhood (TEC) at 21 months and 19 months of age, respectively. The boy's illness followed an upper respiratory infection, while for his sister, it followed chicken pox. Both patients recovered rapidly during prednisone therapy. The question of a genetic predisposition for TEC in this family is raised.
TRANSIENT ACUTE LEUKAEMIA IN A NEWBORN WITH DOWN'S SYNDROME
Authors: BARAK Y. , MOGILNER B. M. , KAROV Y. , NIR E. , SCHLESINGER M. , LEVIN S.
Published: January 2008

ABSTRACT. A female newborn infant with Down's syndrome presented at birth with clinical and haematologic signs indistinguishable from acute lymphoblastic leukaemia. Specific therapy was withheld, and in contrast to the regular outcome of true congenital leukaemia, complete clinical and haematologic recovery occurred within one month of diagnosis. Cultures of bone marrow cells in the soft agar colony production assay exhibited normal growth pattern, in contrast to the‘leukaemic’pattern regularly seen in leukaemic patients and also in patients with Down's syndrome and true leukaemia. In vitro cultures of bone marrow cells can provide useful information about the likelihood of spontaneous resolution in newborns with Down's syndrome and transient acute leukaemia.
EFFECT OF PHOTOTHERAPY AND EXCHANGE TRANSFUSION ON PRIMARY BILE ACIDS IN THE SERUM OF HYPERBILIRUBINAEMIC NEWBORNS
Authors: FINNI KALEVI
Published: January 2008

ABSTRACT. Serum primary bile acid (cholic (CA) and chenodeoxycholic (CDCA) acid) concentrations were measured in 14 preterm and 11 full‐term hyperbilirubinaemic newborns at the beginning and end of, and 24 and 72 hours following phototherapy. Only in the preterm newborns with gestational ages of 35‐38 weeks there was a significant decrease of mean serum bile acid concentrations which could be shown 72 hours after the beginning of phototherapy. It can be hypothesized that the decrease was a result of a direct effect of light on the excretory liver function. Serum CA and CDCA concentrations were also measured in 5 hyperbilirubinaemic newborns at the beginning and end, and 24, 48 and 72 hours after the end of exchange transfusion. Exchange transfusion caused a clear immediate decrease in the mean serum primary bile acid concentrations. However, on day 2 after exchange transfusion the mean serum concentration of CA was about 150% and that of CDCA about 110% of the initial values. The most hyperbilirubinaemic newborns had extremely high primary bile acid serum concentrations before therapy. As bile acids compete with bilirubin for albumin binding it should be considered whether high bile acids in the serum of hyperbilirubinaemic newborns presuppose exchange transfusions.
MECONIUM SCREENING FOR CYSTIC FIBROSIS An Eight‐Year Follow‐Up Study
Authors: HELLSING K. , BARRLJUNG K. , CEDER O. , KOLLBERG H.
Published: January 2008

ABSTRACT. The results of more than eight years of screening for cystic fibrosis (CF), utilizing the albumin concentration in meconium, are reported. Over 28 000 meconium samples were tested, over 24 000 of them by the Boehringer‐Mannheim strip test, and all samples considered as showing a trace or positive result were followed up by an immunological technique. Eighty‐three meconium samples contained more than 20g albumin/kg dry weight meconium and five of these were from children who were found to have CF. One child with CF was missed in the screening. From these figures the sensitivity of the method for detecting CF children at birth was calculated to be 75%, the specificity 99.7%, the negative predictive value 100%, the positive predictive value 4.0% and the incidence of CF in Sweden about 1: 4,500. The incidence of pathologically elevated meconium albumin concentrations was found to be 25 times higher in premature than in fullterm infants. Since the number of false positive results creates a problem, we suggest that premature children (birth weight <2500 g) and newborns with melaena should be excluded from further follow‐up studies.
RENAL FUNCTION IN CYSTIC FIBROSIS WITH SPECIAL REFERENCE TO THE RENAL SODIUM HANDLING
Authors: BERG U. , KUSOFFSKY E. , STRANDVIK B.
Published: January 2008

ABSTRACT. Renal function was studied in 16 patients with cystic fibrosis, aged 5 to 19 years. The mean glomerular filtration rate and filtration fraction were increased compared to those in controls. Basal urinafy sodium excretion as well as renal responses to oral and intravenous sodium loads were low, indicating an increased renal sodium reabsorption. Diluting capacity, measured as free water clearance, was decreased because of a low distal sodium delivery which might indicate an increased proximal sodium reabsorption.
BRAIN OEDEMA IN NEONATAL SEIZURES: THE VALUE OF COMPUTED TOMOGRAPHY IN THE EARLY DIAGNOSIS AND FOLLOW‐UP
Authors: WEITZ R. , MATZ S. , MERLOB P. , REISNER S. H.
Published: January 2008

ABSTRACT. Marked unilateral brain oedema was demonstrated by cranial computed tomography in a newborn who had multiple focal seizures on the 3rd and 4th days of life. Cerebral atrophy in the previously oedematous area developed by 8 months. The occurrence of brain oedema and subsequent atrophy in neonatal seizures seems to be a strong reason for early CT scanning and appropriate therapy in convulsing neonates.
NON‐DYSTROPHIC, MYOGENIC MYOPATHIES WITH ONSET IN INFANCY OR CHILDHOOD
Authors: GAMSTORP I.
Published: January 2008

ABSTRACT. Some “congenital stationary muscle diseases” and some myopathies with known metabolic or endocrine background are reviewed. The clinical picture is described as well as the histological picture in the muscle, the diagnostic and differential diagnostic considerations and procedures, and–when available–the treatment.
INCIDENCE OF CHILDHOOD LEUKEMIA IN SWEDEN 1975‐1980
Authors: GUSTAFSSON G. , KREUGER A.
Published: January 2008

ABSTRACT. During the six‐year period 1975‐1980, leukemia was diagnosed in 466 children in Sweden, giving an estimated incidence of 4.4/100000 children per year (0‐15 years at diagnosis). The incidence of acute lymphoblastic leukemia (ALL) was 3.7, of acute nonlymphocytic leukemia (ANLL) 0.6 and of chronic myelocytic leukemia (CML) 0.1/100000 children per year. The over all incidence among boys was 4.5/100000 per year and among girls 4.2. The male:female ratio was 1.13. This ratio was 1.22 in ALL and 0.71 in ANLL. Fifty per cent of the children were below 5 years of age at diagnosis, with a pronounced peak between 2‐3 years, which was explained by the ALL distribution. In children with acute leukemia 13% had WBC values of >100×109l, 4% had CNS leukemia and 10% had a mediastinal mass at diagnosis. The geographical distribution of leukemia in Sweden was analysed in a search for clusters of cases.
THE AMOUNT OF MILK CONSUMED BY 1‐3 MONTHS OLD BREAST‐ OR BOTTLE‐FED INFANTS
Authors: HOFVANDER Y. , HAGMAN U. , HILLERVIK C. , SJÖLIN S.
Published: January 2008

ABSTRACT. The consumption of breastmilk was studied by the weighing method in 75 infants aged 1, 2 and 3 months (±1 week), 25 infants in each group. Similarly the same number of infants in the same age groups, bottle‐red ad libitum, was studied and the consumption and consumption pattern were compared between the two groups. The mean and range of consumed amounts of both types of milk were similar to that found in other studies. The means for breastmilk were 656‐773‐776 g and for breastmilk substitutes 713‐811‐853 g in the 1, 2 and 3 months infants, respectively, but with wide variations. When expressed as kcal/kg it appeared to be practically no difference between the two feeding groups. The bottle‐fed infants had fewer meals and had a more even consumption from meal to meal. It is concluded that infants largely regulate themselves the intake they require.
LONG TERM PULMONARY CONSEQUENCES OF OESOPHAGEAL ATRESIA WITH TRACHEO‐OESOPHAGEAL FISTULA
Authors: COURIEL J. M. , HIBBERT M. , OLINSKY A. , PHELAN P. D.
Published: January 2008

ABSTRACT. Lung function was studied in 20 children, aged 8‐17 years, who had successfuly repaired oesophageal atresia with tracheo‐oesophageal fistula. Spirometry and plethysmography showed mild restrictive lung disease. Airways obstruction was assessed using maximal expiratory and inspiratory flow‐volume loops in air and after breathing a helium‐oxygen mixture. Analysis of the flow‐volume data demonstrated significant obstruction at the level of the trachea and little evidence of small airways disease. Bronchial hyperreactivity, as assessed by histamine challenge, was present in 22% of subjects. Respiratory and oesophageal symptoms were common, but decreased in frequency with increasing age. The mechanisms involved in the frequent respiratory symptoms these children suffer are discussed in the light of the physiological findings.
CATCH‐UP GROWTH FOLLOWING LONG‐TERM ADMINISTRATION OF ESSENTIAL FATTY ACIDS IN A GIRL WITH GROWTH FAILURE AND ESSENTIAL FATTY ACID DEFICIENCY
Authors: HEYMANS H. S. A. , HEUVEL C. G. VAN DEN , SMIT W. , STEENDIJK R.
Published: January 2008

ABSTRACT. A 10‐year‐old girl with benign recurrent intrahepatic cholestasis, malabsorption of fat, growth failure (growth rate 1.2 cm/year) and deficiency of essential fatty acids (EFA) is described. Long‐term administration of EFA, mainly by cutaneous application of sunflower seed oil, was followed by a remarkable catch‐up growth (23.8 cm in 3.5 years) while the serum values for EFA improved. Since no other changes in the therapeutic regimen occurred and other causes of growth failure and subsequent acceleration of growth could be ruled out, it is highly probable that the observed increase in growth rate was the result of the administration of EFA.
IV. Effects of Silver Nitrate Prophylaxis on Mother‐Infant Relationship
Authors: WAHLBERG V. , LUNDH W. , WINBERG J.
Published: January 2008

The effects of silver nitrate versus Hexarginum on maternal behaviour during care and breast‐feeding were examined in a double‐blind study of 65 mother‐infant pairs. Observations and interviews took place on day 4 or 5 post partum. A follow‐up interview was conducted 6–8 weeks later. The Neonatal Perception Inventories (Broussard) were used on both occasions. Mothers of infants in the silver nitrate group had significantly less eye contact with their newborns during breast‐feeding than those in the Hexarginum group. This difference was even greater for mothers with complicated deliveries. Since eye‐contact behaviours were infrequent, the results should be judged with caution. The maternal attitude towards the child, delivery, and post‐partum care as expressed at 4–5 days and at 6 weeks did not differ between the groups. The frequency of breast‐feeding at 6 weeks was similar. Eye prophylaxis was administered about 2 hours after birth and rooming‐in was practised in the maternity wards. It is discussed whether the postponed Credé prophylaxis and other contact‐facilitating routines contributed to lessen possible adverse effects of the silver nitrate prophylaxis.
BLOOD LEVELS OF CRITICAL AMINO ACIDS IN VERY LOW BIRTHWEIGHT INFANTS ON A HIGH HUMAN MILK PROTEIN INTAKE
Authors: LINDBLAD B. S. , HAGELBERG S. , LUNDSJÖ A.
Published: January 2008

Lindblad, B. S., Hagelberg, S. and Lundsjö, A. (Department of Paediatrics, Karolinska Institute, St. Göran's Children's Hospital, Stockholm, Sweden). Blood levels of critical amino acids in very low birthweight infants on a high human milk protein intake. Acta Paediatr Scand, Suppl. 296: 24, 1982. — A method for a semi–industrial production of human milk subfractions (human milk protein and human milk fat isolates) is described. Four very low birthweight (VLBW) newborn were given a human milk protein isolate added to the mother's own fresh expressed milk in addition to sodium chloride up to 20 mEkv/liter. Growth followed the intrauterine growth curve. Urea levels did not increase in spite of providing a double‐normal protein intake. There was no metabolite acidosis and the blood levels of free amino acids determined with a micro‐method did not exceed those seen after a normal meal. The concentrated human milk protein product showed a considerable specific sIgA activity against E. coli 0‐antigen. It seems possible to use similar “lacto‐engineering”‐techniques in order to satisfy the increased protein requirements of the VLBW infant, while providing the caloric requirements, without causing any visible disturbance of blood‐homeostasis of urea, amino acids or base excess. The method could provide knowledge about the “human milk protein requirements” and a controlled study has been started.
TAURINE IN THE NUTRITION OF THE HUMAN INFANT
Authors: GAULL G. E.
Published: January 2008

Gaull, G. E. (Department of Human Development and Nutrition, Institute for Basic Research in Developmental Disabilities and Department of Pediatrics, Mount Sinai School of Medicine of the City University of New York). Taurine in the nutrition of the human infant. Acta Paediatr Scand, Suppl. 269:38, 1982. — The precise biological role of taurine is unknown apart from its conjugation with bile acids and xenobiotics. Evidence is accumulating, however, that taurine may have a more general biological role in development and membrane stability. Furthermore, there is a dietary requirement for taurine in the human infant. Whether or not it is “essential” in man, awaits further study.
BODY WATER METABOLISM IN EARLY INFANCY
Authors: FRIIS‐HANSEN B.
Published: January 2008

Friis‐Hansen, B. (Department of Neonatology, University Hospital, Rigshospitalet, Copenhagen, Denmark). Body water metabolism in early infancy. Acta Paediatr Scand, Suppl. 296:44, 1982.—A short survey is given over water metabolism from early fetal life to infancy. The close connection between water metabolism and body composition is described as well as the changes taking place during growth. The impact of intrauterine malnutrition, delivery and postnatal nutrition is discussed, and it is pointed out how the premature infant differs from the full‐term infant.
THE MUCOSAL IMMUNE RESPONSE IN THE NEONATE
Authors: HANSON L. Å. , BRINTON C. , CARLSSON B. , DAHLGREN U. , MELLANDER L. , SUTTON A. , SÖDERSTRÖM T.
Published: January 2008

Hanson LÅ, Brinton C, Carlsson B, Dahlgren U, Mellander L, Sutton A and Söderström T. (Departments of Clinical Immunology and Paediatrics, University of Göteborg, Sweden, Bureau of Biologies, FDA, Bethesda, and Department of Life Sciences, University of Pittsburg, USA). The mucosal immune response in the neonate. Acta Paediatr Scand, Suppl. 296:53, 1982. — Human infants are relatively deficient in the IgA system defending mucosal membranes, but are provided via the maternal milk with considerable amounts of SIgA directed against microbes and food antigens to which both mother and infant are exposed. It is possible that serum antibodies may support the mucosal defense as do the lactoferrin, lysozyme and other defense factors present in the milk.
BILE ACID METABOLISM IN LOW BIRTHWEIGHT INFANTS
Authors: STRANDVIK B.
Published: January 2008

Strandvik, B. (Department of Paediatrics and Research Center, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden). Bile acid metabolism in low birth weight infants. Acta Paediatr Scand, Suppl. 296: 71, 1982.—The early synthesis of bile acids is described. From 28 weeks of gestation cholic acid is the predominating bile acid, but the bile acid pool is very small in preterm infants, leading to a low intraduodenal concentration of bile acids, especially during digestion of meals. Preliminary results indicate that preterm infants excrete less cholic and more 3β0H5‐cholenoic acid in the urine than fullterm infants indicating a functional minor pathway in the synthesis of chenodeoxycholic acid. The tetrahydroxylated bile acids, which tend to dominate in the urine of newborn, have been shown to be products of the most common bile acid in cholestatic adults, and may thus be the result of a “physiological cholestasis” in the newborn.
CRITICAL VITAMINS FOR LOW BIRTHWEIGHT INFANTS
Authors: ORZALESI M. , COLARIZI P.
Published: January 2008

Orzalesi, M. and Colarizi, P. (Department of Child Health, University of Sassari and the Department of Paediatrics, University of Rome, Italy). Critical vitamins for low birthweight infants. Acta Paediatr Scand, Suppl. 296: 00, 1982.—All vitamins are “critical” by definition for the growing infant. However, some of them are particularly relevant to the preterm or low birthweight (LBW) infant in whom a deficiency can occur more frequently than in a full‐term newborn. In LBW infants vitamin deficiency may develop due to (1) low body stores at birth, (2) low intake, (3) limited absorption, (4) increased need or utilization, (5) presence of certain clinical conditions. The first reason concerns all lipid‐soluble vitamins, and particularly vitamin E and K, which cross the placenta with some difficulty. Among hydro‐soluble vitamins, cord‐blood levels of vitamin B6 have been shown to be abnormally low in preterm infants. Low intake can occur because of low vitamin levels in milk or because of delayed and/or insufficient feeding. Limited intestinal absorption of vitamins in LBW infants has only been demonstrated for vitamin E and folic acid. The rapid post‐natal growth may lead to increased vitamin utilization. In some clinical conditions particularly high intakes of certain vitamins are indicated. In our opinion, the really “critical” vitamins in LBW infants are vitamin D, E, K and folic acid, for which routine supplementation can be recommended, and possibly vitamins C and B6 under special circumstances.
AGGLUTININS IN CHILDREN VACCINATED WITH THE DPT VACCINES USED IN FINLAND, SEROTYPES OF BORDETELLA PERTUSSIS STRAINS ISOLATED DURING WHOOPING COUGH EPIDEMICS IN 1976–1977 AND WHOOPING COUGH ATTACK RATE IN CHILDREN IN THE EPIDEMIC AREAS.
Authors: Huovila R , Kuronen T , Jännes L , Hallman N.
Published: January 2008

The purpose of this study was to find an answer to the question of why whooping cough cases occur in Finland in spite of the high acceptance rate of DPT vaccine.

To this end agglutinins 1,2 and 3 were determined in children vaccinated in 1962–1976 with vaccine A, manufactured by the National Public Health Institute, Helsinki. The amount of agglutinins 1 and 2 was unmeasurable, while an agglutinin 3 titre of±40 was obtained in 9/14(64%). This vaccine contains strain no. 18 530, which is serotype 1.2.3.

Vaccine B from the same manufacturer contains strains 18 530 and 1 772, both of which are serotype 1.2.3. In children vaccinated with vaccine B since 1976 the agglutinin 1 titre was±20 in 14/18 (78%) cases. A similar titre of agglutinin 2 was obtained in 14/19 (74%) of cases and of agglutinin 3 in 5/19 (26%). A titre of±40 was obtained for agglutinin 1 in 4/18(22%) cases, for agglutinin 2 in 5/19 (26%) cases and for agglutinin 3 in 14/19 (74%) cases.

Of the Bordetella pertussis strains isolated during two whooping cough epidemics in 1976–1977, 83 were serotyped. All these strains were serotype 1.2.

The whooping cough attack rate was estimated in 242 incompletely and 44 completely vaccinated children during the epidemics in question. Of the incompletely vaccinated children 188/242(78%) contracted whooping cough and 54/242(22%) remained healthy. Of the completely vaccinated children 17/44(38%) contracted whooping cough and 27/44(62%) remained healthy.
ADVERSE REACTIONS IN CHILDREN VACCINATED WITH DPT AND PERTUSSIS VACCINE
Authors: Riitta Huovila
Published: January 2008

A total of 508 children were vaccinated with DPT vaccine (Lot 76 327). The vaccination policy was that basic DPT vaccination started at the age of three months and three injections were given at one‐month intervals. In another 370 cases pertussis vaccine (Lot 76 012) was given. In these, vaccination started at the age of five weeks and three injections were given at four‐week intervals. In the children basically vaccinated with DPT vaccine some local reactions occurred in 26/508(5.1%) cases and systemic reactions in 48/508(9.4%). In the children basically vaccinated with pertussis vaccine local reactions occurred in 13/370(3.5%) cases and systemic reactions in 33/370(8.9%).

Booster vaccination with DPT vaccine (Lot 76 327) was given to 565 children aged one–6 years, while 138 children aged 2–6 years were booster vaccinated with pertussis vaccine (Lot 76 012). The children booster vaccinated with DPT vaccine exhibited some local reactions in 118/565(20.9%) cases and some systemic reactions in 53/565(9.3%). In the children vaccinated with pertussis vaccine local reactions occurred in 14/138(10.1%) cases and systemic reactions in 7/138(5.1%). None of the vaccinated children developed any severe neurological or systemic complications from vaccination.

DPT and pertussis vaccine contain equal amounts (about 5 000 million cells/ml vaccine) of the Bordetella pertussis strains 18 530 and 1 772 and aluminium hydroxy phosphate as adjuvant. One dose vaccine was 0.5 ml.
WATER—THE MAJOR NUTRIENT
Authors: FRIIS‐HANSEN B.
Published: January 2008

Friis‐Hansen, B. (Department of Neonatology, University Hospital, Rigshospitalet, Copenhagen, Denmark). Water—the major nutrient. Acta Paediatr Scand, Suppl. 299: 11, 1982.—Water metabolism is a major problem in infants of very low birth weight. Their surface is proportionally larger, they have a relatively low intracellular water volume and a high extracellular and total body volume. Kidney function is immature compared to bigger infants, and the neuroendocrine function is also immature. Finally the large surface and the high skin permeability causes a very high insensible water loss in the early neonatal period. Water imbalance presents itself as either dehydration or overhydration. Dehydration gives poor peripheral—and renal circulation and thereby decreased renal function with acidosis. Furthermore hyperosmolar dehydration will give increased hematocrit and blood viscosity and hyperbilirubinaemia. Excessive administration of water will give oedema and congestive heart failure and possibly an increased risk for patent ductus arteriosus, broncho‐pulmonal dysplasia and necrotising enterocolitis. The evaporative water losses varies according to the thermal environment and air humidity and it is therefore impossible to give narrow limits for the daily water intake. Clinical examination, frequent controls of body weight (twice daily) and measurements of urine volume and osmolarity serve as guide lines. Yet inappropriate secretion of ADH may confuse the value of measuring urine osmolarity. Finally a neonatal weight loss of 5‐10 % may be beneficial as a decrease in extracellular water may lessen the working load of the heart and therefore possibly lessen the risk for a patent ductus. Renal immaturity in handling sodium reabsorption on the other hand, will often give an excessive dehydration. For this reason about 2 mmol Na/kg body weight should be given daily to very low birth weight infants from the fourth day of life to the 3rd‐4th week if the baby is on human milk or a low salt formula.
FOOD AND METABOLISM IN INFANCY The relationships of plasma amino acids as an indicator of the adequacy of protein intake
Authors: HEIRD WILLIAM C. , B.DELL RALPH , WINTERS ROBERT W.
Published: January 2008

Heird, W. C., Dell, R. B. and Winters, R. W. (Department of Pediatrics and Institute of Human Nutrition, Columbia University College of Physicians & Surgeons, New York). Food and metabolism in infancy. Acta Paediatr Scand, Suppl. 299: 24, 1982.—Published plasma amino acid data from normally‐growing term and preterm infants fed varying quantities of protein as well as proteins of varying quality were examined in an effort to assess the efficacy of these data as indicators of the adequacy and/or inadequacy of protein intake. Although the absolute plasma concentrations of most amino acids vary considerably, all sets of data from term infants, with exception of those from infants fed inadequate protein or inordinately large quantities of protein, when expressed as the ratio of TEAA/TAA and ind. EAA/TEAA, are remarkably similar. Despite variations in absolute plasma amino acid concentrations of as much as 60 %, for example, fasting and postprandial TEAA/TAA and ind. EAA/TEAA ratios are similar. The plasma TEAA/TAA ratio of infants fed a low protein intake (1.1 g/kgd) is low but this ratio is similar in plasma of infants fed either 3.0‐3.5 g/kgd or 9 g/kgd. Ind. EAA/TEAA ratios, on the other hand, are the same in plasma of infants fed either 1.1 or 3.0‐3.5 g/k ‐ d but some are dramatically higher in plasma of infants fed a protein intake of 9.0 g/kgd. Although ind. EAA/TEAA ratios vary somewhat as a function of the quality of protein intake, this variation is not nearly as great as that of the intake ratios. Finally, the relatively constant plasma ratios of TEAA/TAA and ind. EAA/TEAA are remarkably similar to those of the tissue deposited during normal growth. These observations support the hypothesis that the various enteric, hepatic and other mechanisms which determine the amino acid composition of plasma have as their target these relationships among various amino acids rather than absolute plasma concentrations of the various amino acids. If so, it follows that maintenance of these relationships may be an important factor for optimal protein synthesis. If these hypotheses prove to be correct, an appropriate criteria for efficacy of alternative feeding regimens chosen for the infant who is not or cannot be breast fed is whether or not this regimen overwhelms the mechanisms responsible for maintaining these apparent relationships among the amino acids in plasma.
HOW MUCH BREAST MILK DO BABIES NEED?
Authors: WHITEHEAD R. G. , PAUL ALISON A. , COLE T. J.
Published: January 2008

Whitehead, R. G., Paul, A. A. and Cole, T. J. (MRC Dunn Nutrition Unit, Cambridge, U.K.). How much breast milk do babies need? Acta Paediatr Scand, Suppl. 299: 43, 1982.—A reassessment of the breast milk requirements of young babies at different ages has been made from a statistical analysis of energy intake data collected prospectively in Cambridge, U.K. and from data derived from a literature survey of cross‐sectional food energy intakes of infants from Canada, Sweden, the U.K. and USA. In contrast to the slow progressive linear decline in energy requirements per kg body‐weight that has previously been assumed, measured intakes have been shown to fall more rapidly in the first six months of life. Thereafter they then rise again as the baby becomes more active. These findings are of fundamental importance to a realistic assessment of the adequacy of breast milk as the sole source of food in the first six months of life. The data show that typical breast milk intakes found in the industrialized countries can satisfy infant energy needs for healthy growth for much longer than would be indicated by current international dietary recommendations. A discussion of the physiological interpretation of the results is included as is an appraisal of their practical significance both to breast and bottle feeding practices.
DIAGNOSIS AND MAIN CLINICAL FEATURES OF CYSTIC FIBROSIS WITH SPECIAL ATTENTION TO SCREENING PROCEDURES
Authors: KOLLBERG HANS
Published: January 2008

Kollberg, H. (Department of Paediatrics, University of Umeå, Umeå, Sweden). Diagnosis and main clinical features of cystic fibrosis with special attention to screening procedures. Acta Paediatr Scand 1982; suppl 301:15‐25. – The diagnosis of cystic fibrosis (CF) must be based on a combination of clinical observations of all symptoms and the results of laboratory tests. The numerous symptoms from the respiratory and gastrointestinal tracts and from the sweat glands are briefly described and the specific diagnostic tests referring to these systems are enumerated. CF is a common disease which constitutes a substantial problem both for the individuals concerned and for the community. Screening most probably would result in an improvement for the early diagnosed patients with respect both to survival and to physical function. The society has the means to provide resources both for confirming the diagnosis and for providing complete long‐term therapy for CF patients, but the diagnostic and therapeutic possibilities need to be organized more firmly. Alternative ways of diagnosis other than screenning are unsatisfactory and lead to a diagnostic delay which most probably is detrimental for the patient. Promising screening tests are on the way; the test for trypsin in serum, in particular, seems to be specific, non‐injurious to the patient and applicable to all newborns in countries with Caucasian populations, but it remains to be seen whether it is sufficiently sensitive and inexpensive. It is concluded that CF is a top ranked candidate for general screening in the neonatal period and further intensive studies in this field must get every support. The multicentre study for screening, proposed and supported by ICF(M)A is heartily welcomed.
PROGNOSIS FOR SURVIVAL WITH CYSTIC FIBROSIS: THE EFFECTS OF EARLY DIAGNOSIS AND CYSTIC FIBROSIS CENTER CARE
Authors: WARWICK WARREN J.
Published: January 2008

Warwick, W.J. (Department of Pediatrics, University of Minnesota Hospitals, Minneapolis, Minnesota, 55455, U.S.A.) Prognosis for survival with cystic fibrosis: the effects of early diagnosis and cystic fibrosis center care. Acta Paediatr Scand 1982; suppl 301: 27‐31. — Improved diagnosis, i.e. more cystic fibrosis (CF) patients diagnosed at an early age, is possible but will require a great increase in the sensitivity of physicians, providing care for infants and young children, to the possibility that early symptoms could be CF at a time a baby is “too well to have CF” coupled with a simple fast screening type of sweat test. Prognosis for survival for CF patients treated at CF Centers is improved with early diagnosis but the data concerning newborn screening are still too few. The general care of CF patients around the world in the absence of a CF Center shows expected survival of 50 percent to 4 or 5 years of age; addition of a CF Center and a CF Care Team increases that 50 percent survival to 20 years. Improvement in early diagnosis or newborn screening is needed to reduce the number of CF patients who die undiagnosed. CF Center and CF team care increases the survival age of CF patients by 4 to 6 times. Early diagnosis before pulmonary complications have begun more than double the effectiveness of CF Center care. In Denmark, the Paediatric Department TG provides the leadership and training and clinical care and research needed to maintain progress and to improve upon the prognosis for CF. Data from Denmark obtained through the central Danish CF Registry confirm in Denmark these observations from around the world of the benefits of early diagnosis and center treatment.

Improvement in early diagnosis or discovery of and general adoption of a newborn screening program is what is needed to reduce the number of CF patients who die undiagnosed. CF Center and CF Team care increases the survival age of CF patients by 4 to 6 times. Early diagnosis before pulmonary complications have begun more than double the effectiveness of CF Center care. In Denmark, the Paediatric Department TG provides the leadership and training and clinical care and research needed to maintain progress and to improve upon the prognosis for CF.