bluuebunny/crossref_metadata_2025 huggingface dataset:
Fluctuation of Specific IgA Antibodies in Human Milk
Authors: CRUZ J. R. , ARÉVALO CAROLINA
Published: January 2008

ABSTRACT. The concentration of secretory IgA and the levels of IgA specific antibodies against Escherichia coli labile‐toxin, Shigella flexneri 6, and rotaviruses were determined in milk samples obtained serially from women during the first 16 weeks postpartum. The mean concentration of secretory IgA followed the expected pattern; the levels of specific antibodies fluctuated in an unpredictable manner and independently of milk secretory IgA content, becoming undetectable in many instances. Under some circumstances, continued breast‐feeding may not guarantee continued intake of antibodies against intestinal pathogens by the breast‐fed infant.
Physical Activity and Sports Involvement in 8‐ and 13‐Year‐Old Children in Sweden
Authors: SUNNEGÅRDH J. , BRATTEBY L.‐E. , SJÖLIN S.
Published: January 2008

ABSTRACT. The physical activity of randomly selected 8‐ and 13‐year‐old children, living in four different regions of Sweden, was investigated by means of a questionnaire. The younger children of each sex were found to be physically more active than the older ones, and within each age group the boys were physically more active than the girls. The results points to higher sports involvement today compared with 10–15 years ago, especially among younger children. It was also shown that regular physical training constituted a smaller proportion of the total physical activity among the younger children than among the older ones. At both ages and in both sexes the rate of regular physical training was lower in municipalities of less than 1000 inhabitants, and in the 8‐year‐old children it was also lower in municipalities of less than 5 000 inhabitants. Among the girls regular physical training was more common in those whose fathers had a high educational level compared with the girls who had fathers of a lower educational level.
Reduced Serum Proteins in Diabetic Children on a Twice‐Daily Insulin Schedule
Authors: GEBRE‐MEDHIN MEHARI , EWALD UWE , TUVEMO TORSTEN
Published: January 2008

ABSTRACT. The concentrations of selected proteins of transport and nutrition were investigated in 27 diabetic children and 13 healthy controls by an immunodiffusion technique. The diabetic children had significantly lower mean pre‐albumin (p<0.001), albumin (p<0.01) and orosomucoid levels (p<0.05) than the healthy controls. No correlation was observed between age or sex and the blood concentrations of the specific proteins analyzed in this series. Haptoglobin and hemopexin showed positive correlations with serum triglycerides (both p<0.01) and slight positive correlations with some of the variables of carbohydrate control. The reduced levels of prealbumin and albumin were not correlated to diabetic control as measured by HbA1, fasting plasma glucose or urinary glucose excretion. The non‐physiological distribution site and the abnormal temporal pattern of insulin offered to diabetic children might be the reason for the protein abnormalities found in this study. This is seemingly the first time reduced serum levels of proteins have been reported in diabetic children.
Ethanol Poisoning
Authors: GIBSON P. J. , CANT A. J. , MANT T. G. K.
Published: January 2008

ABSTRACT. A 3‐year‐old boy with severe ethanol poisoning metabolised ethanol more rapidly than expected (0.33 g/l/hour or 7.16 mmol/l/hour) and recovered fully with conservative management. It is concluded that active elimination techniques are unnecessary for most children with acute ethanol poisoning, child
Atherosclerosis precursors in Finnish children and adolescents. III. Blood pressure
Authors: DAHL M. , UHARI M. , VIIKARI J. , ÅKERBLOM H. K. , LÄHDE P.‐L. , PESONEN E. , PIETIKÄINEN M. , SUONINEN P.
Published: January 2008

ABSTRACT. In connection with the Finnish Multicentre Study on the precursors of atherosclerosis in 3‐, 6‐, 9‐, 12‐, 15‐ and 18‐year‐old children and adolescents, blood pressure was measured in 3,596 subjects in the five university hospital areas. Blood pressure was measured with an ultrasound device (Arteriosonde 1020±, Roche) in the 3‐year‐old children, and an ordinary mercury sphygmomanometer was used in the rest of the subjects. The syslolic and diastolic values increased with age as has been shown earlier. There were no significant differences in the values between boys and girls except that the 15‐ and 18‐year‐old boys had values a little higher than girls of the same age. Weight and height correlated well to both systolic and diastolic blood pressures. Physical maturation also correlated to blood pressure.
Atherosclerosis precursors in Finnish children and adolescents. VII. Serum immunoreactive insulin
Authors: LAUTALA P. , ÅKERBLOM H. K. , VIIKARI J. , LOUHIVUORI K. , UHARI M. , DAHLSTRÖM S. , DAHL M. , LÄHDE P.‐L. , PESONEN E. , PIETIKÄINEN M. , SUONINEN P. , KNIP M.
Published: January 2008

ABSTRACT. In the Finnish Multicentre Study of the risk factors of coronary heart disease serum immunoreactive insulin (IRI) was measured in 3,486 children and adolescents aged 3–18 years. Serum IRI increased with age till the age of 15 years in both sexes. The increase in serum IRI levelled off with the progression of pÜbertal development. Serum IRI levels were higher in girls than in boys from the age of 6 years onwards. Comparison of serum IRI gave identical results from eastern and western parts of the country. Serum IRI correlated positively with skinfold thickness, weight, relative weight and body mass index in all age groups except the 3‐year‐old children.
Atherosclerosis precursors in Finnish children and adolescents. VIII. Food consumption and nutrient intakes
Authors: RÄSÄNEN L. , AHOLA M. , KARA R. , UHARI M.
Published: January 2008

ABSTRACT. A dietary survey was conducted in 1980 in connection with the Multicentre Study on Atherosclerosis Precursors in Finnish Children in five urban and 12 rural communes in various parts of Finland. 1,768 children aged 3, 6, 9,12,15 and 18 years were interviewed using the 48 hour recall method. Food consumption, and the intakes of energy and 49 nutrients were calculated. The intakes of energy and most nutrients increased in the successive age groups until the age of 15 years. There were only small differences in the diet of children belonging to different social classes. Protein accounted for 14 % of total energy intake, fat for 38 %, total carbohydrate for 48 %, and sucrose for 10 %. The ratio of polyunsaturated and saturated fatty acids in the diet (P/S) was 0.24 for the whole material, which is higher than found in previous studies in Finland. The P/S ratio was higher in urban areas and West Finland than in rural areas and in East Finland.

The share of fat of energy intake exceeded the recommendation given by the Ministry of Health and the P/S ratio was lower than recommended The mean daily intakes of energy and vitamins met the recommendations. Of the mineral elements, the intakes of calcium, phosphorus, potassium, magnesium and manganese were abundant. The intakes of iron, copper, zinc, molybdenum and chromium were lower than recommended in most age groups and the intakes of selenium and fluorine in all age groups. The large share of refined foods in the children's diet was the main reason for the low nutrient densities.
Atherosclerosis precursors in Finnish children and adolescents. XIV. Zinc and copper concentrations in deciduous teeth
Authors: HAAVIKKO K. , ANTTILA A. , HELLE A. , PESONEN E.
Published: January 2008

ABSTRACT. Zinc and copper concentrations were analysed from cariesfree deciduous teeth of 125 Finnish children, 6–7‐ and 9–10‐year‐olds, from three cities. Enamel and dentine were separated and prepared into pills which were analysed individually with the proton induced x‐ray emission spectrometry (PIXE) method. The total mean (± SD) zinc concentrations for enamel and dentine were 143 ± 31 and 133 ± 36 ppm, respectively, and are in agreement with the values reported recently. The median copper concentration for enamel was 0.54 ppm with a range from 0.0 to 4.29 and for dentine 0.27 ppm with a range from 0.0 to 3.60 being among the lowest reported. The low copper values are interesting as to the possible association with the development of atherosclerosis. Geographical differences were noted between the zinc concentrations of the three cities, the children of Helsinki having significantly higher zinc values than the children of Kuopio and Oulu. No linear correlation was found between zinc and copper concentrations at the individual level.
The Search for Perinatal Definitions and Standards
Authors: DUNN PETER M.
Published: January 2008

ABSTRACT. Progress made during the last 60 years in reaching international agreement on perinatal terminology is reviewed. Agreed terms currently in use in respect to birthweight, gestational age and the collection of perinatal mortality and morbidity statistics are stated and defined. Arguments are advanced in support of an internationally agreed methodology for the measurement and reporting of infant growth in the perinatal period.
A Methodology for Evaluating Size at Birth
Authors: KARLBERG P. , NIKLASSON A. , ERICSON A. , FRYER J. G. , HUNT R. G. , LAWRENCE C. J. , MUNFORD A. G.
Published: January 2008

ABSTRACT. Data from the Swedish Medical Birth Registration, 1977‐78, were utilized to develop methods of calculating reference standards for evaluating size at birth. Using the clinical information available, a ‘healthy’ sub‐group was extracted. The individual distributions of birthweight (BW), birth length (BL) and birth headcircumference (BHc) at each week of gestational age (GA) were modelled following some truncation of their ranges. Application of the Box‐Cox power family of transformations was generally found to improve the normality of the data. Certain percentages (such as 2.28, 50 and 97.72) were linked through a smoothing device. Features of the results include a positively skewed BW distribution in most GA weeks, a normal distribution of BL and BHc at term, a larger relative variation in BW at lower GA than at term, and a distinct sigmoid shape of the median and other BW curves. Compared with five commonly quoted standards, the present data show the least deceleration in the fullterm region. Disregarding the clinical information,‘primary’ sub‐groups were also extracted using decomposing techniques. These gave rise to similar BW/GA relationships. Using data from the WHO comparative study, the method just mentioned was applied to standardize BW and BW‐specific early neonatal mortality rates. This resulted in an improved description of biological events.
Growth Dynamics of Low‐birth‐weight infants
Authors: BRANDT I.
Published: January 2008

ABSTRACT. The growth of weight, length and head circumference of 65 appropriate for gestational age (AGA) preterm infants and 85 full term controls has been studied longitudinally, with emphasis on growth velocity in the perinatal period. In comparison growth patterns of 51 small for gestational age (SGA) preterm infants have been analysed with respect to catch‐up growth in relation to feeding practices. Weight gain of the AGA preterm infants is retarded until the corrected age of two months; their length remains below that of full term controls up to 21 months on average. Head circumference growth however is similar to intrauterine standards and from term agrees with that of the full term controls. Growth velocity is very high in the perinatal period and in the first months after term and decreases rapidly thereafter.
Frequency of Foetal Growth Deviations Diagnosed by Ultrasonic Measurement and Analysis of Their Causes
Authors: TEMBERA Z. , KOVAÍK J. , JUNGMANNOVÁ .
Published: January 2008

ABSTRACT. In a population sample, whose congruity with the country‐wide population was verified, the birthweight, menstrual age and gestational age (assessed by repeated ultrasonic foetometry in the course of pregnancy) were mutually correlated. A group of 80% of newborns out of the total population sample, in whom no disturbance of foetal growth rate was found throughout the course pregnancy, served as the basis for preparation of the standard of normal foetal growth. In the interval from the 36th to the 42nd week of pregnancy a highly significant linear relationship between gestational age and birthweight was found, without terminal flattening of the “normal foetal growth curve”. In the remaining 20% of the population there was a twofold predominance of growth retardation over growth acceleration.
Intrauteríne Growth Curves: Problems and Limitations
Authors: KEEN D. V. , PEARSE R. G.
Published: January 2008

The provision of accurate weight data to determine prenatal growth status and monitor post‐natal development has been particularly problematic at the lowest gestational ages. Recent improvements in neonatal intensive care, which have increased the survival rate of very pre‐term infants, have meant that the accuracy of these data is no longer of merely academic significance but has also become a matter of practical concern. Hitherto, however, the mass of data available had been recorded prior to 1971 (1‐6). As might be expected, the number of recorded livebirths at less than 28 weeks gestation in that period was extremely small. As a result, they were either excluded from the studies (6, 7, 8) or if included, formed samples of very small size (3, 6, 9).
Failure to Thrive in the Perinatal Period
Authors: RUDOLPH ARNOLD J.
Published: January 2008

ABSTRACT. Identification of newborn nutritional inadequacy is one of the major areas in perinatal medicine where intervention can influence outcome. An infant's failure to thrive may be the result of prenatal and/or post‐natal causes. Management of failure to thrive in the newborn infant must include identification of the problem, establishment of an efficient therapeutic regimen and means of evaluating the morbidity which may occur.
New Fetal Growth Curves for Japanese
Authors: NISHIDA H. , SAKAMOTO S. , SAKANOUE M.
Published: January 2008

ABSTRACT. New fetal growth curves for Japanese have been made with the cooperation of 37 major medical centers throughout Japan by the sponsorship of the Ministry of Health. They are reliable in regard to the adequacy of the sample number, the accuracy of the data on gestational age and the proper processes of composing growth curves. Effect of sex and parity are significant on weight but not on length and head circumference growth curves. The light‐for‐dates infant is defined as below mean ‐1.5 SD by the statistic analysis of their morbidity. These new official fetal growth curves will solve current confusion of several fetal growth curves from different institutions in Japan.
The Impact of Abortion Policy on Prematurity in Hungary
Authors: MAKOI Z.
Published: January 2008

ABSTRACT. In our country both the high frequency of prematurity and abortion and the possible correlation between them have been in the focus of professional interest during the last three decades. The harmful effect of abortion is undeniable. However, it is not possible to label it as the only or leading factor responsible for the high frequency of prematurity.
Current Status of Infant Growth Measurements in the Perinatal Period in India
Authors: BHARGAVA SANTOSH K. , SACHDEV H. P. S. , IYER PARVATHI U. , RAMJI S.
Published: January 2008

ABSTRACT. Analysis of currently available information in the Indian literature on the present status of fetal growth measuring birthweight and gestation distribution, and the intra‐uterine growth potential of the fetus has pointed to several interesting findings. The incidence of low birthweight is 24‐39% and of preterms, 7‐22%. In general the process of labour seems to begin at an stage of earlier gestation. A significant proportion of infants that are born with birth weight between ‐1 SD and ‐2 SD show high morbidity and mortality, suggesting the need for them to be categorized as a distinct group. The early neonatal mortality varies between 1.5 and 8.4%. The results show a wide variation between hospital and community care, and between privileged and underprivileged. Logistic problems prevent the recording of birth weight at home or in the community. Recent observations reveal that mid‐arm circumference (MAC) of newborns has a strong correlation with birth weight and neonatal mortality. MAC can be reliably used to assess fetal growth and for screening hgh‐risk neonates in community care.
Intrauterine Growth Retardation: Clinical and Experimental
Authors: ROBINSON J. S. , FALCONER J. , OWENS J. A.
Published: January 2008

ABSTRACT. Intrauterine growth retardation is a common and potentially hazardous problem for the fetus. Despite this, the obstetric factors associated with growth retardation have changed little in the last twenty years. Some of the other factors, the so‐called behavioural factors should be amenable to correction through education or changing social circumstances. Experimental studies presented here support the clinical observations that the growth retarded fetus is often malnourished and/or hypoxaemic. Restriction of placental growth results in fetal growth failure and these fetuses are chronically hypoxaemic and hypoglycaemic. Furthermore the apparent margin of safety between the delivery to and consumption by the fetus is less for the small fetuses. We suggest that this reduction in supply results in the endocrine changes and that these in turn, modulate the pattern of fetal growth.
Tolerance of Intravenously Administered Lipid in Newborns
Authors: LEEUW R. DE , KOK K. , VRIES I. J. DE , BEGANOVICA N.
Published: January 2008

ABSTRACT. The tolerance for intravenously administered Intralipid in 262 premature and sick newborns was studied. The serum concentrations of triglycerides and of free fatty acids were determined during total parenteral nutrition including Intralipid in a maximum daily dose of 2 g/kg. A serum concentration of 1.5 mmol/l or higher was found in 270 out of 985 triglyceride determinations (27.4%). In the 262 infants serum triglyceride concentrations were found elevated once or more in 117 cases (44.7 %). Serum free fatty acids concentrations were normal. A highly significant inverse correlation (p<0.001) between birth weight and triglyceride level was found. Elevated serum triglyceride concentrations were observed especially in preterm small‐for‐gestational‐age infants.
Reduced Vascular Reactivity in Diabetic Children and Its Relation to Diabetic Control
Authors: EWALD U. , TUVEMO T.
Published: January 2008

ABSTRACT.The vascular reactivity in response to ischaemia was studied by a non‐invasive method of measuring transcutaneous oxygen tension used at 37oC, in 28 children with type I diabetes mellitus. Postischaemic hyperaemia was significantly reduced in the diabetic children compared with 34 healthy children. The degree of reduction in vascular reactivity correlated to both short‐term and long‐term diabetic control. Among tested variables, urinary glucose excretion during the night preceding the test showed the highest coefficient of correlation to the peak of the postocclusive reactive hyperaemia (r= ‐ 0.59,p< 0.01). This peak was only weakly correlated to triglycerides and glycosylated haemoglobins and showed no significant correlation to fasting plasma glucose or to the duration of the disease. It was weakly correlated to the total daily insulin dosage but not to the dosage of insulin/kg body weight. Multiple linear regression analysis revealed that urinary glucose excretion, plasma glucose, haemoglobin A1, serum triglyceride and serum cholesterol, duration of diabetes, and insulin dosage per kg body weight together explained 54 % of the variation in vascular reactivity. The reduced vascular reactivity found in diabetic children could not be explained by the usual parameters of carbohydrate control alone. This new non‐invasive method is able to reveal a reduction in vascular function in diabetic children and should therefore be of value in attempts to find the causes of vascular dysfunction in diabetics.
Nosocomial Acute Gastroenteritis in a Paediatric Department, with Special Reference to Rotavirus Infections
Authors: HJELT K. , KRASILNIKOFF P. A. , GRAUBALLE P. C. , RASMUSSEN S. WINTHER
Published: January 2008

ABSTRACT. Nosocomial acute gastroenteritis caused by rotavirus as well as by non‐rotavirus gastroenteritis was registered during a 12‐month period in the paediatric department of a district hospital. The number of patients in the two groups amounted to 27 % (rotavirus) and 7 % (non‐rotavirus) of the total number of patients hospitalised with the corresponding type of acute gastroenteritis. The seasonal and age distributions for the two types of nosocomial acute gastroenteritis followed the pattern of the respective types of hospitalised community‐acquired acute gastroenteritis. Nosocomial non‐rotavirus gastroenteritis was found to occur scattered with regard to time and locality within the department. The same applied to one half of the cases with nosocomial rotavirus gastroenteritis, whereas the other half occurred during an epidemic outbreak in the general infant/toddler ward. Vomiting and diarrhoea were less significant in nosocomial rotavirus gastroenteritis as compared with community‐acquired rotavirus gastroenteritis. As to the other manifestations no difference was found between the two groups. Nosocomial rotavirus gastroenteritis prolonged the stay in hospital with on the average 3.8 days. Guidelines are suggested for isolation of patients with acute gastroenteritis in order to reduce particularly the frequency of nosocomial rotavirus infections.
Congenital Self‐healing Reticulohistiocytoma: A Clinical, Histological and Ultrastructural Study
Authors: ØRNVOLD K. , JACOBSEN S. VIDAR , NIELSEN M. H.
Published: January 2008

ABSTRACT. A 2300 g male infant presented at birth with multiple, firm, bluish skin nodules, petechiae and thrombocytopenia. Physical examination was otherwise normal and no biochemical signs of organ dysfunction were found. A skin biopsy, done on the second day of life, was consistent with self‐healing reticulohistiocytoma by light and electron microscopy. The nodules spontaneously resolved during the following months. At one year follow‐up, he was without evidence of disease, the only sequelae being occasional discrete scarring. The major problem with this rare entity lies in its dramatic presentation and the chance of possible hazardous “overtreatment”.
Vitamin D Deficiency Rickets and Vitamin B12 Deficiency in Vegetarian Children
Authors: HELLEBOSTAD M. , MARKESTAD T. , HALVORSEN K. SEEGER
Published: January 2008

ABSTRACT. During the years 1978‐83 four vegetarian children have been admitted to the pediatric departments of Ullevaal and Aker Hospitals in Oslo and Haukeland Hospital, Bergen, with the diagnosis of vitamin D deficiency rickets. One had vitamin B12 deficiency as well. All had been fed a vegetarian diet with some cows’milk, but without vitamin supplementation. All had marked hypocalcemia, and three had tetany or convulsions. All responded well to conventional doses of vitamin D therapy. Two of the mothers had vitamin D deficiency, and one of them also had vitamin B12 deficiency. This report describes the case histories of these children, and also discusses predisposing factors of vegetarian diets for the development of nutritional rickets
Post‐natal Development of Protein C in Full‐term Newborns
Authors: SCHETTINI F. , MATTIA D. DE , ALTOMARE M. , MONTAGNA O. , CIAVARELLA G. , MANZIONNA M. M.
Published: January 2008

ABSTRACT. The purpose of this study was to determine the concentration of Protein C in the blood of full‐term healthy newborns. The levels of Protein C, evaluated by electroimmunoassay, were low in the first 5 days of life and lower than the critical adult thrombotic level. The antigenic activity increased progressively from the 2nd week of life and the adult values were reached after the 6th month. The reduction of Protein C levels may impair the ability of the newborn to control consumptive disorders, thus exposing the infants to the risk of thrombotic conditions in neonatal age.
Success and Relapse Rate after Treatment of Cryptorchidism with Intranasal LHRH
Authors: SCHWARZ H. P. , AEBI S. , PERISIC M.
Published: January 2008

In a collaborative study 119 cryptorchid prepubertal children with 67 unilaterally and 104 bilaterally undescended testes were treated for four weeks with intranasal LHRH 1.2 mg daily. The age range was 1 1/12 to 12 3/12 2 years with a median of 3 10/12 years. Complete descent was observed in 64 testes (37 %) and partial descent in another 47 testes (27 %). Positive responders were equally distributed in all age groups. At a follow‐up of 57 patients at least six months after the end of treatment, 40 % of the previously fully descended testes were found at higher locations, more than half at the scrotal neck. We conclude that LHRH therapy for cryptorchidism is effective and without any major side‐effects. It may be particularly useful in children of one to three years of age where hCG is practically useless and surgical repair is the only alternative to date. However, efforts should be directed towards elaboration of treatment schedules which would avoid the high relapse rate.
Rett's Syndrome: Prevalence and Impact on Progressive Severe Mental Retardation in Girls
Authors: HAGBERG B.
Published: January 2008

ABSTRACT. The prevalence of Rett's syndrome was studied in a part of southwestern Sweden comprising five counties and the city of Gothenburg. In a population of 315469 children and adolescents, 6‐17 years of age, 10 cases were detected, all girls. The corresponding prevalence was 0.65/10000 girls, i.e. about twice that of phenylketonuria (PKU) in the same area. As progressive brain disorders/metabolic diseases together constitute 5‐6 % (1.5‐2.0/10000 children) of the aetiologies among severely mentally retarded persons of this age group in central Sweden, it can be concluded that within this group Rett's syndrome should be considered as an aetiological factor to think of in females. This syndrome might well be responsible for one‐fourth to one‐third of such cases among girls.
Evaluation of Treatment in Typical Absence Seizures: The Roles of Long‐term EEG Monitoring and Ethosuximide
Authors: BLOMQUIST H. K:son , ZETTERLUND B.
Published: January 2008

ABSTRACT. Eleven children with typical absence seizures were studied clinically and by repeated 24‐h EEGs with portable cassette tape recorder before and during anticonvulsant treatment. The history, the observation of seizures and the amount of spike‐and‐wave activity (episodes >3 sec) were studied in relation to the plasma levels. The EEG revealed spike‐and‐wave episodes, considered as seizures, in a higher frequency than the number of absences reported by the parents. Twenty‐four hour EEG recording was however not superior to long term observation by relatives in establishing freedom from absences. The drug primary used was ethosuximide. Eight of eleven children responded completely on this drug, i.e. no absences observed and EEG was normalized. Of two children in whom the therapy was changed to sodium valproate, one responded completely and one partly. The relation between the ethosuximide dosage given and the plasma concentration level was good. Two cases responded at low plasma levels (<200 μmol/1). Tonic‐clonic seizures occurred in 3/11 children.
Factors Influencing Blood Pressure in Children and Adolescents
Authors: IBSEN KARSTEN KAAS
Published: January 2008

ABSTRACT. The relationship between blood pressure, height‐weight‐obesity, high density lipoprotein (HDL) and total cholesterol was investigated in a population of 871 children and adolescents. The structure of the data was also analysed and a comprehensive control of the model was undertaken. A mean blood pressure (MBP) with minimum variance was used as an integrated measure for the blood pressure. A new children's body mass index CBMI = log weight ‐0.008 × height was used to measure the obesity of the children. This index was proved to be independent of the children's height. The best single descriptive factor for MBP in boys is HDL/total cholesterol (HDLI). In girls, the CBMI is the most descriptive. Weight contributes significantly to the description of MBP in both sexes. In girls, the HDLI also improves the description of MBP. In boys, age is of no significance when weight is included in the analysis. Heart rate (HR) depends significantly on weight in both sexes. In girls, HR furthermore is correlated to cholesterol. None of the parameters; circumference of arm, consumption of tobacco or licorice, serum triglyceride, and diabetes in family were found to contribute significantly to the description of MBP or HR when CBMI, weight, HDLI and total cholesterol are included in the analysis.
Selective Vitamin B12 Malabsorption without Anaemia but with Profound Failure to Thrive
Authors: AUCHTERLONIE I. A. A. , THOM H. , CAMPBELL A. G. M.
Published: January 2008

ABSTRACT. A 7‐month‐old boy presented with vomiting and failure to thrive associated with proteinuria, methylmalonic aciduria and macrocytosis, but without anaemia. Plasma vitamin B12 levels were normal by a radio‐dilution method. He was treated as an inborn error of metabolism with intramuscular cyanocobalamin and a low protein diet. However when treatment was withdrawn he remained well for 11 months before relapsing with vomiting and weight loss. Re‐investigation again showed methylmalonic aciduria, but the haemoglobin was low and plasma vitamin B12 levels by a specific method showed them to be reduced. Studies of vitamin B12 absorption showed the picture of selective malabsorption. He was started on regular cyanocobalamin injections.
Oral Rehydration Therapy in Infectious Diarrhoea
Authors: SÖKÜCÜ S. , MARIN L. , GUNOZ H. , APERIA A. , NEYZI O. , ZETTERSTROM R.
Published: January 2008

ABSTRACT. The clinical response and changes in water and salt homeostasis as judged from serum sodium levels, salt and water retention and renal handling of sodium was studied during 36 hours following the start of oral rehydration therapy (ORT) with a solution containing 60 mmol N d (ORS,) in 17 well‐nourished, moderately dehydrated Turkish infants aged 3 to 15 months who had acute infectious diarrhoea (7 with rotavirus, 3 with enteropathogenic E. coli 0 111: B 84, and one with enteropathogenic E. coli 0 125: B 15, one with salmonella and 5 of unknown etiology. In the sucessfully treated patients sodium and water balance was normalized within 36 hours. In the cases with hypernatremic dehydration the serum sodium concentration rapidly became normal. The results were compared with those obtained in a previous study of the same type of patients who were rehydrated with a solution containing 90 mmol N d (ORSw). Although retention was considered to be satisfactory after OR& it was less than after ORSw. The changes in the fractionary urinary sodium excretion and the potassium sodium quotient in the urine indicated a less rapid normalization after ORS, than after ORSW.
The Effect of Multiple Exchange Transfusions on Bilirubin Binding
Authors: CEPEDA E. E. , ARAN S. SHANK
Published: January 2008

ABSTRACT. Three bilirubin binding tests (hydroxybenzene‐azobenzoic acid dye binding method, the estimation of unbound bilirubin by horseradish peroxidase assay and the saturation of albumin by the salicylate saturation index) were performed on pre‐exchange samples of blood and repeated 24 hours after the procedure. No significant improvement in bilirubin binding was found even in infants receiving as many as four exchange transfusions. Based on these bilirubin binding tests, we find no evidence that the criteria for subsequent exchange transfusions should be different from the first exchange transfusion.
Single‐Dose Netilmicin Therapy of Complicated and Uncomplicated Lower Urinary Tract Infections in Children
Authors: VIGANÒ A. , VILLA A. DALLA , BIANCHI C. , GANDINI G. , GABOARDI F. , PRINCIPI N.
Published: January 2008

ABSTRACT. Thirty children (age 3 months to 10 years) with complicated and uncomplicated lower urinary tract infections were treated with a single intramuscular injection of netilmicin 4.5 mg/kg. The diagnosis of lower urinary tract infection was based on the absence of fever and the presence of normal values for erythrocyte sedimentation rate, C‐reactive protein concentration and urinary excretion of N‐acetyl‐ß‐D‐glucosaminidase. Follow‐up urine cultures in all children demonstrated a cure rate of 97 % and reinfection and relapse rates each of 7 % respectively. The subgroup (12 children) with radiological abnormalities of urinary tract showed a cure rate of 92 %, and reinfection and relapse rates of 9 % respectively. The rates of cure, reinfection and relapse in the complicated and uncomplicated urinary tract infections were not statistically different (p>0.05). A pharmacokinetic study (performed in 5 children) demonstrated that netilmicin urinary concentrations were over the MIC's of the infecting organisms up to 96 hours after the single‐dose injection. Netilmicin was well tolerated and no side effects appeared during treatment. Single‐dose netilmicin therapy is an effective and safe regimen for complicated and uncomplicated urinary tract infections in children. The response to single‐dose netilmicin therapy seems to be related to its prolonged urinary elimination.
Acute Tubular Dysfunction in Infants with Obstructive Uropathy
Authors: HEIJDEN A. J. V.D. , VERSTEEGH F. G. A. , WOLFF E. D. , SUKHAI R. N. , SCHOLTMEIJER R. J.
Published: January 2008

ABSTRACT. Eleven patients are described with severe hyponatremia, hyperkalaemia and metabolic acidosis associated with a urinary tract infection and obstructive uropathy. This clinical entity resembles adrenocortical disorders. Urine culture investigation in combination with abdominal ultrasound examination will reveal urinary tract obstruction. Differential diagnosis, pathogenesis and treatment are discussed. In most patients correction of the metabolic disturbance can be achieved with antibiotic treatment, occasionally in combination with surgical therapy. Some degree of polyuria will generally persist.
Pseudo‐precocious Puberty Caused by Bilateral Idiopathic Testicular Hyperplasia
Authors: FROST G. J. , PARKIN J. M. , SCOTT D. , WATSON M. J.
Published: January 2008

ABSTRACT. A boy aged two years presenting with advanced development of the genitalia, but with prepubertal testes, and accelerated growth is described. Investigation indicated pseudo‐precocious puberty, due to idiopathic interstitial cell hyperplasia. Difficulties in interpretation of the hormonal studies were encountered due to an aberrant left testicular vein. This rare condition which has been called Testotoxicosis is probably due to an inborn error of metabolism not yet identified.
Problems in the treatment of malabsorption in CF
Authors: SINAASAPPEL M. , BOUQUET J. , NEIJENS H. J.
Published: January 2008

ABSTRACT. Several factors play a role in the cause of malabsorption in CF. Besides the enzyme deficiency in the secretion of the exocrine pancreas, decreased bile‐salt concentration in the gut may also be an important factor in the fat malabsorption. The contribution to the fat absorption by other lipases, such as lingual lipase and gastric lipase, remains to he proved. The therapeutic measures are only partly effective because of the breakdown of swalled enzymes by gastric acid. Some improvement is reached by using a new acid‐resistant coating for the enzyme supplement. Newly developed and essential for its success is the application of small coated particles to prevent retention in the stomach, and the easy breakdown of the coating in an alkaline solution. The treatment of the bile salt deficiency has not been successful until now. A trial with additional Tween 80, with the option of supplementing the detergent activity which was found to he successful in Crohn disease, was without marked success.
Status at Two Years in 121 Very Low Birth Weight Survivors Related to Neonatal Intraventricular Haemorrhage and Mode of Delivery
Authors: GREISEN G. , PETERSEN M. B. , PEDERSEN S. A. , BÆKGAARD P.
Published: January 2008

ABSTRACT. All 121 infants with birthweight 1500 g (VLBW) discharged from our department through an 18‐month period were followed up at two years of age. All but 10 infants were examined by cranial ultrasound scanning in the neonatal period. Six had died after discharge; and of these two had severe brain damage following neonatal intraventricular haemorrhage. Twelve children had definite neuromotor abnormality; of these, the nine children with spastic types of cerebral palsy had all been delivered vaginally. Of the remaining children, one half had at least one neurodevelopmental symptom suggesting perinatal brain damage. Outcome was associated to neonatal intraventricular/subependymal haemorrhage when complicated by ventricular dilatation. Outcome in children with simple haemorrhage was similar to that in children without haemorrhage. The association between outcome and haemorrhage was considerably reduced by simultaneously considering the associations of gestational age at birth and the use of mechanical ventilation in the neonatal period. Head circumference at follow‐up was greatest in those children with haemorrhage complicated by ventricular dilatation, when adjusted for actual body weight, birth weight, and gestational age at birth.
Changes in Intracranial Arterial Blood Flow Velocities during Surgical Ligation of the Patent Ductus Arteriosus
Authors: SONESSON S.‐E. , LUNDELL B. P. W. , HERIN P.
Published: January 2008

ABSTRACT. A combined continuous and range‐gated Doppler instrument was used to assess intracranial arterial blood flow velocity changes in infants and neonates undergoing surgical ligation of the Ductus Arteriosus (DA). Continuous recordings during DA closure in six infants (3.5‐10 months old), showed an abrupt increase in diastolic blood flow velocity simultaneous with an increase in systolic and diastolic arterial blood pressure. In five infants, these changes were followed by a rapid fall in systolic and diastolic blood pressure without a concomitant change in blood flow velocity, which may be secondary to a rapid fall in intracranial vascular resistance. The mean blood flow velocity increase following DA closure was 27 % (8‐43 %) and the changes in diastolic and mean blood flow velocity were significant (p<0.01). In seven preterm neonates (24‐28 weeks) studied before and after surgery, a mean blood flow velocity increase of 50 % (14‐115 %) (p<0.01), mainly due to an increase in diastolic blood flow velocity (p<0.01), was recorded. These rapid intracranial hemodynamic changes during surgical DA closure should be taken into consideration when selecting techniques for DA closure.
A Population Study of Severe Aplastic Anemia in Children
Authors: CLAUSEN N.
Published: January 2008

ABSTRACT. The total number of registered cases of severe aplastic anemia in Denmark was 39 among children aged 0–14 years in 1967 to 1982 giving an annual incidence of 2.2 cases per 1 million children in a well defined and stable population. A probable cause of the aplastic anemia was found in 21 cases (54%). Exposure of the population to known etiological factors of aplastic anemia such as chloramphenicol, pesticides and hepatitis was constant in the study period, and accounted for 2, 5, and 2 cases, respectively. Other infections caused 6 cases, other drugs 2 cases, and organic diluents one case. Three children with constitutional aplasia developed severe aplastic anemia among a total of 6 Fanconi's anemias, 3 probable Fanconi's anemias, and 10 cases of erythrogenesis imperfecta diagnosed during the same 16 years. Thirteen patients (33%) died within 3 months after the diagnosis while on supportive treatment and low dose prednisolone supplemented with androgen treatment. Long term survival occurred in 10 patients (26%), of which 5 patients were in complete and 5 in partial remission.
Hyperfunctioning Thyroid Nodules in Children and Adolescents
Authors: DE LUCA F. , CHAUSSAIN J. L. , JOB J. C.
Published: January 2008

ABSTRACT. Eight children and adolescents, seven female and one male, aged 7.1 to 15.0 years, referred over a 12‐year period for a solitary mass in an otherwise normal thyroid gland, exhibited a hyperfunctioning nodule on thyroid scintiscan. Tracer uptake in the surrounding thyroid tissue was reduced or completely suppressed, but could be restored after TSH stimulation. Only one patient had mild clinical hyperthyroidism with normal T4 but increased T3 serum levels and blunted TSH responsiveness to TRH. A similar hormonal pattern suggestive of subclinical hyperthyroidism was found in three other subjects who were clinically euthyroid. One patient initially euthyroid progressed to subclinical hyperthyroidism two years later. In the whole group a significant negative relationship was found between serum T3 level and TRH‐stimulated TSH peak (r= ‐0.829, p<0.02). All the patients underwent selective surgery after a 3‐month to 2‐year period of follow‐up. Microscopic examination was consistent with adenoma in seven patients, while in one case a well‐encapsulated papillary adenocarcinoma was found. Though hyperfunctioning nodules are seldom malignant, their surgical removal must be recommended when they become thyrotoxic, exceed 3 cm or show progressive enlargement.
Antibodies to Staphylococcal Teichoic Acid and Alpha Toxin in Patients with Cystic Fibrosis
Authors: ERICSSON A. , GRANSTRÖM M. , MÖLLBY R. , STRANDVIK B.
Published: January 2008

ABSTRACT. Enzyme‐linked immunosorbent assay (ELISA) was used for IgG antibody determination to teichoic acid and a‐toxin from Staphylococcus aureus in 65 patients with cystic Fibrosis (CF). In patients chronically colonized with S. aureus, elevated titres to teichoic acid were found in 13/35 (37%) patients, to a‐toxin in 12/35 (34%) and to either antigen in 18/35 (51%). Patients with elevated titres to teichoic acid had a significantly lower X‐ray score than patients with normal titres. The highest titres against both teichoic acid and a‐toxin were seen in patients not receiving optimal treatment. These findings suggest that staphylococci contribute to the tissue damage in CF and that the determination of antibodies especially to staphylococcal teichoic acid might be of value in the diagnosis and management of staphylococcal infections in patients with CF.
Impairment of Polymorphonuclear Leucocyte Function during Therapy with Synthetic ACTH in Children Affected by Epileptic Encephalopathies
Authors: COLLESELLI P. , MILANI M. , DRIGO P. , LAVERDA A. M. , CASARA G. L. , ZANESCO L.
Published: January 2008

ABSTRACT. Therapy with synthetic ACTH (zinc tetracosactide) in children affected by epileptic encephalopathy is often associated with a large number of infectious complications. We studied the phagocytic activity of polymorphonuclear leucocytes (PMN) in 9 children with West or Lennox‐Gastaut syndrome, measuring PMN superoxide anion production during the phagocytosis of particles of Zymosan and after phorbol miristate acetate (PMA) stimulation. The test was performed before, during and after therapy with zinc tetracosactide (0.02 mg/kg/day for 15 days). At the same time plasma immunoglobulins, C3, C4, C3 activator and Cortisol were determined. During treatment PMN phagocytic function was significantly reduced but returned to normal levels after suspension of therapy. The other hematological parameters considered remained within the normal range. During the follow‐up of the patients we observed 15 infectious episodes (3 mucocutaneous candidiasis, 2 enterocolitis, 4 urinary tract infections, 1 otitis media, 3 bronchiolitis, 2 pneumonia). One of the patients died of a bilateral pneumonia. Three children were treated with ACTH on alternating days. In these patients PMN phagocytic activity was less impaired and 2 infectious episodes rapidly resolved. Alternate day ACTH therapy seems to be preferable.
A Simplified Model for Adjustment of Gentamicin Dosage in Newborn Infants
Authors: HERNGREN L. , BROBERGER U. , WRETLIND B.
Published: January 2008

ABSTRACT. In a retrospective study of 72 neonates during treatment with gentamicin, poor correlation was found between dosage based on body weight and gentamicin serum concentrations. Calculation of adequate gentamicin dosage regimen during steady‐state based on individual pharmacokinetic parameters according to Gibaldi & Perrier (5) was then studied in 35 newborn infants during therapy. Predictions were based on gentamicin serum concentrations taken prior to and 1, 3, and 5 hours after the first (n=8) or second (n=12) dose (group A), or only prior to and one hour after dose (group B, n=15). Half‐life (t1/2), apparent volume of distribution (Vd), body clearance (Clbody) and elimination rate constant (β) were not significantly different when calculated after the first or second dose or during steady‐state. The correlation between predicted and observed gentamicin concentration was high in both groups (p< 0.005) and the slopes congruent with unity. After dose or interval correction, 73 % of the observed predose concentrations (mean 2.0 μg/ml) were within 1 μg/ml of predicted values. One hour after dose the predicted (mean 5.7 μg/ml) and observed (mean 6.2 μg/ml) values were not significantly different. Higher precision was noted when the predictions were based on 4 samples (group A) compared to 2 (group B). Since the calculations may be performed by a simple desk calculator rapid advice may be given to the clinical staff on adequate gentamicin dosage even in small severely ill preterm infants.
Breastfeeding among Turkish Mothers Living in Suburbs of Istanbul and Stockholm–A Comparison
Authors: KOCTÜRK TAHIRE O. , ZETTERSTRÖM ROLF
Published: January 2008

ABSTRACT. The infant feeding pattern among 96 Turkish mothers living in a suburb of Istanbul and 30 living in a suburb of Stockholm, both with working class characteristics, was determined. The duration of breastfeeding among the Turkish immigrant group living in the Stockholm suburb was significantly reduced compared with the group with a similar social background but living in a native urban area. Infant feeding pattern among the Turkish immigrant mothers was more similar to that of Swedish populations. Attitudes to breastfeeding among the immigrant group had changed. Early weaning, reliance on commercially available infant foods and bottle feeding characterized their infant feeding practices. The majority of the infants of this group showed a tendency to overweight.
Selenium Content of Breast Milk Sampled in 1978 and 1983 in Sweden
Authors: WÄLIVAARA R. , JANSSON L. , ÅKESSON B.
Published: January 2008

ABSTRACT. Selenium in human milk sampled at different intervals after parturition was analyzed on two occasions five years apart. The selenium content of colostrum and transitional milk was higher than that of mature milk. Mature milk sampled in 1983 contained more selenium than mature milk sampled in 1978 (11.9 (0.8) vs. 9.4 (0.5) μg/1, mean (SD), p< 0.01). The selenium and protein content in milk were positively correlated, which may be explained by the occurrence of seleno‐amino acids in proteins. The selenium content was not correlated to that of tocopherol or of highly unsaturated fatty acids in mature milk. The values for the selenium content in human milk found here are lower than those previously reported from other countries.
Ultrasound Imaging in Diffuse Thyroid Disorders of Children
Authors: PÖYHÖNEN L. , LENKO H.‐L.
Published: January 2008

ABSTRACT. The diagnosis of diffuse thyroid disorders in children is based mainly on hormone and antibody determinations and a cytologic sample taken by aspiration biopsy. The cytologic sample is not always obtainable in small children or when the thyroid gland is not enlarged. Thyroid antibodies lead to diagnosis only in a proportion of cases. Gamma imaging is not recommended in children because of the radiation risk. The aim of this study was to demonstrate that ultrasound imaging can detect diffuse thyroid disorders in children. Ultrasound images were abnormal in 92 % of all subjects; they were abnormal in 97 % of cases with thyroiditis and in most cases ultrasound was diagnostic. With antibody determinations, only 60 % of the cases of thyroiditis could be diagnosed. Ultrasound imaging–a risk‐free method‐should be included in the diagnostic investigation of thyroid disorders.