bluuebunny/crossref_metadata_2025 huggingface dataset:
Bovine β‐Lactoglobulin in the Human Milk
Authors: AXELSSON IRENE , JAKOBSSON IRENE , LINDBERG TOR , BENEDIKTSSON BIRGITTA
Published: January 2008

ABSTRACT. Human milk samples (n=232) collected during the whole lactation period from 25 healthy, Swedish mothers were analyzed by radioimmunologic method for content of bovine β‐lacto‐globulin. Detectable amounts (5‐800 μ/1) were found in 93 of 232 milk samples (40%). Six mothers had no detectable β‐lactoglobulin in their breast milk on any occasion. Two mothers had measurable /Mactoglobulin in all their milk samples. No correlation was found between daily cow's milk intake and concentration of β‐lactoglobulin in the milk samples. Six mothers with allergic symptoms such as asthma, hay‐fever, eczema all had detectable amounts of β‐lactoglobulin in their milk. Of 19 mothers without allergy, 13 had detectable amounts. This difference did not show statistical significance. The presence of symptoms in the infant such as diarrhoea, vomiting, colic, exanthema was significantly correlated to high levels of β‐lactoglobulin in the milk. Bovine β‐lactoglobulin was also detected in 7 of 13 serum samples. The two mothers with detectable β‐lactoglobulin in all milk samples had the highest serum values, and their infants suffered from gastro‐intestinal symptoms, weight decline and exanthema.
Gut Hormones and ‘Minimal Enteral Feeding’
Authors: LUCAS A. , BLOOM S. R. , AYNSLEY‐GREEN A.
Published: January 2008

ABSTRACT. Previously we have identified multiple surges in plasma concentrations of gut hormones post‐natally in enterally fed term and preterm infants. In this study on 104 preterm infants we have shown that such surges are induced after ingestion of very small quantities of human milk. Whereas 6‐day‐old exclusively parenterally fed infants showed no postnatal elevation in enteroglucagon, gastrin, GIP, motilin and neurotensin, infants recovering from hyaline membrane disease who had received restricted enteral nutrition had similar hormone surges to those seen in well infants on full enteral feeds. Significant elevations in enteroglucagon, gastrin and GIP occurred after a cumulative mean enteral feed volume since birth of only 24 ml (12 ml/kg body weight) had been consumed and after a mean total intake of 96 ml (50 ml/kg) the response was maximal. Greater feed volumes were required to produce a neurotensin or motilin surge, but even these volumes were substantially lower than those required for full enteral feeding. In view of the proposed roles of gut hormones in the adaptation to extrauterine nutrition these data have implications for mammalian biology and raise the possibility that ‘minimal enteral feeding’ might have a clinical therapeutic role in infants undergoing prolonged parenteral nutrition.
Vasopressin and Oxytocin Levels in Human Neonates
Authors: POCHARD J. L. , LUTZ‐BUCHER B.
Published: January 2008

ABSTRACT. In order to find out whether arterial and venous cord levels of vasopressin (VP) and oxytocin (OT) might be linked to one or more obstetric parameters and to beta‐endorphin (BEP) secretion, 42 successively delivered neonates were studied. Arterial and venous cord blood levels of these peptides were not statistically different whenever the neonates were born vaginally with or without foetal distress, after induction of labour by oxytocic drugs, or by elective caesarean section. BEP levels in cord and maternal blood do not seem to be linked with AVP or OT. The results of the group of infants born after uncomplicated vaginal delivery analyzed with regard to obstetric parameters, led to the following conclusions: 1) arterial cord VP correlated with venous cord VP, with arterial cord OT and with the duration of membrane rupture; 2) arterial cord OT correlated with venous cord OT and with the time taken by the cervix to dilate from 5 to 10 cm, suggesting that the foetal pituitary gland is sensitive to the evolution of labour.
Does Centralized Treatment of Cystic Fibrosis Increase the Risk of Pseudomonas aeruginosa Infection?
Authors: PEDERSEN SVEND STENVANG , JENSEN TIM , PRESSLER TANJA , HOIBY NIELS , ROSENDAL KIRSTEN
Published: January 2008

ABSTRACT. Two hundred and forty Danish patients with cystic fibrosis (97% of the total CF population in Denmark) participated in a point‐prevalence study of Pseudomonas aeruginosa infection. One hundred and ninety‐two patients were treated at the Danish CF centre and 48 patients were treated in other places. The age distribution was significantly different as no patients older than 19 years were found in the non‐centre group. Pathogenic bacteria were isolated from the sputum of 96% of the patients. P. aeruginosa was more prevalent in patients from the centre, whereas Staphylococcus aureus was more prevalent in the non‐centre group. No difference in serogroup and phage pattern of P. aeruginosa was found. There was a tendency that non‐centre treated patients acquired chronic broncho‐pulmonary P. aeruginosa infection later, but at the age of 16 years 90% of all patients will be chronically infected. Chronic P. aeruginosa infection was significantly more common in the age group 10‐14 years at the centre than outside the centre. It is not possible to prevent chronic P. aeruginosa infection in CF patients treated in small groups and because of the better prognosis of centralized treatment the latter must be recommended.
Hypodipsic Hypernatremia Associated with Absence of Septum Lucidum and Olfactory Dysfunction
Authors: OHZEKI T. , HANAKI K. , ASANO T. , ISHITANI N. , WAKATSUKI H. , SHIRAKI K.
Published: January 2008

ABSTRACT. A case of hypodipsic Hypernatremia in a 16‐month‐old Japanese boy is reported. Partial antidiuretic hormone deficiency was present. Computed tomography of the brain revealed absence of septum lucidum. No ophthalmological abnormality could be found. He had hyp‐osmia, which has not been reported previously in association with Hypernatremia due to hypodipsia. Forced fluid administration and nasal l‐deamino‐8‐d‐arginine vasopressin treatment could maintain serum electrolyte levels within normal ranges. However, episodes of Hypernatremia could not be completely avoided while he was treated with l‐deamino‐8‐d‐arginine vasopressin and ad libitum oral fluid.
Ring Chromosome 21 and SOD Activity of Blood Cells
Authors: AOKI T. , YOSHIMITSU K. , ITODAGAWA M. , OKAZAKI H. , SUGIMOTO T. , KOBAYASHI Y.
Published: January 2008

ABSTRACT. A female infant was found to have an abnormal karyotype with mosaicism: 45,XX,‐21/ 46,XX,r(21) (pll.2 q22.3). She showed a slightly decreased level of superoxide dismutase (SOD) activity in erythrocytes, polymorphonuclear and mononuclear leukocytes. The cupro‐zinc SOD (SOD‐1) activity of leukocytes was 70‐80% of normal level, while their manganese SOD (SOD‐2) activity was within the normal range. The relationship between the chromosomal aberration and the SOD activity is discussed in relation to the gene dosage effect.
Iron Deficiency in the Weanling: a Nutritional Problem on the Way to Resolution
Authors: DALLMAN PETER R.
Published: January 2008

ABSTRACT. The rapidly growing weanling becomes vulnerable to iron deficiency when neonatal iron stores have been consumed after the first few months following birth. Whether the infant will progress from the harmless condition of depleted iron stores to the physiological handicaps associated with iron deficiency depends on the selection of foods during the period of weaning. Consumption of fresh cow's milk and of unfortified cow's milk formulas and cereal products predispose to iron deficiency. Breast feeding, iron‐ and ascorbic acid‐fortified cow's milk formulas and cereals, and the use of ascorbic acid‐rich foods and meat decrease the likelihood of iron deficiency. Recent changes in infant feeding practices in the United States have been associated with a marked decline in iron deficiency anemia. A challenge for the future will be to extend this success, particularly to developing countries.
The Role of the Food Industry
Authors: METTLER A. E.
Published: January 2008

ABSTRACT. The role of the manufacturing food industry in relation to provision of foods for the weanling encompasses 4 main objectives viz. customer satisfaction, safety, providing product information and the maintenance of commercial viability. The effectiveness of the manufacturing food industry to fulfil these roles is judged by the customer wishing to buy for quality and convenience reasons, by the law of the land in meeting legal requirements for safety and labelling and by its generation of profit in terms of commercial viability. Whereas it is commonly expected that industry should fulfill a role in nutrition education this is seen as a primary role of health professionals whilst industry needs to provide full and detailed product information. The industry is highly creative in both its technological innovation and adaptation and works hard at trying to satisfy the requirements of consumers, the industry, health professionals and its critics.
Treatment by hGH of Constitutional Delay of Growth and Adolescence
Authors: BIERICH JR.
Published: January 2008

ABSTRACT. In constitutional delay of growth and adolescence (CDGA), all growth and maturation parameters are delayed by 2–4 years. Provocation tests of hGH secretion give normal values, but spontaneous (endogenous) secretion is low. This can be assessed by measuring night‐time hGH secretion, when the differences between normal subjects and CDGA patients are highly significant. Replacement therapy with hGH produced growth spurts in all but one patient, improving their growth prognosis. A new series of 16 CDGA patients has now been treated with hGH for 1–3 years. Catch‐up growth was seen during the first year, which decreased to normal growth velocity by the third year. This normal growth rate is still faster than the pretreatment velocity. Although hGH therapy may be effective in CDGA, it may only be justified in cases with psychological problems arising from their short stature.
Doppler Evaluation of Atrial Septal Defect, Ventricular Septal Defect, and Complex Malformations
Authors: STEVENSON J. GEOFFREY
Published: January 2008

ABSTRACT. The Doppler approaches, accuracy, pitfalls and quantitation of atrial and ventricular shunts are reviewed. For both levels of shunting, Doppler demonstration of flow through the septum confirms the diagnosis and directional flow information may provide physiologic information. Shunt sizes may be measured directly by Doppler, and should be reflected by chamber dimensions and volumes. The flow disturbances present in complex malformations such as Ebstein's malformation, transposition of the great arteries with ventricular septal defect, atrial shunting before and after balloon atrial septostomy, total anomalous pulmonary venous return, closely related high velocity flows and coarctation are described. A sequential approach to each anomaly allows one to evaluate each, even if multiple defects are combined in a given patient.
The Usefulness of Echo‐Doppler in Pediatric Cardiology
Authors: DANIELS O. , KNECHT S. DE , OORT A. VAN , BUSCH H. J.
Published: January 2008

ABSTRACT. In the last three decades ultrasound investigation is used in cardiology. Especially in the last ten years it is not only possible to visualize cardiac anatomy and function by M‐mode or 2‐dimensional echocardiography but it is also possible to visualize the bloodflow velocity by continuous wave Doppler, single or multigate Doppler and 2‐dimensional Doppler. Ibe combination of the different modalities of ultrasound investigation of the heart gives us so much insight in cardiac anatomy and function that cardiac pathophysiology can be better undep stood and so invasive diagnostic procedures can be avoided, especially in children with congenital heart malformations. It is clear that not only the patient will benefit from this possibility but also the economical sources. In a 15 years review of our institution, where in 1976 2‐dimensional echocardiography and in 1979 Doppler echocardiography has been introduced, it can be seen that ultrasound technique replaces invasive heart catheterization.
Intracranial Doppler Flow Velocimetry Compared with Extracranial Carotid Blood Flow Measurements
Authors: LUNDELL B. P. W. , KENNEDY K. A. , LINDSTROM D. P. , SUNDELL H. , STAHLMAN M. T.
Published: January 2008

ABSTRACT. The effects of changes in carotid blood flow on intracranial blood flow velocities were examined in six newborn lambs under general anesthesia. Carotid blood flow was measured using electromagnetic flow cuffs. A combined continuous and pulsed Doppler instrument was used to measure intracranial blood flow velocities on the base of the skull through artificially created fontanels. Baseline carotid blood flow was 96±18 ml.min‐1 (mean ± SD) and increased by 58±13% following contralateral occlusion. A close correlation between changes in carotid blood flow and intracranial blood flow velocity was found (y= ‐6.28+3.72x, Sy=182.3, Sy/x=0.30, r=0.89, p<0.001). The closest estimate of changes in blood flow to the brain was the temporal mean of the cross‐sectional average velocity.
Plasma Catecholamine Levels in Preterm Infants
Authors: GREENOUGH A. , LAGERCRANTZ H. , POOL J. , DAHLIN I.
Published: January 2008

ABSTRACT. Catecholamine levels were measured in cord arterial blood from preterm infants. Relatively lower catecholamine levels were found in the preterm infants than in term infants, although no significant correlation was found between noradrenaline and adrenaline levels and either gestational age or birthweight. Significantly higher catecholamine levels were found after labour. Preterm females had significantly higher catecholamine levels than boys after asphyxia and tended also to have higher catecholamine levels without asphyxia, although not significant. Catecholamine levels were also significantly elevated in those infants with a low Apgar score (<7 at 5 min) and those who were acidotic (cord arterial pH <7.25). A good correlation was found between a low Apgar score and the presence of acidosis.
AIDS in Two African Infants Born in Belgium
Authors: BROCK P. , NINANE J. , CORNU G. , MOULIN D. , SONNET J.
Published: January 2008

ABSTRACT. Two African infants born in Belgium, dying from the acquired immune deficiency syndrome are reported. The first patient was a premature baby girl born to healthy parents. However, her asymptomatic mother was found to have polyclonal hypergammaglobulinaemia, a reversed T‐helper/T‐suppressor ratio and a decreased lymphocyte response to mitogens. The second patient's mother was treated for Pneumocystis carinii pneumonia during the fourth month of gestation and was subsequently diagnosed with AIDS. The rapid clinical evolution of the acquired immunodeficiency syndrome in infancy suggests that the incubation period is shorter than in adults.
Proportionality at Birth
Authors: OUNSTED M. , MOAR V. A.
Published: January 2008

ABSTRACT. 501 small (SGA), 330 average (AGA) and 460 large for gestational age (LGA) babies were measured at birth. Head‐chest, head‐crown‐rump length, and chest‐crown‐rump length ratios were used to evaluate the changing patterns of proportionality with increasing gestational age. The SGA group showed strong negative correlations for head‐chest and head‐length ratios, and positive correlations for chest‐length ratios. The patterns were similar in the AGA group, only less evident. For all three measures of proportionality, correlations with gestational age in the LGA group were close to zero. In each group boys had higher head‐chest ratios than girls.
Elevation of Cerebrospinal Fluid Sialic Acid Concentration in Children with Central Nervous System Leukemia
Authors: ASAMI T. , TANAKA A. , GUNJI T. , SAKAI K. , ASAMI K.
Published: January 2008

ABSTRACT. We studied sialic acid in the cerebrospinal fluid (CSF) of 52 children with leukemia and 51 children with non‐leukemic diseases. The CSF sialic acid concentration in the children with central nervous system (CNS) leukemia was significantly higher than that in the children with acute lymphoblastic leukemia without CNS involvement, acute non‐lymphocytic leukemia without CNS involvement, non‐hemopoietic diseases, non‐suppurative meningitis, epilepsy, and other neurologic diseases. Serial determinations revealed a rapid decline in the CSF sialic acid concentrations in the patients with CNS leukemia who responded well to the therapy and who were free from relapse of CNS leukemia. The simultaneously determined CSF β2 microglobulin concentration did not show any significant changes. These results suggest that the CSF sialic acid may be a good indicator of CNS leukemia.
Impaired Response of Growth Hormone‐Releasing Hormone (GHRH) Measured in Plasma after L‐Dopa Stimulation in Patients with Idiopathic Delayed Puberty
Authors: ARGENTE J. , BRION D. EVAIN , DONNADIEU M. , GARNIER P. , VAUDRY H. , JOB J. C.
Published: January 2008

ABSTRACT. In order to investigate the regulation of GH secretion in patients with idiopathic delayed puberty (IDP), either prepubertal (stage P1) or early pubertal (P2), GHRH levels in plasma were measured after stimulation with L‐Dopa in a group of 16 patients with IDP. The results were compared to those obtained in 12 patients with constitutional short stature (CSS) at the same stages of puberty, who underwent L‐Dopa test for insufficient height. Plasma GHRH levels were measured, after extraction and concentration on C18 Sep Pack columns, by radioimmunoassay using an antibody against 1–40 GHRH, which cross‐reacts 100% with 1–44 GHRH. The sensitivity of the assay is 6–8 pg/ml. After L‐Dopa intake, the peak of GH was mean ± SEM 8.6±1.4 ng/ml in IDP and 12.0±0.8 ng/ml in CSS (NS). The peak of GHRH after L‐Dopa was 41±10 pg/ml in IDP and 96±25 pg/ml in CSS (p<0.02). A significant (p<0.02) decrease of plasma GHRH peak values (mean ±SEM 17.3±4.4 pg/ml) was noted in the five patients with IDP whose growth velocity was below ‐2 SD for their bone age compared to the patients with normal growth velocity (mean ± SEM 75.0±14.5 pg/ml). These results suggest a hypothalamic dysfunction in patients with IDP, and a relationship between the well‐known partial and transitory somatotropic deficiency found in some adolescents having a pubertal delay and their secretion of the releasing hormone GHRH.
Renovascular Hypertension in a Child with Rett's Syndrome
Authors: UHARI M. , RANTALA H.
Published: January 2008

ABSTRACT. A girl with Rett's syndrome and renovascular hypertension because of a stenosis in the right renal artery is described. The girl was operated on twice because of the stenosis. Her blood pressure normalized after the second operation in which the artery was reconstructed. High blood pressure causes neurological symptoms which may be difficult to distinguish from the basic disease. The importance of the measurement of blood pressure in every child with neurological symptoms is emphazised. The possibility of an association between renovascular hypertension and Rett's syndrome should be studied in large series.
Cerebral Blood Flow, PaCO2 Changes, and Visual Evoked Potentials in Mechanically Ventilated, Preterm Infants
Authors: GREISEN GORM , TROJABORG WERNER
Published: January 2008

ABSTRACT. Two estimations of global cerebral blood flow (CBF) using 133‐Xenon clearance were done with an interval of about one hour in 16 mechanically ventilated, newborn infants, of less than 33 weeks gestational age. In eight infants CBF was estimated just before a change in ventilator settings, and again when the Paco2 was stable. In the remaining eight infants small spontaneous changes in Paco2 occurred. The CBF‐CO2 reactivity was similar in the two groups (+67%/kPa (95% confidence interval 13–146) and 52%/kPa (24–86)) and considerably higher than the CBF‐CO2 reactivity estimated from the interindividual variation of flow and Paco2 (+19%/kPa (4–36)). There were no significant relations between CBF and arterial blood pressure. Flash evoked potentials (VEP) were recorded during the 133‐Xenon clearances in 8 of the infants. VEP showed no relation to changes in CBF, even when the blood flow rose from the lowest levels. CBF and VEP were obtained once in 9 other infants. Among the 17 infants, the latency of the first negative wave of the VEP was not related to the CBF level. Mean CBF in the 25 infants was 12.3 ml/100 g/min (range 4.3 to 18.9), mean Paco2 was 4.2 kPa (range 2.3 to 6.4). Thus, CBF‐CO2 reactivity appeared to be normal in these clinically stable, mechanically ventilated, preterm infants, suggesting that their low cerebral blood flow was well regulated. The absence of a relation of CBF with VEP suggested that cerebral blood flow was not critically decreased.
Epidemiological Aspects of P‐fimbriated Escherichia coli IV. Extraintestinal E. coli Infections before the Age of One Year and Their Relation to Fecal Colonization with P‐fimbriated E. coli
Authors: TULLUS K. , KÄLLENIUS G.
Published: January 2008

ABSTRACT. In two retrospective studies we have found outbreaks of E. coli pyelonephritis and septicemia to be due to nosocomial spread and fecal colonization with virulent E. coli strains in the neonatal ward of Danderyd Hospital. The incidence of extraintestinal E. coli infections before the age of one year was therefore prospectively studied in all children born at Danderyd Hospital during two and a half years (n=7963). The number of infections was correlated to the previous fecal colonization with P‐fimbriated E. coli. During this study we found no outbreaks of E. coli infections. The incidence of E. coli pyelonephritis before the age of one year was 0.6–0.7%, which we propose to be a baseline incidence. This corresponds well with the low incidence of fecal colonization with P‐fimbriated E. coli found among these children. Fecal colonization with P‐fimbriated E. coli during this non‐epidemic period had no predictive value for the individual child for the later development of pyelonephritis.
Analysis of Linear Growth Using a Mathematical Model
Authors: KARLBERG J. , ENGSTRÖM I. , KARLBERG P. , FRYER J. G.
Published: January 2008

ABSTRACT. According to the “ICP‐growth model” (ICP=Infancy, Childhood and Puberty components), linear growth during the first three years of life can be represented mathematically by a combination of a sharply decelerating Infancy component and a slowly decelerating Childhood component. Growth as measured by supine length is analysed for 191 longitudinally followed healthy infants using this model. The main aim is to devise ICP‐based methods for biological and clinical applications. The onset of the Childhood component, which occurs some time between 6 and 12 months of age and is typically abrupt, can be detected on an individual basis. Its starting point probably defines the as yet unknown age at which growth hormone begins to exert a significant influence. The analyses have also revealed some new facets of linear growth. Most infants are found to have a non‐linear decelerating Infancy component, free from seasonal influence. Age at onset of the Childhood component is earlier for girls than for boys and is positively related to the magnitude of the Infancy component. During the second year of life the variation in growth rate of the cohort increases. This fluctuation is found to be seasonal and greater for those with late onset of the Childhood component. During the third year of life the growth pattern is stabilized.
Increase of Serum Lipids and Serum Lipoproteins in Girls under Therapy with Estrogen and Norethisteron for Height Reduction
Authors: WENINGER M. , FRISCH H. , SCHOBER E. , STROBL W. , WIDHALM K.
Published: January 2008

ABSTRACT. The effect of a combined treatment with ethinyl estradiol and norethisteron for height reduction on serum lipids and lipoproteins was investigated in 23 excessively tall girls (>97th percentile). Serum cholesterol, triglycerides, HDL‐C and LDL‐C were determined before and 3, 6, 9 and 12 months after the onset and 3 to 12 months after cessation of therapy. Treatment with ethinyl estradiol and norethisteron resulted in significant (p<0.01) mean increases in serum cholesterol, triglycerides, HDL‐C, and LDL‐C of 20.6%, 95.5%, 23.6%, and 22.2% above pretreatment values, respectively. This increase occurred during the first 3 months of therapy and thereafter no further significant change was observed. After cessation of therapy elevated levels returned to pretreatment levels within 3 to 12 months in all but two patients. The results obtained suggest an influence of ethinyl estradiol and norethisteron on serum lipids and lipoproteins. Whether these reversible changes of serum lipids and lipoproteins are associated with an increased risk for developing atherosclerosis has to be evaluated in long term investigations.
Risk Factors and Sib Correlation in Physiological Neonatal Jaundice
Authors: NIELSEN H. E. , HAASE P. , BLAABJERG J. , STRYHN H. , HILDEN J.
Published: January 2008

ABSTRACT. The effect of a number of explanatory variables on the degree of physiological jaundice in mature infants was evaluated by multiple regression analysis. The sampling was designed so that comparisons could be made between siblings. We found an effect of gestational age, gender, infant nutrition, ABO incompatibility and induction of labour. Taking these factors into account we still found a highly significant correlation between the peak bilirubin levels of siblings. Whether this correlation is genetically or environmentally determined is not clear.
The Nutritional Role of Breast‐Milk IgA and Lactoferrin
Authors: PRENTICE A. , EWING G. , ROBERTS S. B. , LUCAS A. , MacCARTHY A. , JARJOU L. M. A. , WHITEHEAD R. G.
Published: January 2008

ABSTRACT. The nutritional enigma concerning the extent to which breast‐milk immune proteins are digested has been investigated by measuring the intakes and faecal outputs of IgA and lactoferrin over 7 days in 10 exclusively breast‐fed (BF) and 9 formula‐fed (FF) fullterm infants at 6 and 12 weeks post‐partum. BF outputs (mg/day) greatly exceeded FF values (p<0.001): at 6 weeks secretory‐IgA BF=160±28, FF=14±2, lactoferrin BF=M±2, FF=0.9±0.1; at 12 weeks secretory‐IgA BF=94±17, FF=25±5, lactoferrin BF=7±1, FF=1±0.3. Secretory‐IgA represented 42% and 27% of BF faecal protein at 6 and 12 weeks compared with 6% for FF infants at both ages. BF secretory‐IgA outputs were highly correlated with intakes (r=0.83, p<0.001). IgA and lactoferrin outputs and the presence of faecal secretory‐IgA fragments in BF and FF infants were influenced by defaecation rate, suggesting that partial degradation occurred in the large intestine. By 6 weeks post‐partum only 1% lactoferrin and 17% secretory‐IgA intakes appeared in the faeces and 95% breast‐milk protein could be regarded as nutritionally available. The elevated BF outputs of IgA and lactoferrin relative to endogenous excretion suggest, however, that breast‐milk may still make a considerable contribution to intestinal defence mechanisms after the neonatal period despite the small proportion of daily intake which escapes digestion. The protective action of IgA and lactoferrin may also depend on their site of degradation and the nature of fragments.
Comparison of Different Rates of Artificial Ventilation in Preterm Neonates with Respiratory Distress Syndrome
Authors: GREENOUGH A. , POOL J. , GREENALL F. , MORLEY C. , GAMSU H.
Published: January 2008

The effectiveness of three different ventilator rates of artificial ventilation (30, 60 and 120/min) was studied in 32 preterm infants, all of whom were suffering from the Respiratory Distress Syndrome (16 were paralysed). Ventilator pressures, I: E ratio and MAP were kept constant at each rate. Increase in rate from 30 to 60 and to 120/min was well tolerated and not associated with episodes of hypotension. The only significant improvement in oxygenation was amongst the non‐paralysed infants and at a rate of 120/min (p<0.01) this was associated with synchronous respiration. Two different ventilators were used in the study and a significant change in Paco2, (reduction) occurred only in non‐paralysed infants ventilated at a rate of 120/min by Sechrist ventilators (p<0.05). This difference may be a direct reflection of differences in ventilator performance at fast rates.
Unexpected Occurrence of Retinopathy of Prematurity: Is There a Need for Custom‐Made Screening Procedures?
Authors: CATS B. P. , TAN K. E. W. P.
Published: January 2008

Widely differing screening routines for retinopathy of prematurity (ROP) are encountered in the literature. Because no standard pattern in the development of retinopathy of prematurity has so far been recognized and substantial differences exist between patient‐populations, none of these procedures seem generally applicable. Diverse manifestations of this entity cast doubt upon the usefulness of rigid screening procedures. As illustrated by two cases, some retinas seem to be at risk of developing ROP over a considerable period of time which may even extend beyond term. It is suggested that very low birthweight neonates, suffering serious illness or undergoing anesthesia after the initial “routine” ROP screening, should be reexamined for ROP thereafter.
P‐fimbriated Escherichia coli in Children with Acute Cystitis
Authors: LIDEFELT K.‐J. , BOLLGREN I. , KÄLLENIUS G. , SVENSON S. B.
Published: January 2008

P‐fimbriation of Escherichia coli is an important factor in the pathogenesis of childhood pyelonephritis. The present study investigates children with single episodes of symptomatic non‐febrile urinary tract infection, i.e. cystitis, with respect to clinical appearance and bacteriology, especially the frequency of P‐fimbriated E. coli. The study included 75 children, 57 of whom had their first attack of urinary tract infection. E. coli was the causative agent in 88% (66/75) of the infections, and 48% (32/66) of E. coli strains were P‐fimbriated. No association was found between identification of P‐fimbriated E. coli at index infection and proneness to reinfection during the following six‐month period. It is suggested that P‐fimbriated E. coli is a virulence factor even in lower urinary tract infections, when occurring in single, symptomatic episodes.
Dietary Survey of Finnish Adolescent Diabetics and Non‐Diabetic Controls
Authors: VIRTANEN S. M. , RÄSÄNEN L. , MÄENPÄÄ J. , ÅKERBLOM H. K.
Published: January 2008

Food consumption data of 152 diabetic and 74 non‐diabetic adolescents were collected by means of two 48 h recall interviews. The nutrient density of the diet was systematically higher for the diabetics than the controls. The energy intake from protein was higher for the diabetics (18% vs. 15%), and correspondingly the proportion of fat lower (33% vs. 36%). The ratio of polyunsaturated to saturated fatty acids was higher for the diabetics (0.49 vs. 0.39) and the share of energy from sucrose for the controls (14% vs. 4%). The intra‐individual variation in nutrient intakes was higher for the controls. The diet of the diabetics met reasonably well the recommendations for diabetics and also the general recommendations for a healthy population. However, the differences between the diabetics and controls regarding food consumption, nutrient intake and intra‐individual variation of nutrient intake decreased with age.
Motor Performance of Neonatal Risk and Non‐Risk Children at Early School‐Age
Authors: LINDAHL E.
Published: January 2008

The motor skills of 382 children with neonatal risk factors and 107 children with no risk factors, in the age group 8–9 years, were studied using the Test of Motor Impairment (Stott‐Moyes‐Henderson). Neonatal disturbances, such as low birthweight and neurological symptoms were associated with marked clumsiness. The test performance was found, unexpectedly, to be significantly affected by age and sex in both the study and the control group. The test items were the same for an age range of one whole year, with no allowance for continuous development of skills. The need of normative data for each country is stressed.
Is Growth Hormone Deficiency a Useful Diagnosis?
Authors: BROOK C.G.D. , HINDMARSH P.C. , SMITH P.J.
Published: January 2008

Evidence is presented that there is a continuum in endogenous hGH secretion ranging from those children with poor growth velocities who secrete very little, formerly called hGH deficient, to those with normal growth velocities who secrete a much greater amount. The relationship between growth velocity and hGH secretion in short children is described by an asymptotic regression. Further, the relationship between growth and hGH is modulated by hGH pulse amplitude. The therapeutic implications of this relationship are that any short child given hGH will grow more rapidly, and that those children growing most slowly with the least endogenous hGH secretion will have the greatest increment in height velocity for a standard dose of exogenous hGH.
Early Initiation of Growth Hormone Treatment: Influence on Final Height
Authors: VANDERSCHUEREN‐LODEWEYCKX MAGDA , BROECK JAN VAN DEN , WOLTER RENEE , MALVAUX PAUL
Published: January 2008

Vanderschueren‐Lodeweyckx, M., Van den Broeck, J., Wolter, R. and Malvaux, P. (Department of Paediatric and Adolescent Endocrinology, University of Leuven, Department of Paediatrics, University of Brussels and Department of Paediatrics, University of Louvain, Belgium). Early initiation of growth hormone treatment: influence on final height. Acta Paediatr Scand [Suppl] 337:4, 1987.

Retrospective growth data for 34 hGH deficient patients who had been treated for at least 3 years with hGH were analysed in a Belgian multicentre study. Final height was related to target height and was usually below it, hut it was not determined by chronological or bone ages, bone age delay, height velocity before or during therapy, nor by duration of treatment. Total height gain during long‐term substitution with hGH is inversely related to chronological and hone ages at the start of therapy, and is positively related to the duration of therapy. Early diagnosis of hGH deficiency is thus important, as it allows catch‐up growth to optimal height before puberty, which in turn results in a good pubertal growth spurt.
Comparison of Short‐term Lower Leg Growth with Statural Growth in Children Treated with Growth Promoting Substances
Authors: WIT J. M. , TEUNISSEN D. M. , WAELKENS J. J. J. , GERVER W. J.
Published: January 2008

Wit, J. M., Teunissen, D. M., Waelkens, J. J. J. and Gerver, W. J. (Departments of Paediatrics of the University Hospital for Children and Youth, Utrecht, Catharina Hospital, Eindhoven and University Hospital, Maastricht, The Netherlands). Comparison of short‐term lower leg growth with statural growth in children treated with growth promoting substances. Acta Paediatr Scand [Suppl] 337:40, 1987.

Lower leg growth was determined by knemometry in 11 children with short stature, before and during therapy with growth promoting drugs. The growth response of lower leg length was determined by comparing growth velocities over periods of 6 weeks. The growth response of total body height was determined by comparing the growth velocity during 3 months of therapy with the growth velocity over 1 year before therapy. Significant knemometric growth responses were always associated with positive height responses, hut smaller knemometric responses were associated with positive as well as negative height responses.
Urine Growth Hormone Determinations Compared with Other Methods in the Assessment of Growth Hormone Secretion
Authors: OKUNO AKIMASA , YANO KOICHI , ITOH YOSHIYA , HASHIDA SEIICHI , ISHIKAWA EIJI , MOHRI ZEN‐ICHI , MURAKAMI YOSHIAKI
Published: January 2008

Okuno, A., Yano, K., Itoh, Y., Hashida, S., Ishikawa, E., Mohri, Z‐I. and Murakami, M. (Department of Paediatrics, Asahikawa Medical College, Hokkaido; Medical College of Miyazaki, Kiyotake, Miyazaki; and Research and Development Division, Sumitomo Pharmaceuticals Co Ltd, Hyogo, Japan). Urine growth hormone determinations compared with other methods in the assessment of growth hormone secretion. Acta Paediatr Scand [Suppl] 337:74, 1987.

Urinary excretion of hGH was studied in children with short stature using a sensitive sandwich enzyme immunoassay technique. Urinary hGH excretion, in terms of hGH: creatinine ratio, showed excellent correlation with the mean and peak hGH values during physiological and pharmacological tests. It seems that the urinary hGH levels reflect serum hGH profiles during the urine collection period. A border zone for the lower limits of normal hGH levels in the urine was 7.5–13.4 ng/g creatinine for the physiological test at night (from 2000 hours to 0600 hours) and 17.4–35.0 ng/g creatinine for the pharmacological tests. Assessment of hGH secretory status by the urinary hGH levels showed good agreement with the serum hGH response. Measurement of urinary hGH could be used as a diagnostic test for impaired hGH secretion, and the multiple blood drawing required in physiological and pharmacological tests might be replaced by urine sampling.
Spanish Multicentre Trial on Somatrem (1985–1986)
Authors: VICENS‐CALVET ENRIC , CUATRECASAS‐MEMBRADO JOSEP M.
Published: January 2008

Vicens‐Calvet, E., Cuatrecasas‐Membrado, J. M. and the Spanish Collaboraative Group. (Endocrinology Unit, Children's Hospital Tall ‘d'Hebron’, and Medical Department, KabiFides Peptide Hormones, Barcelona, Spain). Spanish multicentre trial on somatrem (1985–1986). Acta Paediatr Scand [Suppl] 337:126, 1987.

In an open multicentre trial, the safety and efficacy of somatrem, 4 IU i.m. three times weekly for 12 months, were evaluated in children with hGH deficiency with or without previous treatment with pituitary hGH. Patients were divided into young and prepubertal groups according to chronological age, and catch‐up growth after treatment was greater in the former. Bone age evolved at the same rate as chronological age, irrespective of whether patients were previously untreated (naïve) or previously treated. Fewer previously treated patients exhibited anti‐hGH antibodies than naive patients. Somatrem appears to be a safe, efficient product for treating different degrees of hGH deficiency.
The Benefits of the Very Early Introduction of Powdered Rice and Dried Edible Seeds (Dal Moong) in the Oral Rehydration Solution during the Treatment of Acute Infectious Diarrhoea of Infancy
Authors: MURTAZA ASIFA , ZULFIQAR IMTIAZ , KHAN SHAUKAT‐RAZA , LINDBLAD BO S. , SAHLGREN B. Å. , APERIA ANITA
Published: January 2008

ABSTRACT. We have examined whether the addition of powdered rice and pulses (Dal moong) to oral rehydration solution will decrease the purging rate and thereby increase the efficacy of the oral rehydration therapy. The study was carried out on 60 male infants, with acute watery diarrhoea, moderate dehydration but without fever, vomiting, or other conditions like septicaemia and meningitis. The infants were treated with either the standard WHO oral rehydration salt solution (ORS) or with a modified solution where glucose was removed and powdered rice and Dal moong were added. We found that the infants receiving ORS with powdered rice and Dal moong had significantly lower fluid losses in the stools, a significant and more rapid weight gain, and needed significantly less fluid than the infants receiving ORS only.
Megaloblastic Anemia and Immune Abnormalities in a Patient with Methionine Synthase Deficiency
Authors: ZITTOUN J. , FISCHER A. , MARQUET J. , PERIGNON J. L. , LAGRUE A. , GRISCELLI C.
Published: January 2008

ABSTRACT. We report a case of methionine synthase deficiency associated with cellular immune deficiency discovered in a 14‐year‐old boy. Principal findings were: developmental delay, recurrent upper and lower respiratory tract infections, megaloblastic anemia, discovered at 3 months of age, unresponsive to cyanocobalamin and poorly responsive to folinic acid. Biochemical studies showed: an abnormal deoxyuridine suppression test despite normal serum folate, cobalamin and transcobalamin levels; a normal intracellular uptake of these two coenzymes; and an absolute requirement of methionine for fibroblast growth, suggestive of defective methionine synthesis. An absence of methionine synthase activity in the patient's bone marrow and a profound depression of this activity in lymphocytes and liver were found. Hypergammaglobulinemia with variable lymphopenia, depressed lymphocyte transformation after lectin or recall‐antigen stimulation, defective delayed‐type hypersensitivity and decreased natural killer activity were noted as well. The patient died at the age of 14.
Increased Intestinal Permeability to (51 Cr) EDTA Is Correlated with IgA Immune Complex‐Plasma Levels in Children with IgA‐Associated Nephropathies
Authors: DAVIN J.‐C. , FORGET P. , MAHIEU P. R.
Published: January 2008

ABSTRACT. Intestinal permeability was investigated in 10 normal young adults, in 11 control children and in 9 children presenting with either Berger disease (4 cases) or Henoch‐Schönlein nephritis (5 cases), making use of (51 Cr) EDTA as a probe molecule. All subjects exhibited a normal creatinine clearance at the time of testing. After oral administration of (51 Cr) EDTA, 24‐hour urine radioactivity was measured and results were expressed in percentage of the oral dose administered. Means and SD were 2.35%±0.77, 2.51%±0.70, and 5.10%±2.35 for normal adults, control children and patients with IgA‐associated nephropathies, respectively. The differences of permeability between controls and patients were statistically significant (p < 0.01). In addition, a significant, direct, linear correlation has been established between the percentage of (51 Cr) EDTA excreted in 24‐hour urine and IgA immune complex‐plasma levels. Our results therefore support the hypothesis that increased gut permeability could play a role in the pathogenesis of IgA‐associated nephropathies.
Difficulties in Psychological Adjustment to a New Neonatal Screening Programme
Authors: FYRÖ KARIN , BODEGÅRD GÖRAN
Published: January 2008

ABSTRACT. Previous studies have shown the impact of psychological stress in neonatal screening where the test result turns out to be false‐positive. The families in these studies received standardized medical and psychological support in connection with the clinical examination of their newborns. It was thus of interest to study the effect of making the same neonatal screening procedures—i.e., for congenital hypothyroidism—a part of the routine. Eleven families, who had been routinely examined at one of the five pediatric clinics in Stockholm were investigated. In the present study the same method as in previous studies was used, but the interviews were done 1–4 years after the screening. The psychological experiences of the parents were assessed with the aid of hypothetical models based on psychoanalytical theory. Only two families had a satisfactory outcome and nine families had experienced the clinical procedures as chaotic. The mother‐child relationship and the child's development were clinically evaluated. In six families the relationship was affected but only one child appeared to be disturbed. In conclusion, the development of routines for screening newborns is very important and the psychological needs of parents must be considered, even when the test result is false positive.
Protein Content of Infant Formula—How Much and from What Age?
Authors: LÖNNERDAL B. , ZETTERSTRÖM R.
Published: January 2008

It is generally agreed that the protein concentration of human milk adequately fulfills the amino acid requirements during early infancy. This level of protein is considered as the absolute minimum which can be recommended for infant formulas. Since proteins from other sources than human milk have a different amino acid composition and have been believed to be digested to a somewhat lower extent than human milk proteins, it has been common practice to use a higher protein level in formulas than in human milk. During the last decade, most infant formulas have had a protein concentration of 15–18 g/1, which can be compared to the protein level of 12 g/1 in human milk during early lactation and 9–10 g/1 in later lactation (>2–3 months). Whether a protein concentration of 15 g/1 in formulas is an “optimal” level of protein, i.e. adequate for the amino acid requirement of infants (including some safety margin) while not associated with any negative consequences caused by potentially excessive levels of some amino acids and metabolites, has recently been a subject of discussion.
Growth and Total Body Water in Premature Infants Fed “In‐utero” or “Ex‐utero”
Authors: BHATIA J. , RASSIN D. K.
Published: January 2008

ABSTRACT. Total body water and anthropometric measurements were compared in two groups of premature infants. The first group included infants with birthweights less than 1501 g who were fed under usual clinical circumstances and studied at a body weight of 1800–2100 g (“Ex‐utero”); the second group of infants had a birthweight of 1800 to 2100 g and were studied within the first week of life (“In‐utero”). Triceps and subscapular skinfold thicknesses were significantly greater in “Ex‐utero” infants than in “In‐utero” infants, whereas body length was significantly greater in the latter group compared to the former. There were no differences in total body water, abdominal skinfold thickness, or midarm circumference between the two groups. These data suggest that feeding premature infants a standard premature infant formula under established guidelines leads to differences in body fat distribution but not total body water compared to infants nourished “in utero”.
Glycogen Storage Disease Type I and III and Pyruvate Carboxylase Deficiency: Results of Long‐Term Treatment with Uncooked Cornstarch
Authors: ULLRICH K. , SCHMIDT H. , van TEEFFELEN‐HEITHOFF A.
Published: January 2008

ABSTRACT. Three patients with glycogen storage disease type I (GSD‐I), three with glycogen storage disease type III (GSD‐III) and one with pyruvate carboxylase deficiency (PCD) could be successfully switched over from continuous nocturnal gastric drip feeding (GDF) to nocturnal feeding with uncooked cornstarch in yoghurt or “quark” (CSF) at the age of 4–20 years. The new kind of therapy is much more convenient for the patients. When followed up to 30 months, patients on CSF showed the same clinical and laboratory findings as during the last two years with GDF. CSF was not introduced to three patients with GSD‐I. Two of them refused the permanent starch‐yoghurt meals. In the third patient the morning blood glucose concentrations were too variable.
Hypoglycaemia in Childhood Diabetes I.
Authors: ÅMAN J. , WRANNE L.
Published: January 2008

ABSTRACT. Hypoglycaemia (blood glucose 1.3–2.5 mmol/l) was induced in twenty‐eight diabetic children by reduction of their morning meal. Fatigue and pallor were the most common signs of hypoglycaemia. Compared to findings during normoglycaemia, plasma concentrations of adrenalin, noradrenalin and Cortisol were significantly higher at glucose nadir. Plasma glucagon concentration at glucose nadir was correlated to the fasting C‐peptide concentration and inversely to the duration of diabetes. Children who lacked C‐peptide also lacked glucagon response to hypoglycaemia. The parents' opinion of the need to give carbohydrates corresponded to the blood glucose level. The presence of adrenergic signs correlated to the plasma adrenalin and the neuroglucopenic signs to blood glucose. The lowest glucose level correlated inversely to the concentration of free insulin. When facilities for glucose infusion are lacking, a rational step in treating the unconscious hypoglycaemic child seems to be the injection of glucagon, considering the blunted or absent glucagon secretion.