bluuebunny/crossref_metadata_2025 huggingface dataset:
Aldosterone Concentrations in Dehydrated Infants
Authors: PASSWELL J. , RIGLER S. , ALADJEM M. , BOICHIS H. , WAGNER I. , ESHKOL A.
Published: January 2008

ABSTRACT. The mean serum aldosterone concentration of 37 infants with acute gastroenteritis and dehydration was markedly elevated on admission (mean ±SE 94.3±12.1 ng/ml) and approximated to normal values (18.2±3.7 ng/ml) following recovery from the acute disease (t=3.56 p<0.005). Serum aldosterone levels were significantly positively correlated with the percent weight loss (r=0.41, p<0.05) and with the blood urea nitrogen levels (r=0.55, p<0.001). There was no correlation between either serum sodium levels or blood osmolarity and aldosterone concentrations. Serum potassium levels were positively correlated with aldoster‐one levels (r=0.53, p<0.001). These findings indicate that small infants when dehydrated respond appropriately with elevated aldosterone levels. The amount of body fluid depletion and hyperkalemia are the major factors determining the amount of aldosterone response.
Autoimmune Haemolytic Anaemia Treated with Multiple Transfusions, Immunosuppressive Therapy, Plasma Exchange, and Desferrioxamine
Authors: ANDERSEN O. , TAANING E. , ROSENKVIST J. , MØLLER N. E. , MOGENSEN H. H.
Published: January 2008

ABSTRACT. Severe autoimmune haemolytic anaemia in a five year old boy was unaffected by treatment with prednisone and splenectomy, but subsided after combined immunosuppressive therapy and three plasma exchanges. Over five months, a total of 93 transfusions of concentrated erythrocytes was given (equal to 18.6 grams of iron or 1.1 g/kg BW). This resulted in severe iron overload with cardiac, hepatic, and pancreatic complications, together with growth‐retardation. These complications disappeared after treatment with desferrioxamine and vitamin C, but despite a normal growth hormone response to glucagon the concentration of somatomedin in serum remained low. Treatment by plasma exchanges and immunosuppressive agents may therefore be of value in severe haemolytic anaemia refractory to corticosteroids and splenectomy. Iron chelating therapy should be considered if multiple transfusions result in iron overload.
The Association of Extrahepatic Bile Duct Atresia and Neonatal Epstein‐Barr Virus Infection
Authors: WEAVER L. T. , NELSON R. , BELL T. M.
Published: January 2008

ABSTRACT. An infant with uncorrectable extrahepatic bile duct atresia was found to have evidence of Epstein‐Barr virus infection during the neonatal period. It is probable that the infection was acquired in utero. In view of the association of hepatitis with the Epstein‐Barr virus in later life, it is possible that this infection was responsible for the development of bile duct obstruction.
Males with Low Birthweight Examined at 18 Years of Age
Authors: NILSEN STEIN TORE , FINNE PER H. , BERGSJØ PER , STAMNES OLA
Published: January 2008

ABSTRACT. An 18 years follow‐up study of 105 males born in 1962/63 with birthweight ≤ 2500 g was made at the military draft board examinations in 1981. The medical and psychological tests were compared to the tests of the total cohort of 35 728 Norwegian conscripts. The early neonatal mortality in the study was 15.2 %, and of those examined at 18 years of age was 6.7 % unfit for military service, compared to 6.2 % in the total cohort. Ten organ systems were analyzed, significantly increased frequency of unfitness being found only for the vision. Intelligence testing was done on 71 of the studied subjects, and the mean was the same as the national average. Children with weight‐for‐date centile < 10 at birth had the same general intelligence at 18 years as the national average. However, the weight and height at adult age were significantly correlated to the weight‐for‐date at birth. The study indicates that those low birthweight children who survived the neonatal period in the beginning of the nineteen‐sixties, were except for stature and minor defects of vision, indistinguishable from those of normal birthweight at the age of eighteen.
Growth Pattern of Intrauterine Growth Retarded (IUGR) Babies in First Nine Months of Life
Authors: BHATIA B. D. , AGARWAL K. N. , JAIN N. P. , BHARGAVA V.
Published: January 2008

ABSTRACT. Forty‐one full term intrauterine growth retarded (IUGR) babies of different maternal etiologies viz. maternal undernutrition (12), small maternal size (12), toxaemia of pregnancy (9) and idiopathic (8) were studied for growth pattern during first 9 months of life. Eighteen fullterm and 11 preterm who were appropriate for gestational age served as controls. These mothers were comparable for age, parity, socioeconomic status, weight and height (except in small size mothers), haemoglobin and plasma albumin (except in undernourished group). The various anthropometric parameters studied were weight, crown‐heel length, head circumference, their velocities and ponderal index. The IUGR babies of undernourished mothers had lowest means for weight, crown‐heel length and skull circumference. The babies of small sized mothers suffered most in crown‐heel length followed by weight. The head growth was not affected in these babies. The IUGR babies of mothers with toxaemia of pregnancy demonstrated a catch up growth for all three parameters. The IUGR babies of idiopathic group showed a spurt in weight gain around 3 to 6 months and a similar spurt for crown heel length and head circumference was observed between 6 to 9 months of age. These babies were close to IUGR babies of mothers with toxaemia of pregnancy at 9 months. The preterm AGA babies also demonstrated a catch up growth for the weight, crown heel length and circumference.
Serum 25‐Hydroxyvitamin D Levels in Finnish Children Aged 2 to 17 Years
Authors: ALA‐HOUHALA MARJA , PARVIAINEN M. T. , PYYKKÖ KAIJA , VISAKORPI J. K.
Published: January 2008

ABSTRACT. Serum levels of 25‐hydroxyvitamin D (25‐OHD) in summer and winter were studied in 564 children aged 2–17 years living in the northern, central or southern parts of Finland. The mean levels of 25‐OHD were significantly lower in winter (13.3 ± 10.8 ng/ml) than in summer (27.2 ± 10.3 ng/ml) in all age groups (p < 0.001). The mean 25‐OHD levels in the northern part of the country did not differ significantly from the others. In both seasons the levels of 25‐OHD were lower in the 11–17 year age group than in younger children. In that age group 22.4 % of the children had serum levels of 25‐OHD below 5 ng/ml (the limit of risk for rickets), compared to 16.8 % of children 6–10 years old and 7.5 % of children 2–5 years old, but none of the children showed any laboratory evidence of rickets.
Imerslund‐Gräsbeck Anemia
Authors: BROCH H. , IMERSLUND O. , MONN E. , HOVIG T. , SEIP M.
Published: January 2008

ABSTRACT. A follow‐up study has been performed on 14 patients, now aged 6–46 years, with Imerslund‐Gräsbeck anemia (congenital, hereditary selective malasorption of vitamin B12). On intramuscular vitamin B12 therapy, the patients are clinically and hematologically normal. Those who had constant proteinuria in childhood continue to excrete protein in the urine. Our patients excrete an average of 750 mg of protein per 24 hours (range 13–1460 mg). The proteinuria is predominantly of glomerular origin, but some is also of tubular origin. Renal biopsies of the two oldest patients were normal on light microscopy. Electron microscopy revealed moderate signs of chronic glomerulopathy of mesangioproliferative type in both patients. The renal lesions do not seem to be progressive.
A Prospective Study of Intrapulmonary Fat Accumulation in the Newborn Lung Following Intralipid Infusion
Authors: LEVENE M. I. , BATISTI O. , WIGGLESWORTH J. S. , DESAI R. , MEEK J. H. , BULUSU S. , HUGHES E.
Published: January 2008

In order to assess the safety and stability of a parenteral fat emulsion (Intralipid8) in total parenteral nutrition (TPN), 29 infants were infused Vamin glucose and Dextrose electrolyte solution as well as one of two isocaloric regimens; either 25 % Dextrose (Group I) or 10 % Intralipid (Group II). Regular biochemical monitoring was performed in all cases and no infants became lipaemic nor developed abnormally high levels of total free fatty acid. Eight infants died and only those who had received fat emulsion had lipid staining material distending the pulmonary vessels. One infant having low infusion rates of Intralipid had massive fat accumulation in the lungs, but biochemistry during life had been normal. We speculate that in ill infants the emulsion becomes less stable and agglomeration of fat particles occurs which are then fully filtered out by the lungs before metabolism of the exogenous fat can occur.
Neonatal Meningitis in Nigerian Infants
Authors: LONGE A. C. , OMENE J. A. , OKOLO A. A.
Published: January 2008

53 Nigerian infants with neonatal meningitis were prospectively studied. The striking features were: (a) the higher predisposition (26.7‐fold) of LBW infants to developing meningitis than has been previously reported in the literature; (b) the predominant role of E. coli and Staphylococcus aureus; and (c) the rarity of salmonella organisms and the conspicuous absence of group B streptococcus as aetiological pathogens. The outcome was related to the age of onset and type of micro‐organism. The presence of neurological signs, particularly nuchal rigidity and bulging anterior fontanelle, carried a poor prognosis. The overall mortality was 37.7%
The Pattern of Growth in Children with Constitutional Tall Stature from Birth to Age 9 Years
Authors: DICKERMAN Z. , LOEWINGER J. , LARON Z.
Published: January 2008

A study was made of the longitudinal growth pattern of 29 girls and 36 boys with constitutional tall stature (CTS) from birth to age 9 years. In these children, all of whom had a normal birth length, there was very rapid growth during the first 4 years of life, following which growth velocity dropped to normal and remained parallel to the 50th percentile. In the 49 subjects for whom actual final height was also obtained there was a very good agreement between this and the final height as predicted by Tanner's method from the height at ages 4 and 8 years. Significant differences were found between the mean maternal, paternal and mid‐parental height and the tall stature of their offspring, but there was a very good correlation between the individual patients final height and their parental heights. The findings of this study stress the importance of periodical measurements of length and height in all children during the first few years of life so as to have appropriate data on which to base future considerations of possible therapy.
A Prospective 12‐Year Follow‐up Study of Children with Wheezy Bronchitis
Authors: FOUCARD T. , SJÖBERG O.
Published: January 2008

Eighty children with wheezy bronchitis were followed prospectively for 12 years. At the end of the follow‐up period only 22 (28 %) still had symptoms of asthma. Forty‐three children (54 %) had ceased to wheeze before the age of 3 years, four children between 3 and 7 years of age and 11 children between 7 and 11 years of age. Of the 22 children who still had asthma, all but one were much improved, although 70 % of them noticed asthmatic symptoms during exercise. Heredity for asthma/wheezing, allergy, the occurrence of eczema, and onset of wheezing after 18 months of age were associated with an increased risk of persistent asthma. Allergy had developed in 59 % of the children with persistent asthma and in 10 % of those who had stopped wheezing. Serum IgE was above the mean +1 SD in 45 % and above the mean +2 SD in 24 % of the children at the end of the 12‐year follow‐up. A serum IgE above the mean +2 SD was found in 8 of 13 children with asthma combined with proven allergy, but only in 1 of 9 children with asthma without allergy. Surprisingly, 8 of 48 children who had stopped wheezing and had no clinical allergy had as high IgE levels as the children with asthma and allergy, which reduced the allergy predictive value of a high serum IgE to 36 %. Some of these high IgE levels seemed to be a family trait.
The Incidence of Congenital Malformations in Various Socioeconomic Groups in Sweden
Authors: ERICSON A. , ERIKSSON M. , ZETTERSTROM R.
Published: January 2008

The incidence of congenital malformations reported to the Register of Births during 1976–77 in various socioeconomic groups were studied combining the informations from the birth register with that from the 1975 census (including occupation of the mother, income of the family, type of family and housing standard). The total population of 190 024 infants were divided into three groups; 6915 infants (3.6 %) were assigned to the most privileged group (group I) and 26430 (13.9 %) to the less privileged group (group III). The total incidence of 5.01 % of any malformation did not differ significantly between the groups. Neither was any variation found for specific malformation types, such as neural tube defects, cleft palate or morbus Down
Elevated Serum Vitamin B12 in Cystic Fibrosis
Authors: LINDEMANS J. , ABELS J. , NEIJENS H. J. , KERREBIJN K. F.
Published: January 2008

ABSTRACT. In 62 patients with cystic fibrosis the serum vitamin B12 concentration ranged from 160–2 600 pmol/l with a mean of 1105 pmol/l. Both vitamin B12‐binding proteins in the serum, transcobalamin II and R‐binders, carried increased amounts of vitamin B12, but showed relatively normal levels of unsaturated vitamin B12‐binding capacity. This combination is rather typical for hepatic dysfunction, although the recurrent pulmonary infections might exert an upward effect on plasma R‐binder concentration through increased turnover of myeloid cells. A significant positive correlation between transcobalamin II‐vitamin B12 and serum alkaline phosphatase suggests that transcobalamin H‐bound vitamin B12 might be an early indicator of focal biliary cirrhosis, which is known to occur in these patients.
Follow‐up of Children of Insulin Dependent (Type I) and Gestational Diabetic Mothers
Authors: PERSSON B. , GENTZ J. , MÖLLER E.
Published: January 2008

ABSTRACT. Fifty‐three children of insulin dependent (IDM) and 20 children of gestational diabetic mothers (IGDM) representing 80 and 91 %, respectively, of all surviving infants of diabetic mothers born between 1969 and 1972 at Sabbatsberg's hospital, Stockholm, participated in the follow‐up study. The first follow‐up examination was performed when the children had reached approximately 5 years of age and included measurement of height and weight, insulin response to intravenous glucose, and HLA typing. When the children were approximately 11 years old, a search was performed in the national register for type I diabetes in children in order to ascertain the frequency of type I diabetes mellitus in the total series (n=88). The majority of children had a normal height for age and desirable weight for height. At the first follow‐up all children had normal glucose disappearance rates (kt) and the insulin response including the early insulin response to glucose were not different between IDM and IGDM groups. The frequency distribution of HLA antigens (A, B, C) was not different from normal and there was no association between HLA B 8 and/or B 15 and early insulin respone or kt values. At the second follow‐up, two children of type I diabetic mothers had acquired type I diabetes, both were HLA B 15 positive, had normal kt values at the first follow‐up, one with low, one with a high early insulin response. The frequency of type I diabetes in offspring of insulin dependent diabetic mothers was 3%.
Evidence of Circulating Interferon‐γ in Newly Diagnosed Diabetic Children
Authors: TOVO P. A. , CERUTTI F. , PALOMBA E. , SALOMONE C. , PUGLIESE A.
Published: January 2008

ABSTRACT. Acid‐stable interferons (IFN‐α or IFN‐β) are produced by nucleated cells infected by virus, while acid‐labile interferon (IFN‐γ) is synthesized by activated T‐lymphocytes. IFN‐γ or an atypical form of acid‐labile IFN‐α have been observed in the circulation of some patients with autoimmune disease. It is believed that autoimmunity and/or viral infections are involved in the pathogenesis of insulin dependent diabetes mellitus. We therefore examined the sera of newly diagnosed diabetic children for the presence of virus‐induced or acid‐labile IFN. Significant IFN levels (≥8 U/ml) were observed in 11 of 29 patients when compared to 31 healthy children in the same age range. The inhibitor is characterized by species specificity, acid‐lability and neutralization with anti‐serum for IFN‐γ.
Selenium Status of Infants on Nutritional Support
Authors: CAILLIE‐BERTRAND M. VAN , DEGENHART H. J. , FERNANDES J.
Published: January 2008

ABSTRACT. We investigated the selenium status of 5 infants while on nutritional support. After 4 weeks of parenteral nutrition a significant fall in plasma selenium concentrations was observed (mean ± SD: 0.8±0.5 μg/dl; normal for this age: 3.6±0.9 μg/dl). In 1 infant the decline in selenium value occurred simultaneously with a transient rise in transaminases. A parallel but delayed decrease in red blood cell‐glutathione peroxidase activity was seen in 3 patients. After reintroduction of enteral foods, the selenium levels increased progressively to and reached control values after 6 weeks, 4 and 5 months respectively in 3 patients, suggesting that the selenium requirement on TPN was not met. We consider it essential to provide longterm TPN patients with physiological amounts of selenium in order to prevent the progressive development of a deficiency state.
The Influence of Parity, Age and Maturity of Pregnancy on Antimicrobial Proteins in Human Milk
Authors: LEWIS‐JONES D. I. , LEWIS‐JONES M. S. , CONNOLLY R. C. , LLOYD D. C. , WEST C. R.
Published: January 2008

ABSTRACT. Sequential samples of colostrum, transitional and mature milk from 47 women were investigated to determine the concentrations of US IgA, IgG, IgM, α1, ‐antitrypsin, lactoferrin, lysozyme, B,A globulin (C3) and B,E globulin (C4) by single radial immunodiffusion. These were all found to be high in colostrum with a decline in concentration as lactation proceeds although a wide variation in concentration was noted between different individuals at any given post‐partum time interval. For each time interval considered, parity, age and maturity of pregnancy did not appear to influence significantly the variation in protein concentrations. Statistical analyses of the results obtained from samples taken during the first four days of lactation, when protein concentrations were highest, showed that parity and age did influence the variation in antimicrobial protein concentrations when examined using an analysis of variance but significantly higher concentrations of protective proteins were not consistently seen in the milk from any one or more parity or age groups. Mean concentrations of all proteins excluding IgA were found to be greater in those women delivering before their expected date of confinement during the first four days of lactation. This was statistically signficant for C3 and C4 and approaching significance (p<0.08) for α1‐antitrypsin.
Circulating Immunoreactive Parathyroid Hormone Levels in Premature Infants and the Response to Calcium Therapy
Authors: COOPER LINDA J. , ANAST CONSTANTINE S.
Published: January 2008

ABSTRACT. Serum immunoreactive parathyroid hormone (iPTH), calcium, magnesium, and phosphorus levels were measured in 13 premature infants during the first 96 hours of life. Hypocalcemia at 12–24 hours of age was associated with a markedly elevated mean serum iPTH level. Six of the hypocaicemic infants received a continuous infusion of calcium while seven were not treated. In the untreated infants, the mean serum calcium remained in the hypocaicemic range while the serum iPTH progressively increased. By contrast, the mean serum calcium in the treated infants increased to 2.35 mmol/l at 96 hours of age and was accompanied by a decline in serum iPTH. At 72 and 96 hours, the mean serum iPTH was twofold greater in the untreated than in the treated infants. The results indicate that the parathyroid glands of premature infants respond to calcium signals and that a factor(s), other than parathyroid insufficiency, plays an etiologic role in the hypocalcemia of prematurity.
Silent Seizures in Sick Infants in Early Life
Authors: HELLSTRÖM‐WESTAS L. , ROSÉN I. , SWENNINGSEN N. W.
Published: January 2008

ABSTRACT. Cerebral electric activity was surveilled with a Cerebral Function Monitor (CFM) technique in 87 newborn infants under neonatal intensive care. A total of 26 infants had electrographical signs of repeated seizure activity. Among these infants 14 had periods of one hour or more of silent seizures, i.e. typical pattern of ictal epileptic activity on CFM without clinical symptoms or signs of convulsions. The occurrence of silent seizures and their pattern in relation to the clinical condition and management was unpredictable in most cases. Besides general limpness or flaccidity in an outward quiet baby these infants showed no clinical fits or clonic convulsions. The findings indicate that anticonvulsive therapy in small infants may be insufficient and need re‐evaluation, since the long‐term effect of silent seizures on cerebral function and activity is still uncertain.
Cardiac Rhabdomyomas in a Newborn Baby
Authors: PESONEN ERKKI , LEIJALA MAURI , JÄRVENPÄÄ ANNA‐LIISA , TERAMO KARI
Published: January 2008

ABSTRACT. Cardiac tumours are rarities in newborn infants. The majority of them are rhabdomyomas as a manifestation of the basic disease‐tuberous sclerosis. The clinical picture may vary from serious arrhythmias to A‐V valve obstruction and gross myocardial dysfunction. Therefore these patients are extremely poor candidates for invasive diagnostic procedures and surgical treatment. Our patient had intrauterine cardiac arrhythmias, and a prenatal echocardiogram showed features of A‐V septal defect malformation. Therefore the echocardiogram was repeated soon after birth and it revealed intracardiac tumours. The patient was operated on the first day of life and four intracavitary tumours were successfully removed.
Neonatal Jaundice and Fatty Acid Composition of the Maternal Diet
Authors: UHARI M. , ALKKU A. , NIKKARI T. , TIMONEN E.
Published: January 2008

ABSTRACT. The role of serum fatty acid composition in neonatal jaundice was studied by comparing the incidence of jaundice among 332 newborn infants receiving breast milk from mothers on a diet with either a low (0.1, n=145) or a high (1.5, n=187) polyunsaturated to saturated fatty acid (P/S) ratio. The diet was started immediately after delivery. The composition of fatty acids in the breast milk and sera of the mothers and in the sera of the newborns was evaluated from a random sample of 15 mother‐newborn pairs on the control diet (low P/S ratio) and 19 pairs on the experimental diet. Five days after delivery the relative amounts of fatty acids, especially that of linoleate, in the sera of the mothers differed significantly depending on the diet. Differences were also observed in breast milk samples taken three, four or five days after delivery and in the sera of the newborns sampled at the age of four or five days. Nine of the 145 newborn infants (6.2 %) in the control group had to be treated with light therapy compared with 12 out of 187 (6.4 %) of the newborn infants in the experimental group (high P/S ratio). Serum bilirubin concentrations were 142.5 μmol/l (SD 65.8) and 140.7 μmol/l (SD 73.5) in the experimental and control groups, respectively, at the age of five days. It appears that the changes in the composition of serum fatty acids reached in this study had no effect on the neonatal jaundice.
Lacteal Zinc and Copper in Relation to Volume, Total Ash and Energy during the First Three Months of Lactation of Brazilian Women
Authors: DOREA J. G. , HORNER M. R. , CAMPANATE M. L.
Published: January 2008

ABSTRACT. The concentrations of zinc and copper were longitudinally studied during the first three months of self‐determined lactation periods of nine Brazilian women. Both elements were studied in relation to volume, energy and total ash of milk. During the six bi‐weekly intervals, zinc showed a significant difference between the high initial value (as mass/volume), mass/g of ash and mass/kcal) and later values toward the end of the third month, but no significant difference was observed for copper. With respect to all three of those parameters, regression analysis of zinc against length of lactation (six bi‐weekly intervals) showed a significant and inverse correlation. Only when expressed as mass/g of ash was copper significantly and directly correlated with length of lactation. The data indicate that zinc secretion into human milk occurs independently of copper and mineral mass and also follows a previously identified physiological pattern.
Blood Pressure Responses to Care Procedures in Ventilated Preterm Infants
Authors: OMAR S. Y. , GREISEN G. , IBRAHIM M. M. , YOUSSEF A. M. , FRIIS‐HANSEN B.
Published: January 2008

ABSTRACT. Responses of mean aortic blood pressure to sequences of routine care procedures in 22 ventilated, preterm infants were studied daily for the first 3 days of life. In the first 11 infants standard care procedures were used, whereas the next 11 infants were preoxygenated by a preceding 10% increase in inspired oxygen concentration; in these infants, chest physiotherapy was entirely omitted while the frequency of endotracheal suctioning was reduced. A total of 259 blood pressure responses were recorded. In general, responses were biphasic, consisting of an initial blood pressure drop followed by a greater blood pressure rise of longer duration. Baseline blood pressure, as well as the minimum and maximum blood pressure during the care procedures, increased with gestational age and with postnatal age. The blood pressure drop was most pronounced in the infants requiring the most intensive ventilatory support and was reduced by modifying the care procedures. The blood pressure rise was the least in the infants receiving pancuronium and phenobarbitone. Eight infants, 4 in each group, had intraventricular haemorrhage; in these infants, the care procedures induced more pronounced blood pressure drops in the first day of life when compared to the infants without haemorrhage.
Pyruvate‐Carboxylase Deficiency with Urea Cycle Impairment
Authors: GRETER J. , GUSTAFSSON J. , HOLME E.
Published: January 2008

ABSTRACT. We report a case of pyruvate‐carboxylase deficiency (EC 6.4.1.1, McKusick 26615) with neonatal onset of lactic acidosis, hyperammonemia, and citrullinemia. The patient developed signs of severe liver damage and died at 13 days of age after increasing metabolic acidosis and severe bleedings. The pyruvate‐carboxylase activity in fibroblasts was less than 1% of controls, but normal activities of propionyl‐CoA carboxylase (EC 6.4.1.3) and 3‐methylcrotonyl‐CoA carboxylase (EC 6.4.1.4) were found. To prepare for early prenatal diagnosis of pyruvate‐carboxylase deficiency, the activity of the enzyme has been measured in chorionic villus samples
Evaluation of the measurement of children's blood pressure in an epidemiological multicentre study
Authors: UHARI M.
Published: January 2008

ABSTRACT. Reliability and repeatability of blood pressure (BP) measurements performed by both a local nurse and a control nurse visiting all five study areas in the Finnish Multicentre Study were analysed. As an objective control, Rose's tape recordings were played at least three times during the study period to each nurse. It was found that the nurses differed from each other with variations of 2.5 mm Hg, 54.6 mm Hg and 17.9 mm Hg in the recordings of systolic, diastolic Korotkoff's IV (KlV) phase and diastolic KV phase sounds respectively, in assessing the tape. Correlation coefficients between the systolic BP and diastolic BP measurements made by the local and control nurses in 3‐year‐old children varied from 0.10 to 0.72 and from –0.16 to 0.46 respectively. Correlation coefficients in 6–18‐year‐old subjects between systolic, diastolic KIV and diastolic KV BP measurements made by the control and local nurses varied from 0.69 to 0.81, from 0.42 lo 0.63 and from 0.38 to 0.58 respectively. All of the fiurses had a significant terminal digit preference and it was pronounced in two of them. Because of these findings it was concluded that comparisons of BP values in different areas should be done cautiously.
Atherosclerosis precursors in Finnish children and adolescents. IV. Serum lipids in newborns, children and adolescents
Authors: VIIKARI J. , ÅKERBLOM H. K. , NIKKARI T. , SEPPÄNEN A. , UHARI M. , PESONEN E. , DAHL M. , LÄHDE P.‐L. , PIETIKÄINEN M. , SUONINEN P.
Published: January 2008

ABSTRACT. A multicentre study on atherosclerosis precursors in Finnish children and adolescents was carried out in five urban and 12 rural areas in the autumn of 1980 and spring of 1981. Serum lipids, i.e. cholesterol (TC), HDL‐cholesterol (HDL‐C) and triglyceride (TG) concentrations were determined and LDL‐cholesterol (LDL‐C) was calculated in 630 newborns and 3,596 children aged 3, 6, 9, 12, 15 and 18 years. In the newborns the mean serum TC concentration was 1.50 mmol/l, and the ratio of HDL‐C to TC was 0.44. Newborn boys had lower mean TC, HDL‐C and LDL‐C values than the girls. In 3 to 18‐year‐old children the mean TC, LDL‐C and HDL‐C concentrations were 4.83 mmol/l, 3.09 mmol/l and 1.38 mmol/l, respectively. During puberty, TC mean values decreased, more so in boys. The serum levels of HDL‐C also decreased, especially in boys, and after passing puberty boys had lower mean HDL‐C levels than girls (1.26 vs. 1.39 mmol/l, p<O.OOl). The HDL‐C/TC ratio was similar in all age groups (0.29). The mean TG value increased with age, being 0.88 mmol/l at the age of 18 yr. During sexual maturation, TG levels increased, more clearly in boys. There were no regional differences in serum lipid concentrations in the newborns, but in 3‐ to 18‐year‐old children the mean TC, LDL‐C and TG values were lower in western than in eastern Finland. Mean TC and LDL‐C values were lower in urban than in rural areas, but there was no difference in TG concentrations. The percentages of children aged 3–18 years having serum cholesterol values above 4.0, 5.0, 6.0, and 7.0 mmol/l were 84.5, 38.5, 8.1 and 1.0 % respectively.
Atherosclerosis precursors in Finnish children and adolescents. IX. Socioeconomic status and risk factors of coronary heart disease
Authors: BYCKLING T. , ÅKERBLOM H. K. , VIIKARI J. , LOUHIVUORI K. , UHARI M. , RÄSÄNEN L. , SUONINEN P. , PIETIKÄINEN M. , PESONEN E. , LÄHDE P.‐L. , DAHL M. , DAHLSTRÖM S. , AROMAA A. , PYÖRÄLαÄ K.
Published: January 2008

ABSTRACT. Relationships between parental Socioeconomic status and CHD risk factors were examined in the Finnish Multicentre Study on Atherosclerosis Precursors comprising a material of 3,596 study subjects aged 3–18 years in five university cities and 12 rural communes. The work is based on the hypothesis that Socioeconomic status has associations with important lifestyle factors related to the evolution of CHD risk factors. Although there is some indication that parental status variables correlate with CHD risk factors, the majority of the data point to the conclusion that Socioeconomic status indicators have little relevance for children's CHD risk factor levels. The main exceptions to the above stated were the lower P/S ratio of the diet in farmers’children compared to the other Socioeconomic groups in all age cohorts, and the higher serum total and LDL‐cholesterol levels in the farmers’children as compared to the others in some age cohorts. The explanation to these findings is the dietary practice in farmers’households, full milk and butter being favoured instead of other milk types and vegetable margarine, respectively. Our findings illustrate the importance of the families’dietary habits with regard to certain CHD risk factors.
Atherosclerosis precursors in Finnish children and adolescents. XII. Smoking behaviour and its determinants in 12–18‐year‐old subjects
Authors: BYCKLING T. , SAURI T.
Published: January 2008

ABSTRACT. The cross‐sectional study of 1980 for atherosclerosis precursors in Finnish children and adolescents aimed at a wide coverage of the relevant relationships of the smoking behaviour to Socioeconomic and psychoSocial factors. The initiation and establishment of the smoking habits were primarily viewed as a function of the youngsters’main Socializing agents: the peer group and the family.

A subpopulation comprising 1,790 children and adolescents aged 12, 15 and 18 years of the total sample was included in the study on smoking behaviour. The information on smoking habits was collected in connection with the medical examination in a solitary room where the youngsters could respond undisturbed. Data on the children's families were obtained by means of a general questionnaire filled out by the parents.

The prevalence of daily smoking was 1 % in the 12‐year‐old, 10 % in the 15‐year‐old, and 30 % in the 18‐year‐old subjects. The best friend's behaviour was the best predictor of an adolescent's smoking behaviour, although the family had retained its role as an important model as regards the learning of smoking behaviour. Quitting school turned out to be a major event leading to an increased risk of becoming a habitual smoker. No clear associations between Socioeconomic status of the family and daily smoking were found, except that farmers’children had generally lower rates of daily smoking than children from other Socio‐economic groups. First contacts with tobacco formed part of a normal behaviour pattern at a certain age, and this experimentation was unrelated to a later regular habit. Smoking seemed to become part of a more general health behavioural pattern after the age of 15 in a young person's life.
Possibilities of a preventive approach to coronary heart disease starting in childhood
Authors: PUSKA PEKKA
Published: January 2008

ABSTRACT. Promotion in youth of lifestyles that are likely to result in optimum levels of cardiovascular risk factors is the basis for early prevention of cardiovascular diseases and promotion of health. Health behaviour is closely linked to the general lifestyle of any community. Thus for any long‐term major change, a community‐based approach is essential. Experience from the North Karelia project indicates that through a comprehensive community‐based programme, health behaviour and risk factor levels of a whole country could be changed, and that resulted in reduction of coronary heart disease (CHD) in the area. Studies among children carried out as part of the North Karelia project have shown that children's smoking rates and nutrition habits can be influenced and their serum cholesterol levels can be modified. At least in Finland, family‐based practical counselling and provision of Social support seems to be an effective strategy in changing the nutrition habits of both adults and children. No evidence has been observed to indicate that this type of intervention would have any harmful emotional consequences among children. A study to show the impact of risk factor modification on coronary heart disease risk in adulthood is hardly feasible and, instead, studies to test the feasibility and effects of different intervention approaches for influencing health related behaviour and risk factors in children and adolescents should be emphasized.
Zinc in the Fetus and Newborn
Authors: SIMMER KAREN , THOMPSON R. P. H.
Published: January 2008

ABSTRACT. The growing fetus and infant are at risk of becoming deficient of zinc, an adequate supply of which is essential for normal growth and development. Mild maternal zinc depletion was strongly associated with intrauterine growth retardation. Low levels of zinc in maternal plasma and poor placental perfusion reduced the materno‐fetal transfer of zinc. Mean maternal dietary intake of zinc was 60% recommended daily allowance and mothers of small‐for‐gestational‐age (SGA) babies consumed significantly less zinc than mothers of appropriate‐for‐gestational‐age babies. In addition, iron/folate supplements, which are often routinely prescribed during pregnancy, despite dietary intakes of iron and folate being adequate, significantly decreased the oral bio‐availability of zinc in pregnant women. Zinc supplementation may be beneficial to women at risk of delivering SGA babies. Zinc requirements and interactions are also important to consider when designing mineral supplements for preterm babies, infant formulae and food fortification in developing countries.
Mechanisms of Pancreatic B‐Cell Degeneration during the Course of Insulin‐dependent Diabetes Mellitus
Authors: SANDLER STELLAN , WELSH NILS
Published: January 2008

ABSTRACT. This paper presents a review of different mechanisms possibly responsible for the degeneration of the pancreatic B‐cell in insulin‐dependent diabetes mellitus. The genetic dependence probably located in the HLA DR‐locus of the sixth chromosome and its role in an autoimmune reaction against antigenieally altered pancreatic B‐cells is discussed. The actions of alloxan and streptozotacin in the induction of experimental diabetes, as models for postulated human B‐cytotoxins, are described.
Platelet Aggregation during the First Year of Diabetes in Childhood
Authors: KOBBAH M. , EWALD U. , TUVEMO T.
Published: January 2008

ABSTRACT. Platelet aggregability in 24 newly diagnosed diabetic children was investigated on five occasions from onset of the disease until one year after diagnosis. Twenty healthy children of similar age and sex served as controls. The magnitude of the platelet shape change after adenosine diphosphate (ADP) stimulation was decreased in diabetic children on admission (p<0.05) in comparison with controls but normalized during the year of the study. Maximal aggregation and initial rate of aggregation after ADP stimulation did not change significantly during the study year, and did not differ from those in controls. Aggregation by low dose collagen (0.5 and 1.0 mg/l) increased significantly (maximal aggregation, p<0.01; aggregation velocity, p<0.001) in the diabetics during the first year after admission from seemingly normal to clearly supranormal. Aggregation induced by high‐dose collagen (5.5 mg/l) remained unchanged during the observation period and did not differ from that in the control group. No correlations were found between the indicators of platelet aggregation and those of carbohydrate control at any time after diagnosis. Platelet dysfunction is thus present already during the first year of diabetes. The different time courses of the ADP‐induced platelet shape change and collagen‐induced aggregation imply that the mechanisms underlying the abnormalities of these two platelet functions differ.
Obstetric Care in Diabetic Pregnancy
Authors: TYDEN OLOF , BERNE CHRISTIAN
Published: January 2008

ABSTRACT. In diabetic pregnancy near‐normalization of maternal blood glucose levels improves the perinatal outcome. Strict metabolic control can be achieved by self‐monitoring of blood glucose in ambulant praxis. The obstetric supervision may now therefore be organized on an out‐patient basis aiming at early recognition of pregnancy complications such as preeclampsia and deviation in fetal growth. For uncomplicated and well‐controlled diabetes without vascular complications the obstetric care should be individualized and routine programmes for obstetric surveillance, such as fetal heart rate monitoring and determination of fetal maturity, are usually not necessary. Special attention should, however, be paid to patients with poor metabolic control or vascular complications, particularly in the presence of disturbances of intra‐uterine growth.
Children of Alcoholic Mothers: Growth and Motor Performance Compared to Matched Controls
Authors: KYLLERMAN M. , ARONSON M. , SABEL K.‐G. , KARLBERG E. , SANDIN B. , OLEGÅRD R.
Published: January 2008

ABSTRACT. Twenty‐one children born 1970‐76, selected from 103 children of 30 alcoholic women, were paired to controls matched for sex, age, birth weight and gestational age. The sample (10 girls, 11 boys) was representative of the whole group with regard to weight, length and head circumference at birth. At follow‐up (mean age 70 months) the study group was significantly leaner, shorter and had smaller mean head circumference than the control group. The controls had significant catch‐up growth from birth to follow‐up of weight, height and head circumference to the mean for Swedish children. The study group had no catch‐up growth. Compared to controls the study group had significantly lower fine and gross motor age test scores and inferior coordination. One child had cerebral palsy (spastic hemiplegia) and in 6 other children slight tremor and ataxia were observed. Malformations and/or other signs of the fetal alcohol syndrome (FAS) were found in 10 cases. Study group children with FAS had significantly slower growth of head circumference than others without FAS. Children placed in foster home care (n=11) were found to have significantly (p<0.05) lower birth weight, birth length and head circumference than children raised at home (n=10). There were no significant differences at follow up between study group children raised in foster homes or in homes of their biological mother.
Breast‐feeding and Social Factors
Authors: STÅHLBERG M.‐R.
Published: January 2008

ABSTRACT. Information about every tenth child aged 14 to 38 months was collected by means of a questionnaire in Turku, Finland in March, 1983. This paper reports on duration of breastfeeding and its relation to social factors. The average duration of breast‐feeding was 5.7 months. Length of breast‐feeding was unaffected by sex, number of siblings, and birth order among siblings. The socioeconomic status of the father was associated with duration of breastfeeding: children in high status families were breast‐fed longer than children in low status families. Mothers with occupations in the health service, education, and the social sector breast‐fed longer than mothers in other occupations. Mothers who were working at the time of the study had breast‐fed longer than housewives. For further promotion of breast‐feeding, information must be made more effective in the lower social groups and among fathers.
The Composition of the Faecal Microflora in Breastfed and Bottle Fed Infants from Birth to Eight Weeks
Authors: LUNDEQUIST B. , NORD C. E. , WINBERG J.
Published: January 2008

ABSTRACT. Recent technical advances have improved the possibilities to classify anaerobic bacteria. The aim of the present study was to examine the validity of the time‐honoured opinion that the faecal flora is dominated by bifidobacteria in breastfed infants but not in bottle fed ones. The compositon of the faecal flora of 15 breastfed and of 7 bottle fed infants was followed from birth to 8 weeks. Strictly anaerobic conditions were carefully applied. At 5 days and 3 weeks the incidence of Staph, epidermidis was significantly greater in the breastfed group compared to the bottle fed one. We were unable to confirm earlier reports of difference in the anaerobic flora between breastfed and bottle fed infants. In both feeding groups Bacteroides dominated among the anaerobic bacteria and bifidobacteria occurred in less than half of the faecal specimens. The results of the study add to other recent observations that it has been increasingly difficult to demonstrate bifidobacteria in babies delivered in large, urban hospitals. We found different frequencies of bifidobacteria in infants from different wards, suggesting the importance of environmental factors in gut colonization after delivery.
Accidents in Childhood: from Epidemiology to Prevention
Authors: MANCIAUX M. R. G.
Published: January 2008

ABSTRACT. The overwhelming importance of accidental injuries, deaths and disabilities in children and adolescents is no longer a “privilege” of the industrialized world: many developing countries are now facing a tremendous increase in accidents in the young. A sound epidemiological knowledge of accidents is a prerequisite for any preventive programme: it is based on hospital or community surveys, in which the epidemiological approach seems more meaningful than the clinical one. The conditions to be fulfilled are reviewed in the light of several WHO publications. Finally, some preventive strategies are presented, based on models more and more currently used in planning for prevention. The role of paediatricians, either individually or through their professional associations, is emphasized
Bone Mineral Content in Preterm Infants at Age 4 to 16
Authors: HELIN INGEMAR , LANDIN LENNART A. , NILSSON BO E.
Published: January 2008

Using photon absorptiometry the forearm bone mineral content (BMC) was determined in 75 children aged 4 to 16, who all had a low birth weight. Forty‐five of them were born preterm AGA (27 boys, 18 girls, mean weight 1580 g; range 920‐2060 g) and 30 preterm SGA (17 boys, 13 girls, mean weight 1510; range 940‐2130 g). The results were compared with a control group of children of the same age, and analyses of covariance with age, height and weight as the covariant factors were performed. The BMC, weight and height did not differ between the children born AGA or SGA. Irrespective of AGA or SGA, the BMC was significantly decreased in boys but the difference was less pronounced and less significant when height and weight were used as covariant factors. Boys who had been born preterm had a less BMC than the control boys for their age but the were also somewhat shorter and lighter than expected with regard to their age.
A 13q‐ Syndrome with Extensive Intestinal Atresia
Authors: NISHIKAWA A. , MITOMORI T. , MATSUURA A. , INOUE A. , MORI H. , TAKAHASHI M.
Published: January 2008

ABSTRACT. The first autopsy case of a 13q‐ syndrome with extensive intestinal atresia, viz., absence of almost the entire jejunum and ileum, is reported. The absence of the mesentery and the histological properties of the intraperitoneal string‐structures composed of some muscle layers resembling the tunica muscularis of the alimentary tract suggest that one of the causative agents of the atresia may be abnormalities of mesenteric vessels.
Intrathecal Administration of Human Leukocyte Interferon to a Patient with Subacute Sclerosing Panencephalitis
Authors: NAKAGAWA M. , MICHIHATA T. , YOSHIOKA H. , SAWADA T. , KUSUNOKI T. , KISHIDA T.
Published: January 2008

ABSTRACT. An eight‐year‐old boy with subacute sclerosing panencephalitis was treated with human leukocyte interferon (HuIFN‐α) by intravenous and intrathecal injections. We observed some remarkable improvements in his clinical course.
A 5‐year Prognosis of Childhood Asthma
Authors: LINNA O.
Published: January 2008

ABSTRACT. A series of 207 asthmatic children aged 4‐10 years studied during the years 1976‐1978 were called for a follow‐up study 4‐6 years later. Of these, 53 (26 %) children were completely symptom‐free and 154 still had symptoms. The proportion of symptom‐free patients was highest (45 %) among those having attacks only during respiratory infections. The prognosis was worsened by such factors as a high rate of attacks, an association with eczema and a history of otitis media or adenoidectomy. The clinical picture of disease among children having attacks only during respiratory infections (wheezy bronchitis) was distinctive from that in asthma and may be separated as its own entity. Subgrouping of childhood asthma is beneficial for a clinician when considering the intensity of therapy or the need for controls.
Tay‐Sachs Disease Associated with Precocious Puberty
Authors: TANAKA T. , LIN K. , TSUCHIDA M. , INUI M. , YOSHIHARA S. , KOBAYASHI F. , HARA M.
Published: January 2008

ABSTRACT. A girl with Tay‐Sachs disease developed enlargement of the mammary glands at the age of 4 years and menstruation at the age of 6 years. It was demonstrated that the precocious puberty in this patient was due to the hypersecretion of gonadotropins.