bluuebunny/crossref_metadata_2025 huggingface dataset:
Premature Cranial Synostosis in X‐Linked Hypophosphatemic Rickets: Possible Precipitation by 1‐alpha‐OH‐Cholecalciferol Intoxication
Authors: CARLSEN N. L. T. , KRASILNIKOFF P. A. , EIKEN M.
Published: January 2008

ABSTRACT. A child suffering from X‐linked hypophosphatemic rickets developed vitamin D intoxication under treatment with 1‐alpha‐OH‐cholecalciferol (1(OH)D3) and phosphorus. Beside the usual findings in this condition he showed precocious synostosis of the skull with signs of raised intracranial pressure. In view of earlier reports of coincidence of craniostenosis and X‐linked hypophosphatemic rickets, we conclude that the possibility exists that intoxication with 1(OH)D3 has been the precipitating factor. In addition we found hypersensitivity to 1 (OH)D3 2 months after cessation of treatment, and normal levels of calcitriol (1,2S(OH)2D3) at the same time.
The Changing Panorama of Cerebral Palsy in Sweden
Authors: HAGBERG B. , HAGBERG G. , OLOW I.
Published: January 2008

From a population‐based series of 773 patients with cerebral palsy (CP) born in 1959–78, an analysis was made of the epidemiological trends over this period of 20 years, divided into five 4‐year periods with emphasis on the last two. After a significantly decreasing incidence of CP in the first three periods (1959–70) from 1.9 to 1.4 per thousand, there was a significant increase in the last two periods, reaching 2.0 per thousand in the period 1975–78. Both the decreasing trend in the earlier periods and the increasing trend in the more recent ones were mainly referrable to spastic/ataxic diplegia in preterm CP, and to dyskinetic syndromes in CP infants born at term. With respect to pathogenesis, the corresponding changes in CP incidence were mainly accounted for by the group with potential perinatal risk factors. When analysed on the basis of surviving babies in birth‐weight‐specific groups, the incidence of CP in 1971–78 was found to have increased in all groups, but this was only statistically significant in the low birth weight group of 2 000–2 500 g. Changing trends in incidences ran parallel with a steadily progressive decline in perinatal mortality through all five periods. A considerable and cumulative net gain of surviving non‐CP children was continuously achieved; this was also true for 1970–78, in spite of an increasing CP morbidity during these last two 4‐year periods.
Pulmonary Fat Embolism after Intralipid Therapy– a Post‐Mortem Artefact?
Authors: SCHRÖDER H. , PAUST H. , SCHMIDT R.
Published: January 2008

The lungs of 22 low‐birth‐weight infants were investigated, mean gestational age 29 weeks (range 25 to 35). Thirteen of the 22 newborns had been treated with Intralipid®–10 % for an average of 20 days (range 3 hours to 75 days). The mean maximum rate of fat infusion was 2.0 g/kg/day (range 0.5 to 3.6). Nine of the 22 newborns had been fed formula and given supplemental amounts of amino acids and glucose intravenously, but no Intralipid. The lungs were fixated in situ immediately after death with glutaraldehyde. Neither in the Intralipid group nor in the non‐Intralipid controls was intravascular fat accumulation identified, either by light microscopy or by electron microscopy. It is speculated that an agglomeration of lipoprotein globules to larger stainable lipid droplets cannot take place in the short interval between the actual time of death and the time of fixation of the lung tissue. Thus, fat globules found in lungs of premature infants and described as fat embolism might have been post mortem artefacts.
Severe Infections in Childhood Leukemia
Authors: SAARINEN ULLA M.
Published: January 2008

Severe infections during the course of childhood ALL were surveyed as a whole in 100 consecutive patients, followed up for 2–8.5 years from the ALL diagnosis. The most important findings were a total absence of disseminated candidiasis, a relative infrequency of gram‐negative septicemia (8 episodes), and a predominance of gram‐positive cocci (29 episodes) in the 48 verified septicemias. S. aureus was responsible for 50 % of culture‐positive septicemias. The gram‐positive predominance depended probably on local factors, and reservation in using broad‐spectrum antibiotics might have played a part. There were 9 cases of disseminated Varicella‐zoster, cured successfully with antiviral agents. Pneumocystis carinii pneumonitis numbered 8 episodes, concentrated to the early remission period. One case of miliary tuberculosis was found. Risk factors regarding age of patient and phase or intensity of cytotoxic therapy are evaluated.
Pulmonary Function and Oxygen Uptake During Exercise in 16 Year Old Boys with Cystic Fibrosis
Authors: HJELTNES N. , STANGHELLE J. K. , SKYBERG D.
Published: January 2008

Eight of altogether 9 Norwegian boys with cystic fibrosis (CF), aged 15–17 years, and 8 healthy boys of the same age underwent pulmonary function and bicycle exercise testing. Although the CF boys showed large individual variations, the two groups showed great differences in mean body height and weight, pulmonary function variables and maximum oxygen uptake. The maximum oxygen uptake for the CF boys ranged from 40 to 125 % (mean 79 %) of predicted values. Increased ventilatory equivalent for oxygen was a characteristic finding during rest and exercise for the CF boys, and their oxygen uptake was higher during rest and corresponding work loads compared with the controls. As physical training is beneficial in cystic fibrosis, such exercise tests are of value for prescribing individual training programs and in evaluating their effects.
Congenital Liver Damage after Treatment of Mother with Valproic Acid and Phenytoin?
Authors: FELDING I. , RANE A.
Published: January 2008

A female neonate, whose mother had been treated throughout pregnancy with valproic acid and phenytoin, showed evident signs of liver damage, confirmed by laboratory investigations and biopsy.
Surgery of the ill, Extremely Low Birthweight Infant: Should Transfer to the Operating Theatre be Avoided?
Authors: BESAG F. M. C. , SINGH M. P. , WHITELAW A. G. L.
Published: January 2008

The transportation of seriously ill, extremely low birthweight (<1000 g) infants with conditions requiring surgery can be hazardous. In two such infants, considered to be too ill to be transferred to the operating theatre, surgery was carried out on the neonatal unit. The outcome was good in both cases. Peri‐operative management is described in detail.
Catecholamine Surge and Metabolic Adaptation in the Newborn after Vaginal Delivery and Caesarean Section
Authors: HÄGNEVIK K. , FAXELIUS G. , IRESTEDT L. , LAGERCRANTZ H. , LUNDELL B. , PERSSON B.
Published: January 2008

The immediate postnatal metabolic adaptation and sympatho‐adrenal activation were studied in infants delivered vaginally or by elective caesarean section. Vaginally delivered infants showed high catecholamine levels at birth compared to infants born by caesarean section under epidural or general anaesthesia. Umbilical arterial glucose levels were significantly higher in the vaginal group than in both caesarean section groups. At 30 min, all groups showed a marked decrease with several infants showing asymptomatic hypoglycaemia in the caesarean section group. C‐peptide levels showed no difference at birth but later became significantly higher in the vaginal group. Although the levels of free fatty acids and glycerol were low at birth, they were significantly higher in the vaginal group. In all groups they increased substantially with time. Considering the marked differences in catecholamine levels, the differences in metabolic adaptation were unexpectedly small. This implies an attenuated metabolic response to sympatho‐adrenal stimulation in the newborn.
From Breastmilk to Family Food
Authors: PERSSON L. Å. , SAMUELSON G.
Published: January 2008

The feeding habits of 312 Swedish infants have been followed longitudinally from birth to one year of age. The duration of breastfeeding had increased in comparison with the low figures in the beginning of the 1970s. Complementary foods were usually introduced from three months of age. At the age of 6 months all infants received complementary foods such as semi‐solids and solids and about 90% were given follow‐up formula. Parents belonging to higher socioeconomic strata were more prone to act in accordance with genera) feeding recommendations, e.g. regarding breastfeeding duration, time of introduction of complementary foods and gluten‐containing foods and the use of sucrose‐rich foods
Relation between Antibody Response to Pseudomonas aeruginosa Exoproteins and Colonization/Infection in Patients with Cystic Fibrosis
Authors: GRANSTRÖM M. , ERICSSON A. , STRANDVIK B. , WRETLIND B. , PAVLOVSKIS O. R. , BERKA R. , VASIL M. L.
Published: January 2008

ABSTRACT. Enzyme‐linked immunosorbent assay (ELISA) was used to measure the antibody response to Pseudomonas aeruginosa exotoxin A, elastase, alkaline protease and phospholipase C in patients with cystic fibrosis (CF). Only the chronically colonized patients showed elevated antibody titres to phospholipase C (22/22 patients), alkaline protease (16/22 patients), exotoxin A (15/22 patients) and elastase (5/22 patients). In a few patients where serial specimens were available, rising titres were recorded to all four antigens during periods of active infection. Antibiotic treatment resulted in decrease of titres against all four antigens, but only the anti‐exotoxin A and anti‐elastase titres decreased to normal levels. Titres to phospholipase C were the least influenced by antibiotic treatment. The results imply different roles for these exoproteins in chronic colonization versus active infection. The levels of P. aeruginosa antibodies to exoproteins could probably be used in monitoring treatment of patients with CF.
Unexplained Protracted Infant Deaths
Authors: VARIEND S.
Published: January 2008

ABSTRACT. Seven unexplained, protracted infant deaths with similar clinical, biochemical and laboratory characteristics are described, being similar to other groups reported previously. Although autopsy examination frequently revealed extensive tissue damage, a primary cause of death could not be elucidated. It is argued that this condition represents a protracted form of conventional cot death and should be considered in any severely shocked infant where the cause is not readily identifiable. Many of the clinical and pathological manifestations are similar to those described in endotoxic shock and a small intestinal mucosal abnormality on histology of unknown pathogenesis was common.
Nine‐year Follow‐up of Infants Weighing 1 500 g or Less at Birth
Authors: MICHELSSON K. , LINDAHL E. , PARRE M. , HELENIUS M.
Published: January 2008

ABSTRACT. A nine‐year follow‐up of 116 children born consecutively in 1971‐74 with a birthweight of 1500 g or less showed that 59 had died. Of those who were alive, four had severe motor and/or mental handicaps and three were blind because of retrolental fibroplasia. The low birthweight children without severe handicaps were found to have impaired motor function, speech defects and impaired school achievement more often than the controls. There was a significant correlation between the test results at the age of five and nine years, which indicates that children with school failure can be recognized and early remedial treatment started before school or on starting school.
Bone γ‐Carboxyglutamic Acid Containing Protein in the Perinatal Period
Authors: SHIMA MASAAKI , SEINO YOSHIKI , TANAKA YOSHIYUKI , YABUUCHI HYAKUJI , TSUTSUMI CHIHARU , MORIUCHI SACHIKO
Published: January 2008

ABSTRACT. We measured bone γ‐carboxyglutamic acid‐containing protein (BGP), calcium (Ca), phosphorus (P), and alkaline phosphatase (Al‐P) in paired maternal and cord sera, and urinary γ‐carboxyglutamic acid (γ‐GIa) in neonates. The circulating BGP was 41.21±2.47 ng/ml and 7.44±0.87 ng/ml in the cord (n=15) and the maternal (n=14) sera, respectively. The urinary γ‐GIa in the neonates was 147.68 ± 10.75 μ.mol/g creatinine (n=15). The cord serum BGP was significantly higher than the normal adult level. The maternal serum BGP was at the same level as in other adults. It is conceivable that the fetus may produce BGP during gestation, as the cord serum BGP level was significantly higher than the maternal level and there was no correlation between the cord and maternal serum BGP concentrations. The reason for the elevated circulating BGP level in the cord serum is not known, but increased bone turnover may be a factor. The cord serum BGP may include not only carboxylated but also non‐γ‐carboxylated BGP because of fetal vitamin K deficiency.
Storage Iron in Human Foetal Organs
Authors: SINGLA P. N. , GUPTA V. K. , AGARWAL K. N.
Published: January 2008

ABSTRACT. Maternal plasma iron and storage iron (non‐heme) in the foetal liver were estimated in 108 foetuses whose gestational ages ranged from 12–44 weeks. Simultaneous estimations of storage iron were also made on the spleen and kidney in 70 and 69 of these foetuses respectively. Although the concentration of iron per g wet tissue in these organs remained practically the same at all gestations, the total storage iron content increased with the increase in gestation due to growth of these organs. The liver, in particular, showed a steep rise in total iron content in the last 8 weeks of gestation. There was a significant positive correlation between the total storage iron content in the foetal organs and the birth weight and gestational age of the foetus, suggesting that the preterm infants had smaller iron stores at birth as compared to infants born at term. The direct relation of the concentration as well as the total content of storage iron in the foetal liver with the maternal plasma iron levels suggested that babies born to iron deficient mothers had poor iron stores in their livers.
Mortality, Pathological Findings and Causes of Death in the de Lange Syndrome
Authors: BECK B. , FENGER K.
Published: January 2008

ABSTRACT. The mortality of 48 de Lange patients born 1917–82 was found slightly raised compared with the expected number of deaths, and the survival rates appeared to be lowered. No sex differences were observed. The causes of death and the pathological findings were evaluated in 11 patients. Pneumonia was the most frequent cause of death (6 patients). Congenital malformations seemed to be contributory causes of death in 5 patients, the most frequent being congenital heart disease and gastro‐intestinal malformations. A wide variety of malformations were found but no consistent macroscopic or microscopic abnormalities could be demonstrated. An incidence figure of 1:50000 was found for the years 1967–82.
Zinc and Copper in Hair and Plasma of Children with Chronic Diarrhea
Authors: RODRIGUEZ A. , SOTO G. , TORRES S. , VENEGAS G. , CASTILLO‐DURAN C.
Published: January 2008

ABSTRACT. Zinc and copper status was evaluated in nineteen children with chronic diarrhea. An intestinal biopsy suggested that eight of these patients had celiac disease and eleven suffered chronic diarrhea without malabsorption and had normal villi or minimal changes. They were studied for malabsorption and compared with two control groups consisting of nineteen healthy and eleven malnourished children. Plasma zinc was depressed in the celiac disease group when compared with the normal children, but was similar to that of the malnourished children. Hair zinc was also depressed for the chronic diarrhea groups (23.2± 15.2 and 34.4±21.9 μg/g for those with or without malabsorption respectively, vs. 97.9± 15.2 for the healthy group). Plasma and hair copper values were diminished in both groups with chronic diarrhea. A significant correlation was found between plasma carotene levels after oral carotene overload, and both plasma zinc and hair copper values (r=0.62, P<0.01 and r=0.56, p<0.05, respectively). There was also a significant correlation between plasma zinc and plasma protein (r=0.54, p<0.05). Hair determinations seem to be more sensitive than plasma values to changes in zinc or copper status in chronic diarrhea. Chronic diarrhea in children is associated with lower levels of zinc and copper, especially when accompanied by malabsorption.
Scanning Electron Microscopy of Jejunal Biopsies in Patients with Untreated and Treated Coeliac Disease
Authors: CARPINO F. , CECCAMEA A. , MAGLIOCCA F. M. , FAMILIARI G. , LOMBARDI M. E. , BONAMICO M.
Published: January 2008

ABSTRACT. Biopsy specimens of jejunal mucosa from children with coeliac disease (CD) were examined by scanning electron microscopy (SEM) and light microscopy (LM) before and after gluten‐free diet. The results demonstrate that SEM is more sensitive than LM in documenting early morphological restoration of jejunal mucosa in patients treated with gluten‐free diet.
A Risk Group's Visits to Medical Services: Five Years’Usage of Well‐Baby and Medical Clinics by a Group of Children with a1‐Antitrypsin Deficiency
Authors: SVEGER T. , THELIN T. , McNEIL T.
Published: January 2008

ABSTRACT. Visits to medical services during the first 5 years of life for 61 children with a, ATD (but without liver disease) and 61 demographically similar control children without ATD were studied for frequency, diagnosis, severity of illness/complaint and extent of treatment. No significant differences were found between the ATD and control groups on any of these variables, suggesting no increased sickliness in the ATD‐group and no evidence of increased parental anxiety about the child's health reflected in medical visits for little or no physical abnormality.
Initiation of Spermatogenesis during Chemotherapy for Leukemia
Authors: MÜLLER JØRN , SKAKKEBÆK NIELS E. , HERTZ HENRIK
Published: January 2008

ABSTRACT. Although the information is sparse, cytotoxic drugs have been suspected to cause serious damage to the immature testis, especially when the treatment is given during puberty. In a prospective, longitudinal study, we have investigated the effect of combination chemotherapy on the maturation of the germinative epithelium in 22 testicular biopsy specimens from 10 pubertal boys with acute lymphoblastic leukemia. Five of the boys developed complete spermatogenesis including spermatozoa during the treatment, the biopsy specimens of two patients showed partial maturation of the seminiferous epithelium, while the germ cells of two boys remained immature. In one patient, who received large doses of cyclophosphamide and cytosine arabinoside, all germ cells disappeared during the therapy. We conclude that a significant proportion of boys with acute lymphoblastic leukemia may develop potential fertility even while on treatment with cytotoxic drugs during puberty.
II. Extra Early Mother‐Infant Contact and Duration of Breast‐feeding
Authors: TAYLOR P. M. , MALONI J. A. , TAYLOR F. H. , CAMPBELL S. B.
Published: January 2008

ABSTRACT. We tested the hypothesis that extra early physical contact between mother and infant is associated with prolonged breast‐feeding. Healthy, advantaged mothers and their healthy, mature, vaginally‐delivered, firstborn infants were randomly assigned to receive either regular contact (N=39) or extra early contact beginning approximately one‐half hour after delivery (N=39). Fifty‐three (68%) of the 78 infants were breast‐fed. Age at which complete weaning occurred was known for 50 (94%) of the 53 infants. Prolonged breast‐feeding was not significantly associated with extra contact. Suckling during extra early contact was associated with greater incidence of breast‐feeding at two months (p < 0.001) and three, four and five months (0.10 > p > 0.05) for male and female infants combined.
Atherosclerosis precursors in Finnish children and adolescents. V. Fatty acid composition of serum cholesteryl esters: regional differences in Finland
Authors: MOILANEN T. , NIKKARI T. , VIIKARI J. , ÅKERBLOM H. K. , RÄSÄNEN L. , AHOLA M. , DAHL M. , LÄHDE P.‐L. , PESONEN E. , PIETIKÄINEN M. , SUONINEN P. , UHARI M.
Published: January 2008

ABSTRACT. Fatty acid compositions of serum cholesteryl esters (CE) were analysed with gas chromatography from a total of 1,348 Finnish children. The study was a part of a comprehensive survey of atherosclerosis precursors among children, and included 3‐, 6‐, 9‐, 12‐, 1.5, and 18‐year‐old children and adolescents from five urban and twelve rural communities in Finland. In all age groups and both sexes, the mean percentages of linoleate (CE‐18:2) were lower and those of saturated and monounsaturated fatty acids higher in eastern rural areas than elsewhere. Eastern rural children also had significantly higher proportions of ω3 polyunsaturated fatty acids in their serum CE's. The percentage of serum CE‐18:2 parellels the PIS values obtained by a dietary survey from the same populations. The reason for higher percentages of the ω3 fatty acids in rural communities cannot be explained by diet, and remains unclear.
Some Introductory Concepts of Human Growth: an Overview
Authors: FALKNER F.
Published: January 2008

ABSTRACT. Growth study methodology is described with emphasis upon cross‐sectional versus longitudinal methods. The uses and advantages of velocity growth data are presented. Catch‐up growth is defined and measurement ratios‐indices discussed. The methodology necessary for the measurement of key indicators of human growth is described. These are body weight, recumbent length, head circumference.
Correlates of Fetal Growth and Survival
Authors: KESSEL E. , SASTRAWINATA S. , MUMFORD S. D.
Published: January 2008

ABSTRACT. Data on 36611 singleton deliveries in Indonesia were used to contrast patient characteristics, obstetric history and pregnancy outcome for two birth weightgroups among women experiencing the best and poorest stillbirth rates, namely 3000‐3499 g and <2500 g, respectively. The low birthweight groiup was characterized by younger age at first marriage, rural residence, lower educational attainment, less antenatal care and poorer pregnancy outcome and infant survival. Both groups showed progressive anemia prevalence with increasing parity with lower hemoglobin levels for the low birth weight group. Stillbirth rates were particularly high (60.6 per 1000 pregnancies) for the under 20 year olds in the lower birthweight group. The results suggest poorer maternal nutrition among women with lower educational achievement, higher energy expenditures among rural women, nutritional reserves depletion with increasing parity and competition between the teenager's nutritional needs for her own physical growth and fetal growth as factors in low birthweight and perinatal mortality.
Zinc, Pregnancy and Parturition
Authors: ELÍZAGA I. VILLA , FERREIRA R. M. C. DA CUNHA
Published: January 2008

ABSTRACT. The role of zinc in the nutrition of pregnant women and its relations to prenatal growth and parturition are reviewed. Zinc deficiency (ZD) affects fetal growth and development both in experimental animals and in man. The teratogenicity of zinc deficiency was widely demonstrated in animals and is also evident in humans. Alcohol intoxication potentiates the effects of ZD in animals. Plasma zinc levels decrease during pregnancy and apparently an adequate and continuous intake of zinc is required for a normal embryonic development. The zinc content of amniotic fluid seems to be related with fetal growth but its value as an indicator of embryonic development is controversial. Zinc deficiency also affects adversely parturition. Mild zinc deficiency may affect a large number of pregnant women, being potentially harmful to the mother and the fetus. This situation requires the screening of high‐risk groups, the definition of adequate dietary intakes for each population, and the supplementation with zinc when deficits are detected.
Sorrento Studies of Birthweight Case for International Reference Data
Authors: WHARTON B. A.
Published: January 2008

ABSTRACT. There is little doubt that the mother's state of protein‐energy nutrition affects birthweight and intra‐uterine growth generally. The state of nutritional balance (i.e. intake minus expenditure) during the second trimester is probably more important than dietary intake alone. Not all mothers producing poorly grown babies are undernourished, however, so that preventative and therapeutic measures should be aimed only at those who require them. As with many other aspects of medical practice, unnecessary treatment can have adverse effects. The effect of maternal nutrition on intra‐uterine growth is one more reason against adopting a plethora of local intra‐uterine growth standards. Just as for postnatal growth, international reference data of weight (and other measurements) for gestational age should be established and accepted, against which the growth of all babies irrespective of geographical, ethnic or economic background, may be compared. These international reference data should allow for sex of the baby, parity and maternal height. They should not allow for smoking, weight, diet, physical activity. “FIGOFeGS” (Fédération Internationale de Gynécologie et d'Obstétrique Fetal Growth Standard) is proposed.
Mortality in the First Week of Life and Mode of Delivery
Authors: CORCHIA C. , PAONE M. C.
Published: January 2008

ABSTRACT. 11923 singletons with birthweight >775 g born consecutively at the 2nd School of Medicine of Naples daring a four‐year period (November 1975 to October 1979) were the subjects of the study. Mortality in the first week of life was 10.9, 9.7, 6.7 and 10.7 per 1000 respectively in the four years. The total variability of the crude death rates was reduced by 21.4 % after standardization for birthweight distribution alone and by 28.6 % when both birthweight and mode of delivery were taken into account. Therefore only a small fraction of the variations in mortality can be ascribed to changes in the distribution of modes of delivery during the study period. Most of these variations are probably related to the quality of perinatal care, which seems to have improved only for babies under 1526 g. Birthweight specific mortality in relation to mode of delivery is further discussed.
The Influence of Long‐term Cimetidine as an Adjuvant to Pancreatic Enzyme Therapy in Cystic Fibrosis
Authors: CHALMERS D. M. , BROWN R. C. , MILLER M. G. , CLARKE P. C. N. , KELLEHER J. , LITTLEWOOD J. M. , LOSOWSKY M. S.
Published: January 2008

ABSTRACT. Seventeen patients on constant doses of pancreatic enzymes were randomised to receive either cimetidine or placebo for either of two successive six month periods. Nutritional state and maldigestion were assessed at the beginning and end of each period. Reductions in mean values of faecal fat, nitrogen, wet weight, and bile salts of approximately 30 % were found on cimetidine therapy. Results showed considerable variation and only the fall in faecal fat was statistically significant. No benefit was demonstrated for height, weight, skinfold thickness, albumin, vitamin A, bone age or Crispin‐Norman score.
Interferon Production in Children with Respiratory Diseases
Authors: VANERÊEK K. , LEHOVCOVÁ A.
Published: January 2008

ABSTRACT. In 110 children aged between 6 months and 18 years the ability of leukocytes to produce the leukocyte interferon (IFN‐alpha) in vitro was studied. The decrease or disappearance of IFN‐alpha production was observed in some children with chronic or repeated respiratory diseases and in the majority of children who had been treated with prednisone. Increased production of IFN‐alpha was found in a child with hypogammaglobulinemia and bronchopneumonia. In children affected by allergic or autoimmune diseases or bacterial infections IFN‐alpha production was mostly normal. Age and sex had no influence on the production of IFN‐alpha.
Sensorineural Deafness in Congenital Hypopituitarism with Severe Hypothyroidism
Authors: LUCA F. DE , ARRIGO T. , MANGIONE O. A. , MAIOLINO M. G. , MURITANO M.
Published: January 2008

ABSTRACT. Marked sensorineural hearing loss was documented in an 18‐year‐old boy with untreated congenital anterior panhypopituitarism. The clinical manifestations of the hypothalamic thyroid failure were unusually severe in this patient. Seemingly this is the first case report of perceptive‐cochlear deafness in a subject with non primary congenital hypothyroidism.
Hepatitis B Virus Infection and Vaccination in Children Undergoing Hemodialysis
Authors: CALLIS L. M. , CLANXET J. , FORTUNY G. , CABALLERIA J. , CARRASCO J. L. , LARDINOIS R.
Published: January 2008

ABSTRACT. Among 54 patients, between 2 and 18 years of age, submitted to hemodialysis due to severe chronic renal failure, the prevalence of hepatitis B virus markers was 66.7 % and that of HBsAg was 13.0 %. Eighteen children, with no evidence of hepatitis B virus infection, were vaccinated. Following three vaccine injections, only 2 patients did not respond and a third one developed low anti‐HBs titers. The vaccine was well tolerated. No relationship was observed between the intensity of the humoral immune response and age, sex, type of renal disease and time on dialysis. Seroconversion rates (87.5 %) and geometric means of anti‐HBs titers (>4 000 Ausab Units) of these patients are similar to those observed following vaccination of healthy adults.
Defective Leukocyte Interferon Response in Children with Recurrent Infections Accompanied by Arthralgia
Authors: BONDESTAM MARGARETA , KEIKO FUN A , ALM GUNNAR V.
Published: January 2008

ABSTRACT. Children with recurrent and/or unusually severe infections were investigated for possible defects in the interferon (IFN)‐natural killer (NK) cell system. Two series, each of 13 children, were examined, one in 1982 and one in 1983. Healthy children, seven in 1982 and eight in 1983, served as controls. Peripheral blood mononuclear leukocytes were examined for IFN production induced by the IFN‐α inducers Sendai virus and Escherichia coli and by the IFN‐γ inducers Concanavalin A and Lens culinaris lectin. None of these inducers discriminated patients from controls. However, the bacteria Staphylococcus aureus Cowan I (SACol), inducers of atypical IFN in null lymphocytes, yielded significantly lower IFN production in infection‐prone children than in controls, particularly in children with recurrent infections accompanied by arthralgia. No differences in basal NK activity or in the in vitro enhancement of such activity by IFN‐α were found between patients and controls.
Subclinical Thyroid Hormone Abnormalities in Type I Diabetic Children and Adolescents. Relationship to Metabolic Control
Authors: DORCHY H. , BOURDOUX P. , LEMIERE B.
Published: January 2008

ABSTRACT. The serum levels of thyroid hormones and thyroid stimulating hormone were compared in 64 type I diabetic children and adolescents without ketosis and in 28 age matched normal subjects. Only T3 levels were significantly different in the diabetic patients (2.38±0.41 nmol/1) than in controls (2.64±0.52 nmol/1) (p<0.01) confirming the existence of the‘low T3 syndrome’in diabetic children. A negative correlation was found between T3 and blood glucose as well as glycosylated haemoglobin suggesting that short‐term hyperglycaemia could regulate T3 concentration. Thyroid function was not different in diabetic children with or without thyroid antibodies. We conclude that serum T3, level is influenced by the degree of metabolic control and that thyroid function in diabetic children should be assessed by the measurement of the serum concentration of T4, FT4 and TSH.
Treatment of Infantile Colic with Surface Active Substance (Simethicone)
Authors: DANIELSSON BERNT , HWANG CARL PHILIP
Published: January 2008

ABSTRACT. The effect of Simethicone on “colicky” (n=27) infants was tested in a double‐blind cross‐over study. Three different parameters were used to measure the efficiency of the treatment: interviews, 24‐hour records and behavioral observations. No effects of Simethicone on the symptoms of infantile colic could be demonstrated. However, 67 % of the infants improved during the treatment, which could be ascribed to a high‐grade placebo‐effect.
A Longitudinal Study of Growth in Children with Acute Lymphoblastic Leukemia
Authors: BERGLUND G. , KARLBERG J. , MARKY I. , MELLANDER L.
Published: January 2008

ABSTRACT. Growth in terms of both height and weight was studied in a longitudinal sample consisting of ten children who all experienced the onset of acute leukemia between 18 months and 7 years of age. In spite of the lack of deviation in body size at birth, these children had somewhat higher values for attained size than the reference group one year before diagnosis. The information from this study showing a decrease in growth rate before the start of treatment, could suggest that the disease causes the growth failure. Growth rate for height increased with time from the first year of treatment, which could be correlated to a positive effect of medical treatment of the disease. These results indicate a very stable regulation of growth between 18 months and 12 years of age. The children dropped temporarily in mean one standard deviation (SD) corresponding to about 4 cm, from one year before the start of treatment to the end of the three years of treatment. It seems, however, that it is possible for the body to repair such a temporary growth inhibition as is seen in the catch‐up growth during the following two years. Height measured in SD for the group two years after discontinuing treatment was practically the same as height at the time of the start of treatment. Children with leukemia during the first years of life and during the pubertal period may not show a similar growth pattern.
Plasma 1.25‐Dihydroxyvitamin D Concentrations in Preterm Infants
Authors: FETTER W. P. F. , METTAU J. W. , DEGENHART H. J. , HOOGENBOEZEM T. , MOLENAAR A. , VISSER H. K. A.
Published: January 2008

ABSTRACT. 1.25‐Dihydroxyvitamin D concentrations were measured in 10 preterm infants (mean gestational age 29 weeks, range 26‐32; mean birthweight 1226 g, range 980‐1700). Total parenteral nutrition was begun after birth and partial enteral feeding was started at 1 week of age. Total enteral feeding was achieved at a mean age of 26 days (range 16‐47). The daily vitamin D3 intake was about 400 I. U. No clinical, chemical or radiological signs of rickets were observed. The mean 1.25‐dihydroxy vitamin D concentration ± SEM was 103.2±24.0 pmol/1 at 1 week (range 9.6‐252.0), 141.6±26.4 at 3 weeks (range 31.2‐324.0), 153.6±21.6 at 6 weeks (range 67.2‐ 256.8), 165.6±24.0 at 9 weeks (range 74.4‐307.2) and 153.6±21.6 at 12 weeks (range 76.8‐268.8) postnatal age. The mean values at 6, 9 and 12 weeks were significantly higher (p resp. <0.01, <0.002 and <0.005) than in adults (88.8±7.2; n=27). 1.25‐Dihydroxyvitamin D concentrations were highly variable and did not correlate with 25‐hydroxyvitamin D concentrations, plasma calcium and phosphorus concentrations and plasma alkaline phosphatase levels, nor with illness nor postnatal age. The data demonstrate that preterm infants are capable of producing high plasma levels of 1.25‐dihydroxy vitamin D.
Cerebrospinal Fluid C‐Reactive Protein in the Laboratory Diagnosis of Bacterial Meningitis
Authors: MACFARLANE D. E. , NARLA V. R.
Published: January 2008

ABSTRACT. Samples of cerebrospinal fluid from 112 cases of suspected meningitis were tested for the presence of C‐reactive protein (CRP), using a qualitative and quantitative slide test. Bacterial meningitis was confirmed in 34 patients, based on CSF and blood culture results, and/or elevated CSF white blood cell (WBC) count and typical biochemical profile. There were 8 patients with early onset, and 3 who had received prior antimicrobial therapy among the 5 neonates, 23 children, and 6 adults with bacterial meningitis. Organisms recovered from CSF, and/or blood, included Haemohilus influenzae 14, Streptococcus pneumoniae 9, Streptococcus group B 5, Staphylococcus aureus 2, E. coli 2 and Klebsiella penumoniae 1. Slide test was positive for CRP in 33 cases, giving a sensitivity of 97 % which compared favourably with elevated CSF protein 33 %, decreased CFS glucose 64.7 % CSF glucose/blood glucose <l/2, 85 %, raised CSF WBC 38.2 %, raised CSF PMN 61.7 %, CSF culture positive 88.2 %, and CSF gram‐positive 82.5 %. Slide test was positive for CRP in 1 of 78 CSF samples negative for bacterial meningitis, giving a specificity of 98%. It was concluded that testing of CSF for CRP is a simple, rapid and accurate method for the laboratory diagnosis of bacterial meningitis, which is particularly appropriate for areas lacking adequate laboratory facilities.
Normal Plasma‐Urine Osmolality Relationship in Preterm Infants on Positive Pressure Mechanical Ventilation
Authors: SUJOV P. , ZELTZER M. , HOCHBERG Z.
Published: January 2008

ABSTRACT. Mechanical ventilation with positive pressure has been implicated in the inappropriate release of vasopressin. To examine whether such a phenomenon occurs in infancy, 26 preterm neonates with Respiratory Distress Syndrome were studied. Simultaneous urine and plasma were collected for osmolality determination during mechanical ventilation with positive end expiratory pressure of 4‐8 cmH2O. Results were plotted onto our previously described nomogram. The data show normal distribution of plasma to urine osmolality ratio in 25 out of 26 infants. These results do not support the common belief that positive pressure mechanical ventilation in the newborn with RDS provokes inappropriate secretion of vasopressin.
Bile Acid Malabsorption in Cystic Fibrosis; Membrane Vesicles, a Tool for Revealing the Role of the Ileal Brush Border Membrane
Authors: DE ROOIJ F. W. M. , VAN DEN BERG J. W. O. , SINAASAPPEL M. , BOSMAN‐JACOBS E. P. , TOUW‐BLOMMESTEIJN A. C.
Published: January 2008

ABSTRACT. Increased fecal bile acid loss in cystic fibrosis (CF) may result from ileal dysfunction. A method to quantitate in vitro Na+‐dependent taurocholate uptake into brush border membrane vesicles prepared from frozen ileum and ileal biopsy specimen is described. This transport across the ileal brush border membrane can be measured selectively, in contrast to in vivo measurements which represent a complex overall process. Preliminary results obtained with ileal specimen of 2 CF patients, suggest that in vitro bile acid uptake is low but not abnormal.
Delayed Growth and Reduced Intelligence in 9–17 year old Intrauterine Growth Retarded Children Compared with Their Monozygous Co‐twins
Authors: HENRICHSEN L. , SKINHØJ K. , ANDERSEN G. E.
Published: January 2008

ABSTRACT. Fourteen pairs of monozygous twins who differed from one another mainly in terms of intrauterine growth the one being ±25 % lighter at birth than the other were studied at a mean age of 13 years. There had been no major problems during pregnancy or the neonatal period and no serious diseases during childhood. The twins grew up in the same environment. At follow‐up height, head circumference, global IQ and performance IQ were reduced in the originally light twins. Intrauterine growth retardation of a certain magnitude thus has a long‐term deleterious effect upon growth and development.
Daily Subcutaneous Administration of Human Growth Hormone in Growth Hormone Deficient Children
Authors: ALBERTSSON‐WIKLAND KERSTIN , WESTPHAL OTTO , WESTGREN ULF
Published: January 2008

Sixteen children (10 boys, 6 girls) on treatment for some years with i.m. injections twice or thrice weekly of human growth hormone (hGH; Crescormon® KabiVitrum), participated in a prospective study. The weekly amount of hGH (8, 12, or 16 IU) was kept the same in each child, but divided into daily (7) s.c. injections at bedtime. The growth rate increased in all children during the first year on s.c. daily hGH (5.3 to 7.4 cm/year; 1.95 to 4.27 SDS). This increased growth rate did not persist during the second year on daily s.c. hGH, but an increased predicted final height was found. The plasma profile of hGH was followed: i.m. injected hGH gave mostly a high (200 mU/1) plasma level of some hours (wide intra‐ and inter‐patient variation), and s.c. injected hGH a lower max level of longer duration (wide inter patient variation). The daily s.c. regimen of hGH was extremely well accepted by the children and their parents and no GH‐antibodies or other adverse effects were found. We recommend daily s.c. injection of hGH as an alternative in the treatment of GH‐deficient children.
Antimicrobial Therapy of Pseudomonas Pulmonary Exacerbations in Cystic Fibrosis
Authors: SCHAAD U. B. , DESGRANDCHAMPS D. , KRAEMER R.
Published: January 2008

ABSTRACT. High‐dose anti‐Pseudomonas chemotherapy is mandatory in the treatment of acute pulmonary exacerbations in patients with advanced cystic fibrosis and Pseudomonas aeruginosa isolated from their sputum. However, neither the regimen itself nor its objective evaluation have been optimized yet. In a prospective controlled evaluation 42 such exacerbations were treated for two weeks with netilmicin combined by randomisation with either azlocillin or ticarcillin. Other aspects of therapy were constant. The two therapy groups were comparable in all aspects. Both regimens produced similar improvements in clinical, radiological, laboratory, bacteriological and pulmonary function measurements. Concentrations of sputum bacteria were significantly reduced; transient eradication was documented in 29% and correlated with antibiotic susceptibility of the initially isolated Pseudomonas strains. The highly dosed antibiotics were well tolerated and emergence of resistance was rarely observed. It is concluded that both antibiotic combinations are beneficial and safe in cystic fibrosis. Monitoring of such intensive hospital treatment must include multiple parameters.
A Long‐term Gastrointestinal Follow‐up in Patients Operated on for Congenital Hypertrophic Pyloric Stenosis
Authors: VILMANN P. , HJORTRUP A. , ALTMANN P. , ANDERSEN F. H. , SØRENSEN C.
Published: January 2008

ABSTRACT. A gastrointestinal follow‐up of 91 patients operated on for congenital hypertrophic pyloric stenosis (CHPS) between 1942 and 1964, using the Fredet‐Ramstedt method, is presented. Among 85 patients available for follow‐up, 72 responded to a request for reexamination. These patients were interviewed personally by one of the authors. Thirty‐four patients (47%) consented to have a Roentgen examination done, performed as a double contrast study, investigating the structure and function of the stomach and duodenum. Forty‐two patients (58%) had varying minor gastrointestinal complaints. Only two patients had severe symptoms. X‐ray examination in 34 patients (47%) showed only three with pathological changes, i.e. one with mild deformation of the duodenal bulb, another with slight duodenal reflux. The third X‐ray showed massive gastric retention with duodenal bulb deformation. The patient suffered from severe dyspepsia and vomitus. No correlation was found between the severity of the CHPS and the presence of later gastrointestinal symptoms. It is concluded that the Fredet‐Ramstedt's operation for CHPS is an efficious operation with few perioperative complications and good long‐term results.
Mumps IgA Antibodies Are Not Absorbed from Human Milk
Authors: KLEMOLA T. , SAVILAHTI E. , LEINIKKI P.
Published: January 2008

ABSTRACT. We measured mumps virus specific IgA antibodies in the sera of preterm infants after a feeding period on human milk rich in such antibodies. In full‐term infants the possibility of absorption was determined from the content of these antibodies in the child's mother's milk, an umbilical cord blood sample and a later serum sample. No absorption of IgA antibodies was found.
Leucocyte Migration Inhibition in Cow's Milk Protein Intolerance
Authors: KHOSHOO V. , BHAN M. K. , ARORA N. K. , SOOD D. , KUMAR R. , STINTZING G.
Published: January 2008

ABSTRACT. The leucocyte migration inhibition (LMI) was determined in an assay after in vitro challenge with beta‐lactoglobulin. The assay was considered positive when migration inhibition index was greater than 20 % (mean +3 SD of healthy infants). Ninety‐eight infants with protracted diarrhoea and failure to thrive, 16 healthy, 12 malnourished, and 16 infants suffering from acute gastroenteritis were studied. Of the 98 patients with protracted diarrhoea, 12 fulfilled Goldman's criteria for cow's milk protein intolerance, 63 had lactose malabsorption, and in 15 no associated causative factor was identified. The mean index of migration inhibition in the cow's milk allergic group (58.83 ± 11.98) was higher than in healthy controls (8.25 ± 3.91), the difference being statistically significant (p< 0.05). The test was positive in all patients with caw's milk protein intolerance. The assay was also positive in four other patients suffering from protracted diarrhoea, two of whom had lactose malabsorption. All the infants with acute gastroenteritis and malnutrition had values within the normal range. The migration inhibition index in five patients with cow's milk intolerance had declined to 24.74 ± 4.87 in assays performed 1‐6 weeks after return of clinical tolerance to cow's milk (p< 0.05) but the test was still within the postive range in three of the five infants. These results suggest that this cell mediated immune assay is a sensitive test for the diagnosis of cow's milk protein intolerance in infants. The specificity needs to be reassessed in the light of more objective criteria for the diagnosis of cow's milk protein intolerance.
Severe Growth Failure Associated with Atrophic Intestinal Mucosa and Ring Chromosome 15
Authors: KOSZTOLÁNYI G. , PAP MÁRIA
Published: January 2008

ABSTRACT. Ring chromosome 15 was detected in a boy with severe growth failure and no dysmorphic features who had previously been found to have an atrophic intestinal mucosa, a finding not observed in about 300 patients with ring autosome reported so far. Of the 137 metaphases examined, 8.1 % had secondary aneuploidy produced by the structural and behavioural instability of the ring. Ring derivatives could also be seen in lymphocytes after only one cycle in the culture, indicating that such cells are also generated in vivo. We observed an increased cell death rate in fibroblast culture by Trypan Blue exclusion. These results suggest that there is a continuous in vivo generation of cells with increased mortality resulting in both growth failure and atrophic intestinal mucosa in the patient. The atrophic intestinal mucosa might be a manifestation of ring instability.
Growth Hormone Therapy of Short Stature1
Authors: KNUDTZON J.
Published: January 2008

ABSTRACT. Considerable progress has been made in the diagnosis and treatment of growth hormone‐related short stature. Knowledge about growth hormone releasing factor (GRF) and somatomedin C has provided the possibility of distinguishing between hypothalamic and pituitary growth hormone deficiency and growth hormone resistance. It has been shown that treatment with GRF may stimulate growth in certain cases of growth hormone deficiency. Recombinant DNA techniques may, in the near future, provide sufficient amounts of GRF, growth hormone and possibly somatomedin C for clinical use. At present, many countries have prohibited the use of human pituitary growth hormone due to a possible risk of transmission of Creutzfeldt‐Jakob disease. It has become increasingly clear that several short children without classical growth hormone deficiency, may increase their growth velocity during growth hormone treatment. There are many medical, psychological, ethical and economical implications involved in the extended treatment of children with short stature. It is necessary to maintain a restricted approach towards the treatment of children with short stature, and such treatment should be prescribed and controlled by a limited number of well‐trained paediatric endocrinologists. This article reviews some of the present knowledge in this rapid developing field of paediatric endocrinology.