bluuebunny/crossref_metadata_2025 huggingface dataset:
On the Construction of the Infancy‐Childhood‐Puberty Growth Standard
Authors: KARLBERG J.
Published: January 2008

Karlberg J. (Department of Anatomy, University of Gothenburg, Sweden and the Departments of Pediatrics and Biostatistics, University of North Carolina, Chapel Hill, North Carolina, USA). On the construction of the infancy‐childhood‐puberty growth standard. Acta Paediatr Scand [Suppl] 356: 26, 1989.

Using the infancy‐childhood‐puberty (ICP) growth model, the postnatal linear growth curve is mathematically broken down into three components: infancy, childhood and puberty. The fact that each component of this model seems to represent a defined biological phase of the growth process, extends its clinical application. The principles used to construct the ICP growth standard and the basic‘clinical’ICP‐based growth charts are described. These charts have a number of advantages over the conventional growth charts currently in use. Most importantly, the ICP growth chart provides reference values not only for total growth but also for each of the three individual components. Using this methodology, the magnitude and the onset of each component can be assessed in an individual child. The age at onset of the childhood component, which is a newly discovered and important feature of human growth, can easily be detected in an individual child. Furthermore, prepubertal growth, onset of puberty and pubertal growth can be accurately assessed, because the difference in pubertal maturation is taken into account when setting standards during adolescence. The methodology also offers a new and highly accurate predictor of final height and permits assessment of growth rates over shorter and longer periods using a simple and effective method of assessing change. The ICP growth model appears to be a refined instrument for detecting and understanding growth disturbances.
Catch up Growth in Preterm Infants
Authors: ALTIGANI M. , MURPHY J. F. , NEWCOMBE R. G. , GRAY O. P.
Published: January 2008

Seventy‐one surviving infants were followed up from birth to 24 weeks of postnatal age. Their mean gestational age was 32 weeks with a range of 26–36 weeks and a standard deviation of 2.1 weeks. Their mean birth weight was 1.805 kg with a range of 0.675–2.5 kg and a standard deviation of 0.408 kg. Their weights, lengths and head circumferences were measured at birth, 6, 12 and 24 weeks. Curves for the mean weight, length and head circumference were produced and superimposed on the available intrauterine and extra‐uterine growth charts. The growth curves of the preterm infants did not show the flattening noted in the intrauterine curves towards term. The curve of the mean weight of the preterm infants started at the 50th centile for Gairdner & Pearson (1971) at birth to drop below that shortly after birth. At 40 weeks of postconceptional age the mean weight curve of preterm infants crossed the 50th centile and continued above it to reach the 90th centile at 60 weeks. The curves of mean length and head circumference started below the 50th centile at birth and crossed it at 40 weeks and continued above it to approach the 90th centile at 60 weeks. Growth velocity was calculated as a relative gradient using the straight line equation (y=a+bx), where y is the weight, length or head circumference, and x is the independent variable and here it is the group mean of the parameter at the corresponding ages. Catch up growth is taken as a relative gradient significantly greater than one. The first 24 weeks of postnatal life are defined as a period of catch up growth with the first 8 weeks as an interval of maximum head velocity.
Plasma Zinc Concentration and Catch Up Growth in Preterm Infants
Authors: ALTIGANI M. , MURPHY J. F. , GRAY O. P.
Published: January 2008

Changes in plasma zinc concentration during the period of catch up growth were examined in 44 preterm infants. Blood samples were collected at birth, 6, 12 and 24 weeks. Plasma zinc concentration showed a mean of 13.6 μmol/l at birth and dropped to 9.8 μmol/l at 6 weeks and rose to 11.3 and 15.4 μmol/l at 12 and 24 weeks respectively. Plasma zinc concentrations showed significant correlation with weight velocity at 12 weeks. Male infants had significantly lower plasma zinc concentrations than females at 12 weeks. Infants of gestational age more than 32 weeks had lower plasma zinc concentrations at 12 and 24 weeks than those of earlier gestations. At the same time males were growing faster than females and also infants of gestational ages more than 32 weeks were growing faster than those born at earlier gestations. These observations, together with the finding that the decline in zinc occurred during the phase of rapid growth, suggest that growth is the predominant modulator of plasma zinc concentration.
Prediction of Outcome in 164 Infants Born after 24 to 28 Weeks Gestation
Authors: Greisen G.
Published: January 2008

Eg‐Andersen, G. (Department of Neonatology, Rigshospitalet, Copenhagen, Denmark). Outcome in 164 infants born after 24 to 28 weeks gestation. Acta Paediatr Scand Suppl. 360: 56, 1989.

Between 1984 and 1987 164 infants born after 24 to 28 completed weeks were admitted to our unit. In 6 children respirator treatment was withdrawn between days 6 and 57 mainly on the basis of severe intracranial bleeding and periventricular leuco‐malacia. Among 102 (62%) surviving infants, 18 (18%) had a major handicap (cerebral palsy, IQ <50, blindness) at follow‐up, in 6 of the 18 (6%) there was a combination of several major handicaps. We conclude that we can still not reliably predict serious handicap and we are therefore faced with a serious ethical dilemma which we think can best be approached in a trust‐relationship between parents and staff.
The Severity of RDS during the First Two Neonatal Days in Relationship to Fluid Intake
Authors: HALLMAN M.
Published: January 2008

Hallman, M. (Departments of Paediatrics, University of Helsinki and University of California, Irvine). The severity of RDS during the first two neonatal days in relationship to fluid intake. Acta Paediatr Scand Suppl 360: 93, 1989.

There are no generally accepted guidelines regarding the degree of hydration of small preterm infants with RDS. In the present prospective study, liquid intake (intravenous fluids, drugs, and enteral nutrition) during the first 48 h was correlated with the degree of respiratory failure at the age of two days in 120 consecutive, mechanically ventilated, small preterm infants with RDS (GA<30 w, BW< 1750 9). There was a positive linear relationship between the amount of liquids given and the degree of respiratory failure. Multiple regression analysis taking into consideration various perinatal factors revealed that the liquid intake explained the degree of respiratory failure (p < 0.0001). The regression analysis revealed a similar dependence of respiratory failure on the liquid intake in the following groups of infants: GA<27 w (p=0.023); GA 27–30 w (p=0.005); SGA (p=0.104); Non‐SGA (p=0.001); severe preeclampsia (p=0.018); surfactant substitution (p=0.002); liquid intake 127–240 m1/48 h (p < 0.006); liquid intake 240430 mU48 h (p < 0.047). The present results demonstrate the need to re‐evaluate the optimal needs of hydration among infants with RDS during the very early neonatal period.
The Effects of D‐penicillamine on the Renal and Liver Functions in Neonates and the in Vitro Influence on Granulocytes
Authors: LAKATOS LAJOS , SZABÓ IMRE , CSÁTHY LÁSZLÓ
Published: January 2008

Lakatos, L., Szabó, I. and Csáthy, L. (Department of Paediatrics, Kenézy Gyula County Hospital and University Medical School, Debrecen, Hungary). The effects of D‐penicillamine on the renal and liver functions in neonates and the in vitro influence on granulocytes. Acta Paediatr Scand Suppl 360: 135, 1989.

D‐Penicillamine (DPA) was introduced to treat neonatal hyperbilirubinemia in 1973 and to prevent retinopathy of prematurity in 1980. In this study we investigated the renal and liver functions of neonates treated with DPA and the in vitro effect of the drug on superoxide anion generation and beta‐glucuronidase release as well as phago‐cytic and intracellular killing activation of human peripheral blood granulocytes. Our data concerning the renal and liver functions before and after 3 to 4 days DPA treatment reveal that the drug does not produce any pathological change during short‐term administration in the neonatal period. Furthermore, it was found that superoxide anion generation was slightly increased, and beta‐glucuronidase release markedly increased by preincubation with DPA at concentrations of 0.5–5 mM. The rise was directly proportional to the concentration in the examined range. On the other hand, none of the examined DPA concentrations influenced the phagocytic or killing activity of neutrophils.
Overview of Childhood Acute Diarrhoea in Europe: Implications for Oral Rehydration Therapy
Authors: GUANDALINI STEFANO
Published: January 2008

Guandalini, S. (Department of Pediatrics, University of Naples, Naples, Italy). Overview of childhood acute diarrhoea in Europe: Implications for oral rehydration therapy. Acta Paediatr Scand Suppl 364: 5, 1989.

Infant mortality from acute diarrhoea has sharply declined in the last few decades throughout Europe. However, acute diarrhoea is still a very common occurrence in European children, who experience, in their first 3 years of life, approximately 1 episode/year. The commonest agent responsible for infectious diarrhoeas appears to be rotavirus, followed by campylo‐bacter. Although water loss may be high, the mean sodium Loss is close to 40 mmol/l of stool in rotaviral diarrhoea, and to 60 mmol//l in diarrhoeas due to invasive pathogens such as campylobacter and salmonella. Larger fluid losses but a somewhat lower sodium loss accompanies non‐cholera secretory diarrhoeas, which appear to be commoner in infants than in older children. This evidence indicates that an ORS for European children should have a sodium concentration lower than 90 mmol/l which was primarily intended for use in developing countries. Clearly, the glucose concentration is crucial, as it is now evident that concentrations higher than the recommended 110 mmol/l may lead, particularly in rotaviral enteritis, to worsening of diarrhoea and development of hypernatraemia. Finally, it appears that in Europe the use of commercially available ORS is strikingly low, so that infants and children are often given a variety of “clear fluids”, generally inadequate to ensure proper rehydration or maintenance of hydration. Thus an effort should he made not only to devise the “ideal” solution, but also to effectively implement its use.
Optimising Oral Rehydration Solution Composition in Model Systems: Studies in Normal Mammalian Small Intestine
Authors: SANDHU B. K. , CHRISTOBAL F. L. , BRUETON M. J.
Published: January 2008

Sandhu, B. K., Christobal, F. L. and Brueton, M. J. (The Royal Hospital for Sick Children, Bristol and Westminister Children's Hospital, London, U.K.). Optimising oral rehydration solution composition in model systems: Studies in normal mammalian small intestine. Acta Paediatr Scand Suppl 364:17, 1989.

Small intestinal perfusion studies have been carried out in animals to evaluate the role of the individual constituents of oral rehydration solution (ORS), in order to draw some conclusions relating to the optimal composition of ORS. Two commercially available ORS, Dioralyte and Rehidrat have also been compared to the World Health Organisation (WHO) standard solution. Maximum rate of water absorption occurred with the WHO solution and least with Rehidrat. The findings of the perfusion studies suggest that in the normal small intestine, optimal water absorption occurs from a solution containing 60 mmol/l of sodium and 80–120 mmol/l of glucose. The addition of bicarbonate and citrate at concentrations present in ORS does not appear to have a significant effect on water absorption. The addition of glycine and diglycine to the standard ORS reduced the net rate of absorption of sodium and water, probably because of the effect of increased osmolality.
Disease‐related Animal Models for Optimising Oral Rehydration Solution Composition
Authors: FARTHING M. J. G.
Published: January 2008

Farthing, M. J. G. (Department of Gastroenterology. St Bartholomew's Hospital, London, U.K.). Disease‐related animal models for optimising oral rehydration solution composition. Acta Paediatr Scand Suppl 364:23. 1989.

To optimise the composition of oral rehydration solutions (ORS) for European children is not a simple task. Although controlled clinical trial is ultimately the only way to determine whether a new solution is superior to an established ORS, testing many different formulations is neither feasible nor ethical. Several groups of investigators have evolved the concept of using animal models to test new ORS formulations. Disease‐related animal models using perfusion of cholera toxin‐treated rat small intestine or experimental rotavirus infection of neonatal rats suggest that optimal water absorption will he obtained by using a hypotonic ORS with a sodium concentration of 50–60 mmol/l and a glucose Concentration of 50–100 mmol/ml. Addition of citrate or bicarbonate had no benefit with respect to the promotion of water absorption.
The Role of Human Perfusion Techniques in the Assessment of Oral Rehydration Solutions
Authors: ELLIOTT E. J.
Published: January 2008

Elliott, E. J. (Leicester Royal Infirmatory, Leicester, U.K). The role of human perfusion techniques in the assessment of oral rehydration solutions. Acta Paediatr Scand Suppl 364:31, 1989.

Early human intestinal perfusion studies provided valuable information on gut transport procession in vivo. Subsequently, similar models have proved a useful means of assessing the efficacy of glucose‐electrolyte oral rehydration solutions. In contrast to clinical trials they enable quantification of water and solute movement across the small intestine and, unlike animal studies, results are directly applicable to man. However, limitations exist, including the fact that a short, usually normal, segment of intestine is studied. Recent studies confirm the relationship between oral rehydration solution sodium concentration and sodium movement; the stimulatory effect of glucose on sodium and water movement; and the detrimental effect of high glucose content. Glycine, bicarbonate, citrate and acetate provide little additional benefit for water absorption when added to solutions containing glucose. Preliminary comparative studies of results obtained in the rat and in man show parallels between these models suggesting they may be complimentary methods of assessing new oral rehydration solutions.
Growth Hormone Secretion and Growth Hormone Treatment in Children with Intrauterine Growth Retardation
Authors: ALBERTSSON‐WIKLAND K.
Published: January 2008

Albertsson‐Wikland, K. (Departments of Paediatrics II and Physiology, University of Gothenburg, Gothenburg, Sweden). Growth hormone secretion and growth hormone treatment in children with intrauterine growth retardation. Acta Paediatr Scand [Suppl] 349: 35, 1989.

Few children with intrauterine growth retardation (IUGR) fail to show catch‐up growth during the first year of life. There may he many reasons for this, ranging from disturbances of hormone production to hormonal unresponsiveness of target cells. This report presents preliminary data on growth hormone (GH) secretion and responses to GH treatment in 16 children with IUGR and poor catch‐up growth, six of whom had Silver‐Russell stigmata. GH secretion was assessed by measurement of the GH response to an arginine‐insulin test and determination of spontaneous GH secretion over 24 hours. GH production was heterogeneous hut, more often than expected, children showed both a low response to GH provocation and low spontaneous secretion of GH. Five out of six of the children with Silver‐Russell syndrome and seven out of 10 of the children with non‐Silver‐Russell IUGR gained more than 2 cm in height during 1 year of treatment with GH at a dose of 0.1 IU/kg/day. These results clearly demonstrate that some children with IUGR and poor catch‐up growth secrete insufficient amounts of GH, and that many of these very short children show an improvement in growth rate during treatment with physiological doses of GH.
Child Sexual Abuse
Authors: LINDBLAD F.
Published: January 2008

ABSTRACT. In a study of suspected cases of child sexual abuse, 22 persons (21 men and one woman) were identified as probable perpetrators according to the child psychiatric evaluation. Eight perpetrators admitted abuse, although denying certain aspects of the allegations, and two persons made what was categorized as partial confirmations. Nine cases led to a charge and eight of these to a conviction. Disease, addiction, sexual frustration, unwanted separation, ageing and adolescence were identified as factors which in individual cases seemed to have influenced a person's predisposition to abuse children sexually.
Acute Otitis Media and Facial Palsy in Children
Authors: JACOBSSON M. , NYLÉN O. , TJELLSTRÖM A.
Published: January 2008

ABSTRACT. Two cases of facial palsy in connection with acute otitis media are presented. The patients were 2 months and 2 years old, respectively. In both cases the facial palsy disappeared after treatment with myringotomy and antibiotics. The etiological mechanisms behind and the different approaches to the treatment of facial palsy in children with acute otitis media are discussed.
Abdominal Mass: “Fetus in Fetu”
Authors: MARTINEZ‐URRUTIA M. J. , PEREIRA P. LOPEZ , LASSALETTA L. , GRACIA R. , UTRILLA J.
Published: January 2008

ABSTRACT. A female newborn presented a mass in the left upper abdominal quadrant. It was removed by surgery and contained two independent fetuses. Dissection and radiological study of the fetuses showed an axial skeleton and long bones. It corresponds to the generally recognized diagnostic criteria of fetus in fetu.
The Effect of a Warm Environment on Respiratory Water Loss in Fullterm Newborn Infants on Their First Day after Birth
Authors: RIESENFELD T. , HAMMARLUND K. , SEDIN G.
Published: January 2008

ABSTRACT. Continuous measurements of respiratory water loss (RWL), oxygen consumption and carbon dioxide production were made in 21 fullterm infants on their first day after birth. The infants were first studied in incubators with a temperature of 32.5°C and an ambient humidity of 50%. After an interval with stable conditions the incubator temperature was raised to 36.5°C while the water vapour pressure was kept constant. When the rectal temperature had increased to 37.8°C or when the infant had started to sweat, the relative humidity in the incubator was increased to 50%. At the start of the measurements mean RWL was 4.9 mg/kg min. On the average, RWL increased to a maximal value of 7.0 mg/kg min in the warm environment. Mean oxygen consumption only increased from 5.3 to 5.8 ml/kg min. This meant that when nursed in this warm environment the infants were able to increase their respiratory water loss by nearly 50% without a significant change in oxygen consumption.
Fibrodysplasia Ossificans Progressiva An 11‐Year‐Old Boy Treated with a Diphosphonate
Authors: BRUNI L. , GIAMMARIA P. , TOZZI M. C. , CAMPARCOLA D. , SCOPINARO F. , IMPERATO C.
Published: January 2008

ABSTRACT. Fibrodysplasia ossificans progressiva (FOP) is a severe, rare, autosomal dominant, ectopic ossifying condition, with primary involvement of the skeletal muscles associated with skeletal abnormalities. This report concerns an 11‐year‐old boy suffering from FOP, who presented signficant modification of the musculoskeletal structure of the thorax and problems with articular movements. The patient showed progress after treatment with ethane‐l‐hydroxyl, l‐diphosphonate (EHDP). In fact, using a scintiscanner we were able to observe a significant improvement in symptoms and a recovery of some of the active sites of ossification.
Physical and Laboratory Characteristics of Heterozygote Carriers of the Fanconi Aplasia Gene
Authors: PETRIDOU M. , BARRETT A. J.
Published: January 2008

ABSTRACT. Fanconi anaemia (FA) is a recessively inherited disorder associated with a typical physical appearance and a spectrum of clinical and laboratory characteristics. Parental heterozygotes of FA patients are superficially normal in appearance and lack overt laboratory abnormalities. Furthermore, they are indistinguishable from normal subjects on chromosome analysis. In order to determine if any of the clinical or laboratory abnormalities seen in FA patients were detectable to a lesser degree in heterozygotes, we carried out detailed skeletal measurement and laboratory investigation on 16 obligate FA heterozygotes and compared the results with 40 normal control subjects. Skeletal proportions in FA heterozygotes showed significant differences from normal subjects in the ratio of the height to the inter‐acromial distance (p<0.001), and in having significantly shorter forearms (p <0.05). Apart from two patients with presumed iron deficiency, haemoglobin levels were normal, but three patients showed neutropenia (<1.5 × 109/1). Foetal haemoglobin measurements were significantly higher (p < 0.01) and natural killer cell subsets lower (p < 0.05) in heterozygotes. Significantly reduced mitogenetic responses to phytohaemagglutinin and interleukin‐2 of peripheral blood lymphocytes in heterozygotes was also demonstrated. These results suggest that heterozygotes show minor physical and haematological abnormalities consistent with partial expression of the Fanconi gene in the heterozygote.
Cranial Computed Tomography in Infantile Spasms
Authors: HOWITZ P. , NEERGAARD K. , PEDERSEN H.
Published: January 2008

ABSTRACT. Out of 109 children with infantile spasms (IS), prospectively tested during the years 1976 to 1979 in Denmark, 52 children were examined by cranial computed tomography (CT). The classification of IS into cryptogenic (CR), symptomatic (SY) and doubtful (DO) was done clinically without considering the CT‐findings. Sixty per cent of the scannings were abnormal. Only 6/30 (20%) of the children in ACTH treatment were found to develop cerebral atrophy which means that this finding is not an obligatory side‐effect of ACTH treatment of children with IS. Normal CT‐findings were found in 50% of the CR and 50% of the SY + DO‐groups, and could not be used as a prognostic tool for estimating the mental development. This was also the case for children with cerebral atrophy. Abnormal CT‐findings (minus atrophy) were highly correlated to the group with clinical symptoms and indicate an extremely unsatisfying long‐term mental prognosis. CT‐scanning is a valuable tool for the examination of clearing children with infantile spasms.
Fecal Alpha1‐Antitrypsin in Breast‐Fed Infants Is Derived from Human Milk and Is not Indicative of Enteric Protein Loss
Authors: DAVIDSON L. A. , LÖNNERDAL B.
Published: January 2008

ABSTRACT. Alpha1‐antitrypsin is a serum protein commonly used as a marker of enteric protein loss. In this study, we have quantified α1‐antitrypsin concentration in human milk and its excretion by healthy term breast‐fed infants. We found high concentrations of α1‐antitrypsin in early milk (0.3‐0.6 mg/ml during the first week of lactation) while the concentration fell during subsequent weeks, being detectable through at least 3‐4 months of lactation. Significant quantities of intact α1‐antitrypsin were found to be excreted by the breast‐fed infants studied. The amount excreted was typically higher in early weeks (as much as 200 mg/24 h) and decreased with infant age, possibly due to both decreased intake from the milk as well as increased digestion of the protein by the maturing infant. In vitro studies demonstrated that the trypsin‐α1‐antitrypsin complex resisted proteolysis by pepsin and pancreatic enzymes; thus, α1‐antitrypsin in milk can escape gastrointestinal degradation. We conclude that α1‐antitrypsin is not a suitable marker for intestinal protein loss by term breast‐fed infants.
Effect of an Intravenous Gammaglobulin Preparation on the Opsonophagocytic Activity of Preterm Serum against Coagulase‐Negative Staphylococci
Authors: ETZIONI A. , OBEDEANU N. , BLAZER S. , BENDERLY A. , MERZBACH D.
Published: January 2008

ABSTRACT. Recent reports have described cases of septicaemia caused by coagulase‐negative staphylococci in preterm neonates, mainly due to the use of artificial intravenous devices. It was of interest to examine if intravenous immunoglobulin therapy, known to be effective in group B streptococcal infections of neonates, had a similar beneficial effect in coagulase‐negative staphylococcal infections. Opsonophagocytosis of coagulase‐negative staphylococci by normal polymorphonuclear leukocytes in the presence of cord blood serum supplemented with the commercial IgG preparation ‘Sandoglobulin’ was investigated, using luminol‐dependent chemiluminescence. It was found that with two different coagulase‐negative staphylococcal strains, Sandoglobulin had a concentration‐dependent enhancing effect on the chemiluminescent response. This effect was demonstrated in the presence of native as well as inactivated cord blood serum and in the presence of sera from preterm infants (28‐33 weeks). It is concluded that intravenous Sandoglobulin therapy may be effective in the treatment of preterm infants with severe coagulase‐negative staphylococcal infections.
Congenital Adrenal Hyperplasia in Sweden 1969‐1986 Prevalence, Symptoms and Age at Diagnosis
Authors: THILÉN A. , LARSSON A.
Published: January 2008

ABSTRACT. A retrospective study of all Swedish patients with congenital adrenal hyperplasia (CAH) born 1969‐1986, was conducted to elucidate possible benefits of neonatal screening for CAH. Information was obtained about 150 patients (67 male, 83 female). One hundred and fortythree cases were regarded as classical and seven as non‐classical (symptoms after 5 years of age or cryptic). All but two (one girl with 11‐hydroxylase deficiency and one boy with β hydroxysteroid‐dehydrogenase deficiency) had 21‐hydroxylase deficiency. The prevalence was 1: 11500. Ninety‐three patients (48 male, 45 female) displayed salt loss, all before the age of 3 months. Two boys had died and many children had been critically ill during the first weeks of life. The median age at diagnosis for boys in this group was 21 days. Gender assignment was a major problem in 38 of 57 girls with ambiguous genitalia noticed during the first day. Fifteen of these girls were considered to be male for their first 40 days (median), before the CAH diagnosis was established. Patients in whom the first symptom was manifested after the age of one year often showed growth acceleration, which frequently was overlooked. Median diagnostic delay in this group was 17 months. Possible benefits of neonatal screening are: avoidance of a serious salt‐loss crisis; earlier diagnosis and correct gender assignment in virilized girls; decreased virilization, growth acceleration and premature pubarche in prepubertal children; and reduced negative consequences for psycho‐social development and final height.
Effects of Formula Protein Level and Ratio on Infant Growth, Plasma Amino Acids and Serum Trace Elements I. Cow's Milk Formula
Authors: LÖNNERDAL B. , CHEN C. ‐L.
Published: January 2008

Abstract. The optimum level and ratios of protein to be used in cow's milk formula has recently been under discussion. Healthy term infants were fed from birth exclusively human milk or a formula that varied in protein level or whey:casein ratio: (A) 1.4 g/dl; 55:45, (B) 1.5 g/dl; 55:45, (C) 1.3 g/dl; 55:45, (D) 1.4 g/dl; 60:40, (E) 1.4 g/dl; 20:80. Infants were followed for 12 weeks and blood samples were taken at 2, 4, 8 and 12 weeks. Anthropometric indices did not show any significant differences among groups. Plasma amino acid and BUN levels of the C group were closest to the breast‐fed group, while the formula with the highest protein level (B) resulted in high values for some amino acids. When comparing the formulas with 1.4 g protein/dl, the high casein group had the lowest plasma tryptophan levels. Taurine was added to all formulas at a level similar to that of breast milk; plasma taurine levels were similar for all groups. All formulas contained 0.7 mg iron and 0.7 mg zinc/dl; no differences were found among the groups in hematological indices or serum trace elements. These data show that feeding a formula with 1.3 g protein/dl and 55:45 whey: casein ratio from birth will result in growth and metabolic indices similar to those of breast‐fed infants, although some plasma amino acid levels are not identical, 1990.
Effects of Formula Protein Level and Ratio on Infant Growth, Plasma Amino Acids and Serum Trace Elements II. Follow‐up Formula
Authors: LÖNNERDAL B. , CHEN C. ‐L.
Published: January 2008

Abstract. Infants, that had been formula‐fed from birth, were fed follow‐up formula with 1.5, 2.2 or 2.9 g protein/dl together with 25 g of cereal/day as supplemental food, or formula only (15 g/dl). Formulas were started at 4 months of age and daily intake, anthropometric measurements and plasma samples taken at 5, 6 and 7 months. Protein intake was 2.0, 3.0 and 3.7 g/kg/d, respectively. Growth data were similar for all groups, as were hemoglobin and serum protein values. BUN values for the group fed only formula with 1.5 g protein/dl were lower than for the group fed the same formula with cereals and the other groups. Plasma amino acids were not affected by the addition of the small amount of cereals to the formula with 1.5 g protein/dl, but significantly higher levels of valine, leucine and histidine were found at 7 months for infants fed the two higher protein levels. The highest protein level also appeared to have a negative effect on plasma zinc levels. These results suggest that a protein level of 1.5 g/dl in follow‐up formula (2.0 g/kg/d) is adequate during 4 to 7 months of age and that higher protein levels may be excessive.
Glucagon and Insulin Secretion in Low Birthweight Preterm Infants The Effect of Glucose Infusion
Authors: GRASSO S. , FALLUCCA F. , ROMEO M. G. , DISTEFANO G. , SCIULLO E. , REITANO G.
Published: January 2008

Abstract. The effect of the intravenous glucose on plasma levels of glucagon and insulin were evaluated in thirty‐five LBW preterm infants who were appropriate for gestational age. Their mean birthweight and gestational age were 1220·55 g (range 750‐1730 g) and 29·1 weeks (range 25–35 weeks), respectively. A 30 min glucose infusion in 16 infants (1 g/kg b. w. in 30 min) caused a prompt and sustained suppression of plasma glucagon and a delayed but significant insulin release. The mean of the sum of maximal plasma glucagon decrements below the baseline was 173·42 pg/ml. In another 12 infants a significant fall in plasma glucagon and a variable but significant plasma insulin release also occurred throughout the 24 h study on continuous intravenous glucose (rate 2.4‐2.7 mg/kg/min). The mean of the sum of maximal plasma glucagon decrements below the baseline up to 12 h was 282·36 and was similar to that seen in the previous group.
Spontaneous Clearance of Asymptomatic Bacteriuria in Infants
Authors: WETTERGREN B. , JODAL U.
Published: January 2008

Abstract. In an unselected population of 3581 infants, 14 girls and 36 boys were found to have bacteriuria verified by suprapubic aspiration. Among the bacteriuric infants, one girl and one boy developed symptoms of pyelonephritis close to the time of detection; the others remained asymptomatic. Eleven girls and 34 boys were left untreated. One of these girls and 7 of the boys became abacteriuric after treatment for respiratory tract infections. Ten girls and 26 boys became spontaneously abacteriuric, with a median persistence of bacteriuria of 2 months in girls and 1.5 months in boys. Recurrences were observed among boys only in those who had been treated with antibiotics.
Cerebral Blood Flow Reactivity in Spontaneously Breathing, Preterm Infants Shortly after Birth
Authors: PRYDS O. , ANDERSEN G. E. , FRIIS‐HANSEN B.
Published: January 2008

ABSTRACT. In 18 spontaneously breathing, preterm infants (mean gestational age 30.3 weeks) cerebral blood flow (CBF) was investigated twice, 2 and 3 hours after birth when spontaneous changes in arterial carbon dioxide tension (PaCO2) and mean arterial blood pressure (MABP) were expected. Transcutaneous oxygen tension (TcO2) was kept normal by adjusting the inspiratory oxygen fraction. In 12 infants, plasma adrenaline and noradrenaline were constant throughout the study. Changes in CBF infinity (CBF∞) were significantly related to changes in PaCO2 (p=0.0001) whereas neither changes in MABP nor TcO2 reached a significant association to changes in CBF (p=0.67 and p=1.0, respectively). The calculated CBF‐CO2 reactivity of 28.9% per kPa PaCO2 (95% confidence interval 16.1–43.0) is comparable to findings in older newborns and healthy adults. Only one of 18 infants developed germinal layer haemorrhage (grade I) in spite of the hypercapnic state which was observed during the first hours of life. Periventricular leucomalacia was not detected. It is suggested that the cerebral blood flow is well regulated within physiological variations of PaCO2 and MABP in the healthy, preterm newborn even shortly after birth.
Macromolecular Absorption in Infants with Infantile Colic
Authors: LOTHE L. , LINDBERG T. , JAKOBSSON I.
Published: January 2008

ABSTRACT. Intestinal absorption of macromolecules, using human α‐lactalbumin (α‐LA) as a marker, was studied in breast‐fed and formula‐fed infants with infantile colic. Serum samples taken at 30 and 60 min after an intake of human milk were analyzed for α‐LA by a competitive radioimmunoassay technique. Breast‐fed infants with infantile colic had significantly higher s‐α‐LA levels compared with age‐matched breast‐fed control infants 0‐1 month of age: median value 926 μg α‐LA/I serum/I human milk/kg bodyweight (n= 11) versus 150 (n= 34); 1–2 months of age: 173 (n= 22) versus 31 (n= 16); 2–3 months of age: 132 (n= 8) versus 11 (n= 16). Similarly, formula‐fed colicky infants had significantly higher s‐α‐LA levels than agematched formula‐fed control infants 1‐2 months of age: median value 126 (n= 12) versus < 10 (n= 14); 2–3 months of age: 156 (n= 11) versus < 10 (n= 10). The increased absorption of the macromolecule human α‐lactalbumin in infantile colic suggests that the gut mucosa is affected in infants with infantile colic.
Epidemiology of Haemophilus influenzae Type b Infections among Children in Denmark in 1985 and 1986
Authors: KRISTENSEN K. , KAABER K. , RØNNE T. , LARSEN S. OLESEN , HENRICHSEN J.
Published: January 2008

ABSTRACT. A retrospective epidemiological study of invasive Haemophilus influenzae type b infections among children in Denmark 1985 and 1986 was carried out and 226 cases were identified. Of these 93% occurred in patients younger than five, corresponding to an annual incidence of 40 cases per 100 000 children aged 0‐4 years, 68% occurred in patients younger than two years of age, and 6% in patients younger than six months. The annual incidences of meningitis and epiglottitis were 27 and 8 cases, respectively, per 100000 children aged 0‐4 years. Of the 156 cases with meningitis four patients died and seven had severe neurological sequelae. Only 67% of the cases of meningitis had been notified.
Selective Effect of Mineralocorticoid Replacement Therapy on Renal Acid Excretion in Congenital Adrenal Hyperplasia
Authors: SIMÓN J. , MENDIZABAL S. , MARTINEZ F. , CARLES C. , ZAMORA I.
Published: January 2008

ABSTRACT. The renal acid excretion of eight children with salt‐losing congenital adrenal hyperplasia, was studied in three different situations: before treatment (period I), under glucocorticoid therapy (period II) and when both glucocorticoid and mineralocorticoid were given as replacement treatment (period III). Although administration of glucocorticoid therapy alone allowed the correction of acidemia, normalization of urinary net acid excretion was achieved only after mineralocorticoid was added to the treatment.
Influence of Baseline Lung Function on Exercise‐Induced Response in Childhood Asthma
Authors: LINNA OLAVI
Published: January 2008

ABSTRACT. The dependence of bronchial reactivity to exercise on baseline lung function was studied in 84 asthmatic children aged 7–16 years. The percentage fall in PEF values after a standard exercise running test was 8.4± 8.6 % in the 39 children with an attack rate of less than 10 per year and 29.6±23.3% in the 45 children with an attack rate of 10 or more per year (p<0.001). A significant negative correlation (r=‐0.46, p<0.001) was found for pre‐exercise MMEF and other sensitive tests of airway calibre with the response to exercise, but no such correlation was found between baseline PEF or SGaw values and the exercise response. These results show that bronchial hyperreactivity to exercise is dependent on residual airway obstruction, but a wide variety of reactivity can occur. If the baseline flow‐values are less than three standard deviations below the mean reference, however, a clinically significant response to exercise can be predicted.
Recurrent Enterocolitis‐Like Symptoms as the Possible Presenting Manifestations of Neonatal Brucella Melitensis Infection
Authors: LABRUNE P. , JABIR B. , MAGNY J. F. , GUIBERT M. , DAMAY M. , ODIEVRE M.
Published: January 2008

ABSTRACT. A premature infant had three episodes of enterocolitis‐like symptoms during the first three months of life. Brucella melitensis was isolated in a prolonged blood culture on day 85. The clinical manifestations disappeared under treatment and did not recur. A maternofetal transmission is suggested in this case. The importance of prolonged blood cultures when brucellosis is epidemiologically suspected is emphasized.
Concentration of Twelve Plasma Proteins at Birth in Very Low Birthweight and in Term Infants
Authors: POLBERGER STAFFAN K. T. , FEX GÖRAN , RÄIHÄ NIELSC. R.
Published: January 2008

ABSTRACT. Plasma samples obtained at birth from 70 very low birth weight (VLBW) infants (gestational age 24 to 34 weeks) and from 20 term infants were analysed for concentrations of 12 different proteins. The plasma concentrations of albumin, transthyretin (TTR), retinol‐binding protein (RBP), vitamin D‐binding protein, apolipoprotein A I, fibronectin, orosomucoid and α1‐antichymotrypsin were significantly lower in the VLBW infants than in the term infants, whereas the values of α‐fetoprotein (AFP) were significantly higher in the VLBW infants. No differences were found between the two groups for apolipoprotein A II, apolipoprotein B and transferrin. Birth asphyxia and sex had no influence on the measured plasma protein concentrations. The plasma concentrations of apolipoprotein A I and A II were significantly lower in small‐forgestational age (SGA), VLBW infants compared with appropriate‐for‐gestational age (AGA), VLBW infants. Possible acute inflammation (defined as raised concentrations of orosomucoid or α1‐antichymotrypsin) was associated with significantly higher values of vitamin D‐binding protein in both VLBW and term infants, suggesting that this protein may act as an acute phase protein in newborn infants.
Urinary and Serum Urea as Indicators of Protein Metabolism in Very Low Birthweight Infants Fed Varying Human Milk Protein Intakes
Authors: POLBERGER STAFFAN K. T. , AXELSSON IRENE E. , RÄIHÄ NIELS C. R.
Published: January 2008

ABSTRACT. Urea concentrations in serum and urine were measured in 28 growing, very low birth weight, appropriate‐for‐gestational age infants fed varying human milk protein intakes (range 1.7 to 3.9 g/kg/day). We found a high correlation between serum urea values at the end of the study and mean protein intake (r3=0.85, p<0.001) and between urinary urea concentrations in eight‐hour urine collections and protein intake (r3=0.81, p<0.001). All serum and urine urea values were below 1.6 and 18 mmol/l, respectively, at protein intakes less than 3 g/kg/day. Higher protein intakes caused higher serum and urinary urea concentrations. We also found a strong correlation between the individual serum and urinary urea values at the end of the study (r3=0.90, p<0.001). The presented data are consistent with the growth data previously reported and indicate that inadequate or excessive protein intakes can be detected by measurement of urea concentrations in serum and/or urine. If urine urea samples alone can be used for estimating optimal protein intake, painful blood sampling procedures could be obviated.
Myocardial Dysfunction and Cerebral Blood Flow Velocity Following Birth Asphyxia
Authors: BEL F. VAN , WALTHER F. J.
Published: January 2008

ABSTRACT. Birth asphyxia often leads to left ventricular myocardial dysfunction. To assess the effect of myocardial dysfunction on cerebral perfusion, we evaluated cardiac output and cerebral blood flow velocity in the anterior cerebral and internal carotid arteries in 20 asphyxiated term newborn infants during the first 4 days of life using 2‐dimensional/pulsed Doppler ultrasound. In 8 infants with myocardial dysfunction cardiac output was reduced on days 1 and 2 and within normal limits thereafter. In these infants changes in mean cerebral blood flow velocity and pulsatility index were passively related to changes in mean arterial pressure and cardiac output. In 12 infants without myocardial dysfunction a stable cerebral blood flow velocity pattern was found, which was unaffected by changes in mean arterial pressure. We conclude that infants presenting with a reduced cardiac output after deliveries associated with severe asphyxia may be at risk for additional ischemic or hemorrhagic cerebral damage because of lack of autoregulation.
Anticardiolipin Response in Kawasaki Disease
Authors: VAARALA O. , SALO E. , PELKONEN P. , PALOSUO T. , AHO K.
Published: January 2008

ABSTRACT. Antibodies against cardiolipin are formed in many different infectious diseases, and high levels are associated with susceptibility to thrombosis, especially in patients with systemic lupus erythematosus. In view of the postulated infectious etiology of Kawasaki disease and its association with thrombosis, we have studied the occurrence of anticardiolipin antibodies in this disease. Serial serum specimens from 36 patients were tested, using a solid‐phase enzyme immunoassay. A change of at least 0.3 optical density units between two consecutive specimens for at least one immunoglobulin class was observed in 47% of cases. Peak levels occurred one to two weeks after the onset of symptoms. Four patients developed coronary artery aneurysms, and they all showed a clear anticardiolipin response. Anticardiolipin antibodies might be one factor contributing to coagulation abnormalities in patients with Kawasaki disease.
Increased Interleukin‐1 (IL‐1) Production from LPS‐Stimulated Peripheral Blood Monocytes in Children with Febrile Convulsions
Authors: HELMINEN MERJA , VESIKARI TIMO
Published: January 2008

ABSTRACT. Peripheral blood mononuclear cells (MNC) from 27 children with a febrile convulsion were tested for production of interleukin‐1 (IL‐1) in culture. MNC stimulated with lipopolysaccharide (LPS) showed a significantly increased production of IL‐1 when compared to MNC from children without convulsions but with bacterial infections (p < 0.001), viral infections (p < 0.005) or no infection (p < 0.005). Children who had experienced a febrile convulsion were retested several months later; this time the IL‐1 production from LPS‐stimulated MNC was not different from controls. These results demonstrate that MNC at the time of febrile convulsions have increased sensitivity to LPS and possibly to other IL‐1 inducers; the resulting enhanced IL‐1 response from sensitized MNC may have a role in the pathogenesis of febrile convulsions.
Growth after Treatment of Solid Tumours in Childhood
Authors: MÄKIPERNAA A. , DUNKEL L. , SIIMES M. A.
Published: January 2008

ABSTRACT. We examined 90 survivors of childhood solid tumours diagnosed in our hospital between 1960 and 1976. Their ages at the time of this study ranged from 12.2 to 41.5 years. Adult standing height was usually normal. However, final standing height was less than expected in the females, and sitting height was below the normal mean in the males. The males who had received both chemotherapy and radiation therapy to the spine had a greater decrement in sitting height, but we did not find any association between radiation therapy to the spine without chemotherapy and subsequent total growth of the spine as measured by sitting height. We conclude that these children generally do not experience any major growth disturbances.
Acute Alcohol Intoxications in Children Treated in Hospital
Authors: LAMMINPÄÄ ANNE , VILSKA JUSSI
Published: January 2008

ABSTRACT. Cases of alcohol intoxication in children are common; they are encountered every day in Finland. Studies other than case studies of alcohol intoxication in children are few. Metabolic acidosis was a frequent finding in juvenile alcohol intoxication. Capillary or arterial blood pH was below normal (<7.36) in 61.4% of patients and bicarbonate (< 22) in 55.3% of patients. pCO2 was varied; the higher the blood alcohol concentration the higher the pCO2. Metabolic acidosis and blood pH correlated with the blood alcohol concentration and consciousness. The lower the blood pH the higher the serum glucose. Hypoglycemia is the most common reported symptom in children under 5 years of age. In the present study three patients were slightly hypoglycemic. Hypokalemia was the most important change (in 12.2%) in serum electrolytes. Alcohol intoxication causes metabolic acidosis and respiratory depression in children. Metabolic acidosis reduces consciousness.
Progress in the Prevention of Iron Deficiency in Infants
Authors: DALLMAN P. R.
Published: January 2008

ABSTRACT.Our present success in preventing iron deficiency in infants is based on a gradual growth in our understanding of iron nutrition. It became recognized that full term infants only become vulnerable to iron deficiency after about 5 months of age, and to a lesser degree if they are breast‐fed. The specific foods in which iron is provided during infancy were found to be more important in determining iron absorption than the actual amount of iron in the diet. Experience has also shown that fortification of infant foods is more reliable and cost effective than providing iron medication. Our current approaches to preventing iron deficiency in infants include: 1) maintaining breast feeding for at least 6 months, if possible; 2) using an iron‐fortified infant formula if a formula is used and using formula in preference to cow's milk; 3) using iron‐fortified infant cereal as one of the first solid foods; and 4) providing supplemental iron for low birth weight infants.
Does Early Diet Program Future Outcome?
Authors: LUCAS A.
Published: January 2008

Despite intensive research in infant nutrition throughout this century, uncertainty persists over nearly every major aspect of practice. Reasons for this uncertainty are analysed and the need for prospective studies on the later effects of early diet is justified. Evidence is presented that nutrition at a critical or sensitive period in early life predetermines future metabolism, performance and morbidity in animal models. Similar data in Man have been collected mainly in retrospective and flawed studies and are correspondingly less convincing. A prospective multicentre randomized study on preterm infant feeding is discussed to illustrate the feasibility of conducting long‐term outcome studies in Man and to emphasize the critical importance of outcome data as a basis for clinical practice. Preliminary evidence from this study suggests that the way a preterm infant is fed, in just the early weeks post partum, may have a major impact on later growth and development.