bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Study of the Electrocardiograms of Healthy Fullterm and Premature Newborns
Authors: THOMAIDIS C. , VARLAMIS G. , KARAMPERIS S.
Published: January 2008

ABSTRACT. The electrocardiograms of 421 healthy fullterm and premature newborns, recorded on the fifth day of life, were evaluated for possible systematic differences related to gestational age. All newborns were appropriate for gestational age and were divided into four groups according to birthweight. As birthweight increased, we noted: (a) a progressive rightward shifting of the QRS axis in the frontal plane; (b) an increase in the amplitude mainly of the precordial R and S waves reflecting the right ventricle and both ventricles combined, whereas a less significant increase or even a decrease was noted in the R and S waves reflecting the left ventricle; (c) a more frequent occurrence of diphasic and positive T waves in the right precordial leads; and (d) a prolongation in the duration of the P wave and the QRS complex. These findings reflect both an increase in total myocardial mass as well as a progressive right ventricular predominance, as birthweight or gestational age increases. Practical implications for electrocardiographic identification of cardiac hypertrophy in newborns of different gestational age are discussed.
A Prospective Study of Cow's Milk Allergy in Exclusively Breast‐Fed Infants
Authors: HØST ARNE , HUSBY STEFFEN , ØSTERBALLE OLE
Published: January 2008

ABSTRACT. A cohort of 1749 newborns in the municipality of Odense were followed prospectively for the development of cow's milk allergy (CMA) during their first year of life. Altogether 39 fulfilled the criteria for CMA (2.2%). Out of the 39 infants, 17 developed symptoms of CMA during breast‐feeding, in all cases before the age of 3 months. Nine of these were solely breast‐fed at the time of diagnosis, giving a one year incidence of CMA in exclusively breastfed infants of 0.5% (9/1 749) in a study population with a frequency of exclusive breast‐feeding of 52% at 3 months of age. None of the infants had signs of CMA in the neonatal period. Review of records from the newborn nursery revealed that all 9 infants had been exposed to cow's milk formula in amounts corresponding to approximately 0.4‐3.0 g of Beta‐lactoglobulin (BLG) during the first three days of life. Human milk samples were analyzed by enzyme‐linked immunosorbent assay (ELISA) for the content of bovine BLG. Detectable amounts (0.5–45 ng/ml) were found in 3/9 samples of human milk against which the infants reacted clinically. Analysis of the size distribution by high pressure liquid gel permeation chromatography in combination with ELISA indicated a molecular weight of BLG corresponding to that of monomeric BLG (18 kD). Possibly early inadvertent and occasional exposure to cow's milk proteins may initiate sensitization in predisposed neonates. Subsequent exposure to minute amounts of bovine milk proteins in human milk may act as booster doses eliciting allergic reactions.
Growth in Children Treated for Acute Lymphoblastic Leukemia with and without Prophylactic Cranial Irradiation
Authors: MOËLL C. , GARWICZ S. , MARKY I. , MELLANDER L. , KARLBERG J.
Published: January 2008

ABSTRACT. Growth and weight gain were studied longitudinally over a period of four years in thirty‐nine children treated for acute lymphoblastic leukemia. The children were divided into two groups according to treatment. Twenty‐eight children were given prophylactic cranial irradiation and eleven children were treated without such irradiation. The duration of cytostatic treatment was three years in all cases. Average growth during the first two years was similar in the two groups, and the standard deviation scores (SDS) were below average. The rate of growth (in height) during the fourth year was significantly higher among those children who had not received cranial irradiation (p<0.01). After four years the average attained height had declined 0.5 SD for children treated with cranial irradiation and 0.2 SD for children without such treatment. Weight velocity was significantly greater than the expected mean in the non‐irradiated group during the first year and in the irradiated group during the fourth year of the study. Attained weight after four years had increased 0.4 SD more among those children who had not received irradiation. The results suggest that prophylactic cranial irradiation is responsible for the greater part of the prepubertal growth inhibition in these children.
Growth in Rabbits during Alternate‐Day Cortisone Injections: Near Normal Growth on Days without Cortisone
Authors: MOËLL C. , ARONSON A. S. , SELVIK G.
Published: January 2008

ABSTRACT. Longitudinal bone growth in rabbits during treatment with hydrocortisone was measured by means of Roentgen Stereophotogrammetric Analysis, RSA. This method allows accurate measurement of the distance between metallic markers inserted into long bones. Hydrocortisone was given in i.m. injections as single doses and as repeated doses, daily or every other day. Single injections of hydrocortisone resulted in three types of growth effect, depending on dosage. Low dosage (less than 4 mg/kg b.w.) produced no blunting of growth. Intermediate dosage (4–32 mg/kg b.w.) retarded growth during the first but not the second day after the injection. The effect of high dosage (64–128 mg/kg b.w.) lasted for two days. During daily treatment (4 and 16 mg/kg b.w.), growth decreased to a constant level. During alternate‐day steroid injections with a double dose every other day, growth almost normalized during the steroid‐free days. Average growth was significantly greater during alternate‐day injections than during daily injections. It is concluded that alternate‐day treatment has no unfavorable effect on growth so long as the interval between injections exceeds the duration of the growth effect of each single dose.
Turner Syndrome: Effect of Hormone Therapies on Height Velocity and Adult Height
Authors: LENKO HANNA LIISA , SÖDERHOLM ANNLIS , PERHEENTUPA JAAKKO
Published: January 2008

ABSTRACT. 76 patients with Turner syndrome received estrogen alone, androgen and estrogen started simultaneously or, after preceding androgen therapy, estrogen with or without androgen. Six patients had spontaneous pubertal development and received no estrogen. Two patients received human growth hormone with androgen during >2.0 years. Height velocity increased during all therapies to mean SD scores of 7.6 during androgen‐estrogen started simultaneously, 4.6 during androgen alone, 4.2 during androgen‐estrogen after preceding androgen, 2.7 during estrogen alone, and 0.6 during estrogen after preceding androgen. Adult height was measured in all cases, it was 145.5±5.7 (mean ± SD) for the whole series without significant differences between the groups. It correlated strongly with midparent height, and was greater for patients with the 45,X karyotype than for the others combined.
Mineral Metabolism in Obese Children
Authors: ZAMBONI G. , SOFFIATI M. , GIAVARINA D. , TATÓ L.
Published: January 2008

ABSTRACT. Blood levels of glucose, insulin (IRI), Calcium (Ca), phosphorus (P), alkaline phosphatase (AP), osteocalcin (OC), parathyroid hormone (PTH), calcitonin (CT), 25‐hydroxyvitamin D3 (2SOHD3), 1,25‐dihydroxyvitamin D3 (1,25(OH)2D3) and urinary excretion of Ca (Ca/Cr), P (TmP/GFR), hydroxyproline (OH‐P/Cr) and cyclic AMP (cAMP/GFR) were determined in 16 obese children, aged 8 to 11 years, on a diet rich in calories and carbohydrates and in 15 controls of the same age. Blood glucose, IRI, Ca, P, PTH and CT were also determined in both groups of subjects, during an oral glucose tolerance test (OGTT). In basal conditions glucose, IRI, AP, OC, PTH, CT and 1,25(OH)2D3 levels were significantly higher, and 2SOHD3 levels lower, in obese children than in controls. Urinary Ca/Cr, TmP/GFR were lower in obese than in non obese children, while OH‐P/Cr and cAMP/GFR were higher. Bone mineral content (BMC), measured by photon absorptiometry, and BMC/bone width ratio were lower in obese than in non obese children. During OGTT serum Ca and P decreased and serum PTH and CT increased less in obese than in non obese children. In obese children receiving a diet with high carbohydrate content, an alteration of mineral metabolism occurred, characterized by secondary increase of PTH and 1,25(OH)2D3. Ca decreased and PTH and CT increased less markedly during OGTT.
A Syndrome of Progressive Pancytopenia with Microcephaly, Cerebellar Hypoplasia and Growth Failure
Authors: HREIDARSSON S. , KRISTJANSSON K. , JOHANNESSON G. , JOHANNSSON J. H.
Published: January 2008

ABSTRACT. A male infant with congenital thrombocytopenia, progressing to pancytopenia in the second year of life is presented. Other findings included microcephaly with cerebellar hypoplasia, growth failure of prenatal onset and severe psychomotor retardation. He died at 23 months of age from Candida albicans septicemia. Laboratory studies and a postmortem examination failed to reveal any known etiology for his disorder, but parental consanguinity suggests a genetic basis with an autosomal recessive mode of inheritance. Heyeraal et al. have previously reported two brothers with similar clinical and laboratory findings. It is proposed that the condition of these three patients should be considered as a separate syndrome of congenital pancytopenia, distinguished from other congenital myeloid dysplasias by the extramedullary findings.
Transcutaneous Bilirubinometry
Authors: YAMAUCHI YOSHITADA , YAMANOUCHI ITSURO
Published: January 2008

ABSTRACT. A total of 576 transcutaneous bilirubin measurements were performed on 336 Japanese full‐term breast‐fed newborn infants during the first twelve days of life. Our present study revealed that transcutaneous bilirubin measurements obtained from the forehead, chest, and sternum correlated well with serum bilirubin concentrations measured by AO bilirubinometer (0.910–0.922, p<0.001, n=576). The 95% confidence lmits were ±3.04 mg/dl for the forehead, ±2.85 mg/dl for the chest, and ±2.84 mg/dl for the sternum readings. The overall mean of values from the forehead, chest and sternum, when compared with individual means, was found to correlate better with serum bilirubin concentrations (r=0.930, p<0.001, n=576) and improve the 95% confidence limits to ±2.68 mg/dl. These results demonstrated that the accuracy and reliability of TcB measurement could be increased further with multiple site measurement. The study clearly indicates that transcutaneous bilirubinometry is useful for clinical screening of serum bilirubin levels in Japanese full‐term newborn infants.
Plasma Antibodies to Cow's Milk Are Increased by Early Weaning and Consumption of Unmodified Milk, but Production of Plasma IgA and IgM Cow's Milk Antibodies Is Stimulated Even during Exclusive Breast‐Feeding
Authors: TAINIO V.‐M. , SAVILAHTI E. , ARJOMAA P. , SALMENPERÄ L. , PERHEENTUPA J. , SIIMES M. A.
Published: January 2008

ABSTRACT. We measured levels of cow's milk‐specific (CM) antibodies of immunoglobulin classes G, A and M by enzyme‐linked immunosorbent assay in plasma of 198 healthy infants; a variable number of samples taken at birth and at ages of 2, 4, 6, 9, 12 and 28 months were available (altogether 765 samples). The rise in the level of IgG CM antibodies was highest and most rapid in infants exposed to CM formula before the age of 1 month. The level fell by 9 months, but rose again by 12 months. This second rise was attributed to the introduction of dairy milk. Partially breast‐fed and fully weaned infants had similar levels of IgG CM antibodies. The levels of IgG CM antibodies were unaffected by the infants' own atopy, their heredity for atopy, and the umbilical serum level of IgG CM antibodies. IgA and IgM CM antibodies were absent at birth. Their levels increased similarly in exclusively breast‐fed infants and infants fed CM formula. We conclude that plasma IgG antibodies to cow's milk are increased by early weaning and by consumption of unmodified cow's milk. Production of plasma IgA and IgM antibodies to cow's milk is stimulated even during exclusive breast‐feeding.
Sudden Infant Death in Stockholm
Authors: RAJS JOVAN , HAMMARQUIST FOLKE
Published: January 2008

ABSTRACT. During a ten year period, March 1976‐February 1986, 83 non‐selected consecutive cases of sudden unexpected death in infants, between one week and one year of age, were examined at the Department of Forensic Medicine in Stockholm. Forty‐three deaths (52%) were classified as typical or possible cases of Sudden Infant Death Syndrome (SIDS), 35 (42%) as non‐violent non‐SIDS cases and 5 (6%) as non‐natural deaths. Cardiovascular disease, including myocarditis, was found in 21 (25%) instances, infections with inflammatory manifestations in various organs outside the heart in 12 (14%) and miscellaneous, non‐violent causes of death in 2 (2%) cases. The male: female ratio was 1.15:1 for SIDS and 1.30:1 for non‐SIDS cases. A peak of incidence was found for SIDS cases in infants between two and four months of age, while non‐SIDS victims tended to be somewhat older. Ninety‐five percent of the SIDS fatalities occurred during the winter months (October‐April) as compared to 71% of the non‐SIDS cases. Outdoor temperature below the annual mean of 5.9°C in combination with a sudden decrease in temperature was associated with sudden deaths, particularly SIDS. Thirty‐three percent of the SIDS victims died in their cribs compared to 51% of the non‐SIDS cases. Corresponding figures for deaths outdoors in a pram were 33% and 11%, respectively. Fourteen percent of the infants in both groups died while in bed with one of the parents. Ninety‐five percent of the SIDS victims were previously healthy, but in 9% one or more periods of abnormal breathing had been noted. The corresponding figures for non‐SIDS were 70% and 3%, respectively. Among the cases of non‐natural deaths was one infant who died of heroin poisoning and one of hypothermia.
Cystic Fibrosis in Denmark 1945 to 1985
Authors: NIELSEN O. H. , THOMSEN B. L. , GREEN A. , ANDERSEN P. K. , HAUGE M. , SCHIØTZ P. O.
Published: January 2008

ABSTRACT.The entire population of cystic fibrosis (CF) patients in Denmark diagnosed in the period January 1, 1945, to June 30,1985, comprised 514 persons of whom 62 were diagnosed at autopsy. Of the remaining 452 patients, 372 were probands and 80 were secondary cases. The effect of a centralized treatment on the prognosis was evaluated using a Cox's regression model. Furthermore an incidence analysis was performed using probands including autopsies. Centrab'zed treatment had a significantly beneficial effect on the prognosis (p=0.02), the death intensity (hazard rate) being decreased by a factor of 0.60. It was calculated that at present 1 out of 4760 newborn Danes may be diagnosed as suffering from CF before the age of 15 years, and 3% of the Danish population are heterozygotes for CF.
Excretion of Urinary Collagen Metabolites Correlates to Severity of Pulmonary Disease in Cystic Fibrosis
Authors: AMMITZBØLL T. , PEDERSEN S. S. , ESPERSEN F. , SCHIØLER H.
Published: January 2008

ABSTRACT. The urinary excretion of collagen metabolites (hydroxylysine, hydroxyproline and proline) was significantly increased in 10 patients with cystic fibrosis and chronic broncho‐pulmonary Pseudomonas aeruginosa infection as compared with 14 age matched controls. The increase was significantly correlated to impaired pulmonary function (FVC and FEV1). The results indicate that urinary collagen metabolites reflect degradation of lung connective tissue and may be an indicator of the severity of pulmonary disease in cystic fibrosis. Parts of the excreted hydroxyproline may be degradation products of elastin.
The Natural History of Liver Disease in (α1‐Antitrypsin Deficient Children
Authors: SVEGER T.
Published: January 2008

ABSTRACT. During 1972–1974, 200 000 Swedish infants were screened for α1‐antitrypsin deficiency. Of 127 PiZ (Protease inhibitor) children followed from infancy to 12 years of age, four PiZ children with neonatal liver disease have died; two of liver cirrhosis, one was found to have liver cirrhosis at autopsy, having died of aplastic anemia and the fourth died in an accident. Liver microscopy showed a mild increase of periportal fibrous tissue. Another PiZ child died of anaphylactic shock. At 12 years of age, none of the PiZ children have clinical symptoms of liver disease. No PiZ‐, PiSZ, PiS‐ or PiFZ child has had any clinical symptom of liver disease. One PiSZ child died of sudden infant death syndrome. Laboratory analyses from birth through 12 years of age have shown increased S‐Bilirubin levels in 11% of the PiZ infants, which normalized within the first half year of life. S‐GT was abnormal in about half of the infants, but had normalized when checked at 8 and 12 years of age in all but 6‐3% of the PiZ children. The percentage of abnormal S‐ALAT test results have decreased from 73% during the first year of life, to about 15% at the age of 12. The range of the abnormal levels also decreased considerably. Abnormal S‐GT or S‐ALAT levels were found in about 20% of the PiSZ infants, the proportion decreasing to 2% at the age of 12.
Prevalence of Xerophthalmia in Relation to Nutrition and General Health in Preschool‐age Children in Three Regions of Tanzania
Authors: PEPPING F. , KAVISHE F. P. , HACKENITZ E. A. , WEST C. E.
Published: January 2008

ABSTRACT. Integrated nutrition/health surveys were carried out in IVfbeya, Iringa and Kagera Regions in Tanzania in which a total of 12880 children were examined for the presence of xerophthalmia. Xerophthalmia was found to be a problem of public health significance in two of the three regions surveyed where the prevalence of active corneal xerophthalmic lesions was above the criteria set by WHO. Because of clustering of the children with Bitot's spots, corneal xerosis/ulceration and corneal scarring, only certain villages or groups of villages could be regarded as areas where xerophthalmia is a problem. The results of the ophthalmo‐logical examinations are discussed in relation to the nutritional status of the children as measured by anthropometric indices, serum levels of retinol‐binding protein and prealbumin, haematological parameters, and vaccination status.
45,X/47,XY,+ 13 Mosaicism and Crohn's Disease
Authors: KNUDTZON J. , LEDAAL P. , MIDDELTHON‐MOE M. , AARSKOG D.
Published: January 2008

ABSTRACT. The unusual karyotype 4S,X/47,XY,+13 in an 8.5‐year‐old girl with the Turner phenotype is described. She displayed none of the phenotypic manifestations of trisomy 13. The patient suffered from Crohn's disease, which is known to be associated with the Turner syndrome. To our knowledge this is the first reported case of Crohn's disease in a patient with 45,X and Y chromosome mosaicism.
Iatrogenic Arteriovenous Fistula in Infancy
Authors: PARRI F. J. , MESTRES C. A. , MORALES L. , RODRIGUEZ‐MIGUELEZ M. , ROVIRA J. , MULET J.
Published: January 2008

ABSTRACT. Iatrogenic arteriovenous fistulas (AVF) in infancy are rare and are usually located at the level of femoral and antecubital vessels. They are generally secondary to multiple diagnostic or therapeutic arterial or venous punctures. The diagnosis is usually easy to make on clinical grounds; however, invasive procedures such as digital subtraction angiography (DSA) can be used to locate the fistula. These iatrogenic AVF may present as direct vascular communications or pseudoaneurysms originating in the venous wall. Surgical treatment is the therapy of choice. The case of an infant with an iatrogenic AVF of the femoral vessels is presented.
THE INTERACTION BETWEEN THE INFANT AND THE ENVIRONMENT: THE IMPORTANCE OF MOTHER‐CHILD CONTACT AFTER DELIVERY
Authors: DE CHÂTEAU PETER
Published: January 2008

Abstract.Birth is more than just the physical beginning of a new life — it is also the start of the psychosocial development of the newborn infant together with its family. Immediately after delivery parents and infants can start to exchange signals that maybe are of major importance for this development. The early post partum period has been regarded to have great potentials and especially the mother has been regarded to play a very powerful role, whereas the infant's contribution has been accorded little discussion. The individual reactive capacity of the newborn baby and its influence on the environment can be illustrated in a number of ways. In recent years studies of fetal movements have been made by means of ultra sound registration and it has been discussed whether these are precursors of later behavior in the neonate‐infant. The transition at birth can be considered either to be continuous or discontinuous, the outcome of this discussion has great bearing on the importance of early neonate‐environment interactions.

Short and long term outcome of different routine care procedures around the time of delivery and transition are controversial subjects. Although several studies support the importance of early post delivery interaction, other studies do not seem to find correlations between early experiences and later developmental outcome measurements. In this paper several of these aspects will be discussed, examples from the literature given and possible clinical applications suggested, as well as their impact on the care of healthy and sick newborns and their families.
LESSONS DRAWN FROM OBSERVING YOUNG PEERS TOGETHER
Authors: ECKERMAN CAROL O. , DIDOW SHARON M.
Published: January 2008

Abstract. Based on studies during the past 13 years of what transpires between young peers, lessons are drawn about the nature of human sociability and the development of social skill during the first three years of life. Peer encounters have proven especially helpful for discovering the forms of sociability and social skill the infant is capable of without the aid of a more skillful social partner.

From early in infancy, children are quite sociable with peers (age‐mates), both in novel play settings and in their own home or customary group care settings, both with an unfamiliar peer and with those quite familiar, both at the start of acquaintanceship with a particular peer and after many encounters with that peer. Their sociability is seen in their attraction to peers, their directing to peers of such distinctively social behaviors as vocalizations, smiles, and gestures, and the predominantly friendly nature of their behavior. Peer encounters in the absence of customary play materials refute claims that attraction to peers is a by‐product of interest in toys and the inanimate spectacles peers create through their actions on toys.

Distinctions should be drawn between sociability and social skills, especially interactive skills. Interactive skills are systematic ways the young child relates his/her own behavior to the details of a partner's behavior that function to facilitate such valued social outcomes as the generation of a cooperative game or a conversation or the resolution of a dispute. Observations of young peers highlight the distinctive nature of the infant's interactive skills. Social influence between peers is present from 6 months, but rarely takes the form customary for older children. Joining a peer and manipulating the same play material as the peer are rudimentary interactive skills that emerge by 12 months. Interactive skills enabling the generation of extended sequences of social interaction on a common cooperative theme progress rapidly during the third year of life.

The distinctive form of the young child's interactive skills produces distinctive patterns of interaction among young peers. Their interactions are managed largely nonverbally well into the third year of life, and extended Cooperative interactions most often take the form of games in which one or both children imitate each other's actions. Despite the predominance of imitation, their encounters are also marked by complementary role relationships. The distinctive features of peer encounters prompt speculations about the role peer encounters can play in early development.
Characteristics of the Obstetric Population in a Saudi Maternity Hospital
Authors: SERENIUS F. , EDRESSEE A. W. , SWAILEM A. R.
Published: January 2008

ABSTRACT.Mothers who delivered in a large Maternity hospital and who represented a large proportion of the obstetric population in Riyadh are described. The mothers were characterized by a high material standard of living, by adequate energy reserves at confinement, by a low rate of pregnancy complications and preterm birth, and by the absence of smoking and of hard physical work during pregnancy. The mothers were also, however, characterized by pregnancies occurring at the extremes of the reproductive age, by short birth intervals, by short maternal stature, by low educational attainment, by poor utilization of antenatal services and by a high rate of previous infant loss, that is by characteristics previously found to consitute riskfactors for adverse perinatal outcome.
Growth and Nutritional Status of Less Privileged Urban Children in Saudi Arabia
Authors: SERENIUS F. , SWAILEM A. R.
Published: January 2008

ABSTRACT. The attained growth was assessed in a cross‐sectional study of Saudi children 1–71 months of age, growing up in a less privileged area of Riyadh. Individual data on weight, height and weight for height were expressed in SD scores of the NCHS reference and those of triceps skinfold thickness in percent of the reference median. The mean (SD) weight, height and weight for height of the entire material were ‐0.9 (1.0), ‐0.8 (1.0), and ‐0.5 (0.9), respectively and the median tricpes skinfold was 90 percent of the reference median. When stratified by age groups the means were nearly identical with those of the reference populations in the 1–5 month age group. The mean weight and height were significantly below the reference means at 6–11 months, however. There was a similar decline in the mean weight for height and the median tricpes skinfold during the second year of life. The growth deficits of early life remained unchanged or increased slightly up to 6 years. According to WHO citeria, 14 percent of the children were classified as chronically and 3 percent as acutely undernourished. The faltering growth was different from that of privileged Saudi children whose growth pattern was found to resemble that of Western reference populations.
Patterns of Breastfeeding and Weaning in Saudi Arabia
Authors: SERENIUS F. , SWAILEM A. R. , EDRESSEE A. W. , HOFVANDER Y.
Published: January 2008

ABSTRACT. The patterns of breastfeeding and weaning were studied in 4 groups of Saudi children: Privileged urban children; children representing the average urban population; less privileged urban children, and rural children from 3 different areas. The data represented retrospective and actual information and were analyzed according to the life table technique. The median duration of breastfeeding of rural, urban low, urban average and urban privileged children was 17.8 months, 10.8 months, 7.5 months and 2.1 months, respectively. In all groups the rate of breastfeeding was lower in young compared with old mothers. Thus the median duration of breastfeeding was 11.7 months for rural mothers <23 years and 23.6 months for mothers >31 years. Corresponding figures for urban low mothers were 3.4 months and 11.4 months, respectively. By one month 52 percent of privileged and 42 percent of urban low children were started on bottle. By contrast, 26 percent of rural children were started on bottle at 6 months, At 6 months, 6 percent of rural children were started on any kind of solid foods compared with 90 percent of privileged children; at 12 months the figures were 33 and 96 percent, respectively. The data indicated a successive decline in the duration of breastfeeding with increasing affluence, and late introduction of weaning foods to rural children.
HEMIPLEGIC CEREBRAL PALSY AETIOLOGY AND OUTCOME
Authors: UVEBRANT PAUL
Published: January 2008

Hemiplegic cerebral palsy (CP) was studied in a retrospective population‐based series of 169 cases from the South‐westem Swedish health care region covering the birth years 1969‐78. The purpose was to analyse the prevalence, aetiology and neuro‐developmental outcome in children born preterm and at term, and to correlate pathogenetic periods, aetiological factors and clinical parameters to neuroradiology.

The prevalence at the ages 6‐15 years was 0.66 per 1000.

Postnatally acquired hemiplegia, mainly postinfectious, iatrogenic or posttraumatic, constituted 11%. Amongtermchildren with congenital hemiplegia (pre and perinatally derived) the aetiology was considered prenatal, mainly circulatory brain lesions and maldevelopments, in 42%, combined pre and perinatal in 9%, perinatal (cerebral haemorrhage, hypoxia) in 16% and untraceable in 34%. The corresponding distribution amongpretermchildren was 29%, 47%, 25% and 6%, respectively. The rate of preterm birth among congenital cases was 24%. Birth asphyxia was shown to be a poor indicator of pathogenetic period, whereas a cascade of postpartum complications suggested perinatal brain damage. Clinical follow‐up of 152 children revealed that 50% had mild, 31 % moderate and 19% severe motor dysfunction. Stereognostic sense was impaired in 44% of the children (astereognosia in 20%). Additional impairments (mental retardation, epilepsy, impaired vision, hearing and speech, severe behavioural/perceptual problems) were present in 42%. Term children with congenital hemiplegia tended to be more severely affected than preterm children. The resulting total handicap was considered mild in 40%, moderate in 44% and severe in 16%. The prevalence of severe total handicap was highest among postnatal cases.

Computerised tomography (CT), performed in 109 congenital cases, was normal in 26%, showed unilateral ventricular enlargement in 36% and revealed cortical/subcortical cavities in 20%. In the remaining 18% CT findings were classified as “other”. With the classification so far used, correlations between CT findings and aetiologies were unsatisfactory and disappointing. In contrast, CT findings showed a strong correlation with clinical degree of severity and magnitude of associated handicap. As a rule, normal CT implied mild disability and unilateral ventricular enlargement moderate, whereas cortical/subcortical cavities were frequently associated with severe handicap, including mental retardation and epilepsy.
The Outcome of Neonatal Septicemia during Fifteen Years
Authors: BENNET R. , BERGDAHL S. , ERIKSSON M. , Zetterström R.
Published: January 2008

ABSTRACT. The outcome of neonatal septicemia in 320 infants seen during 1969–83 has been evaluated. Mortality decreased from 27% to 12%. The incidence of moderate to severe handicaps in survivors remained unchanged at around 20%. Sixty percent of these handicapped children had meningitis or osteomyelitis, and many of these were healthy prior to onset. All handicapped infants without osteomyelitis or meningitis had several other risk factors that may have contributed to the final outcome.
Serum Antibodies to Cow's Milk Proteins in Pediatric Inflammatory Bowel Disease: Crohn's Disease vs. Ulcerative Colitis
Authors: LERNER AARON , ROSSI THOMAS M. , PARK BYUNG , ALBINI BORIS , LEBENTHAL EMANUEL
Published: January 2008

ABSTRACT. Serum antibodies to five cow's milk proteins, α‐casein, bovine serum albumin (BSA), β‐lac‐toglobulin A and B (BLG‐a, BLG‐b) and α‐lactalbumin (ALA) were investigated in young patients with inflammatory bowel disease, 56 with Crohn's disease (CD), 24 with ulcerative colitis (UC). IgG antibodies against BSA and BLG‐a and ‐b were higher in Crohn's disease patients as compared to those with ulcerative colitis and controls. The IgG anti‐BSA were higher in the group of CD patients with higher score of disease activity. Additionally, IgA antibodies to a‐casein were higher in CD and UC compared to control. These findings may be due to increased uptake of dietary antigens or enhanced immunological response occurring in CD patients.
Child Neuromuscular Disease in Southern Norway
Authors: TANGSRUD S. E. , HALVORSEN S.
Published: January 2008

ABSTRACT. In a survey carried out to determine the incidence of Duchenne muscular dystrophy in South East Norway, 38 cases were ascertained among 149 975 live male births during the years 1968–1978. The overall incidence is 1:3917 in live male births (25.33×10‐5). This incidence is compared with those in other studies. There is an apparent drop in incidence in the last cohort studied, and the possible role of genetic councelling and antenatal sexing are discussed.
Inborn Errors of Amino Acid and Fatty Acid Metabolism with Hypoglycemia as a Major Clinical Manifestation
Authors: SøVIK O.
Published: January 2008

ABSTRACT. During the last decade it has become increasingly clear that severe hypoglycemia may be caused by specific enzymatic defects of amino acid and fatty acid metabolism. Several reports have presented hypoglycemic syndromes with reduced fatty acid transport or oxidation, decreased ketogenesis, or abnormalities of the Krebs cycle and electron transport chain. It is of particular interest that several enzymatic defects here discussed may present as Reye's syndrome. An intriguing fact is a highly variable clinical presentation, even in the presence of well‐defined enzyme deficiencies. Some patients are desperately ill in the newborn period, whereas in other cases there are symptoms only during catabolic phases later in childhood. The presence of hypoglycemia may be related to low levels of acetyl Co A, with consequently reduced gluconeogenesis; alternatively the glucose‐sparing effect of ketones is lost in states of reduced ketone body production. Treatment with pharmacological doses of vitamins may be attempted, depending upon the established or suspected diagnoses. With manifest hypoglycemia i.v. glucose infusion is the treatment of choice. By such means convulsions, and brain damage may be prevented.
Development of a Human Milk Protein Standard
Authors: DONOVAN SHARON M. , Lönnerdal BÖ
Published: January 2008

ABSTRACT. Accurate quantitation of the protein content of human milk (HM) is clinically important for both determining protein and energy intakes of HM‐fed infants. Protein can be determined by Kjeldahl analysis or colorimetric assays. Colorimetric assays are rapid and convenient, but usually overestimate the protein content when compared to Kjeldahl protein (KP). In this study a protein standard based on human milk protein (HMPS) was isolated by size exclusion column chromatography. Purity and composition of the standard was determined by gel electrophoresis, Kjeldahl and amino acid analyses. The protein content of 20 mature milk samples was determined by the Lowry, BCA and BioRad colorimetric assays, using bovine serum albumin, human serum albumin/IgG, and HMPS as standards. These results were compared with KP results using Student's f‐test. All colorimetric assays overestimated milk protein content; however, the Lowry assay gave the lowest protein levels, with our protein standard yielding values closest to the KP value.
Oxygenation, Heart Rate and Temperature in Very Low Birthweight Infants during Skin‐to‐Skin Contact with Their Mothers
Authors: ACOLET D. , SLEATH K. , WHITELAW A.
Published: January 2008

ABSTRACT. Fourteen very low birthweight infants were studied positioned either prone horizontal or skin‐to‐skin at 60 degree tilt between the mother's breasts. Heart rate, skin temperature and oxygenation by transcutaneous Po2 and pulse oximetry were measured. Nine of the infants had normal lungs when studied. These infants showed no change in tcPo2, or oxygen saturation but heart rate increased significantly by a mean of 6.5 beats per min during skin‐to‐skin contact. Five infants with chronic lung disease, including two on nasal catheter oxygen, showed a significant 1.0 kPa rise in tcPo2 during skin‐to‐skin contact. Back skin temperature was well maintained during skin‐to‐skin contact with the room temperature at 26 to 29°C. None of the infants had a significant apnoea or bradycardia during the study. Stable very low birthweight infants can enjoy such close contact with their mothers and the tilted position may improve pulmonary function in some cases.
Hyperferritinemia in Malignant Histiocytosis, Virus‐Associated Hemophagocytic Syndrome and Familial Erythrophagocytic Lymphohistiocytosis
Authors: ESUMI N. , IKUSHIMA S. , TODO S. , IMASHUKU S.
Published: January 2008

ABSTRACT. Data on 28 patients with malignant histiocytosis (MH), fourteen patients with virus‐associated hemophagocytic syndrome (VAHS) and two patients with familial erythrophagocytic lymphohistiocytosis (FEL) were collected from 21 hospitals in Japan to study the serum ferritin levels and clinical features. At diagnosis, the serum ferritin values were a median of 3000 ng/ml (range, 59–270000 ng/ml) in MH and 10500 ng/ml (range, 44–68600 ng/ml) in VAHS/FEL. Clinical signs and symptoms were not substantially different between MH and VAHS/FEL. Thus, serum ferritin markedly increased in the majority of MH/VAHS/FEL patients and should be a useful marker of disease activity in either neoplastic or reactive histiocytic proliferative disorders.
Autistic Behaviour in Moebius Syndrome
Authors: GILLBERG C. , STEFFENBURG S.
Published: January 2008

ABSTRACT. Seventeen children and young adults with Moebius syndrome were examined with a view to finding symptoms of autism. Some 40% of the group showed all or many of the symptoms typical of autistic disorder. The high frequency of autistic symptoms in Moebius syndrome might be a marked overrepresentation and could be suggestive of a common underlying neurobiological deficit at the brainstem level.
Paralytic Ileus, a Serious Complication in Acute Diarrhoeal Disease among Infants in Developing Countries
Authors: MURTAZA A. , KHAN S. R. , BUTT K. S. , FINKEL Y. , APERIA A.
Published: January 2008

ABSTRACT. Intestinal hypomotiHty is a common late complication in infants with acute diarrhoeal disease in Pakistan. Among the infants admitted to our gastrointestinal unit with a history of acute diarrhoea, 35% developed abdominal distension and 12% developed the full clinical picture of paralytic ileus. The infants with ileus were treated with decompression and total parenteral nutrition; in this group the mortality rate was 25%. We compared 30 infants who developed ileus (group A) with an age‐matched control group of infants (group B) who were admitted because of acute diarrhoea but did not develop ileus. The use of antimotility drugs was significantly more frequent in group A. Serum‐K was not different in group A (3.92±0.22 mmol/1) and group B (4.32±0.18 mmol/l). However, there were more patients who had serum‐K below 3 mmol/l in group A (8/30) than in group B (5/30). We conclude that the use of antimotility drugs predisposes to the development of ileus in infants with acute diarrhoea. Hypokalemia may contribute to ileus in a few cases but is generally not a prerequisite.
Familial Occurrence of Neuroblastoma, Von Recklinghausen's Neurofibromatosis, Hirschsprung's Agangliosis and Jaw‐winking Syndrome
Authors: CLAUSEN N. , ANDERSSON P. , TOMMERUP N.
Published: January 2008

ABSTRACT. A family is reported with ganglioneuromas in the mother and neuroblastomas in her two daughters co‐existing with cases of von Recklinghausen's neurofibromatosis, Hirschsprung's agangliosis, and the jaw‐winking syndrome in other family members. There were no detectable constitutional chromosomal defects in the family even when high resolution techniques were applied. Similarly, DNA‐hybridization analysis did not reveal gross molecular rearrangements in the vicinity of the proto‐oncogenes N‐myc‐, c‐myc, neu, and N‐ras. However, the aggregation of several rare, autosomal dominant diseases affecting tissue derived from the neural crest not only suggests a link between the pathogenesis of these diseases, but also makes it highly likely that a single mutation segregating within the family is responsible for this association.
Trunk Asymmetry and Scoliosis Anthropometric Measurements in Prepuberal School Children
Authors: NISSINEN M. , HELIÖVAARA M. , TALLROTH K. , POUSSA M.
Published: January 2008

ABSTRACT. A total of 1060 children (515 girls, 545 boys) were examined for screening of trunk asymmetry and scoliosis at an average age of 10.8 years. The physical examination consisted of height, sitting height, total arm length and leg length inequality determinations and moire topography. Trunk asymmetry was measured by forward bending test and a posteroanterior standing radiograph of the spine was taken of those 188 (17.7%) children who had a trunk hump 6 mm. Only 20.1 % of the children were found to be exactly symmetric in the forward bending test, 47.3% had a right‐sided hump and 32.6% had a left‐sided hump. Humps of 6 mm or more were significantly (p=0.03) more prevalent among girls (21.7%) than boys (16.3%). Moiré fringe asymmetry was proved to be common: only 9% of the material was totally symmetric, two thirds had asymmetry of 1 fringe, 26.6% had asymmetry >1 and 2 and 5.4% >2. The prevalence of scoliosis (trunk hump 6 mm and Cobb angle 3±10) was 4.1%. The majority (72.1%) of the curves were left convex.
Relationship between Exposure to Icterogenic Agents, Glucose‐6‐Phosphate Dehydrogenase Deficiency and Neonatal Jaundice in Nigeria
Authors: OWA J. A.
Published: January 2008

ABSTRACT. In a study of the relationship between exposure to icterogenic agents, G‐6‐PD deficiency and severe neonatal jaundice (NNJ) (serum bilirubin 3±205 umol/I) in 234 Nigerian term male neonates, 106 infants with severe NNJ and 128 controls, it was found that 62.3 % of the jaundiced infants and 13.3 % of the infants without NNJ were G6PD deficient (p<0.01). The proportion of infants exposed to icterogenic agents in the two groups was very similar (p<0.5). There was a strong association between exposure to icterogenic agents and NNJ in 83 G6PD deficient infants (p<0.01), but there was no association between exposure to icterogenic agents and NNJ in the whole group of 234 infants or in 151 infants with normal G6PD status. It is concluded that there is an association between genetically determined G‐6‐PD deficiency and exogenous agents in causing severe NNJ in Nigerian infants.
Validity of a Questionnaire Measuring Food Frequency Compared to a 7‐Day Record
Authors: BLOM L. , LUNDMARK K. , DAHLQUIST G. , PERSSON L. A.
Published: January 2008

ABSTRACT. A questionnaire measuring food frequency was validated against 7‐day records of food intake in a group of 30 children, 2–16 years of age. Special emphasis was given to the ability of the questionnaire to estimate frequency of intake of foods of particular interest in diabetes mel‐litus. Fifteen children had insulin‐dependent diabetes; 15 were healthy. Comparison of the two methods regarding frequency of foods with high content of sucrose, protein, fat, fibres, nitrite or vitamin C showed a correlation of 0.52–0.76. The frequency of intake of some staple foods was often overestimated by the questionnaire, while the frequency of meat, sausage and some sweet snacks was underestimated. The use of the questionnaire to identify high or low consumers of the mentioned nutrients showed a rather low sensitivity (0.38–0.50), but a high specificity (0.86–1.0) when compared with results of the 7‐day record. In our limited sample of subjects no systematic differences were found comparing sexes or diabetic and healthy children. A food frequency questionnaire may, in spite of some important reservations, be a useful tool for screening purposes when more time‐consuming and resource‐demanding methods cannot be used.
Congenital Adrenal Hypoplasia and Glycerol Kinase Deficiency
Authors: OLEESKY D.A. , HAKEEM V.
Published: January 2008

ABSTRACT. An unusual case of salt‐wasting id a male infant is reported. The cause was a small X‐chromosomal deletion within Xp21 resulting in the syndrome of congenital adrenal hypoplasia with glycerol kinase deficiency. This syndrome can readily be diagnosed by routine biochemical tests.
Growth Disturbance in an Urban Area of Lahore, Pakistan Related to Feeding Patterns, Infections and Age, Sex, Socio‐Economic Factors and Seasons
Authors: JALIL F. , KARLBERG J. , HANSON L. Å. , LINDBLAD B. S.
Published: January 2008

ABSTRACT. Infantile growth in 910 longitudinally‐followed infants in a poor urban population of Lahore, Pakistan was followed from birth to two years of age and correlated to various socio‐economic variables, infections, and feeding‐practices. Attained body size was correlated with the number of episodes of diarrhoea and with family educational level and also, to some extent, with housing standards. The influence of environmental factors on growth was greatest during the hot and warm seasons, for children at an age of 6–9 months and in this culture especially for girls. Children living under the same conditions showed great individual variations in resistance to environmental factors as measured by growth parameters.
Individual Growth Curves and Longitudinal Growth Charts between 0 and 3 Years
Authors: MILANI S. , BOSSI A. , MARUBINI E.
Published: January 2008

ABSTRACT.From a statistical viewpoint, the construction of longitudinal growth norms involves two classes of problems: (a) the choice of a mathematical function having as few constants as possible, hut suitable for describing individual growth process in the growth period of concern; (b) the estimation of the mean growth constants for a homogeneous group of subjects, and of the covariance matrix of data collected longitudinally, to compute tolerance intervals which enable us to draw growth charts. Although growth constants should have some biological interpretation, the choice of functions rests mainly on the criterion of following observed growth as closely as possible. As to the second problem, the simplest situation implies that growth function is linear in the constants and all subjects have measures on the same prefixed occasions: in this case, multivariate Potthoff‐Roy model (1964) directly applies. In longitudinal growth studies, however, it happens that subjects do not come for measurements at exactly the age specified: two‐stage models seem to be more appropriate to this latter case. They consist of (a) fitting individual growth curve on each subject to obtain estimates of 1st‐stage constants; (b) obtaining estimates of 2nd‐stage constants, characteristic of the whole group of subjects, in terms of weighted averages of the estimates of the 1st‐stage constants. This paper deals with the application of a two‐stage model to the growth in length of 203 girls and 217 boys horn in Naples between 1977 and 1981. Children, whose growth records are used to trace longitudinal standards, have been measured at birth, and at least 5 times in the course of a follow‐up made up of 8 visits, between 3 months and 3 years of life.
Hypoglycemia: A pathophysiologic approach
Authors: SENIOR BORIS , SADEGHI‐NEJAD ABDOLLAH
Published: January 2008

An exploration of the factors that sustain glucose levels in the normal fasting subject reveals that the single major component is conservation of glucose rather than gluconeo‐genesis. Conservation is achieved by recycling of glucose carbon as lactate, pyruvate and alanine, and a profound decrease in the oxidation of glucose by the brain brought about by the provision and use of ketones. What glucose continues to be oxidized is for the most part formed from glycerol. Gluconeogenesis from protein plays little part in the process.

Fasting hypoglycemia results from disorders affecting either one of the two critical sustaining factors—the recycling process or the availability and use of ketones.

Individual hypoglycemic entities are examined against this background.