bluuebunny/crossref_metadata_2025_split huggingface dataset:
19. NEW APPROACHES TO THE DELIVERY OF HEALTH CARE TO ADOLESCENTS
Authors: MILLAR HILARY E. C. 
Published: January 2008

ABSTRACTAdolescents are a new population group showing certain common characteristics which transcend the confines of geography, economics, education, culture and race. Certain health problems have emerged which are closely related to the life style of teenagers. These health needs are not met by existing health care delivery systems, and future planning must take into account the morals of young people. At present there is no unified approach to the development of health care programs for adolescents, but important explorations of effective methods are taking place in a fragmentary way. The challenge is to provide the necessary technology and professional expertise in an accessible setting and then to weld these services into programs which will become cohesive and stable.Analyses of data show that adolescents seek help more often for primary and preventive care than for serious ilnesses. Services are particularly needed for addictive problems, emotional disorders, suicidal states, and conditions related to sexual activity. Consideration of the effect of adolescent behavior on the reproductive cycle is of the utmost importance. These sequelae of conception and veneral disease can be extremely serious for the immature girl and her baby. Therefore the opportunity for birth control, health education, abortion and prenatal care for teenagers should be priority goals in any program for adolescents. The provision of services for the young mother and her baby should be included in the overall plan.New approaches in the ambulatory care of adolescents include an age‐specific operation, satellite clinics with hospital backup, and the inclusion of young people in the planning of services. Care should be comprehensive and continuous, and a multi‐disciplinary staff team would permit a more effective approach. The involvement of other teenagers as assistants in counseling has been found an effective method of communication; this relationship may bridge the generation gap when highly personal experiences must come to the surface.Financial and legal barriers should be removed so that care is available to all. Social systems which affect the adolescent should coordinate their activities at all levels. Examples of some innovative methods are available. The ideal approach to health care delivery for adolescents is not yet established; but it must obviously do more than merely cope with a series of crisis oriented episodes. A recognition of underground self‐help methods is needed, even if in the last analysis these methods are found to be irrelevant and are discarded. The health of teenagers automatically and immediately affects the wellbeing of the following generation. No effort to improve the situation should be spared.
HOW TO APPROACH THE CHILD SUSPECTED OF MALABSORPTION Experience from a Prospective Investigation of Suspected Malabsorption in Children 1968–1976 in Malmö
Authors: BERG N. O. , BORULF S. , JAKOBSSON I. , LINDBERG T. 
Published: January 2008

ABSTRACT. 180 children (mean age 20 months) suspected of malabsorption because of failure to thrive, abnormal stools more than 3 weeks, vomiting, an/or abdominal distension were investigated with peroral small intestinal biopsy at duodeno‐jejunal flexure (172 children) and/or duodenal intubation for analysis of trypsin and amylase activity in duodenal juice before and after a test meal of water (76 children). Results of xylose tolerance test, lactose tolerance test, faecal fat, B‐folate, S‐iron, and S‐albumin were related to morphology of mucosa. A normal finding of one of these tests means in 15–26% a normal mucosa (diagnostic sensitivity). An abnormal finding means in 40–85% a severely damaged mucosa and in 85–100% a slightly, moderately, or severely damaged mucosa (diagnostic specificity). Combinations of these tests increase the diagnostic sensitivity 10–15%. Faecal chymotrypsin seems to be a reliable screening test for exocrine pancreatic function. Border values or low values indicate a direct evaluation of exocrine pancreatic function. The simple test meal (water) method with determination of trypsin in duodenal juice gives, from a practical point of view, good information of the exocrine pancreatic function.The following plan of investigation is proposed: Step 1. careful clinical history and examination; Step 2. analysis of faeces for Giardia lamblia, entero‐pathogenic microorganisms, and chymotrypsin, sweat test; Step 3. peroral small intestinal biopsy and/or duodenal juice analysis, and finally—if steps 2 and 3 give normal results; Step 4. re‐evaluation of dietary history and tests to detect any food intolerance (e.g. carbohydrate).
CLINICAL SYMPTOMS AND COMPLICATIONS OF WHOOPING COUGH IN CHILDREN AND ADULTS
Authors: Riitta Huovila 
Published: January 2008

Clinical symptoms of whooping cough were observed in 100 children and 16 adults who fell ill in 1976–1977 during two whooping cough epidemics and as sporadic cases. The diagnosis of all patients was confirmed by positive Bordetella pertussis cultures.All unvaccinated children (13/13 = 100%), most of whom were less than one year old, showed typical whooping cough. The vaccinated children were one to 15 years old. Of these, 37/87(43% developed typical, 43/87(49%) atypical, and 5/87(6%) abortive whooping cough and 2/87(2%) were symptomless bacteria carriers. The adults, who were parents of these children, had their second attack of whooping cough. The clinical course was typical in 4/16(25%) and atypical in 7/16(44%), while 3/16(19%) showed abortive whooping cough and 2/16(13%) were symptomless bacteria carriers.Children aged six months or less showed leuco‐ and lymphocytosis, whereas vaccinated children 5–15 years old exhibited no changes of the white cell count.The erythrocyte sedimentation rate was generally normal. The most common complication was pneumonia in unvaccinated children (14/35 = 40%) and otitis media in vaccinated children (9/91 =10%).
Daily Subcutaneous Administration of Human Growth Hormone in Growth Hormone Deficient Children
Authors: ALBERTSSON‐WIKLAND KERSTIN , WESTPHAL OTTO , WESTGREN ULF 
Published: January 2008

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

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

ABSTRACT.Vanderschueren‐Lodeweyckx, M., Van den Broeck, J., Wolter, R. and Malvaux, P. (Department of Paediatric and Adolescent Endocrinology, University of Leuven, Department of Paediatrics, University of Brussels and Department of Paediatrics, University of Louvain, Belgium). Early initiation of growth hormone treatment: influence on final height. Acta Paediatr Scand [Suppl] 337:4, 1987.Retrospective growth data for 34 hGH deficient patients who had been treated for at least 3 years with hGH were analysed in a Belgian multicentre study. Final height was related to target height and was usually below it, hut it was not determined by chronological or bone ages, bone age delay, height velocity before or during therapy, nor by duration of treatment. Total height gain during long‐term substitution with hGH is inversely related to chronological and hone ages at the start of therapy, and is positively related to the duration of therapy. Early diagnosis of hGH deficiency is thus important, as it allows catch‐up growth to optimal height before puberty, which in turn results in a good pubertal growth spurt.
Comparison of Short‐term Lower Leg Growth with Statural Growth in Children Treated with Growth Promoting Substances
Authors: WIT J. M. , TEUNISSEN D. M. , WAELKENS J. J. J. , GERVER W. J. 
Published: January 2008

ABSTRACT.Wit, J. M., Teunissen, D. M., Waelkens, J. J. J. and Gerver, W. J. (Departments of Paediatrics of the University Hospital for Children and Youth, Utrecht, Catharina Hospital, Eindhoven and University Hospital, Maastricht, The Netherlands). Comparison of short‐term lower leg growth with statural growth in children treated with growth promoting substances. Acta Paediatr Scand [Suppl] 337:40, 1987.Lower leg growth was determined by knemometry in 11 children with short stature, before and during therapy with growth promoting drugs. The growth response of lower leg length was determined by comparing growth velocities over periods of 6 weeks. The growth response of total body height was determined by comparing the growth velocity during 3 months of therapy with the growth velocity over 1 year before therapy. Significant knemometric growth responses were always associated with positive height responses, hut smaller knemometric responses were associated with positive as well as negative height responses.
Urine Growth Hormone Determinations Compared with Other Methods in the Assessment of Growth Hormone Secretion
Authors: OKUNO AKIMASA , YANO KOICHI , ITOH YOSHIYA , HASHIDA SEIICHI , ISHIKAWA EIJI , MOHRI ZEN‐ICHI , MURAKAMI YOSHIAKI 
Published: January 2008

ABSTRACT.Okuno, A., Yano, K., Itoh, Y., Hashida, S., Ishikawa, E., Mohri, Z‐I. and Murakami, M. (Department of Paediatrics, Asahikawa Medical College, Hokkaido; Medical College of Miyazaki, Kiyotake, Miyazaki; and Research and Development Division, Sumitomo Pharmaceuticals Co Ltd, Hyogo, Japan). Urine growth hormone determinations compared with other methods in the assessment of growth hormone secretion. Acta Paediatr Scand [Suppl] 337:74, 1987.Urinary excretion of hGH was studied in children with short stature using a sensitive sandwich enzyme immunoassay technique. Urinary hGH excretion, in terms of hGH: creatinine ratio, showed excellent correlation with the mean and peak hGH values during physiological and pharmacological tests. It seems that the urinary hGH levels reflect serum hGH profiles during the urine collection period. A border zone for the lower limits of normal hGH levels in the urine was 7.5–13.4 ng/g creatinine for the physiological test at night (from 2000 hours to 0600 hours) and 17.4–35.0 ng/g creatinine for the pharmacological tests. Assessment of hGH secretory status by the urinary hGH levels showed good agreement with the serum hGH response. Measurement of urinary hGH could be used as a diagnostic test for impaired hGH secretion, and the multiple blood drawing required in physiological and pharmacological tests might be replaced by urine sampling.
Spanish Multicentre Trial on Somatrem (1985–1986)
Authors: VICENS‐CALVET ENRIC , CUATRECASAS‐MEMBRADO JOSEP M. 
Published: January 2008

ABSTRACT.Vicens‐Calvet, E., Cuatrecasas‐Membrado, J. M. and the Spanish Collaboraative Group. (Endocrinology Unit, Children's Hospital Tall ‘d'Hebron’, and Medical Department, KabiFides Peptide Hormones, Barcelona, Spain). Spanish multicentre trial on somatrem (1985–1986). Acta Paediatr Scand [Suppl] 337:126, 1987.In an open multicentre trial, the safety and efficacy of somatrem, 4 IU i.m. three times weekly for 12 months, were evaluated in children with hGH deficiency with or without previous treatment with pituitary hGH. Patients were divided into young and prepubertal groups according to chronological age, and catch‐up growth after treatment was greater in the former. Bone age evolved at the same rate as chronological age, irrespective of whether patients were previously untreated (naïve) or previously treated. Fewer previously treated patients exhibited anti‐hGH antibodies than naive patients. Somatrem appears to be a safe, efficient product for treating different degrees of hGH deficiency.
THE INFANT AS A MEMBER OF SOCETY
Authors: RHEINGOLD HARRIET L 
Published: January 2008

Abstract. An analysis of the social development of the infant and young child offers a salutary view of human nature. To defend that claim I use as an example a recent study of how boys and girls in the second year of life assist their mothers and fathers and other persons in performing some everyday tasks. Although the behavior falls under the rubric of social behavior, it will be examined by the different components comprising it. In turn I consider the social, emotional, cognitive, and motor components of the children's helping and briefly trace their development. Their behavior revealed a well‐developed concept of self and despite the children's immaturity deserved the appellation of prosocial.Although wide differences appeared among pairs of children and parents, no differences were found by sex of child or parent, and no differences by culture are anticipated.No current theory of the development of social behavior encompasses all the facets of the whole child here portrayed as active and perceptive, enterprising and creative, and above all responsive.The parents of this study, as well as those of other studies, such as sharing and care giving, and even obeying, by children in the second year of life, seemed scarcely aware of these socially valued behaviors. In fact, parents, like the rest of us, tend to ignore what goes right and fasten on what goes wrong. Not only a good start to mental health but a better start can come from recognizing and rewarding such behaviors at their onset. If we wait until we think children are ready to be taught them, we pay the penalty of a lost opportunity.At any age children are indeed important members of families, but above all they qualify as members of society by providing a glimpse of what could be accomplished by nurturing the early and spontaneous development of their praiseworthy behavior.
A Three‐Dimensional Representation of Linear Growth and Skeletal Maturation
Authors: RUDLIN C.R. 
Published: January 2008

ABSTRACTRudlin C.R. (4600 Grove Avenue, Richmond, Virginia, USA). A three‐dimensional representation of linear growth and skeletal maturation. Acta Paediatr Scand [Suppl] 356: 46, 1989.Traditional two‐dimensional (2‐D) growth charts do not distinguish between the effects of a particular pathology or therapy on skeletal maturation and the effects on linear growth. In this study, longitudinal data from two growth studies on children were analysed using a computer technique to produce a growth chart in three dimensions. The three‐dimensional (3‐D) surface of the graph represents both the linear growth and the skeletal maturation of the patients. If the height and the chronological and bone ages of an individual patient are plotted to give a line in 3‐D space, the line can be compared with the 3‐D surface of the graph. This permits qualitative assessment of the relative effect of a pathology or treatment on skeletal maturation as compared with linear growth. Quantitative assessment is also possible by expressing the data in polar coordinates. The technique can be applied to clinical trials as well as to individual patients.
Changes in Skeletal Muscle after Discontinuation of Growth Hormone Treatment in Young Adults with Hypopituitarism
Authors: RUTHERFORD O.M. , JONES D.A. , ROUND J.M. , PREECE M.A. 
Published: January 2008

ABSTRACTRutherford, O.M., Jones, D.A., Round, J.M. and Preece, M. (Department of Medicine, Rayne Institute, University College and Middlesex School of Medicine; and the Department of Growth and Development, Institute of Child Health, Great Ormond Street, London, UK). Changes in skeletal muscle after discontinuation of growth hormone treatment in young adults with hypopituitarism. Acta Paediatr Scand [Suppl] 356: 61, 1989.Skeletal muscle strength and size were measured for 1 year following discontinuation of human growth hormone (hGH) treatment in 11 patients with hypopituitarism. Quadriceps and forearm flexor maximum voluntary isometric strength and size were measured. At the end of the study, endocrine status was reassessed by an insulin tolerance test. Three of the 11 subjects were found to have normal hGH secretion and were not included in the analysis. At 12 months, quadriceps strength, size and fibre areas were 94.0 ± 8.5%, 94.5 ± 6.3% and 85.6 ± 17.7% (mean ± SD), respectively, of baseline values. Forearm flexor strength and size were 101.4 ± 7.9% and 92 ± 9.2% of control values. Although these changes are relatively small, they suggest a role for growth hormone in the maintenance of muscle in the adult.
Cerebral Blood Flow during Experimental Hypoxaemia and lschaemia in the Newborn Piglet
Authors: ODDEN JAN‐PETTER , STIRIS TOM , HANSEN THOR W. R. , BRATLID DAG 
Published: January 2008

ABSTRACTOdden, J.‐P., Stiris, T., Hansen, T. W. R. and Bratlid, D. (Neonatal Research Laboratory, Department of Paediatric Research, Institute for Surgical Research and Department of Paediatrics, Rikshospitalet, University of Oslo, Oslo, Norway). Cerebral blood flow during experimental hypoxaemia and ischaemia in the newborn piglet. Acta Paediatr Scand Suppl 360: 13, 1989.The effect of selective hypoxaemia or ischaemia on cerebral blood flow was studied in 14 newborn piglets with the microsphere method. Surgery and experiments were performed under general anesthesia with 70% nitrous oxide. The spontaneously breathing piglet was then exposed to either low (zero) oxygen in the inspired air (hypoxaemia), or a graded tourniquet (3–5 kg string weight) of the neck above the level of the tracheostomy (ischaemia). Cerebral blood flow was measured at baseline, during the hypoxaemic/ischaemic insult, and 30 and 60 min thereafter. Brainstem blood flow was remarkably stable during both ischaemia and hypoxaemia. The reduction in blood flow to the cerebrum and to the cerebellum was greater during ischaemia than during hypoxaemia. Reactive hyperaemia followed hypoxaemia but was not obvious after selective ischaemia. Ischaemia and hypoxaemia thus seem to have different effects on cerebral blood flow.
Growth Survey of Schoolchildren in Akita Prefecture: Preliminary Report
Authors: OKAMURA T. 
Published: January 2008

ABSTRACT.Okamura T. (Department of Paediatrics, Yuri Nokyo General Hospital, Honjo City, Akita Prefecture, Japan). Growth survey of schoolchildren in Akita prefecture: preliminary report. Acta Paediatr Scand [Suppl] 349: 73, 1989.This report presents the results of a preliminary epidemiological study of growth in Akita prefecture. Data were collected from 5672 pupils from nine elementary schools in the region. Previous epidemiological investigations of growth have set the screening standard for growth retardation at ‐ 2.58 SD below the mean. On the basis of this figure it was estimated that 22 out of the 5672 pupils screened in this preliminary study (0.39%) would suffer from growth retardation. When this standard is applied to all 102,193 elementary school students in Akita prefecture, 396 children in the region are estimated to be growth retarded. An epidemiological investigation in Niigata prefecture in 1985 found that 10.5% of growth‐retarded patients suffered from growth hormone deficiency. While this percentage is known to vary between different studies and with different methods of statistical analysis, application of this rate to the estimated number of 396 growth‐retarded patients in Akita prefecture suggests that there may be 41 or 42 patients with growth hormone deficiency.
Is there a role for a twins clinic? An evaluation of parents'responses
Authors: Bendefy Ilona M , Elliman Alison , Prior Susan , Bryan Elizabeth M 
Published: January 2008

Bendefy IM, Elliman A, Prior S, Bryan EM. Is there a role for a twins clinic? An evaluation of parents'responses. Acta Pædiatr 1994;83:40–5. Stockholm. ISSN 0803–5253To evaluate parental responses to the Twins Clinic, postal questionnaires were sent to the parents of 141 pairs of twins, born outside the maternity hospital who were referred to the clinic in the first three years. The main outcome measures were: the sources of, and reasons for, referral; previous attempts to find help; experiences at the clinic and outcome of the visit. One hundred and thirteen families (80%) replied, of whom 101 (89%) were self‐referred. The most common problems for which twins were referred related to behaviour (34) and development (28). In 99 (88%) cases, parents had already sought assistance from other sources (39 from health professionals) but only 29 had found this helpful. In 95 (84%) cases, parents felt there had been a positive outcome from attending the clinic, in the form of reassurance (87), change of management (39), successful support for applications (19) or information (11). Parents' responses indicate that the Twins Clinic meets the needs of families with multiples who are inadequately served by existing sources of help. These will only be improved through education of health professionals (and of the community as a whole) so as to obviate the need for Twins Clinics.