bluuebunny/crossref_metadata_2025 huggingface dataset:
DRUG USAGE AND ADVERSE DRUG REACTIONS IN PAEDIATRIC PATIENTS
Authors: WHYTE J. , GREENAN E.
Published: January 2008

Abstract. The development of epidemiological methods for the study of adverse drug reactions is reviewed in connection with the presentation of data obtained by intensive monitoring of 1000 admissions to a medical paediatric unit. Compared with adults and American children, the patients received fewer drugs and experienced fewer reactions while in hospital. The drug usage pattern was different from that of American paediatric practice and general practice in the United Kingdom. Fifty‐one (6%) patients experienced 119 adverse drug reactions. These occurred more frequently in children suffering from serious disorders and in the majority of cases the basic therapy was continued regardless of the severity of the drug side–effects. Treatment was required for the effects of 66 (55 %) adverse reactions. It appears that drug monitoring in paediatric practice may be of greater value if surveillance programmes are designed to provide a “therapeutic audit” and extended to include children receiving drugs in the community.
THE ABSORPTION OF INSULIN
Authors: SCHLICHTKRULL JØRGEN
Published: January 2008

Abstract.It is desirable to improve metabolic control in diabetics receiving insulin. Studies on insulin kinetics provide information that may be useful in the optimization of the injection scheme. Absorption has been measured using 1251‐insulin as marker and counting the residual activity with a crystal detector. Plasma insulin has been measured (by radio‐immunoassay) in the absence of insulin antibodies. The relationship between the rate of absorption and exogenous insulinemia was analyzed using a simple mathematical model. The time course of plasma insulin was calculated for various insulin preparations, including mixtures. The data suggest the significance of the injection site for the effect of insulin, e.g., a more rapid effect atrer injection into the abdominal subcutaneous tissue. The pattern of exogenous insulinemia in patients treated with insulin bears no resemblance to that in normal subjects. The calculated patterns of exogenous plasma insulin aner injection of various preparations suggest that insulin therapy might be improved to obtain a better and more physiological metabolic control.
ALLERGY, OTITIS MEDIA AND SERUM IMMUNOGLOBULINS AFTER ADENOIDECTOMY
Authors: KJELLMAN N.‐I. M. , HARDER H. , HANSSON L.‐O. , LINDWALL L.
Published: January 2008

ABSTRACT. The incidence of atopic disease and of episodes of otitis media, respiratory tract infections as well as levels of serum immunoglobulins were followed during 16 months after adenoidectomy in a consecutive group of 274 children. The total incidence of atopic disease was high (23.6%) at the start of the study and increased further to 39.0% during the study. Increased serum IgE levels, positive RAST tests and/or positive provocation tests were found before the onset of atopic symptoms in 13 out of the 19 children developing such symptoms during the observation period. Otitis media continued to occur in 42.9% of the children. The incidence of episodes of otitis media after the adenoidectomy was higher with lower age, a high number of episodes of otitis media before the operation and/or a history of atropic disease. None of the laboratory tests could predict subsequent episodes of otitis media. Protracted respiratory tract infections developed only in children with laboratory findings indicative of atopy. Serum IgK and IgM levels decreased significantly. No serious infections and no dysgammaglobulinaemias developed. Adeoidectomy seems to be a rather minor trauma from an immunological point of view, but further and controlled studies are needed concerning the possible clinical benefit of adenoidectomy in children with recurrent otitis media.
PUBERTAL DEVELOPMENT IN THE PRADER‐LABHART‐WILLI SYNDROME
Authors: KAULI R. , PRAGER‐LEWIN R. , LARON Z.
Published: January 2008

ABSTRACT. The sexual maturation in the Prader‐Labhart‐Willi (PLW) syndrome was investigated in 14 patients, 10 females and 4 males. A wide variability in the pattern of pubertal development was found including delayed puberty in 5 patients and normal puberty in 4 patients; sexual precocity was also observed in 5 patients, true precocious puberty in one patient and incomplete sexual precocity in the form of precocious pubarche in 4 patients. In 5 patients, 3 of them with precocious pubarche, the appearance of the pubertal signs was followed by a delay or arrest in their future development. An LH‐RH stimulation test was performed in 11 patients. In the 6 patients who eventually developed normal puberty, the basal levels and the peak responses of both LH and FSH were within the range of those observed in normal controls of the same pubertal stage. In 4 patients showing marked delay or arrest of puberty, the basal levels were normal or low and the responses of LH and FSH to LH‐RH were blunted. Priming with repeated LH‐RH stimulation in one of the male patients led to an augmented LH response, suggesting a hypothalamic hypogonadotrophism. It is concluded that the lack of uniformity in the pattern of sexual maturation in the PLW syndrome is due to a variability in the location and extent of a hypothalamic lesion, which may comprise an active process continuing beyond the perinatal period.
CARDIOVASCULAR IMPAIRMENT AND PHYSICAL WORKING CAPACITY IN CHILDREN WITH CHRONIC RENAL FAILURE1
Authors: ULMER H. E. , GREINER H. , SCHÜLER H. W. , SCHÄRER K.
Published: January 2008

ABSTRACT. Forty children with chronic renal failure (CRF) on conservative treatment, on hemodialysis, or after renal transplantation and 22 children representing a nonuremic control group were subjected to repeated cardiologic examinations by ECG, PCG, chest X‐rays and cycle ergometer exercise tests to monitor signs of uremic heart disease and to evaluate physical working capacity (W170). In the CRF group a progressive impairment of W170 was found, starting at an early stage of the disease. Exercise tolerance was inversely related to the degree of CRF. A correlation was also found between W170 and renal anemia. After starting dialysis, W170 failed to increase significantly. Immediately after dialysis an acute drop in W170 occurred. Renal anemia was found to be the main pathogenetic factor of uremic heart disease in children. In some cases hypercirculation following arteriovenous fistulae became equally important as a cause of reduced myocardial performance. Physical rehabilitation, as measured by exercise tolerance tests, was better in transplanted than in dialysed children.
PELIOSIS HEPATIS IN A CHILD
Authors: BANK J. IBSEN , LYKKEBO D. , HÄGERSTRAND I.
Published: January 2008

ABSTRACT. a boy is described with peliosis hepatis. He suffered from a Fanconi anaemia and was treated with prednisolone, dianabol and methyltestosterone. A review of the clinical and pathological aspects of the condition is given.
BILATERAL RENAL APLASIA WITHOUT POTTER'S SYNDROME
Authors: HJALMARSON OLA , SABEL KARL‐GÖRAN
Published: January 2008

ABSTRACT. A Newborn infant with bilateral aplasia of kidneys and ureters and a rudimentary bladder is reported. Other manifestations of Potter's syndrome (oligohydramnios, lung hypoplasia and an abnormal face) were missing as were other congenital malformations. Deviations from the full picture of Potter's syndrome seem to be rare. This case, however, shows that bilateral renal aplasia cannot be excluded as a cause of anuria in a newborn infant, even if all other manifestations of Potter's syndrome are missing.
THE INCIDENCE OF DIABETES MELLITUS IN SWEDISH CHILDREN 1970–1975
Authors: STERKY G. , HOLMGREN G. , GUSTAVSON K. H. , LARSSON Y. , LUNDMARK K. M. , NILSSON K. O. , SAMUELSON G. , THALME B. , WALL S.
Published: January 2008

ABSTRACT. report a retrospective study of diabetic children, 0–14 years of age, from seven Swedish departments of paediatrics. There were 359 new cases in the years 1970–1975. Notification suggested that there was a mean yearly incidence of 19.6 cases per 100000 with a year to year variation of 10.0–26.4 per 100000. Consequently about 330 new cases of childhood diabetes would be expected in Sweden every year. Incidence varied considerably between different geographical areas. The age distribution was bimodal with a main peak at about 12 years and another peak at about 7 years. There was some evidence for clustering of new cases in January and the autumn. The mean prevalence of childhood diabetes in the seven districts was 1.3 per 1000.
BRAIN‐TYPICAL CREATINEKINASE IN THE SERUM OF NEWBORN INFANTS WITH PERINATAL BRAIN DAMAGE
Authors: BECKER M. , MENZEL K.
Published: January 2008

ABSTRACT. Abnormal values of serum‐CK‐activity in healthy newborns varied greatly (95% range: 4–165 U/l; 257 probands) and the borderline to pathological values was not sharp. Brain‐typical CK‐isoenzyme (CK‐BB) could be detected in serum of 6 of 8 infants with perinatal brain damage by means of agar gel electrophoresis. The combination of neuropathological symptoms, increased total‐serum‐CK‐activity, and significant amount of CK‐BB in serum seemed to be a sure sign of severe CNS‐damage in newborns.
SUBCLINICAL PROTEIN‐ENERGY MALNUTRITION IN UNDER‐PRIVILEGED ETHIOPIAN MOTHERS AND THEIR NEWBORN INFANTS
Authors: GEBRE‐MEDHIN MEHARI , LARSSON ULLA , LINDBLAD BO S. , ZETTERSTRÖM ROLF
Published: January 2008

ABSTRACT. An increased glycine/valine ratio in the maternal and cord vein plasma was observed in under‐privileged women and their newborn babies in Ethiopia. There was a delay in the decrease of branch‐chained amino acids during the immediate neonatal period. These findings indicate malnutrition in utero and are identical with those of a previous study in an under‐privileged group in Pakistan. A reduced cord/maternal ratio of tyrosine and methionine was found in the Ethiopian material, indicating placental dysfunction of unknown origin.
LIMB CIRCULATION IN ANOREXIA NERVOSA
Authors: FREYSCHUSS U. , FOHLIN L. , THORÉN C.
Published: January 2008

ABSTRACT.Blood flow, skin temperature and blood pressure of the lower limbs and the effect of indirect, radiant heat on calf blood flow and leg skin temperature was determined in sixteen children with anorexia nervosa (group A) and fourteen healthy children (group H) of the same age and body height. Calf blood flow was measured by venous occlusion plethysmography. Arm blood pressure was obtained by tourniquet and toe pressure and digital plethys‐mograms by a strain‐gauge. Skin temperature was measured with a thermocouple. In group A calf blood flow was about 50–60 % lower than the mean values observed in group H and a marked difference was maintained after the heat load. Skin temperature of the knees and toes were higher in group H. Systolic arm blood pressure and toe pressure were on the average 20 mmHg and 13 mmHg lower in group A. It is suggested that there is a heat‐conserving, selective peripheral vasoconstriction in the anorexic patients.
HAEMORRHAGIC INFARCTION OF THE MYOCARDIUM IN A NEWBORN WITH HAEMOGLOBIN H DISEASE AND ERYTHROBLASTOSIS
Authors: GADOTH N. , KORNMEHL P. , GUERON M. , MOSES S. W.
Published: January 2008

ABSTRACT. Extensive haemorrhagic myocardial infarction developed in a newborn, apparently as a result of anoxia due to erythroblastosis fetalis, associated with haemoglobin H disease. Acute massive myocardial infarction in the neonatal period is rare and usually is associated with congenital malformation of the heart or its blood supply. Neonatal myocardial infarction in the anatomically normal heart with normal coronary vessels, has been described in only 8 patients (1). This communication describes a newborn with acute haemorrhagic myocardial infarction due to anoxia believed to be caused by the combined effect of erythroblastosis fetalis and haemoglobin H disease.
HIGH DOSE METHOTREXATE IN ACUTE LYMPHOCYTIC LEUKEMIA IN CHILDHOOD
Authors: MOE P. J. , SEIP M.
Published: January 2008

ABSTRACT. Gonadal and other types of leukemic “sanctuaries” are probably the main causes of hematological relapse in the treatment of acute leukemia. The introduction of high‐dose Metho‐trexate (HDM) in a consolidation phase is based on theoretical considerations and the use of HDM in malignant tumors. Three courses of Methotrexate, 500 mg/sq.m. at 3‐weekly intervals, has been used as part of a consolidation therapy in Norway during the last two years to 59 children with ALL and one with AML. One child died following HDM. Postmortem examination showed that she was not in complete remission at the time. Among 154 courses of HDM in the 60 patients were eight severe reactions, including six cases of allergic‐toxic skin reactions. Two patients developed a Stevens‐Johnson's like syndrome. Stomatitis was common in those with toxic reactions. The risk of HDM in patients who are not in complete remission is stressed and the use of rescue therapy with two doses of Leukovorin instead of one is recommended. Forty of forty‐two children in 1st complete remission have been in sustained primary remission for 4 to 28 months. Two of these 40 children died after about a year from infections. Only two patients so far have relapsed.
DIAGNOSTIC VALUE OF HAND X‐RAYS IN TURNER'S SYNDROME
Authors: NECIĆ S. , GRANT D. B.
Published: January 2008

ABSTRACT. Previously described radiological signs of Turner's syndrome were evaluated in X‐rays of the left hand from 17 patients with Turner's syndrome (age 10.4–15.3 years) and 17 age‐matched girls with constitutional short stature. While none of the signs clearly distinguished between the two groups, ballooning of the tips of the terminal phalanges with a high ratio between the tip and mid‐shaft diameters seemed to be the most useful sign of Turner's syndrome. Disproportionately long phalanges in the 4th finger and the presence of a coarse reticular pattern in the carpal bones appeared to be the next most useful signs. The presence of a short 4th metacarpal or a narrow carpal angle, and assessment for Madelung's deformity were of little value in distinguishing between the two groups.
RENAL FUNCTION IN IDIOPATHIC RESPIRATORY DISTRESS SYNDROME
Authors: BROBERGER U. , APERIA A.
Published: January 2008

ABSTRACT. Renal function was studied in 11 pre‐term infants with idiopathic respiratory distress syndrome (IRDS) grade 1 according to Prod'hom's criteria. As a reference 16 healthy pre‐term infants were studied. The groups did not differ with regard to mean gestational age (GA) and mean postnatal age (PNA). The studies were preformed twice, first at a PNA of 33–37 hours and then at 132–148 hours. GFR and CPAH were determined with the single injection technique and the ability to excrete Na was determined following an oral Na+ load. GFR was higher in IRDS infants at the first investigation and slightly lower in IRDS infants at the second investigation. The GFR correlated to the lowest recorded Pao2 r=0.45) in IRDS infants. CPAH was similar in IRDS and controls at the first, and lower in IRDS infants at the second investigation. The urinary Na+ excretion was significantly higher in IRDS infants. Treatment with digitalis was in part responsible for the high urinary Na+ excretion. The IRDS infants had a higher Na+ and glucose intake than the control infants. It is suggested that this higher intake is in part responsible for the relatively high GFR and urinary Na+ excretion in the IRDS infants.
URINARY CYCLIC AMP IN INFANTS ADMITTED TO A NEONATAL INTENSIVE CARE UNIT
Authors: AKSNES L. , SØVIK O. , FINNE P. H. , OPSHAUG O.
Published: January 2008

ABSTRACT. The urinary excretion of cyclic AMP was studied during the first 3 days of life in 46 randomly selected infants admitted to a neonatal intensive care unit. The data were compared with those of normal newborn infants. Urinary cyclic AMP concentrations were significantly correlated with gestational age (all patients), and with birth weight (all patients except infants of diabetic mothers (IDMs)). The urinary cyclic AMP/creatinine ratio increased from day 1 to day 3 in normal newborns and in IDMs, and tended to increase also in small‐for‐gestational age (SGA), low birth weight (LBW), and sick, term infants, although the changes in the latter groups were not statistically significant. Four infants studied with parallel determinations showed increased cyclic AMP/creatinine ratio from day 1 to day 3 both in plasma and urine. All urinary cyclic AMP/creatinine ratios were lower than the corresponding ratios found in plasma. In LBW infants, there was an inverse relationship between urinary cyclic AMP and serum calcium. In IDMs a positive correlation was observed between urinary cyclic AMP and blood glucose concentration. In conclusion, the excretion of cyclic AMP in sick newborn infants is influenced by the following factors: gestational age, postnatal age, birth weight, and derangements of serum calcium and blood glucose concentrations.
THE DIAGNOSIS OF IRON DEFICIENCY BY ERYTHROCYTE PROTOPORPHYRIN AND SERUM FERRITIN ANALYSES
Authors: KOLLER M.‐E. , ROMSLO I. , FINNE P. H. , BROCKMEIER F. , TYSSEBOTN I.
Published: January 2008

ABSTRACT. Free erythrocyte protoporphyrin (FEP) and serum ferritin have been determined in 57 healthy children and in 25 children with varying degrees of iron deficiency. FEP was found to be inversely correlated to the concentration of hemoglobin (r=‐0.80) as well as to serum ferritin (r=‐0.64). Elevated FEP was found in children with hemoglobin less than 12.5 g/dl, or serum ferritin less than 8 μg/l. In a group of apparently hematologically normal children between the age of 10–14 years (hemoglobin≥ 12.5 g/dl), a 2‐month‐trial of iron medication resulted in an increase in hemoglobin and ferritin, and a decrease in FEP, indicating suboptimal supply of iron for hemoglobin synthesis before iron medication. In a patient with iron deficiency (FEP 15.3 μmole/l, hemoglobin 5.2 g/dl), iron therapy was followed by a rapid fall in FEP before any changes in hemoglobin, serum iron transferrin saturation and ferritin could be detected. The rapid fall in FEP during start of treatment in iron deficiency makes FEP a sensitive biochemical parameter on iron homeostasis in iron deficiency anemia.
VISUAL DISORDERS IN 7‐YEAR‐OLD CHILDREN WITH AND WITHOUT PREVIOUS VISION SCREENING
Authors: KÖHLER LENNART , STIGMAR GÖRAN
Published: January 2008

ABSTRACT. An analysis of visual defects among 310 children referred from a vision screening of 2178 7‐year‐old children revealed a 50% frequency of significant eye defects among the referrals (7% of screened children). Of the screened children, one group (1530 children) had previous visual screening three years earlier. The other group (648 children) had no previous vision screening until the age of seven. A comparison between the two groups showed that the risk of finding a new significant eye disorder in a school entrant was more than 6 times greater for a child who was not examined in his preschool years, and the risk of finding an ambiyopic child was more than 10 times greater. The results do indicate the need for continuation of the present vision screening program of pre‐school children.
MANNITOL OSMOLAR CLEARANCE IN DIABETES INSIPIDUS OF CHILDREN
Authors: SIMON J. , ZAMORA I. , MARTINEZ‐SANCHEZ F. , BARTOLOME V.
Published: January 2008

ABSTRACT. A modified technique of mannitol‐induced diuresis is described, in order to assess renal concentrating ability in infants and children. The infusion of 10% mannitol in 0.9% saline avoided the hypertonic saline overload and the fluid restriction period, both badly tolerated by infants and small children. In a control group of children aged from two months to seven years, the values of TH2o plotted against Cosm allowed to calculate the adjustment curve y=0.80x0.75, r=0.98 (p<0.0001). In six patients with pituitary diabetes insipidus (PDI), the test was used in order to quantify the degree of ADH deficiency and evaluate the carbamazepine and clofibrate effect, in the renal concentrating mechanism. The test was tolerated perfectly in every case, obtaining qualitative and quantitative data and avoiding the hyponatremia and hypokalemia produced by the mannitol.
GROWTH, BODY WEIGHT AND INSULIN REQUIREMENT IN DIABETIC CHILDREN
Authors: PETERSEN H. DRAMINSKY , KORSGAARD BENTE , DECKERT T. , NIELSEN E.
Published: January 2008

ABSTRACT. The weight and height development of 51 boys and 48 girls who had developed diabetes prior to the age of 15 years was followed for a minimum of 3 years, mean 8.3 years, up to the age of 18 for the girls and 20 for the boys. In addition, the insulin requirements were recorded. Weight and height proved to be within the normal range, and height at onset of diabetes was normal. After a long duration of diabetes, however, there occurred a reduction of height increment of about 1/2 cm/year. This reduction was greater in children who rarely attended as compared with those who frequently attended a sub‐specialized clinic. The daily dose of insulin increased with age, the greatest increase coinciding with the growth spurt. During the first 4 years of diabetes the 24‐hour dose/kg body weight increased, indicating a decreasing endogenous insulin production. Later it was constant at around 0.9 i.u./kg. Modern management of diabetic children leads to normal adult stature.
MALFORMATION OF THE GREAT VEIN OF GALEN WITH NEONATAL HEART FAILURE Report of Two Cases
Authors: EIDE J. , FØLLING M.
Published: January 2008

ABSTRACT. The clinical and pathological findings in two neonates with the malformation of the great vein of Galen are given. They both reported with serious neonatal heart failure suggesting congenital heart disease. In one of them cardiac catheterization revealed a foetal pattern of circulation causing cyanosis. A bruit and in one of them a thrill over the skull gave the clinical diagnosis of an intracranial arteriovenous aneurysm. They died 48 and 144 hours after birth in spite of medical treatment. The outlook for patients having malformation of the great vein of Galen and suffering neonatal heart failure treated conservatively, seems hopeless.
NATURAL HISTORY OF JUVENILE RHEUMATOID ARTHRITIS A Follow‐up Study of a Case with Special Reference to Clinical, Electroencephalographic and Neuropathological Findings
Authors: SILLANPÄÄ M. , LANG A. H. , KALIMO H.
Published: January 2008

ABSTRACT. A detailed comparison between the clinical and EEG findings is made in a case of a boy with juvenile rheumatoid arthritis (JRA) who died at 15 years, 6.5 years after the beginning of the follow‐up period. In the course of the disease, seven EEG recordings were made, showing a progressive diffuse slowing and disorganization with some improvement during short remissions. In relapses, diffuse slowing was associated with grave asymmetries in the EEG which, however, fluctuated and later disappeared without accompanying clinical or neuroradiological abnormalities. An abundancy of different residual findings, however, remained in the EEG after relapses. There were spike‐and‐wave paroxysms in every record except at the terminal stage. A stepwise slowing and disorganization was also seen in these paroxysms as background activity. The final cause of death was an intraventricular haemorrhage. No cerebral amyloidosis was found at autopsy. In conclusion, it is suggested that JRA is also a brain disease manifested as a cerebral vasculitis.
CLASSIFICATION OF INHERITED HYPO‐ AND HYPERLIPIDEMIA
Authors: ANDERSEN G. E.
Published: January 2008

ABSTRACT. A model of lipoprotein dynamics is presented which permits a more rational understanding of the causes of the common types of inherited hypo‐ and hyperlipidemia in man with special reference to childhood.
NEW KNOWLEDGE IN HUMAN MILK IMMUNOGLOBULIN
Authors: HANSON L. Å , AHLSTEDT S. , CARLSSON B. , FÄLLSTRÖM S. P. , KAIJSER B. , LINDBLAD B. S. , ÅKERLUND A. SOHL , EDÉN C. SVANBORG
Published: January 2008

ABSTRACT. One of the anti‐infection principles of maternal milk is the predominant milk immunoglobulin, secretory IgA. This immunoglobulin contains antibodies against many pathogens and potential pathogens, viruses as well as bacteria, including several members of Enterobacteriacae, The antigenic stimuli for these milk antibodies seem to take place in the Peyer's patches of the intestine. Lymphoid cells leaving the patches after antigenic exposure seem to home to the mammary glands via the lymph and blood circulation. As a result, the milk contains secretory IgA antibodies against, among other things, the intestinal bacteria of the mother. These milk antibodies might reflect the spectrum of bacteria and viruses in the community and may be important for the protection of the breast‐fed baby. Via the same homing mechanism the maternal milk obtains antibodies against dietary antigens, including cow's milk proteins. Studies of infants on mixed feeding suggest that the secretory IgA antibodies against the bovine proteins diminish the antigenic exposure, indicating the possibility of an anti‐allergic mechanism.
THE VOLUME OF TRAPPED GAS: A NEW AND SENSITIVE TEST FOR THE DETECTION OF EXERCISE‐INDUCED BRONCHOSPASM IN CHILDREN
Authors: SVENONIUS E. , LECEROF H. , LILJA B. , ARBORELIUS M.
Published: January 2008

ABSTRACT. The volume of trapped gas (VTG) was measured at the end of a nitrogen multiple breath wash out procedure in 16 asthmatic and 10 healthy children before and after exercise. When compared to conventional spirometric variables VTG was the most sensitive test for detection of exercise‐induced asthma (EIA). The VTG was significantly higher before exercise in the asthmatic children and increased significantly after exercise, while it did not change in the healthy controls. The significance of changes caused by EIA increased if VTG/TLC% or VTG/VC% were used. Salbutamol inhalation normalized the VTG in all the asthmatic children.
URINARY TRACT INFECTIONS CAUSED BY PROTEUS MIRABILIS IN CHILDREN The Antibody Response to O and H Antigens and Tamm‐Horsfall Protein and Bacterial Adherence to Uro‐epithelium
Authors: LARSSON P. , FASTH A. , JODAL U. , ÅKERLUND A. SOHL , EDÉN C. SVANBORG
Published: January 2008

ABSTRACT. Sera from seven girls with acute symptomatic pyelonephritis and nine children with acute symptomatic cystitis caused by Proteus mirabilis were analysed for antibodies against the bacterial O and H1 antigens and the Tamm‐Horsfall protein. An increase in antibody levels against O antigen and Tamm‐Horsfall protein was noted only in patients with acute pyelonephritis indicating that antibody determinations can be useful in differentiating between upper and lower urinary tract infection caused by Proteus in similarity to those caused by E. coli. In contrast no difference in adhesive ability was noted comparing Proteus strains causing acute pyelonephritis or cystitis.
LONG‐TERM PROPHYLAXIS WITH METHENAMINE HIPPURATE IN GIRLS WITH RECURRENT URINARY TRACT INFECTIONS
Authors: PETERSEN STEN
Published: January 2008

ABSTRACT. Twenty girls, aged 5–12 years, with recurrent urinary tract infections, were treated with methenamine hippurate, Hiprex®, for a period of 12 months. The number of infections per patient per year was reduced from 3.1 to 0.7 (p<0.001). After prophylaxis was stopped this number increased to 1.4 which is a significantly higher incidence than occurred during treatment (p<0.05). A few girls complained of the taste but no side‐effects were observed. Methenamine hippurate is a useful alternative in long‐term prophylaxis against recurrent urinary tract infections in girls.
CONGENITAL DEFECTS IN A COHORT FOLLOWED FOR SEVEN YEARS
Authors: KLEMETTI ANNELI
Published: January 2008

ABSTRACT. A geographically limited cohort of Finnish children was followed from birth for seven years, and all congenital abnormalities were recorded and classified and special attention was given to the cumulative detection rate, and the time of detection of various defects. Of 3674 pregnancies 135 babies with or without defects were stillborn or died during the neonatal period. The remaining 3539 were followed up to seven years, when the percentage follow‐up was 81.7%. Detailed information on 76 malformed livebirths registered in the neonatal period was available in 63 cases (82.9%). The diagnosis was found to be incorrect in 6 cases and additional defects were registered in 7 of these children. Additional congenital abnormalities detected in the follow‐up study were divided into three groups: all congenital disorders or abnormalities with prenatal etiology (248 children), all congenital defects (111 of these 248) and structural malformations (31 of these 111). The cumulative detection rates in these groups increased with time and at the end of the study when the children were aged seven were 9.4%, 5.6% and 2.6%, respectively.
VARIATIONS OF SERUM TESTOSTERONE ESTRADIOL BINDING GLOBULIN (TeBG) BINDING CAPACITY IN INFANTS DURING THE FIRST YEAR OF LIFE
Authors: CHAUSSAIN J. L. , BRIJAWI A. , GEORGES P. , ROGER M. , DONNADIEU M. , JOB J. C.
Published: January 2008

ABSTRACT. Serum TeBG binding capacity was measured in 8 cord blood samples, and in peripheral venous blood from 39 male and 31 female infants aged from 1 day to 1 year. In cord blood, TeBG binding capacities were low (1.27±0.3 μg/100 ml) with no sex difference. In male infants, TeBG binding capacities increased progressively from birth to 3 months, before decreasing to reach the normal prepubertal level at 6 months. Individual values ranged between 1.16 and 14.5 μg/100 ml and were significantly correlated with plasma testosterone (r=0.671, 95% confidence limits 0.440 to 0.818, p<0.005) and estradiol (r=0.734, 95% confidence limits 0.121 to 0.942, p<0.01) levels. In female infants, individual values ranged between 1.17 and 14.5 μg/100 ml, without correlation with age or plasma estradiol level. In male infants the data suggest a positive control of TeGB binding capacity by estrogens, the negative effect of testosterone being delayed until after the 3rd month of age. In girls, the lack of correlation between TeBG and estradiol can probably be explained by rapid variations of plasma estradiol levels.
PLASMA FREE AMINO ACID CONCENTRATIONS OF BREAST‐FED INFANTS
Authors: LINDBLAD B. S. , ALFVÉN G. , ZETTERSTRÖM R.
Published: January 2008

ABSTRACT. Photometric determination of alpha‐amino nitrogen in peripheral venous plasma and urine from 20 healthy, full‐term infants, 1–5 months of age, showing normal growth and development during an uncomplicated lactation, revealed lower plasma levels than what has been found in adults, or 3.7±1.1 mg/100 ml, and a urinary excretion of 41 + 14 mg/24 hours. Ion‐exchange chromatography of deproteinized peripheral venous plasma showed low valine concentrations, an increased glycine/valine ratio and high cystine and very high taurine levels when compared to the levels of healthy American infants of comparable ages fed 3‐3.5 g/kg of cow‐milk protein. The findings indicate that a formula based on cow‐milk protein should optimally contain only 1.0–1.2 g protein/100 ml provided that it is “humanized” not only with regard to the lactalbumin/casein ratio, but also to the cystine and taurine content. The pattern of the plasma concentrations of free amino acids reported in the present investigation may be used as a normal reference for breast‐fed infants.
SUDDEN INFANT DEATH IN COPENHAGEN 1956–1971
Authors: JØRGENSEN TORBEN , BIERING‐SØRENSEN FIN , HILDEN JØRGEN
Published: January 2008

Abstract. Biering‐Sørensen, F., Jørgensen, T. and Hilden, J. (Municipal Agency of Infant Health Visitors, Copenhagen, and Institute of Human Genetics, University of Copenhagen, Copenhagen, Denmark). Sudden infant death in Copenhagen 1956–71. III. Perinatal and perimortal factors. Acta Paediatr Scand, 68: 11, 1979.—139 cases of the Sudden Infant Death Syndrome (SIDS) among infants born in the Municipality of Copenhagen during the period 1956–1971 were analysed on the basis of data collected from police reports and (for 131 cases) from the infant health visitors' records. In the SIDS group there was a greater male preponderance than among others dying in the same age range. Compared with the living controls, the SIDS mothers had attended less prenatal examinations, more often delivered their babies at home; the SIDS parents were younger, and yet the SIDS infants were less often firstborns. There was no difference with respect to history of abortions, maternal state of health during pregnancy, or events at delivery. The age at death for the SIDS infants is of a distribution similar to that for fatal respiratory infections. Prematures died later than matures, but this difference is not statistically significant. It is concluded that perinatal factors and SIDS are correlated, but owing to changes in predisposing factors and decreasing differences between cases and controls in recent years as well as interdependence of the factors, it seems doubtful whether the incidence of SIDS can be reduced by alleviating the above‐mentioned unfavourable factors.
IgG SUBCLASS LEVELS IN INFANCY AND CHILDHOOD
Authors: OXELIUS VIVI‐ANNE
Published: January 2008

Abstract. Oxelius, V. (Department of Paediatrics, University Hospital, Lund, Sweden). IgG subclass levels in infancy and childhood. Acta Paediatr Scand, 68: 23, 1979.—The concentrations of IgG1, IgG2, IgG3 and IgG4 were determined by electroimmunoassay in 10 pairs of maternal and cord sera and in sera of 162 healthy children, aged 6 weeks to 15 years. Specific rabbit antisera against the IgG subclasses were used. The content of the normal serum pool WHO 67/97 was used as reference. The mean value, standard deviation and normal range of each IgG subclass were calculated for each age group and compared with the adult values. All IgG subclasses were present in cord serum except for IgG4 in those cases where also the maternal serum lacked demonstrable IgG4. The IgG subclasses followed the pattern of total IgG with a fall during the first 3–6 months and a subsequent gradual rise with age. The IgG1 and IgG3 levels rose faster with age than IgG2 and IgG4. Adult levels were not reached before puberty. No IgG4 was detectable in 12–21% of the children above 7 years of age.
RENAL FUNCTION IN INFANTS WITH HYPERBILIRUBINEMIA
Authors: BROBERGER U. , APERIA A.
Published: January 2008

Abstract. Broberger, U. & Aperia, A. (Departments of Paediatrics at Karolinska Sjukhuset and St. Göran's Children's Hospital, Stockholm, Sweden). Renal function in infants with hyperbilirubinemia. Acta Paediatr Scand, 68, 1979.—A total of 45 infants were studied on the fourth or fifth day of life: 13 term and 10 pre‐term infants with serum bilirubin levels ranging between 257 and 390 µmol/l were compared with 12 term and 10 pre‐term infants with serum bilirubin levels below 195 µmol/l. The groups did not differ with regard to mean gestational age or mean post‐natal age. GFR and CPAH were determined with the single injection clearance method and ability to excrete Na+ was determined following an oral loading of sodium chloride. GFR was lower in infants with hyperbilirubinemia and correlated negatively to the highest recorded serum bilirubin value. CPAH was similar in hyperbilirubinemic infants and controls. The urinary sodium excretion was significantly higher in infants with hyperbilirubinemia.
INFLUENCE OF GENERAL ANAESTHESIA ON ANO‐RECTAL MANOMETRY IN HEALTHY CHILDREN
Authors: FRENCKNER B. , MOLANDER M.‐L.
Published: January 2008

Abstract. According to several investigations ano‐rectal manometry is a valuable diagnostic test of Hirschsprung's disease. In order to yield accurate results it requires a quiet, calm child who cooperates. In the few instances when this is not possible, general anaesthesia may be desirable. Manometric recordings of the internal anal sphincter activity were therefore performed in 15 healthy children when awake and during general anaesthesia. The tonic activity at rest was significantly reduced during anaesthesia. Relaxations of the internal sphincter in response to rectal distension were recorded in all children both when awake and during anaesthesia. They were, however, significantly less pronounced during anaesthesia. These findings strongly suggest that ano‐rectal manometry in the diagnosis of Hirschsprung's disease may be performed with advantage during general anaesthesia if the child does not cooperate when awake.
ASSESSMENT OF LUNG FUNCTION ON HEALTHY CHILDREN USING AN ELECTRONIC SPIROMETER AND AN AIR‐FLOWMETER BEFORE AND AFTER INHALATION OF AN ADRENERGIC RECEPTOR STIMULANT
Authors: DALÉN GUNNAR , KJELLMAN BENGT
Published: January 2008

Abstract. VC measured with a Monaghan electronic spirometer equipped with a backflow valve is significantly lower (about 4%) than when measured with the same spirometer without such a valve. The measurements of FEV1.0 were not influenced by the valve. 73 healthy children were investigated with the Monaghan spirometer equipped with the backflow valve and normal reference data were established. The results were very similar to those obtained in an investigation of healthy children with the same spirometer about one year earlier. Reference data on children for a simple flow meter, Airflometer (Glaxo Ltd.), are given. The data correlated very highly to the FEV1.0 values obtained by the Monaghan spirometer. After inhalation of salbutamol healthy children had a small and significant increase of FEV1.0 and of the Airflometer value but not of VC. The deviations of the differences were small. A 6% increase of VC and 10% increase of FEV1.0 were taken as normal upper limits after inhalation of salbutamol. Corresponding increase of the Airflometer values was 15 arbitrary units for children with body heights 116–145 cm and 21 units for children with body heights 146–175 cm.
EFFECT OF INTRAVENOUS HYDROCORTISONE ADMINISTRATION ON GLUCOSE HOMEOSTASIS IN SMALL FOR GESTATIONAL AGE INFANTS
Authors: SANN L. , RUITTON A. , MATHIEU M. , LASNE Y.
Published: January 2008

Abstract. The effects of I.V. hydrocortisone (H) (10 mg/kg) on glucose homeostasis were evaluated at 25 to 85 hours of age in 14 infants who were small for gestational age (SGA) in comparison to 17 control SGA infants. Three hours after H administration, higher levels of plasma glucose than in controls were detected (mean ±S.E.M.): 4.78±0.2 vs. 2.88±0.2 mmol/1 (p<0.01), while lower levels were found for blood pyruvate (38±7 vs. 89±12 μmol/l—p<0.01), plasma insulin (6.4±0.5 vs. 12±0.8 μIU/ml—p<0.05) and plasma glucagon (62.25±6.6 vs. 81.6±6.6 pmol/l—p<0.05). Three hours after H administration, I.V. injection of l‐alanine (150 mg/kg) produced a significant rise over baseline of plasma glucose concentration from 4.78±0.2 to 5.94±0.2 mmol/l at 50 min (p<0.05), whereas no significant change was observed in controls. There was no significant change in plasma glucagon and insulin concentrations after l‐alanine injection in either group. These results show that in SGA infants primed with H, the rise of plasma glucose concentration after l‐alanine administration is observed with low plasma insulin levels and without stimulation of glucagon secretion. They suggest that H induced a reduced peripheral utilization of glucose by lowering the plasma levels of insulin and a production of glucose from alanine through gluconeogenesis.
IMMUNO‐DEFICIENCY IN SCHWARTZ‐JAMPEL SYNDROME
Authors: MOLLICA F. , MESSINA A. , STIVALA F. , PAVONE L.
Published: January 2008

Abstract. Two sisters born in a consanguineous marriage and affected by Schwartz‐Jampel syndrome had a complex immunodeficiency, involving not only the humoral but also the cellular immune response.
A CLINICAL AND NEUROPHYSIOLOGICAL INVESTIGATION OF A DANISH KINDRED WITH HETEROZYGOUS FAMILIAL HYPOBETALIPOPROTEINEMIA
Authors: ANDERSEN G. E. , TROJABORG W. , LOU H. C.
Published: January 2008

Abstract. A three‐generation transmission of under five percentile values for serum low density lipoprotein and low density lipoprotein cholesterol typical of heterozygous familial hypobetalipoproteinemia was demonstrated in a Danish family. Slight clinical signs of CNS abnormality were found in 4 of the 8 subjects with heterozygous familial hypobetalipoproteinemia, but did not resemble the neurological findings in abetalipoproteinemia nor in the previously described patients with familial hypobetalipoproteinemia. There were no signs of myelin dysfunction in the central nervous system as judged from the normal latency of visual and somatosensory evoked potentials.
H2 BREATH TESTS DURING DIARRHEA
Authors: SOLOMONS N. W. , GARCÍA R. , SCHNEIDER R. , VITERI F. E. , von KAENEL V. ARGUETA
Published: January 2008

Abstract. The peak rise in breath hydrogen and the volume of excess pulmonary excretion of hydrogen in response to a 10 g dose of the non‐absorbable disaccharide, lactulose, was significantly lower in children with active gastroenteritis and diarrhea than in non‐diarrheal controls. Thus, despite the fact that the H2 breath test is a convenient, noninvasive technology for use in children, it cannot be recommended for measuring carbohydrate malabsorption in individuals with active, on‐going episodes of diarrhea.
RENAL FUNCTIONAL CHANGES IN ACUTE GLOMERULONEPHRITIS IN CHILDREN. A ONE‐YEAR FOLLOW‐UP
Authors: APERIA A. , BERGSTRAND A. , BROBERGER O. , LINNÉ T. , WASSERMAN J.
Published: January 2008

Abstract. Renal function was studied in three patients with post‐streptococcal, four patients with IgA and one patient with non‐streptococcal proliferative glomerulonephritis (GN) at the onset of the disease and two, six and 12 months later. Renal biopsies were performed at the onset of the disease and 12 months later. Standard clearance techniques were used for the functional studies. The latter were performed during hydropenia and continuous isotonic saline infusion. During hydropenia, the GFR was uniformly depressed shortly after the onset of the disease, but it normalized during the following two months. The filtration fraction was depressed in poststreptococcal GN at the onset and it normalized with the GFR. In IgA GN, the filtration fraction remained within normal limits during the entire course of the illness. The natriuretic response to isotonic saline volume expansion was low in all patients at the onset of the disease, but normalized in post‐streptococcal and IgA GN during the one‐year follow‐up. In spite of normalized renal function, biopsy findings in IgA GN were unchanged 12 months later. An episode of macroscopic hematuria in one patient with IgA GN at the six‐month investigation had no apparent effect on renal function.
STRUCTURAL AND FUNCTIONAL ABNORMALITIES OF THE SMALL INTESTINE IN INFANTS AND YOUNG CHILDREN WITH ROTAVIRUS ENTERITIS
Authors: DAVIDSON G. P. , BARNES G. L.
Published: January 2008

Abstract. Structural and functional alterations in duodenal mucosa from 17 children with rotavirus enteritis were assessed. Structural changes were found in specimens from all patients. Patients with the most severe mucosal damage were more likely to require intravenous therapy to correct dehydration. Depression of one or more mucosal disaccharidases was found in 14 of 16 patients. Repeat duodenal biopsy three to eight weeks later in six patients showed marked improvement. The study clearly shows that rotavirus can cause a marked structural and functional lesion in the upper small intestine which is rapidly reversible.
AGAMMAGLOBULINEMIA ASSOCIATED WITH THE OCCURRENCE OF A MONOCLONAL IMMUNOGLOBULIN
Authors: HENDRICKX G. F. M. , ZEGERS B. J. M. , STOOP J. W.
Published: January 2008

Abstract. A patient is described with a monoclonal immunoglobulin of the IgG class in the serum and no detectable IgM and IgA. Extensive immunological investigations showed the absence of B‐lymphocytes in bone marrow and peripheral blood. Moreover, plasma cells were not present in the bone marrow. The monoclonal IgG was synthesized in the gastrointestinal tract. The cellular immune‐status of the patient was normal. Clinically the patient suffered from gastrointestinal and severe respiratory tract infections. It was concluded that the findings are consistent with the diagnosis congenital agammaglobulinaemia with concurrence of monoclonal IgG. It was postulated that the cell clone in the gastrointestinal tract resulted from an escape of a pre‐B cell clone from the recognized arrest of pre‐B cells in congenital agammaglobulinaemia.
PLASMA AND RED BLOOD CELL FOLATE IN BREASTFED INFANTS
Authors: EK J. , MAGNUS E. M.
Published: January 2008

Abstract. We have studied growth, red blood cell status and folate concentrations in plasma and red cells in a group of 35 breastfed infants during the first year of life. Folic acid supplementation was not given to the mothers during pregnancy or lactation, and none of them developed megaloblastic anaemia. The growth and red blood cell status of the infants were both normal. At birth, and throughout the period of observation, the folate concentrations in plasma and red cells were significantly higher than in the adult reference material. A positive correlation between plasma and red cell folate was demonstrated. During the latter part of pregnancy and lactation the foetuses and infants seem to be protected against folate deficiency. We regard the folate status of normal breastfed infants as optimal. The optimal supply of the vitamin in artificial nutrition should be the amount of folate necessary to maintain plasma and red cell folate concentrations similar to those found in breastfed infants.
SERUM CONCENTRATIONS OF THYROTROPIN, THYROID HORMONES AND THYROID HORMONE BINDING PROTEINS DURING ACUTE AND RECOVERY STAGES OF IDIOPATHIC RESPIRATORY DISTRESS SYNDROME
Authors: JACOBSEN B. BROCK , PEITERSEN B. , HUMMER L.
Published: January 2008

Abstract. A total number of 27 premature infants with idiopathic respiratory distress syndrome (IRDS) and 52 healthy controls with comparable gestational age and body weights were studied during the first month of life. In infants with IRDS a reduced thyrotropin (TSH) response to birth was suggested, as serum TSH was lower in IRDS patients than in controls during the first two days of life. Low serum concentrations of thyroid hormones were found in the acute stage of IRDS reaching minimal values by day 3–5. After that period an increase in thyroid hormone levels occurred. The serum T3 increased to the level of healthy prematures by day 6–10, whereas the serum T4 increased to normal levels by day 21–30. Serum concentrations of thyroxine‐binding globulin (TBG) were significantly lower in IRDS patients than in healthy controls; a gradual increase to normal levels occurred during recovery. Serum prealbumin (TBPA) levels in IRDS infants increased rapidly after birth and exceeded levels of healthy infants. Serum albumin values were not significantly different in the two groups of infants. The serum T4/TBG ratios were low during recovery from IRDS.
QUALITY OF CARE: A TRACER DIAGNOSIS STUDY OF ACUTE OTITIS MEDIA, COMPARING A DISTRICT PAEDIATRIC SERVICE WITH PAEDIATRIC AND OTOLARYNGOLOGY EMERGENCY DEPARTMENTS
Authors: OLIN P. , BOLME P. , EWERT G. , LAGERKVIST B. , STERKY G. , TENGVALD K. , ZETTERSTRÖM R.
Published: January 2008

Abstract. Acute otitis media was used as a tracer condition for comparing patient care as regards patient satisfaction, compliance and medical outcome in a district paediatric office, an otolaryngological and a paediatric hospital emergency department. The initial work‐up of the 216 patients studied at the three units was in good agreement with predefined standards. However, while the district paediatrician arranged a follow‐up for all patients, the hospitals did so only in 10–30 % of the visits. Parent satisfaction was significantly higher at the district office when the time spent waiting and the time the patient was with the doctor were kept constant. Urinary penicillin was not detected in 1/17 of district paediatric and in 6/19 of otological patients. Compliance with follow‐up was also much higher at the district paediatrician. Medical outcome did not differ between the units. The majority of the parents expressed preference for the type of care given in a neighbourhood service. It is suggested that the criteria for adequate treatment of acute otitis media adapted for emergency departments may be revised in case easy access is provided to a medical centre offering continuity of care and proper follow‐up. Studies of the quality of care have so far not managed to demonstrate a definite and positive relationship between the process of care, patient satisfaction and final medical results.