bluuebunny/crossref_metadata_2025 huggingface dataset:
Children with Asthma: How Do They Get Along at School?
Authors: BREMBERG S. G. , KJELLMAN N.‐I. M.
Published: January 2008

ABSTRACT. All 13 653 children, aged 7–15 years, enrolled in the comprehensive schools of Linköping were investigated with respect to asthma. A questionnaire was sent to 329 pupils, identified with asthma by school nurses. Out of these, 210 (1.5 %) stated symptoms during the previous year and they were further studied. Their disease was graded with respect to the stated number of restricted days during the previous year. Grade 1: no restriction (21.4 %), grade 2: 1–9 days (36.7 %), grade 3: 10–99 days (39.1 %) and grade 4: 100 days or more (2.9 %). Prescribed drugs were used daily by 43.3 %. The median time of absence from school due to asthma was 3 days/year. During physical education 78 % had been restricted, during arts and crafts 12 % and during other lessons 11%. School districts were ranked with respect to absence, restriction, perceived understanding of asthma and dustiness. Rank correlation coefficients were significant for absence/restriction and understanding.
Early Neonatal Deaths in Geographically Defined Populations with Different Organization of Medical Care
Authors: EKSMYR R. , EKLUND G.
Published: January 2008

ABSTRACT. A comparison of early neonatal deaths was performed in fourteen Swedish referral districts over six years (1973–1978). Two populations of newborn infants were compared: those born of mothers resident in referral districts of general hospitals with specialized obstetric service but without own neonatal wards; and those born of mothers living in districts of central hospitals with specialized obstetric and neonatal care in the same hospital. The early neonatal death rates of these two populations did not differ significantly. However, a tendency was observed indicating a lower mortality in the former group, necessitating further analysis.
Two Geographically Defined Populations with Different Organization of Medical Care
Authors: EKSMYR R.
Published: January 2008

ABSTRACT. Two geographically defined samples with different perinatal health services were compared concerning certain perinatal risk factors. Differences in maternal age, parity, gestational length and birth weight distributions existed but could not explain an observed difference in early neonatal mortality being lower in districts served by general hospitals with specialized obstetric care but without own neonatal wards than in districts served by central hospitals with both these facilities. Other population‐related variables are also discussed.
Progressive Muscular Dystrophy in Denmark
Authors: LETH A. , WULFF K. , CORFITSEN M. , ELMGREEN J.
Published: January 2008

ABSTRACT. Prevalence of progressive muscular dystrophy in 1965 and incidence in Denmark for the period 1965 to 1975 was studied by collection of data from hospital departments, nursery homes and general practitioners. This material was supplemented with information from death certificates and disablement pension records. Total patient group included 445 patients with progressive muscular dystrophy alive January 1st 1965. Prevalence was 69.4 per 106 male inhabitants in the Duchenne type, whereas the prevalences in the limb‐girdle and facioscapulohumeral types were 36.5 and 18.6 per 106 inhabitants, respectively. Incidence was 222 per 106 male newborns in the Duchenne type, 66 and 26 per 106 newborns for the limb‐girdle and the facioscapulohumeral types, respectively. Figures for the Duchenne type are in agreement with previous results. Both prevalence and incidence rates for the limb‐girdle and the facioscapulohumeral types exceed published figures by a factor 3 to 6. These high Danish rates seem to reflect the true prevalence and incidence in the less serious types of progressive muscular dystrophy, probably because the Danish health system with free medical care and easy access to specialized hospital departments makes it possible to identify all cases of progressive muscular dystrophy.
Selenium Supplementation in X‐linked Muscular Dystrophy
Authors: GEBRE‐MEDHIN M. , GUSTAVSON K.‐H. , GAMSTORP I. , PLANTIN L.‐O.
Published: January 2008

ABSTRACT. The selenium concentrations in serum and erythrocytes and the erythrocyte glutathione peroxidase activity were determined in 15 boys with the Duchenne type and in 5 boys with the Becker type of X‐linked muscular dystrophy before and during long‐term selenium and α‐tocopherol supplementation and compared with values in unsupplemented controls. The purpose of the treatment was to improve the muscular strength. Twelve of the 20 patients had pretreatment levels of selenium in serum that were within the 95 % confidence limit of the unsupplemented control children. The values in 2 patients, both with the Duchenne type of muscular dystrophy, fell below this level. Selenium supplementation in a daily dose of 6 μg/kg/day for 6 months caused a substantial rise in both serum and erythrocyte selenium, suggesting suboptimal pretreatment body contents of selenium. The greatest increases in both serum and erythrocyte selenium were observed in subjects with initially low selenium levels. Only in 4 of the 20 patients did the selenium supplementation result in a significant rise in erythrocyte glutathione peroxidase activity. As no sure improvement was noted in muscular strength during this treatment period, the Se dose was increased to 20 μg/kg/day. This resulted in a further rise in both serum and erythrocyte selenium, but not in erythrocyte glutathione peroxidase activity.
A National Survey of Severe Group B Streptococcal Infections in Neonates and Young Infants in Denmark, 1978–83
Authors: CARSTENSEN H. , HENRICHSEN J. , JEPSEN O. B.
Published: January 2008

ABSTRACT. During a six‐year period, 1978–83, 80 cases of culture proven group B streptococcal (GBS) bacteraemia and meningitis were identified in neonates and young infants up to 12 weeks of age in a national retrospective survey. Two thirds (68 %) were early onset disease (EOD) while one third was late onset disease (LOD) occurring later than the seventh day of life. The overall incidence for the period was 0.24 per 1000 live‐born with a trend towards decline through the period. EOD was associated with low birthweight, twin delivery and congenital anomalies as well as with obstetric risk factors like premature or prolonged rupture of membranes and intrapartum fever. The overall case fatality rate was 23 %, both in EOD and LOD. Seven (11 %) of the surviving infants, six of whom had had meningitis, developed neurological sequelae. Newborns that showed signs of infection with 12 hours of delivery were at a significantly higher risk of running a fulminant course than newborns whose infections developed later (p=0.02). Nosocomial transmission of GBS seemed limited and most hospital‐acquired cases were unconnected.
Isosexual Precocious Puberty in Girls
Authors: LYON A. J. , DE BRUYN ROSE , GRANT D. B.
Published: January 2008

ABSTRACT. This paper reviews the clinical findings, pituitary gonadotrophin reserve and plasma oestradiol, neurological findings and pelvic ultrasound appearance in 47 girls with precocious puberty starting before the age of 7 years. Of the 39 girls who had air encephalograms or cranial CT scans, 19 showed intracranial abnormalities (hamartomas 11; hydrocephalus 5; optic glioma 2; arachnoid cyst 1). There was no significant difference in the peak serum luteinizing hormone and follicle‐stimulating hormone responses to intravenous gonadotrophin stimulating hormone in girls with and without intracranial lesions. Pelvic ultrasound examination showed development of the ovaries, uterus, and vagina similar to that seen in normal puberty. Treatment with cyproterone acetate (50‐100 mg/day) in 26 girls resulted in arrest of breast development and suppression of menstruation, but a definite effect on growth was not documented.
I. Extra Early Physical Contact and Aspects of the Early Mother‐Infant Relationship
Authors: TAYLOR P. M. , TAYLOR F. H. , CAMPBELL S. B. , MALONI J. A. , CANNON M.
Published: January 2008

ABSTRACT. We tested the hypothesis that extra early physical contact between mother and infant enhances aspects of their early relationship. Healthy, middle‐class mothers and their healthy, firstborn, singleton infants delivered vaginally at full‐term were randomly assigned to receive either regular contact (RC; N=39) or extra early physical contact (EC; N=39) following delivery. RC infants remained in cribs beside their mothers’beds, while EC infants and mothers had a mean of 46 min of physical contact in the recovery room.

There was no difference between EC and RC subjects for the following outcome measures: amount of time mothers chose to have infants with them during the postpartum hospital stay; quality of mother‐infant interaction at two days and one month; concern mothers expressed for the infant at one month; mothers’perception of their postpartum adjustment; mothers’perception of the infant at two days and one month, and of the infant's temperament at eight months; and extent of mothers’assisting with and soothing the child during a physical examination at 13 months. EC children cried significantly less during the examination at 13 months. These findings do not support the hypothesis that extra early physical contact between mother and infant enhances their relationship.
Blood pressure in childhood and adolescence. Results from an international collaborative study on juvenile hypertensiona
Authors: GYÁRFÁS I.
Published: January 2008

ABSTRACT. A total of 17,130 children of both sexes born in 1964 and living in Hungary, USSR, GDR and Cuba were examined in 1977. The children were grouped in upper (U) and lower (L) blood pressure groups and 3,640 children were re‐examined in 1978–1981. The parents’age, smoking habits, marital status, the children's order of birth, number of siblings, and proportion of twins did not differ between U and L. The prevalence of hypertension and diabetes in the medical history of the children, and the prevalence of hypertension and stroke and diabetes in the medical history of the parents were significantly higher in U than in L. Signs of left ventricular hypertrophy and systolic murmurs, the magnitude of R and S waves in the ECG, and mean values of cardiothoracic and heart volume indices were higher in U than in L. Children in U were sexually more developed, taller, more obese (greater Quetelet's index and skinfold thickness) and less active physically. Average values of blood sugar and serumuric acid were also higher in U than in L. No difference was found between the two groups in the proportion of smokers and in mean cholesterol values. These differences between U and L were strengthened in comparison of children who showed repeatedly low (below the 30th percentile) or high (at or above the 70th, 90th and 95th percentile) readings in the SBP and DBP distribution curves. Since we did not find important differences when we related various factors to blood pressure taken on one or two separate occasions we emphasize the importance of casual blood pressure measurement in childhood.
Atherosclerosis precursors in Finnish children and adolescents. VI. Serum apolipoproteins A‐I and B
Authors: SOLAKIVI‐JAAKKOLA T. , NIKKARI T. , VIIKARI J. , ÅKERBLOM H. K. , RÄSÄNEN L. , UHARI M. , DAHL M. , LÄHDE P.‐L. , PESONEN E. , PIETIKÄINEN M. , SUONINEN P.
Published: January 2008

ABSTRACT. The concentrations of apolipoproteins A‐I and B were determined in 1,341 3‐ to 18‐year‐old children and adolescents from five urban and 12 rural communities. The analyses were made with radial immunodiffusion. The mean concentrations (± S.D.) of apo A‐I and apo B were 152 ± 25 and 94 ± 22 mg/100 ml. respectively. 3‐year‐old children had the highest apo B levels which then decreased with advancing age in both sexes. Boys tended to have lower levels of apo B than girls. Apo A‐1 concentration was significantly higher in the 9‐ and 12‐year‐old boys than in the other age groups but showed no age‐bound trend in girls. The apo A‐I to apo B ratio increased with age in both sexes. The concentration of apo A‐I was significantly lower, and that of apo B higher, in children living in eastern Finland in comparison with those from the western part of the country. This difference and a higher HDL‐cholesterol to apo A‐I ratio in both sexes in eastern Finland may be asSociated with the regional differences in the prevalence of coronary heart disease in this country. Key words: adolescents, apolipoproteins, apo A‐I, apo B, children, serum lipids.
Atherosclerosis precursors in Finnish children and adolescents. XI. Psychological aspects
Authors: KELTIKANGAS‐JÄRVINEN L. , ÅKERBLOM H. K. , VIIKARI J. , DAHL M. , LÄHDE P.‐L. , PESONEN E. , PIETIKÄINEN M. , SUONINEN P. , UHARI M. , LOUHIVUORI K.
Published: January 2008

ABSTRACT. The role of psychic risk factors in the early history of atherosclerosis was studied in 3,596 Finnish children and adolescents, aged 3, 6, 9, 12, 15, and 18 years. The family atmosphere, behavioural pattern and self‐esteem were tested. The results showed that the abuse of alcohol by the parents and daily smoking by the child were the factors most clearly indicating the existence of psychic problems. The results showed that boys manifested in every age group behaviour most disposed to coronary heart disease (CHD). Furthermore, low serum HDL‐cholesterol, high serum triglycerides, thick triceps skinfold and self‐esteem problems coexisted and they can be supposed to independently contribute to the aetiology of CHD.
Atherosclerosis precursors in Finnish children and adolescents. XIII. Serum and hair copper and zinc concentrations
Authors: VUORI E. , SALMELA S. , ÅLERBLOM H. K. , VIIKARI J. , UHARI M. , SUONINEN P. , PIEIKAJUNEN M. , PESONEN E. , LÄHDE P.‐L. , DAHL M.
Published: January 2008

ABSTRACT. The copper and zinc status of 3–18‐year‐old Finnish children was estimated by analysing 3,480 serum copper and zinc concentrations, 853 hair copper and 868 hair zinc concentrations. Both copper and zinc have been proposed to be connected with the pathogenesis of cardiovascular diseases. In addition, zinc is essential for normal growth and development. The mean serum copper concentration of 3‐year‐old children was 21.2 μmol/l and the concentration was significantly lower in older age groups. The average serum zinc concentration showed a narrow variation between 14.1 and 15.0 μmol/l in all age groups, nevertheless girls had significantly lower and boys higher values with increasing age. The distribution of hair copper concentration was skewed within the age groups; the median vaned between 9.7 μg/g and 29.8 μg/g for 3‐year‐old urban girls and 18‐year‐old rural girls, respectively. Some rural girls had exceptionally high hair copper levels. Hair zinc concentrations increased with age. In the three youngest age groups (3, 6 and 9 years) the distribution was skewed and the levels low compared with results from the USA where a zinc concentration below 30 μg/g is found to be associated with the zinc deficiency syndrome.
Coronary intimal thickenings and lipids in Finnish children who died violently
Authors: HIRVONEN J. , YLA‐HERTTUALA S. , LAAUKSONEN H. , MÖTTÖNEN M. , NIKKARI T. , PESONEN E. , RAEKALLIO J. , ÅERBLOM H. K.
Published: January 2008

ABSTRACT. Intimal thickenings of the coronary arteries were found in healthy children who died violently, of both sexes even in children under 5 years of age. The average incidence was 53 % of the 75 cases. Splitting of the internal elastic lamina was the primary finding, followed by local increase in smooth muscle cells. The thickening could occupy 50 % of the coronary lumen. The accumulation of esterified cholesterol in the coronary arteries began before the age of 10 years. The fatty acid composition of the cholesterol esters suggests that they are derived from the blood. The question whether the thickenings are precursors of forthcoming coronary atheromas needs further detailed studies, especially in young adults. Key words: arterial wall lipids, atheroma precursors, intimal thickenings.
Size at Birth in Iceland
Authors: BIERING G. , SNÆDAL G. , SIGVALDASON H. , RAGNARSSON J. , GEIRSSON R. T.
Published: January 2008

ABSTRACT. Anthropometric standards for weight, length and head circumference of Icelandic infants at birth are presented. The material concerning weight and crown‐heel length consisted of 43364 newborns, the total number of infants born in 1972‐1981. The standards for head circumference were based on 28978 infants born in 1975‐1981. Multiple births and stillbirths were excluded from the material, leaving single livebirths with an estimated length of gestation of 28‐44 weeks. No further exclusions were made. The material was compared with previous standards used in Iceland as well as with other studies of all single livebirths in geographically defined populations. Standards for crown‐heel length and head circumference were compared with other studies based on more limited and selective materials. The differences between these studies emphasize the need for an international agreement on the methodology for measurement and recording of infant growth during the perinatal period.
Intra‐uterine Growth, Birthweights and Maturity of the African Newborn
Authors: RANSOME‐KUTI O.
Published: January 2008

ABSTRACT. The prevalence of low birthweight in many African countries is higher than in developed countries. This is largely because of the greater number of babies who are light for gestational age. In general, mean birthweights of African babies at various gestational ages are lower than those of developed countries. This is due mainly to environmental factors, but an increased prevalence of twinning is one genetic factor. When babies of mothers in optimum health were studied, birthweights for gestational age were similar to Caucasian babies.
Epidemiological Aspects of the Natural History of Childhood Diabetes
Authors: BLOM L. , DAHLQUIST G.
Published: January 2008

ABSTRACT.Studies in identical twins have shown only a 50% concordance for type 1 diabetes, indicating that environmental factors are of major importance. Prospective studies in twins and siblings of type 1 diabetics provide evidence of a long pmdiabetic phase. Environmental factors, inducing a pathological immune response in genetically susceptible individuals, may thus act long before the clinical onset. In Sweden a high and increasing incidence of childhood diabetes has been shown, with peak incidence rates at puberty in both boys and girls. The incidence rate is higher for boys than for girls. Significant geographical and seasonal variations are clearly indicated. The epidemiology of lost beta‐cell function shortly after clinical onset differs significantly from the epidemiology of clinical onset as to sex and geographical and seasonal distribution. Environmental factors that affect the clinical onset of type 1 diabetes may thus differ from factors affecting the beta‐cell function after onset. Factors affecting the peripheral insulin sensitivity should therefore be taken into consideration also when discussing the natural history of type 1 diabetes.Key words: Type 1 akbetes, epidemiology, childhood, natural history, beta‐cell function.
Dietary Intake in Swedish Diabetic Children
Authors: KYLBERG ELISABETH , EWALD UWE , TUVEMO TORSTEN , GEBRE‐MEDHIN MEHARI
Published: January 2008

ABSTRACT. The energy and nutrient intakes by 14 children with type I diabetes and 13 healthy peers were investigated by the 24–h recall method and the results were compared with current recommendations for the general population and with the guidelines for the dietary management of diabetes mellitus. The diabetic children showed not only good compliance with the recommendations but also a better intake in practically all respects than their healthy counterparts. The total energy intake by the diabetic children was in good agreement with the recommendations, while that of the controls was slightly lower. The protein energy per cent in the diet of the diabetic children was 18%, compared with 14% in the controls. Forty percent of the energy in the diet of the diabetic children was derived from fats, 36% in the controls. With the exception of carbohydrates, ascorbic acid and iron, the diet of the diabetic children had a higher nutrient density than that of the control children and the reverse was true for carbohydrates only. Howewr, because of the generally higher energy intake displayed by the diabetic children, even the intake of these nutrients was at least as good in the diabetic children as in the controls. Eighty‐six percent of the diabetic children but only 46% of the control children stated that the day for which intake data were given was a representative day. Key words: Dietary intake, recall, diabetes mellitus, insulin dependent, Sweden.
Diet Therapy for Poorly Controlled Type 2 (Non‐insulin‐dependent) Diabetes Mellitus
Authors: VESSBY B. , KARLSTRÖM B. , BOBERG M. , LITHELL H. , GUSTAFSSON I.‐B. , BERNE C.
Published: January 2008

ABSTRACT. Poorly controlled type 2 diabetes represents a major therapeutic problem. A classification of the disease, based on body weight and presence or absence of adequate insulin‐secretion capacity, may be helpful in the choice of correct treatment. Calorie reduction is the most important therapeutic intervention in overweight patients. In the diabetic diet digestible carbohydrates should comprise at least 50 energy%, while the fat content should be reduced below 30 energy%. Controlled clinical studies show that the blood glucose control can be improved and the urinary glucose excretion be diminished by addition of dietary fibre. In obese type 2 diabetics supplemented fasting may be usehrl to achieve a rapid weight loss and an improved metabolic control. Although our knowledge with regard to the patho‐physiology of type 2 diabetes and the effects of dietary treatment has increased during recent years, several important questions remain unanswered. Also there is a great need for education and training programmes to achieve improved compliance to the dietary advice given.
Ten‐year Experience of Insulin Treatment in Gestational Diabetes
Authors: BERNE CHRISTIAN , WIBELL LARS , LINDMARK GUNILLA
Published: January 2008

ABSTRACT. Between 1975–1984, 119 women with gestational diabetes (GDM) were treated with insulin in Uppsala, representing a mean yearly incidence of 4.5/1000 pregnancies. Women with GDM were older and more obese than the general pregnant population. Insulin treatment was instituted during a 5–7 day stay in hospital. The mean total daily dose of insulin prepartum, when fasting blood glucose had been normalized, was 53 (SD ± 25) units (34 ± 15 units of rapid‐acting and 20 ± 11 units of medium‐acting insulin), divided into two doses daily. Mean duration of treatment was 6.4 weeks. The perinatal mortality was 0.8%, compared with 7.4% in previous pregnancies in the same women. The perinatal morbidity was generally mild and included hypoglycaemia (10.9 %), hyperbilirubinaemia requiring treatment (2.5 %), shoulder dystocia (2.5 %) and one case of mild respiratory distress syndrome. The rate of macrosomia was reduced in the present pregnancies compared with previous ones in the women with GDM, but not abolished completely, probably because of too short a duration of improved metabolic control. Spontaneous delivery was favoured and the rate of Caesarean section was 13.596. Thus, treatment with high doses of insulin in an unselected group of women with GDM is feasible. Normal perinatal mortality, reduced macrosomia, and no gross perinatal morbidity was found in the infants. Though the extent to which insulin treatment per se contributed to the favourable outcome is difficult to assess, it is suggested that the case for a high level of ambition for metabolic normalization in GDM should be a subject of further study.
Clinical Features in Hospitalised Children with Acute Gastroenteritis: Does the Rotavirus Syndrome Exist?
Authors: HJELT K. , KRASILNIKOFF P. A. , GRAUBALLE P. C. , RASMUSSEN S. WINTHER
Published: January 2008

ABSTRACT. In a prospective study of children referred to hospital, rotavirus was identified in 37 % of 128 patients with acute gastroenteritis. As compared with patients with non‐rotavirus gastroenteritis, those with rotavirus gastroenteritis showed the following clinical characteristics: (1) Age between 5 months and 4 years. (2) Occurrence of the rotavirus infection almost exclusively during the winter season. (3) Severe vomiting. (4) Absence of gross blood in the stools. However, these signs did not form a safe basis for the clinical diagnosis of rotavirus gastroenteritis. One or more signs of upper respiratory illness were observed in 36 % of the patients with rotavirus gastroenteritis and in 35 % of those with non‐rotavirus gastroenteritis. Consequently, the existence of a rotavirus syndrome is questioned. It is argued that upper respiratory illnesses in patients with rotavirus gastroenteritis could be due to a separate infection occurring coincidentally.
Intensive Treatment of Pseudomonas Chest Infection in Cystic Fibrosis: a Comparison of Tobramycin and Ticarcillin, and Netilmicin and Ticarcillin
Authors: CONWAY S. P. , MILLER M. G. , RAMSDEN C. , LITTLEWOOD J. M.
Published: January 2008

ABSTRACT. Seventeen cystic fibrosis patients aged 3.1 years to 19.8 years had 30 courses of intensive treatment for relapse of their pseudomonas chest infection. The combination of netilmicin and ticarcillin was compared with tobramycin and ticarcillin in an open study. A significant subjective and objective improvement occurred in all patients. Pseudomonas was cleared temporarily from the sputum in 11 out of the 30 courses of treatment (37 %). There was no significant difference between the netilmicin and tobramycin groups, nor evidence of sustained renal or ototoxicity. Intensive therapy of pseudomonas chest infection in cystic fibrosis patients is described in detail.
Hepatitis B Surface Antigenaemia and Glomerulopathies in Children
Authors: MANNA A. LA , POLITO C. , GADO R. DEL , OLIVIERI A. N. , TORO R. DI
Published: January 2008

ABSTRACT. Serum HBsAg positivity prevalence was studied on 98 children affected by various nephropathies or obstructive uropathies and on a control group of 71 children, consecutively admitted into the same clinical ward, suffering from other than hepatic or renal diseases. No significant difference was found between the group of children with non‐glomeruiar nephropathies or obstructive uropathies and the control group. The prevalence of HBsAg positivity was significantly higher in male children with membranous glomerulopathy and in those with lipoid nephrosis than in the control group. All HBsAg positive children with glomerulopathies were chronic carriers of the hepatitis B virus. However, though left undemonstrated, there still lies a probable pathogenetic relationship between the hepatitis B virus infection and membranous glomerulopathy. The authors hypothesize that an impaired immune response in male children with lipoid nephrosis may account for both the hepatitis B virus infection and the development of the glomerular disease.
Ontogeny of lgG2 Antibodies against S. aureus Teichoic Acid in Normal and Immunodeficient Children
Authors: HAMMARSTRÖM L. , GRANSTRÖM M. , MÖLLBY R. , OXELIUS V. , PERSSON M. A. A. , SMITH C. I. E.
Published: January 2008

ABSTRACT. Anti‐teichoic acid antibodies of various subclasses were found to be effectively transported across the placenta during pregnancy. In adults these antibodies are mainly of the IgG2 subclass although substantial amounts of specific IgGl antibodies may also be found. During ontogeny, specific IgGl antibodies develop during the second year of life whereas specific IgG2 antibodies appear markedly later. In IgG2 deficient children, prolonged deficiency of specific anti‐teichoic acid antibodies was observed, suggesting a lack of maturation of the appropriate idiotype(s). In children who received a bone marrow transplant from adult donors, engraftment of IgG2 producing cells could be seen, thus transferring the ability to produce specific antibodies.
Lyme Disease in a 12‐year‐old Girl
Authors: STURFELT G. , CAVELL B.
Published: January 2008

ABSTRACT. We report the case of a 12‐year‐old girl with erythema chronicum migrans, aseptic meningitis and knee arthralgia. Rise of specific antibody titre against an Ixodes ricinus spirochaete was demonstrated. Circulating immune complexes and high levels of Clr‐Cis‐CIIA complexes indicating activation of the complement system via the classical pathway were found. The clinical features and the laboratory findings warranted a diagnosis of Lyme disease.
Sanfilippo Type C Syndrome in Two Sisters
Authors: UVEBRANT P.
Published: January 2008

ABSTRACT. Two sisters are described with mucopolysaccharidosis (MPS) Sanfilippo type C syndrome. This diagnosis is emphasized to be easily overlooked due to subtile clinical and radiological deviations, but should be considered in any case of unspecific progressive mental retardation, especially when sleep disturbance, aggressivity and hyperactivity are prominent symptoms.
The Establishment of Some Microflora Associated Biochemical Characteristics in Feces from Children during the First Years of Life
Authors: NORIN K. E. , GUSTAFSSON B. E. , LINDBLAD B. S. , MIDTVEDT T.
Published: January 2008

ABSTRACT. This report presents a new approach to the study of the colonization of the digestive tract after birth. We have examined the development of four microflora associated characteristics, MACs, defined as the recording of any anatomical structure, biochemical or physiological function in the macroorganism, which has been influenced by the microflora. These MACs may create a basis for later investigations into the impact of diarrheal diseases and antibiotic therapy. The following biochemical characteristics were studied in feces from children of 0‐61 months of age: conversion of cholesterol to coprostanol and bilirubin to urobilins, inactivation of trypsin and degradation of mucin. These results indicate establishment of microbes capable of converting bilirubin to urobilins within the second year of life. The mucin degrading and cholesterol converting microbes are established in most of the children during the same period. Tryptic activity was found to be absent in meconium, present in feces from all children up to 21 months of age, and absent in 6 out of 15 children in the age group 46‐61 months. The study indicates that the establishment of the MACs in the digestive tract is a remarkably long drawn out process
Severe Anorexia Nervosa Treated with Total Parenteral Nutrition: Clinical Course and Influence on Clinical Chemical Analyses
Authors: CRONER S. , LARSSON J. , SCHILDT B. , SYMRENG T.
Published: January 2008

ABSTRACT. Severe anorexia nervosa in which psychiatric treatment has failed is a life‐threatening condition since the degree of emaciation can be profound. Nine young women with a weight loss of 25‐50 % of their habitual weights were given total parenteral nutrition (TPN) over 3‐8 weeks through a tunneled central venous silicone catheter. They initially received a mean of 55 kcal/kg body weight/24 hours increasing to 65‐70 kcal/kg body weight during the first week. The initial bradycardia and hypotension were normalized and body weight increased with a mean of 2.5 kg/week. All patients showed a general somato‐psychic improvement after two weeks of TPN. The electrolyte disturbances seen at the beginning were normalized during the first weeks of treatment and the previously reported life‐threatening electrolyte disturbances and dehydration in connection with TPN treatment were not seen. The only adverse effect registered was a rise in liver enzymes in two patients who were given >80 kcal/kg and day. With a reduction of the caloric supply these changes normalized, and TPN could be continued. After 3‐8 weeks the oral intake had normalized and TPN was discontinued. – This study confirms that TPN can be used successfully and with minimal risk in severe anorexia nervosa until the patients have normalized their oral intake.
The Growth of Breast Fed and Artificially Fed Infants from Birth to Twelve Months
Authors: HITCHCOCK NANCY E. , GRACEY MICHAEL , GILMOUR ANNABEL I.
Published: January 2008

ABSTRACT. Growth data collected from 394 healthy infants were analysed in relation to feeding practices. Infants were grouped on the basis of sex, if breast fed or artificially fed, and duration of breast feeding. From birth to 3 months, weight gains were similar for boys (2.5 kg) and also for girls (2.3 kg) irrespective of feeding method. From 3 to 6 months weight gains were greater in infants who were artificially fed from birth (2.0 kg both sexes) or breast fed for only a short time (1.9 kg) than for those exclusively breast fed for 6 months (1.6 kg) or longer (1.7 kg). Weight gains continued to be greater in artificially fed infants after 6 months. Over 12 months, artificially fed boys gained 410 g and girls 750 g more than those who were breast fed from birth. These differences occurred even though the artificial feedings that prevailed to 6 months and longer were low‐solute (‘humanized’) formulas.
Trace Element Profiles in Individual Blood Cells from Patients with Down's Syndrome
Authors: ANNERÉN G. , JOHANSSON E. , LINDH U.
Published: January 2008

ABSTRACT. The concentrations of trace elements in three different types of blood cells–erythrocytes, thrombocytes and neutrophils–were determined by nuclear microprobe analysis in 11 children with Down's syndrome (DS) and compared with those in 13 controls. The median concentration of copper in all three types of blood cells and that of calcium in erythrocytes were significantly higher in DS children than in controls. In contrast, the median levels of zinc in erythrocytes, of manganese and iron in erythrocytes and neutrophils, and of magnesium in erythrocytes and thrombocytes were significantly lower in DS than in control children. In 10 of the 11 DS children, detectable erythrocyte levels of titanium were found, which is remarkable, since this was not observed in any of the cells from the control children.
Incidence of Cystic Fibrosis in Ethnic Italians and Greeks and in Australians of Predominantly British Origin
Authors: ALLAN JEAN L. , PHELAN P. D.
Published: January 2008

The incidence of cystic fibrosis among the Australian born children of parents born in Italy was 1: 3 625 live births and among Australian born children of parents born in Greece 1: 3726. These incidences were significantly lower than the incidence for cystic fibrosis of 1: 2021 in children born to Australian born parents, about 90% of whom have ancestors born in the British Isles. The figures suggest there are significant variations in the incidence of cystic fibrosis in different European populations.
Studies of Human Milk
Authors: CRUZ J. R. , CARLSSON B. V. M. , HOFVANDER Y. , HOLME D. T. , HANSON L. A.
Published: January 2008

ABSTRACT. The concentration in human milk of IgA antibodies against six Salmonella and two Shigella groups was determined in specimens obtained from Swedish and Guatemalan nursing mothers of three different socioeconomic levels. The daily intakes of milk antibodies by their children were also estimated. The results show that the concentrations of specific IgA antibodies in milk vary among the different population groups. There is, however, no difference in daily intake of specific IgA by the children.
Hematin and Bilirubin Binding to Human Serum Albumin and Newborn Serum
Authors: HO C.‐K. , ROBERTSON A. F. , KARP W. B.
Published: January 2008

ABSTRACT. In jaundiced newborn infants, hemolytic disease is considered a risk factor for kernicterus due to the suspected competition between bilirubin and other hemoglobin breakdown products for albumin binding. We have studied the effect of hematin on bilirubin‐albumin binding using the peroxidase assay and a light‐scattering technique for measuring unbound bilirubin. Our results show that hematin does not affect bilirubin‐albumin binding. To determine if other albumin binding functions are affected by hematin, we used a microdialysis rate technique employing two ligands, diazepam and monoacetyldiaminodiphenyl sulfone (MADDS). Hematin does not utilize the diazepam binding function of albumin, but does decrease the albumin binding of MADDS. The results of this study indicate that the MADDS and bilirubin binding functions are not identical. The clinical usefulness of reserve albumin equivalent determination using MADDS is discussed.
Electrolyte Excretion in 12‐hour Urine and in Spot Urine
Authors: UCHIYAMA M. , OTSUKA T. , SHIBUYA Y. , SAKAI K.
Published: January 2008

ABSTRACT. Plasma renin activity (PRA) and urinary electrolyte excretion were measured in 137 healthy children aged 6 to 14 years. Plasma aldosterone concentration (PAC) was measured in 52 of the children. Nocturnal 12‐hour urine was collected in 110 of the children. Spot urine was collected on two occasions, once just before lying down, once after 90‐min supine rest in another 27. Na/K ratio and fractional Na excretion rate (FENa) in 12‐hour urine showed a significant inverse correlation with PRA or PAC. Na excretion (mmol/min, mmol/mmol creatinine), Na/K ratio and FENa in the spot urine following 90 min in a supine position showed a significant inverse correlation with PRA or PAC, but they failed to show a significant relationship to PRA or PAC in the spot urine preceding supine rest. A spot urine after 90 min in the supine position is collected easily and hence most appropriate to study the relationship between Na excretion and PRA or PAC clinically.
The Influence of Labor and Delivery on Preterm Fetal Adrenal Function
Authors: PROCIANOY RENATO S. , CECIN SANDRA K. G.
Published: January 2008

ABSTRACT. The influence of labor and route of delivery upon umbilical cord serum levels of Cortisol and dehydroepiandrosterone sulfate in one hundred sixty‐nine preterm infants not exposed prena‐tally to corticosteroids was studied. Vaginally born infants (group A, n=89) presented a higher mean cord Cortisol and dehydroepiandrosterone sulfate concentrations than those delivered by cesarean section (group B, n=80). Although there were no differences in Cortisol and dehydroepiandrosterone sulfate levels between infants delivered by cesarean section after spontaneous onset of labor (group B‐I, n=42) and those without labor (group B‐II, n=38), the mean Cortisol and dehydroepiandrosterone sulfate concentrations were higher in group A than in group B‐I. There was a correlation between umbilical cord Cortisol and dehydroepiandrosterone sulfate levels. It is concluded that there is no association between the presence of labor and high cord serum levels of Cortisol and dehydroepiandrosterone sulfate and there is an association between vaginal delivery and high cord Cortisol and dehydroepiandrosterone sulfate levels in preterm infants. It is suggested that the stress of vaginal delivery stimulates the secretion of fetal Cortisol and dehydroepiandrosterone sulfate in preterm infants.
Unsuccessful Oral Rehydration Therapy in an Infant with Enteropathogenic E. coli Diarrhoea: Studies of Fluid and Electrolyte Homeostasis
Authors: MARIN L. , APERIA A. , ZETTERSTRÖM R. , GÜNÓZ H. , SÖKÜCÜ S. , SANER G. , NEYZI O.
Published: January 2008

ABSTRACT. A 4‐month‐old male infant with severe hyponatremic dehydration due to an enteropathogenic E. coli O125:B15‐induced diarrhoea had continued very high stool fluid output with a very elevated sodium concentration after hospitalization and the institution of oral rehydration therapy (ORT). Thirty‐six hours after start of ORT intravenous therapy was required. The results of studies of fluid and salt homeostasis in this patient have been compared with those obtained in 3 other patients who had acute diarrhoea of the same severity but caused by another strain of enteropathogenic E. coli (0111:B14) and who were successfully treated with ORT. On ORT the patient with treatment failure had a stool volume which was almost 8 times larger and a stool sodium output which was about 5 times higher than in the successfully treated patients. During the 36‐hour‐period of ORT fluid losses were about the same as the fluid intake. The results as regards urinary fractional sodium excretion and the urinary potassium/sodium quotient indicate that the severe sodium depletion which was present on admission in the unsuccessfully treated patient persisted during ORT. The reason for ORT failure may be that the infectious E. coli strain had bacilli‐adherent qualities that cause damage of microvilli.
Selenium in Plasma and Erythrocytes in Patients with Down's Syndrome and Healthy Controls
Authors: ANNERÉN G. , GEBRE‐MEDHIN M. , GUSTAVSON K.‐H. , PLANTIN L.‐O.
Published: January 2008

ABSTRACT. The mean plasma selenium concentration (P‐Se) in 65 patients with Down's syndrome (DS) did not differ from that in 90 healthy controls. The concentration of selenium in the erythrocytes (E‐Se) was higher in DS patients than in controls (p<0.001). P‐Se and E‐Se increased progressively with age through childhood in both DS children and controls. The former children, however, started out with higher levels of E‐Se and reached adult concentrations earlier (at 7‐17 years) than controls (18 years). Adult DS patients and controls did not differ in their mean P‐Se or E‐Se concentration. There was a significant correlation between P‐Se and E‐Se both in DS patients and in controls. In DS patients each of these two variables was significantly correlated to glutathione peroxidase (GSH‐Px) activity in erythrocytes. A sex difference in the DS children, but not in the controls, was observed with regard to P‐Se and E‐Se levels, these being higher in DS girls during childhood (0‐17 years). This was in accordance with an earlier finding of higher GSH‐Px activity in DS girls than in DS boys.
Subclinical Trace Element Deficiency in Children with Undue Susceptibility to Infections
Authors: BONDESTAM MARGARETA , FOUCARD TONY , GEBRE‐MEDHIN MEHARI
Published: January 2008

ABSTRACT. Serum concentrations of iron, copper, zinc and magnesium and also serum transferrin and ceruloplasmin were investigated in 28 children aged 10 months to 10 years with undue susceptibility to infections. None of the children had any classical immune defect. Seven of them had had frequent upper respiratory tract infections, 16 had suffered from frequent infections of the middle ear and five from mainly lower respiratory tract infections. Thirteen healthy children aged 9 to 18 years residing in the same area served as controls. The children with undue susceptibility to infections had significantly lower mean serum iron (p< 0.05) and zinc (p< 0.001) levels than the healthy controls. The mean serum concentrations of copper and magnesium and of transferrin and ceruloplasmin did not differ between the patients and controls. Children with frequent middle ear infections seemed to account for most of the differences in the serum levels of iron and zinc. An inverse correlation was observed between duration of breast feeding and serum concentration of zinc, and between weight as well as height and serum magnesium. The reasons for these changes and the possible role of trace element deficiency as a factor predisposing to or perpetuating undue susceptibility to infections in children are discussed.
Plasma Noradrenaline and Adrenaline in Newborn Infants of Diabetic Mothers: Relation to Plasma Lipids
Authors: HERTEL J. , KÜHL C. , CHRISTENSEN N. J. , PEDERSEN S. A.
Published: January 2008

ABSTRACT. No significant differences in plasma noradrenaline and adrenaline concentrations were found between 14 infants of diabetic mothers (IDMs) and 7 infants of non‐diabetic mothers at birth or at 2 hours of age, although the mean values were higher in the IDMs. The mean blood glucose concentration declined from birth to 2 hours of age and it was lower at 2 hours of age in the IDMs although only one IDM became hypoglycaemic. Plasma non‐antibody bound insulin concentrations were approximately 12 fold higher at birth and at 2 hours of age in the IDMs than in the control infants. Similar increases in plasma free fatty acids and free glycerol concentrations from birth to 2 hours of age were observed in the 2 groups. At 2 hours of age positive correlations were found between plasma noradrenaline and free fatty acids (r=0.85, p< 0.01) and free glycerol (r=0.65, p< 0.05) and between plasma adrenaline and free glycerol (r=0.71, p< 0.05) and the rise in free glycerol from birth to 2 hours of age (r=0.65, p< 0.05) in the IDMs. At birth positive correlations between plasma free fatty acids and plasma noradrenaline (r=0.69, p< 0.02) and plasma adrenaline (r=0.88, p< 0.01) were found in the IDMs. No correlations were found in the control infants. These findings indicate that the catecholamines counteracts the inhibitory effect of insulin on lipolysis in IDMs.
Catecholamine Response to Chest Physiotherapy and Endotracheal Suctioning in Preterm Infants
Authors: GREISEN G. , FREDERIKSEN P. S. , HERTEL J. , CHRISTENSEN N. J.
Published: January 2008

ABSTRACT. Adrenaline and noradrenaline was measured just before and just after chest physiotherapy and endotracheal suctioning in 13 preterm, ventilated, newborn infants. Mean aortic blood pressure was also recorded. Eight of the infants received phenobarbitone. Catecholamine levels were five‐fold higher in the 5 infants with blood pH less than 7.30 compared to the other 8 infants. After the procedure, both adrenaline and noradrenaline were significantly higher than baseline levels. The adrenaline response to the procedure was a two‐fold increase and significantly greater than the noradrenaline response. Analysis of the effects of phenobarbitone treatment and acidosis on catecholamine responses by multiple linear regression demonstrated that the adrenaline response was reduced by phenobarbitone while the noradrenaline response was unaffected. There were no associations of blood pressure responses with catecholamine responses, with acidosis or with phenobarbitone treatment.
Bile Acid Abnormalities and the Diagnosis of Cerebro‐Hepato‐Renal Syndrome (Zellweger Syndrome)
Authors: EYSSEN H. , EGGERMONT E. , ELDERE J. VAN , JAEKEN J. , PARMENTIER G. , JANSSEN G.
Published: January 2008

ABSTRACT. The Zellweger or cerebro‐hepato‐renal syndrome (CHRS) is a congenital disorder characterized by cerebral dysfunction, craniofacial dysmorphic features, transient cholestasis and renal cysts. Patients fail to thrive, and usually die in their first year of life. In some cases, a definite diagnosis on purely clinical signs might not be possible. Several biochemical abnormalities have been observed in these patients and some of them have been tested as diagnostic markers. The aim of this study is to evaluate bile acid metabolites as biochemical markers of the CHRS. From a study of 20 CHRS patients, we conclude that screening for the presence of coprostanic acids and the C‐29 dicarboxylic bile acid in serum or urine is a reliable method for detection of CHRS and confirmation of the diagnosis.
Tuberculin Conversion Following BCG Vaccination in Preterm Infants
Authors: DAWODU A. H.
Published: January 2008

ABSTRACT. Tuberculin conversion following BCG vaccination was evaluated in 3 groups of infants. Group I consisted of 12 preterm appropriate‐for‐gestational‐age (AGA) infants given BCG vaccination at birth; Group II was made up of 15 term AGA infants similarly immunized while 8 preterm AGA infants (Group III) received BCG about the time estimated to be their normal birth‐date. The tuberculin conversion rates of 83 %, 93 % and 88 % in groups I, II and III respectively were not significantly different (p±0.5). The results suggest that the preterm AGA infants born at 32‐36 weeks of gestation can be effectively immunized with BCG at birth.