bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Uristop® on Primary Nocturnal Enuresis
Authors: ELINDER G. , SOBACK S.
Published: January 2008

ABSTRACT. Primary nocturnal enuresis (PNE) is a very common problem in pediatric and child psychiatric practice. Many treatments have been tried, but none has proved entirely successful. Uristop®, a commercially available alarm device based on a theory somewhat different from those used in the common alarm devices, was tried in a prospective randomized double‐blind study. Of 134 enuretic children who were examined on an out‐patient ward, 53 were selected for inclusion in this study on the basis of certain criteria. The children were randomized either in a treatment group with a functioning device, or in a control group with a nonfunctioning device. They used their devices for 6 weeks and were followed for an additional 12 weeks. The sex, age, history of previous urinary tract infection (UTI) or treatment of PNE and a family history of PNE were compared between the groups and no statistical differences were found. In the control group, however, there was significantly more often a history of upsetting life events and previous child psychiatric contact. This difference was not considered as having any effect on the results. The results showed that the device had no effect on the study group as compared with the control group. However, both groups improved significantly as compared with the expected sponaneous cessation of bedwetting.
General Aspects of Nutrition, Absorption and Metabolism in Patients with Cystic Fibrosis
Authors: FERNANDES J. , KNEEPKENS C. M. F. , BIJLEVELD C. M. A. , VONK R. J.
Published: January 2008

ABSTRACT. It is important to determine the energy losses and the possible deficiencies of vitamins and trace elements for the adequate treatment of the patient. The energy loss presumably can be assessed best by direct calorimetry, supplemented by the assay of faecal fat, nitrogen and of breath hydrogen. Restriction of energy losses is feasible by prescribing a high‐protein diet with a normal fat content, preferably polyunsaturated fats, in combination with pancreatin. Deficiencies of vitamins and trace elements can be prevented by timely supplementation.
The Role of the Small Intestine in Cystic Fibrosis Patients
Authors: EGGERMONT E.
Published: January 2008

ABSTRACT. A survey is given of the morphological and biochemical lesions of the small intestine that can he found in cystic fibrosis patients. The available data on the structure and function of the small intestine in CF patients favour the hypothesis that the small intestine itself might contribute to the malabsorption of nutrients in this disease. The most pronounced lesions, i.e. meconium ileus and absent active transport of bile salts are found in the ileum. It might be remembered that the ileum is also the site of intensive exchange of chloride and bicarbonate, a function that is heavily disturbed in the pancreas of CF patients. For this reason, further studies on the ileal function in cystic fibrosis are warranted.
The Nutritional State and Nutrition
Authors: DODGE J. A.
Published: January 2008

ABSTRACT. Cystic fibrosis children tend to have a low birth weight and their mean height and weight during childhood is below that for the general population. They also tend to have a delayed hone age and puberty. The degree of underweight correlates more closely with the respiratory condition than with the degree of malabsorption. There is evidence that their nutritional requirements are increased, perhaps up to 150% of the recommended daily allowance, but in later childhood their food intake is frequently low and maybe the major reasons for their poor growth and development. Specific deficiencies of vitamins, minerals and essential fatty acids occasionally present as clinical problems. New approaches to nutrition include increasing dietary fat, which was traditionally low because of malabsorption, and this change has been made possible with the development of modern pancreatic supplements. Supplementary nutrition with elemental diets or intravenous hyperalimentation have given promising results in some studies and might be expected to improve the patient's resistance to infection as well as his nutritional state. The place of oral essential fatty acid supplements is still being evaluated, but intravenous infusions of fat emulsion are not justifiable in themselves.
Cerebral Blood Flow in Preterm Infants during the First Week of Life
Authors: GREISEN GORM
Published: January 2008

ABSTRACT. Forty‐two preterm infants of 28–33 weeks of gestation were studied once during the first week of life by 133‐Xenon clearance after intravenous injection to estimate global cerebral blood flow. Count rates detected over the chest were corrected for chest wall contribution and used as arterial input function. A neonatal blood‐brain partition coefficient of Xenon was used for the calculation of a mean flow estimator (CBF‐∞). The techique was internally validated by use of differently obtained arterial input functions. In 11 infants wihout respiratory distress, CBF‐∞ was 19.8 ml/100 g/min ±5.3 SD. In 24 infants treated with mechanical ventilation CBF‐∞ was 11.8 ml/100 g/min ±3.2 SD. In 7 infants treated with continous positive airway pressure CBF‐∞ was 21.3 ml/100 g/min ±12.0 SD. When the reduction of CBF‐∞ associated with mechanical ventilation was taken into account, the 9 infants with subependymal/intraventricular haemorrhage had increased CBF‐∞. The effects of gestational age, birthweight, mode of delivery, postnatal age, mean arterial blood pressure, PaCO2, blood haemoglobin and phenobarbitone medication were also analysed and found inconsistent. In conclusion, CBF was lower than expected and in infants requring mechanical ventilation the values were lower still.
Effect of Bromocriptine Treatment on Circulating Somatomedins in Tall Adolescents
Authors: BRION D. EVAIN , REPELLIN A. M. , SCHIMPFF R. M.
Published: January 2008

ABSTRACT. Somatomedin and bromocriptine levels were measured before and after 3 months of bromocriptine treatment (5 mg/day) in the sera of 16 tall adolescents with excessive adult height prediction. Somatomedins were measured by RIA for somatomedin C and IgFII and by measuring thymidine incorporation into human lectin‐ativated lymphocytes. Mean ± SEM levels of bromocriptine after three months of treatment were 0.61 ± 0.08 ng/ml. No changes in radioimmunoassayable somatomedin C were observed after bromocriptine intake respectively 1.34 ± 0.17 U/ml before and 1.4 ± 0.01 U/ml during treatment. On the opposite a significant decrease of thymidine activity (p<0.002) from 1.45 ± 0.17 U/ml to 1.12 ± 0.19 U/ml was observed. No changes of IgFII levels were observed in the sera of the 8 patients where they were measured. In order to test a possible direct effect of bromocriptine on peripheral tissues bromocriptine mesylate was added in somatomedin bioassays. Inhibitory effect of bromocriptine in vitro is seen at higher levels (1 μM) compared to the circulating one (1 nM). This study demonstrates that the major effect of bromocriptine which is the acceleration of bone maturation is not related to changes in somatomedin C.
Anti‐D in a‘D Positive’Mother Giving Rise to Severe Haemolytic Disease of the Newborn
Authors: ØSTGÅRD P. , FEVANG F. , KORNSTAD L.
Published: January 2008

ABSTRACT. An Rh positive woman having the Rh(D) variant designated DVI formed a potent anti‐D which caused a severe haemolytic disease in the infant. The infant received three exchange transfusions within the first 21 hours after delivery and, because of a ‘late anaemia’, three additional blood transfusions during the first 3 months of life. The authors point out the distinction between D variant antigens, where certain epitopes of the D antigen are lacking, and qualitatively normal D antigens with a reduced reactivity, Du. Women with D variant antigens should be subject to the same antenatal serological control as those who are Rh(D) negative, and if they form anti‐D the infant should be controlled as in other cases where haemolytic disease of the newborn is suspected.
Growth Pattern in Krabbe's Disease
Authors: ZLOTOGORA J. , REGEV R. , HADAR S. , IANCU T. C.
Published: January 2008

ABSTRACT. The growth of nine infants with Krabbe's disease was followed longitudinally by repeated measurements of head circumference, length and weight. All infants showed early slowing and then arrest of growth, leading progressively to microcephaly and severe failure to thrive.
Factors Affecting Development: Similarities and Differences among Children Who Were Small, Average, and Large for Gestational Age at Birth
Authors: OUNSTED M , MOAR V. A. , SCOTT A.
Published: January 2008

ABSTRACT.The development of 118 small‐for‐gestational age (SGA), 137 average‐for‐gestational age (AGA), and 118 large‐for‐gestational age (LGA) children was assessed at 7 years. The contributions of different factors to the variance in developmental scores were investigated by multiple regression analyses. All three groups showed the powerful influence of social class on intellectual ability at this age; and in the SGA and AGA groups the gross and fine‐motor skills of girls were superior to boys. Smoking had a small effect in the AGA group, and in the two extreme groups first‐born children did slightly better than later‐born. Hypertension was associated with reduced scores in the SGA group, and LGA children who had spontaneous vaginal deliveries had higher scores than those delivered instrumentally or by caesarean section. There was a significant positive correlation between gestational age and developmental scores in the AGA group; but in the SGA group the relationship was in the reverse direction. Social class and sex affect the development of most children aged 7 years. Other factors seem to manifest an effect only under specified conditions.
HLA Antigens, Jejunal Morphology and Associated Diseases in Children with Dermatitis Herpetiformis
Authors: KÁRPÁTI S. , KÓSNAI I. , VERKASALO M. , KUITUNEN P. , SIMON ZS. , KOSKIMIES S. , REUNALA T. , GYÓDI É. , TÖRÖK É.
Published: January 2008

ABSTRACT. Forty‐five Hungarian and Finnish children from 1.5 to 15 years with dermatitis herpetiformis were studied for HLA antigens, jejunal morphology on gluten‐containing diet and associated diseases in the patients and their relatives. A strong association with HLA‐B8 was found in patients of both nationalities, the relative risks were 12.8 and 9.6, respectively. The Hungarian patients were also typed for HLA‐DR locus, and an association with DR3 but not with DR7 was observed. Patients with subtotal villous atrophy had slightly more often HLA‐B8 and DR3 than those with milder intestinal lesions. Atopic eczema occurred in 20 % of the patients and family history of atopy seemed to have an inverse correlation with HLA‐B8 and DR3.
Circumcision for Phimosis–Indications and Results
Authors: STENRAM A. , MALMFORS G. , ÓKMIAN L.
Published: January 2008

ABSTRACT. A follow‐up study including all boys (n= 117) operated with circumcision for phimosis during 1976 was performed. Most patients were operated on an outpatient basis. Early complications like bleeding or infection were few and mild. In 13 cases there was a postoperative stricture of the urethral orifice which had to be widened. Five patients had complaints about the cosmetic result. Eight boys expressed shyness and unwillingness to undress in school‐gym. In no instance were there any signs of a more serious psychological disorder. The operative indications are discussed and it is concluded that worried parents of boys with phimosis can be safely advised to have their boys circumcised if the prepuce is scarred or there has been recurrent balanitis, or if the boy has reached school age and the foreskin is still nnretractable.
Proximal Renal Tubular Acidosis in a Child with Type 1 Glycogen Storage Disease
Authors: MATSUO N. , TSUCHIYA Y. , CHO H. , NAGAI T. , TSUJI A.
Published: January 2008

ABSTRACT. A 6 1/2‐year‐old Japanese girl with type 1 glycogen storage disease developed a profound metabolic acidosis refractory to bicarbonate renal tubular acidosis and hyperphosphaturia. There was no evidence of distal tubular dysfunction.
Early Feeding Problems in an Affluent Society
Authors: DAHL M. , EKLUND G. , SUNDELIN C.
Published: January 2008

ABSTRACT. The aim of this investigation was to identify different factors of importance for the occurrence of feeding problems during the first year of life. Forty‐two infants, 3‐12 months old, with feeding problems without any obvious medical explanation were matched to 42 controls with respect to age, sex and Child Health Centre (CHC) affiliation. Information was obtained by interviewing the parents and from medical records. Four factors emerged as being highly significant, namely “feeding problems presented by the parents during their own infancy”(p< 0.001), “great anxiety experienced by the mother during the pregnancy” (p<0.02), “breast‐feeding problems experienced by the mother” (p<0.001) and “ill‐health in the mother” (p<0.001). A special study in which the maternal and paternal grandparents were interviewed, corroborated the parents’information on their own early feeding difficulties. This finding could explain a large proportion of the feeding problems that have no obvious medical origin.
Effects of Dietary Fat Modifications on Serum Lipids and Blood Pressure in Children
Authors: VARTIAINEN E. , PUSKA P. , PIETINEN P. , NISSINEN A. , LEINO U. , UUSITALO U.
Published: January 2008

ABSTRACT. Some recent studies have shown an extremely high level of serum cholesterol level among Finnish children. The aim of the present study was to test the effect of a “cholesterol lowering diet” on serum lipids and blood pressure among 36 children aged 8‐18 years residing in two semirural communities in North Karelia, Finland. After a baseline period of two weeks on conventional diets, the proportion of energy derived from fat in the diet was reduced from the baseline level of 35% to 24%, and the ratio of polyunsaturated/saturated fats was increased from the baseline level of 0.18 to 0.61, during a 12‐week intervention period. The children then changed back to their normal diet during a five‐week switch‐back period. The mean serum total cholesterol decreased 15% during the intervention, and then increased to nearly the initial level during the switch‐back period. Similar changes were observed in HDL‐cholesterol and also to some extent in apoproteins Al, All and B. Blood pressure was not affected, although systolic blood pressure decreased during intervention. We conclude that the high level of serum cholesterol in Finnish children is to a great extent caused by the local dietary pattern and can be decreased by dietary modification.
Serum Thiamin, Pyridoxal, Cobalamin and Folate Concentrations in Young Infants
Authors: DAVIS R. E. , ICKE G. C. , HILTON J. M. , ORR E.
Published: January 2008

ABSTRACT. Blood samples were obtained from 509 apparently healthy infants between the age of 3 and 54 weeks attending for routine checks at infant health centres. Serum was assayed for thiamin, pyridoxal, cobalamin and folate. Three hundred and five infants were being breast fed and results from these were used to construct a reference range–thiamin 2‐17 μg/1, pyridoxal 8‐39 ng/1, cobalamin 120‐800 μg/1 and folate 7‐47 ng/1 (95 percentile ranges). One hundred and thirty‐four infants were being fed a manufactured milk formulation and the serum concentrations of thiamin, pyridoxal and cobalamin were significantly higher than those found in breast fed infants. Thirteen infants were receiving pasteurised cow's milk. This milk was found to have more than 3 times the folate content of human breast milk yet these infants had a significantly reduced serum level of folate.
15N Tracer Investigations of the Physiological Availability of Urea Nitrogen in Mother's Milk
Authors: HEINE W. , TIESS M. , WUTZKE K. D.
Published: January 2008

ABSTRACT. The physiological availability of urea in mother's milk was investigated in tracer studies using [15N]2 urea and involving 22 infants. The incorporation of 15N into the body protein was established in 16 subjects by emission spectrophotometrical determination of the 15N excess in the serum protein. Between 2 % and 3.6 % of the serum protein is synthesized from the urea nitrogen in mother's milk. In further studies on the 15N balance in 6 infants, renal excretion of 15N after oral multiple and single impulse labelling with [15N]2 urea constituted 60 % of the dose administered. Three‐tenths–2.5 % was excreted in the feces. The retention of 15N in the protein pool varied between 16.7 and 61.4 %
Transcutaneous Oxygen and Carbon Dioxide Levels and a Clinical Symptom Scale for Monitoring the Acute Asthmatic State in Infants and Young Children
Authors: WENNERGREN G. , ENGSTRÖM I. , BJURE J.
Published: January 2008

ABSTRACT. Measurement of transcutaneous PO2 and PCO2 in addition to a clinical symptom grading system wds used to monitor the acute asthmatic attack in children under two years of age. tcPO2 was lowered already at signs of mild obstruction and decreased in parallel with clinical deterioration. tcPCOl was almost unchanged at mild to moderate obstructive symptoms. With clinical deterioration lcPco2, rised steadily. An increase of the oxygen concentration to 30‐40% in the inspired air increased tcP02, on the average by 70%, but did not change the tcPCO2: level. Continuous recording of tcPo2 and tcPCo2 as well as the clinical grading system are valuable tools when monitoring severely obstructive infants and young children.
A Comparative Study of the Mouth to Caecum Transit Time in Children and Adults Using a Weight Adapted Lactulose Dose
Authors: VREUGDENHIL G. , SINAASAPPEL M. , BOUQUET J.
Published: January 2008

ABSTRACT. Mouth to caecum transit time (M.C.T.T.) was assessed in 41 subjects divided into 3 age groups (0‐1 year, 1‐4 years and 22‐27 years) with the hydrogen breath test (H.B.T.) using lactulose as the hydrogen source (250 mg/kg; minimal dose 1.5 g in a 10% aqueous solution). The M.C.T.T. remained constant from the second month of age. In children under 1 year of age a high percentage of non‐responders was found compared to the older age‐groups. In 8 adults two test‐substrates, pure lactulose (Legendal®, L) and a mixture of lactulose, lactose and galactose (Duphalac®, D) were compared. There was no significant difference in M.C.T.T., mean hydrogen production and clinical symptoms using D or L as substrate. We conclude that the H.B.T. using a relative dosage is a suitable test for children, but under the age of 1 year it is less useful because of the high percentage of non‐responders. Because of the relation between body height and small bowel length the results suggest an increase in the velocity of the intestinal content with age.
The Value of Serum IgE Assay in Milk Aspiration and the Sudden Infant Death Syndrome
Authors: BOULLOCHE J. , MALLET E. , BASUYAU J. P. , TAYOT P. , SAMSON‐DOLLFUS D.
Published: January 2008

ABSTRACT.Global serum levels of IgE (PRIST, Phadebas®) and specific anti‐cow's milk IgE (RAST) were measured in populations of infants with a history of one or more episodes of milk aspiration (n=12), victims of the sudden infant death syndrome (SIDS) (n= 18), “near miss” SIDS infants (n=23), siblings of a SIDS victim (n=21) and control infants (n=38). Only the infants with a past history of milk aspiration had significantly raised global and specific IgE. The absence of raised specific IgE in the subjects who died from SIDS argues against the hypothesis of sensitisation to cow's milk proteins during a previous episode of aspiration. Nasopharyngeal reflux is frequently seen in near‐miss infants. This reflux is more often responsible for reflex apnoea due to stimulation of the laryngeal chemo‐receptors than to a fatal aspiration.
Changing Etiology and Outcome of Neonatal Septicemia in Riyadh, Saudi Arabia
Authors: OHLSSON A. , BAILEY T. , TAKIEDDINE F.
Published: January 2008

ABSTRACT. To study the etiology of neonatal septicemia and factors associated with outcome, all charts of neonates with bacteremia and clinical sepsis admitted to a neonatal unit in Saudi Arabia, from 1 November 1980 to 31 October 1984 were reviewed. The results were compared to a previous study period in the unit (1 November 1976‐31 October 1980). Septicemia was diagnosed on 50 occasions in 49 neonates. The incidence of neonatal sepsis among patients bom in the hospital was 2.5/1000 live births. Mortality from sepsis was 33% and was associated with neutropenia in 63%. The most commonly isolated bacteria were E. coli, Klebsiella and Staphylococcus aureus. Salmonella enteritidis serotypes were isolated in 4% of the cases. Group B streptococci (GBS) were isolated, for the first time, from blood of 3 neonates. Salmonella species were less frequently and GBS more often isolated than previously. GBS have now appeared as etiologic organisms in neonatal sepsis also in Saudi Arabia. Salmonella septicemia remains more common in Saudi Arabia than in the West.
Reduced Albumin Binding of MADDS–a Measure for Bilirubin Binding–in Sick Children
Authors: EBBESEN F , FOGED N. , BRODERSEN R.
Published: January 2008

ABSTRACT. The reserve albumin concentration for binding of MADDS (monoacetyldiaminodiphenyl sulphone) in plasma is used as a measure of the reserve albumin concentration for binding of unconjugated bilirubin. The aim of the present study was to investigate whether a reduction in the reserve albumin concentration for binding of MADDS could exist in sick children after 5 months of age, where the bilirubin binding properties of the albumin has reached the adult level. The material included 75 children, 1‐15 years of age with mild infections, servere bacterial infections, acute viral hepatitis, chronic hepatic diseases or uraemia, and a control group of 22 healthy children. The reserve albumin concentration was significantly lower in children with severe bacterial infections, acute viral hepatitis, and uraemia, than in healthy children (p<0.01), while the reserve albumin concentration in children with mild infections and chronic hepatic diseases did not differ significantly from that of the control group (p > 0.05). The total albumin concentration in plasma in either of the groups of sick children did not differ significantly from that of the healthy children. The plasma concentration of unconjugated bilirubin was elevated in the group of children with acute viral hepatitis, but not enough to influence the concentration of reserve albumin for binding of MADDS to a significant degree. The reserve albumin concentration was significantly lower in children with acute viral hepatitis than in children with severe bacterial infections (p<0.05).
Central Diabetes Insipidus in Children
Authors: FJELLESTAD A. , CZERNICHOW P.
Published: January 2008

ABSTRACT. 1‐deamino‐8‐D‐arginine‐vasopressin, or DDAVP, a potent long acting antidiuretic analogue of AVP, is the treatment of choice in central diabetes insipidus (DI). We have studied the clinical and biological effect in 10 children with DI treated with peroral administration of DDAVP. During a dose ranging study in hospital, followed by 6 months of treatment at home, this peroral DDAVP tablet proved to be as effective as the intranasal administration of DDAVP and was preferred by the patients. Even doses as small as 12.5 μg, have an effect on diuresis and urinary osmolality. Therapeutic effects start at above 100 μg. During the dose ranging study 200 μg peroral DDAVP produced antidiuresis varying from 8 to 12.5 hours, in different patients. The recommended dose is 100‐300 μ 2‐3 times a day. This treatment offers an important alternative to that traditionally used and constitutes one of the first examples of a peptide conserving its biological activity after gastrointestinal transport.
Islet Cell and Other Organ‐specific Autoantibodies in Healthy First‐degree Relatives to Insulin‐dependent
Authors: HÅGGLÖF B. , RABINOVITCH A. , MACKAY P. , HUEN A. , RUBENSTEIN A. H. , MARNER B. , NERUP J. , LERNMARK Å.
Published: January 2008

ABSTRACT. The presence of organ‐specific autoantibodies including islet cell surface, cytoplasmic and cytotoxic as well as thyroid‐gastric antibodies were determined in healthy, non‐diabetic, first‐degree relatives to 30 insulin‐dependent diabetic (IDDM) children. Thirty healthy families without family‐history of diabetes mellitus served as controls. The prevalence of organ‐specific autoantibodies among the healthy members in the diabetic families was increased compared to the control families (p<0.005). Islet cell cytoplasmic antibodies were only detected in diabetes families, since 23% (7/30) of the probands and 7% (2/31) of the siblings were positive and all others negative. Organ‐specific autoantibodies were associated with HLA DR3 only in the diabetes families (p<0.025) while autoantibody positive members in the control families were associated with HLA B7 (p<0.01). This study suggests that childhood IDDM occurs in families with an increased prevalence of organ‐specific autoantibodies.
Evidence for Amino Acid Induced Cholestasis in Very‐low‐birth‐weight Infants with Increasing Enteral Protein Intake
Authors: SENGER H. , BOEHM G. , BEYREISS K. , BRAUN W. , RAIHA N.
Published: January 2008

ABSTRACT. In the present investigation 32 very‐low‐birth‐weight (VLBW) infants fed at three different levels of protein intake (2.92 g/kg/d from human milk, 3.22 and 4.06 g/kg/d from formula) were studied at the mean age of 21 days. Serum total α‐amino nitrogen concentration correlated directly to total bile acid concentration. The serum and urine a‐amino nitrogen and the serum bile acid concentration correlated with protein intake. The increase in protein intake was accompanied by a concomitant decrease in the intraluminal bile acid concentration in the AGA infants. The results offer indirect evidence of decreased bile flow in YLBW‐infants on excessive oral protein intake. The cholestatic effect could be mediated by an increase in the plasma amino acid concentration.
Smoking during Pregnancy–Effects on the Fetal Thyroid Function
Authors: MEBERG A. , MARSTEIN S.
Published: January 2008

ABSTRACT. Infants delivered at term by mothers smoking at least 10 cigarettes daily during pregnancy (n=46) were found to be growth retarded compared to infants of non‐smoking mothers (n=49), birthweights 3445pM385 (SD) g and 3667pM392 g respectively (p<0.05) in the two groups. Cord serum thyrotropin (TSH) was significantly decreased (8.2±4.(1 U/l vs. 10.3±4.9 U/l) and free thyroxine index (FT4I)/TSH ratio significantly increased (18.8±9.0 vs. 14.4±7.6) (p<0.05) in the smoking group compared to infants of non‐smokers. Cord serum thyroxine (T4) and FT4I were higher in the smoking group (149.0±22.4 nmol/1 and 125.5± 14.9 respectively) compared to infants of non‐smoking mothers (140.6±21.6 nmol/1 and 120.0±16.5 respectively), with borderline statistical significance (0.05<p<0.10). The results indicate that infants of smoking mothers may have a hyperfunction of the thyroid gland at birth compared to infants of non‐smokers, with a negative feed‐back on TSH production from the pituitary gland. Increased metabolic rate and oxygen consumption caused by fetal thyroid hyperfunction may be pathogenetic factors for the fetal growth retardation caused by maternal smoking.
Influence of Valproic Acid on the Gonadotropin‐Releasing Hormone Test in Puberty
Authors: LUNDBERG B. , NERGÅRDH A. , RITZÉN E. M. , SAMUELSSON K.
Published: January 2008

ABSTRACT. Twelve epileptic adolescents on valproate (VPA) treatment were studied by means of clinical observation and gonadotropin‐releasing hormone stimulation (GnRH) tests. Five patients were investigated before and during VPA treatment. Before treatment the basal and peak levels of gonadotropins were appropriate for age; during treatment both levels were depressed and the areas under the curves were significantly decreased. The long‐term effect of VPA was studied in an additional seven patients. The basal levels of gonadotropins were as low and their response to GnRH as poor as in the second test of the first five patients–i.e., during VPA treatment. No recovery was noted in two patients after dose reduction or in a further two patients 10 months after the discontinuation of VPA treatment. In all the patients, however, the usual clinical signs of pubertal development and maturity were unaffected by VPA treatment. The significance of the results for sexual development and fertility is therefore uncertain.
Thromboembolic Complications in Children with Nephrotic Syndrome
Authors: HOYER P. F. , GONDA S. , BARTHELS M. , KROHN H. P. , BRODEHL J.
Published: January 2008

ABSTRACT. Coagulation studies were performed in 16 children with steroid responsive minimal change nephrotic syndrome in order to elucidate the incidence of thromboembolic complications. Fibrinogen and a2‐macroglobulin concentrations were inversely correlated with serum albumin concentrations, antithrombin III correlated positively (p<0.001). Factor VIII:R:AG concentration was elevated. Coagulation disturbances in children are not less severe than in adults with nephrotic syndrome. Combined scintigraphic pulmonary ventilation and perfusion studies were employed in 26 children to detect noninvasively events of pulmonary embolism, respectively their residual changes. The lung scintigraphic investigation demonstrated a pattern consistent with pulmonary embolism in 7 patients (27.9%), residual changes in 10 (38.5%) and normal findings in 9 (34.9%). The incidence of thromboembolic complications in children with severe nephrotic syndrome is as high as reported for adults. Pulmonary symptoms may well be due to pulmonary embolism.
Ectopic Thyroid Gland and Thyroxine‐Binding Globulin Excess
Authors: LEUNG ALEXANDER K. C.
Published: January 2008

ABSTRACT. A female infant with an ectopic thyroid gland and thyroxine‐binding globulin excess is described. The infant presented clinically with hypothyroidism while biochemically a falsely high serum thyroxine level posed therapeutic problems.
Milk Protein Intake in the Term Infant
Authors: RÄIHÄ N. , MINOLI I. , MORO G. , BREMER H. J.
Published: January 2008

ABSTRACT. The response of plasma amino acids to two bovine protein formulas with different protein content (1.6 and 1.2 g/100 ml containing 60% whey proteins and 40% caseins) was measured in term infants. These two groups of infants were compared with a group of infants that were breast‐fed; all infants were fed ad libitum. Concentrations of threonine, valine and total branched chain amino acids reflected the amount of protein provided. Thus, the concentrations were higher in the higher protein formula infants from the second week of the study. In the low protein formula infants these amino acids were lower but differed from the infants on breast milk at eight and twelve weeks. Concentration of taurine was lower in the formula fed infants than they were in breast‐fed infants at the end of the study. The valine/glycine ratio in the low protein formula group was lower than in the breast‐fed group for the first four weeks of the study. After this time it was equal to that of the breast‐fed group. These differences in plasma amino acid concentrations give further evidence that formulas now in common use for term infants provide a protein intake in excess of protein requirements after the first months of life.
Epidemiology of Nocturnal Enuresis in a Part of Khartoum, Sudan
Authors: RAHIM S. I. A. , CEDERBLAD M.
Published: January 2008

ABSTRACT. An epidemiological study was made of 8 462 children aged 3‐15 living in the suburban area Hag Vousif, Khartoum, Sudan. The prevalence of enuresis was higher in boys than in girls. Eighty‐eight per cent wetted their beds at least several times per week. Up to the age of 9 both sexes showed prevalences which were significantly higher than comparable age/sex groups discussed in different European studies. Only 5% of the children above 7 years of age had secondary enuresis.
Infantile Hypercalcemia with Subcutaneous Fat Necrosis
Authors: YASUDA T. , SUNAMI S. , OGURA N. , NISHIOKA T. , NAKAJIMA H.
Published: January 2008

ABSTRACT. A case of hypercalcemia in neonatal subcutaneous fat necrosis, which was successfully treated with a low Ca and vitamin D‐free formula, is described. Low l,25(OH)2D and severe calciuria, which were considered to result from hypercalcemia itself as well as parathyroid suppression, were noted during the hypercalcemic phase. The oral Ca load test was repeatedly normal, suggesting that intestinal hyperabsorprion of Ca was not a cause of the hypercalcemia. Later recurrence of calciuria without hypercalcemia was noted concomitant with softening of indurated calcified necrotic tissue. In this patient, cerebral infarction on the left side was detected by CT scanning.
Type 4 Renal Tubular Acidosis (Sub‐type 2) Associated with Idiopathic Interistitial Nephritis
Authors: KRISTJANSSON K. , LAXDAL Th. , RAGNARSSON J.
Published: January 2008

ABSTRACT. An 18‐month‐old girl presenting with anorexia and failure to thrive, was referred for adenoidectomy. Arterial hypertension was discovered on physical examination. Laboratory results revealed hyperkalaemic, hyperchloraemic, metabolic acidosis, with slight azotemia. Urinary aldosterone excretion and plasma renin were decreased. Renal biopsy showed idiopathic interstitial nephritis. The diagnosis of type 4 renal tubular acidosis, sub‐type 2, i.e. primary hyporeninaemic secondary hypoaldosteronism was proposed. According to our knowledge, this disease has not previously been reported in young children, but is well known in azotaemic adults. We therefore propose the inclusion of this uncommon renal disease in the differential diagnosis of failure to thrive in childhood.
The Weanling's Gut
Authors: MILLA P. J.
Published: January 2008

ABSTRACT. The human infant in the first six months of life is particularly vulnerable to diarrhoeal disease. Vulnerability to diarrhoeal processes is associated with the state of development of the infant gastrointestinal tract, not only of its digestive and absorptive processes but also of its unique and elaborate local defence system, consisting of both immune and non‐immune elements. Protection from enteric infection, and sensitisation to food antigens is a function of the integration of gastric acid and biliary secretion, intestinal motor activity and local immune mechanisms. Development of these functions is controlled by a species specific programme in which the potential for accelerated development appears limited. Human milk provides passive protection during the initial vulnerable period. However, premature weaning may at best result in overloading of digestive and absorptive mechanisms and has the potential for the development of sensitisation to food antigens and serious diarrhoeal disease.
How Common Is Food Allergy?
Authors: WOOD C. B. S.
Published: January 2008

ABSTRACT. In the absence of accurate epidemiological data, it is recognised that significant food allergy will affect a proportion of the atopic group, which itself comprises about 10% of the childhood population. Some food allergic children will also be found among non‐atopics and many allergic children will lose their allergy as they grow through infancy. Early feeding choices probably have less effect on the occurrence of allergy than was previously thought. Some children may also react adversely but not immunologically to other natural and added substances in food, although this is not a common problem in weaning diets. In typical food allergy and hypersensitivity, and in more subjective areas concerned with behavioural variations more basic and epidemiological research is needed.
Food for the Weanling: the Next Priority in Infant Nutrition
Authors: WHARTON B. A.
Published: January 2008

ABSTRACT. The 1970s saw a revolution in the nutritional welfare of the suckling but half way through the 1980s we have yet to achieve the same success with the weanling. In the developing world the malnutrition/diarrhoea complex is a major threat to the weanling's life. Throughout the world rickets and iron deficiency are common problems. These three, protein‐energy malnutrition/diarrhoea, rickets and iron deficiency anaemia are the major nutritional problems of the weanling but there are others e.g. zinc deficiency, allergy, obesity. As the weanling crosses the bridge from suckling to schoolchild he wiU eat the suckling's food, specially prepared weaning foods, and eventually “sensible” family foods. Beneath this bridge we need to erect a safety net of fortified foods ensuring an adequate supply of such nutrients as iron and vitamin D.
Human Growth Hormone Produced with Recombinant DNA Technology: Development and Production
Authors: FLODH HANS
Published: January 2008

ABSTRACT. The molecular basis of recombinant DNA technology is described, and the principles of genetically engineered proteins developed. The production of hGH by such methods utilizes a strain of Escherichia coli as host and a vector plasmid containing the appropriate information. Fermentation and purification of the hGH produced gives a preparation of high purity, containing only 1–2 ppm of E. coli polypeptide (ECP). This somatrem (Somatonorm) is identical to pituitary hGH except for an additional methionine residue at the N‐terminal. Monoclonal antibodies fail to distinguish between pituitary hGH and somatrem. Preclinical studies of a variety of pharmacological and toxicological parameters indicate that the two hGH preparations have identical biological effects; no toxicological or mutagenic effects of somatrem have been detected.
Treatment of Pituitary Dwarfism with Biosynthetic Growth Hormone
Authors: BIERICH J.R.
Published: January 2008

ABSTRACT. Over 31/2 years, 54 previously untreated hypopituitary children were enrolled in three studies; 48 had idiopathic pituitary dwarfism. Three preparations of somatrem were used (SI, SII, Somatonorm). Growth velocities on all three preparations were similar, though SI and SII tended to produce slightly higher growth velocities. Serum somatomedin and alkaline phosphatase levels increased during treatment. Antibodies to Escherichia coli polypeptide (ECP) increased to a maximum Z score of about 0.7 with SI, but this was considerably lower with SII and below 0.1 with Somatonorm. Anti‐hGH antibodies had the highest titre in children treated with SI and these antibodies also had quite high binding capacities. Anti‐hGH antibody formation was negligible during Somatonorm treatment.
Growth Hormone Treatment in Short Children
Authors: ALBERTSSON‐WIKLAND KERSTIN
Published: January 2008

ABSTRACT. A study of 31 children with short stature was initiated in 1982. They received subcutaneous injections of pituitary hGH, 0.1 IU/kg/day; no adverse effects were seen and none of the patients acquired antibodies. Only the results of the first year are presented, as final height has not yet been attained. A high growth response was seen in 29 of the 31 children; they experienced an initial rise of IGF‐1, IGF‐2, alkaline phosphatase and procollagen III. The best response was obtained in the child with the lowest levels of endogenous pulsatile hGH secretion.
Psychosocial Aspects of Young Adult Growth Hormone Deficient Patients Previously Treated with Human Growth Hormone‐ a Preliminary Report
Authors: LARON Z. , ARAN O. , NOFAR E. , BEIT‐HALACHMI N. , PERTZELAN A. , GALATZER A.
Published: January 2008

ABSTRACT. This paper describes a multidisciplinary approach to treating patients with hGH deficiency. The team includes paediatric endocrinologists, social workers and psychologists, and is felt to provide a much better standard of care, producing subjects who are well integrated into society.
Single Doppler Detection of Left to Right Shunt through the Ductus Arteriosus
Authors: MELLANDER M. , SABEL K.‐G. , MELLGREN G.
Published: January 2008

ABSTRACT. Forty‐two infants and children were examined with unguided continuous and pulsed Doppler echocardiography before and/or after surgical closure of ductus arteriosus or in connection with cardiac catheterization. Presence or absence of diastolic reverse flow in the main pulmonary artery was evaluated for sensitivity and specificity to detect left to right ductus shunt. Diastolic reverse flow was detected in 15 of 16 patients with such a shunt and in 3 of 38 patients without a left to right ductus shunt. This corresponds to 94% sensitivity and 92% specifcity. It is concluded that the accuracy of a single Doppler system in diagnosing patent ductus arteriosus is comparable to the results obtained with a Doppler interfaced to M‐mode or cross‐sectional echocardiography.
Reproducibility of lntracranial Doppler Flow Velocimetry
Authors: WINBERG P. , DAHLSTRÖM A. , LUNDELL B.
Published: January 2008

ABSTRACT. Doppler velocimetry for assessment of flow in deep cerebral arteries was investigated in 9 term and 11 preterm healthy infants. A combined range gated and continuous wave Doppler instrument was used. A satisfactory reproducibility was found with a variation coefficient of 8–10% between repeated measurements. No systematic difference between examiners or head positions was recorded. The term infants had signifcantly higher mean flow velocities, 21.1 (3.1) cds (mean and 1 SD), compared to the pretenn infants', 15.1 (3.6) cm/s (p<0.01). Both systolic and diastolic flow velocities were higher in the term infants, whereas the pulsatility index was higher in the preterm infants. Recordings from the intracranial part of the internal carotid arteries were found to be easy to obtain with a satisfactory reproducibility.
Pancreatic Enzyme Supplementation as Acid‐Resistant Microspheres versus Enteric‐Coated Granules in Cystic Fibrosis
Authors: PETERSEN W. , HEILMANN C. , GARNE S.
Published: January 2008

ABSTRACT. In order to compare the efficacy of pancreatic enzyme supplementation as pH‐sensitive enteric‐coated microspheres Pancrease® to that of conventional supplementation with enteric‐coated Pancreatin® in cystic fibrosis, a double blind cross‐over study was conducted. Eleven patients under 12 years of age received each of the enzyme preparations for four weeks. Treatment efficacy was evaluated by means of a symptom score card recording stool frequency, consistency, colour, odour, abdominal cramps and appetite as well as a 3 days fat absorption test. Weight increments were recorded 3 months before the study when patients were on Pancreatin, and 3 months after the study when patients were on Pancrease. In eight of the patients fat absorption was improved on Pancrease, but the difference did not reach statistical significance. However, the patients experienced significantly less dyspeptic symptoms, decreased stool frequency, better appetite and increments in weight were significantly higher on Pancrease compared to Pancreatin.
Long‐term Effects of Physical Exercise on Working Capacity and Pulmonary Function in Cystic Fibrosis
Authors: ANDRÉASSON BENGT , JONSON BJÖRN , KORNFÄLT RAGNHILD , NORDMARK EVA , SANDSTRÖM STAFFAN
Published: January 2008

ABSTRACT. Seven patients with cystic fibrosis aged 6 to 20 were enrolled for 30 months in a daily exercise program. After 12 months conventional chest physiotherapy was withdrawn. Patients with low initial Shwachman scores improved as regards maximal working capacity. Spirometric data and volume of trapped gas indicated opening of closed airways. We suggest that physical exercise in general should be the basis of pulmonary therapy in cystic fibrosis. Other forms of physiotherapy are advisable when hard physical exercise is not feasible.
Beneficial Effects of Palatable Guar and Guar Plus Fructose Diets in Diabetic Children
Authors: PAGANUS A. , MÄENPÄÄ J. , ÅKERBLOM H. K. , STENMAN U.‐H. , KNIP M. , SIMELL O.
Published: January 2008

This randomized cross‐over study evaluates the effects of extended, guar and guar + fructose diets on the metabolic balance of children with insulin‐dependent diabetes mellitus (IDDM). We studied 22 children; mean age 12.2 years, mean duration of diabetes 4.4 years. The diet was supplemented for three weeks with guar in palatable form (5% of daily carbohydrate intake) and with guar + fructose (1 g of fructose/kg body weight, max 30 g/d) for another three weeks. A control group (8 children, mean age 12.3, duration of diabetes 4.3 years) followed the same experimental protocol without guar supplementation. The metabolic balance was assessed by glucosuria index (per cent of tests with less than 1% glucosuria from all urine tests) and measurements of red cell glycohaemoglobin A1c(HbA1c). Serum total and HDL‐choiesterol, C‐peptide, pancreatic and enteroglucagon were also measured. HbA1cdecreased during guar (p<0.001) and guar + fructose diet (p<0.001). The glucosuria index improved (p<0.02) and the serum total cholesterol concentration decreased (p<0.02) during the experimental guar diets. Guar in acceptable form and quantity in the diet appears to improve metabolic control of diabetic children.
Diagnosis of Ovarian Follicular Cysts from Birth to Puberty: A Report of Twenty Cases
Authors: LIAPI C. , EVAIN‐BRION D.
Published: January 2008

ABSTRACT. Twenty girls aged 1 day to 17 years have been studied for ovarian follicular cysts. Clinical features leading to the discovery of the follicular cyst were different in prepubertal girls and in girls whose cyst was discovered during puberty. Before seven years of age, four girls presented a precocious pseudopuberty where breast development was in contrast with very low pituitary gonadotropin levels; two girls in this age group were diagnosed after complaining about abdominal pain. In two cases the diagnosis was prenatal during routine ultrasonography of the mother. After ten years of age, abnormal menses (5 cases) or acute abdominal pain (5 cases) were the main clinical features. In only one case the cyst presented as an abdominal mass. Follow‐up of the 20 patients showed: spontaneous disappearance of the cyst within 3 to 32 weeks in 9 cases; ovariectomy in 8 cases, due to a torsion of a large cyst (over 55 mm) in 7 children and because of the fear of a possible tumor in one; limited resection of the cyst in 4 cases. By systematic ultrasonography, discovery of an ovarian cyst as defined by a non‐echogenic area over 20 mm may occur relatively often in young girls. Spontaneous disappearance is frequent when the cyst is small (under 55 mm). Torsion of large cysts remains the major complication.
Statural Growth of Children with Chronic Renal Failure on Conservative Treatment
Authors: POLITO C. , GRECO L. , TOTINO S. F. , OPORTO M. R. , LA MANNA A. , STRANO C. G. , DI TORO R.
Published: January 2008

ABSTRACT. Statural growth was studied in 20 prepubertal children with chronic renal failure on conservative treatment followed‐up 1.1 to 8.9 years (average 3.9). Five children reached end‐stage renal failure during the follow‐up period and underwent dialysis or transplantation. Most patients grew at a normal rate. During the observation period only 1 out of 20 children lost more than 0.5 height standard deviation score whereas 9 gained 0.5 to 3.1. A growth velocity above the 97th percentile for at least 1 year was observed in 6 patients. A normal growth rate and even catch‐up growth is possible in children with chronic renal failure regardless of the degree of reduction of glomerular function.