摘要:

Hofvander Y. (International Child Health Unit, Department of Paediatrics, University of Uppsala, Sweden). International comparisons of postnatal growth of low birth‐weight infants with special reference to differences between developing and affluent countries. Acta Paediatr Scand, Suppl. 296:14, 1982. A large majority of low birthweight infants are born in developing countries where however, only few follow‐up studies have been made. However, there are clear indications that in general the AGA infants catch‐up better than the SGA of the same weight. A particularly poor catch‐up growth is shown by full‐term SGA indicating that if a fetal growth retardations is diagnosed, delivery should be induced prematurely. Social and environmental factors are important for the optimal growth postnatally and particularly so if the environmental conditions ar

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1982.tb09587.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Kollberg, H. (Department of Paediatrics, University of Umeå, Umeå, Sweden). Diagnosis and main clinical features of cystic fibrosis with special attention to screening procedures. Acta Paediatr Scand 1982; suppl 301:15‐25. – The diagnosis of cystic fibrosis (CF) must be based on a combination of clinical observations of all symptoms and the results of laboratory tests. The numerous symptoms from the respiratory and gastrointestinal tracts and from the sweat glands are briefly described and the specific diagnostic tests referring to these systems are enumerated. CF is a common disease which constitutes a substantial problem both for the individuals concerned and for the community. Screening most probably would result in an improvement for the early diagnosed patients with respect both to survival and to physical function. The society has the means to provide resources both for confirming the diagnosis and for providing complete long‐term therapy for CF patients, but the diagnostic and therapeutic possibilities need to be organized more firmly. Alternative ways of diagnosis other than screenning are unsatisfactory and lead to a diagnostic delay which most probably is detrimental for the patient. Promising screening tests are on the way; the test for trypsin in serum, in particular, seems to be specific, non‐injurious to the patient and applicable to all newborns in countries with Caucasian populations, but it remains to be seen whether it is sufficiently sensitive and inexpensive. It is concluded that CF is a top ranked candidate for general screening in the neonatal period and further intensive studies in this field must get every support. The multicentre study for screening, proposed and supported by ICF(M)A is heartily

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1982.tb09638.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1982.tb09650.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Harries, J. T. (Institute of Child Health and Hospital for Sick Children, Great Ormond Street, London). Fat absorption in the newborn. Acta Paediatr Scand, Suppl. 299: 17, 1982.—Dietary fat is an important source of energy to the newborn. Pancreatic lipase and esterase activity are both low in newborns, particularly in premature ones; similarly, bile salt metabolism is markedly compromised. This could result in grossly defective intraluminal lipolysis and micellar solubilisation, leading to appreciable steatorrhea and energy loss. Lingual lipase and bile salt‐stimulated lipase (BS‐SL), however, play an important compensatory role. Lingual lipase is secreted from branching serous glands (von Ebner's glands) located on the dorsal aspect of the posterior region of the tongue, and its physicochemical properties are highly suited to passage through the stomach into the small intestine; a high fat diet and the act of suckling stimulates this enzyme's activity, and it may act in a synergistic fashion with pancreatic lipase. BS‐SL (i.e. milk lipase) also has properties which are well designed for promoting fat absorption in the newborn. For example, it has no positional specificity for the ester bonds of the triglyceride molecule, and the optimal concentration of bile salts required for activation

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1982.tb09622.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1982.tb07354.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Räihä NCR. (Department of Paediatrics in Malmö, University of Lund, Sweden). Plasma amino acid balance in relation to protein intake in preterm infants: What is the optimal protein intake? Acta Paediatr Scand, Suppl. 296:19, 1982. — The milk of a given species should be best adapted for the nutrition of the newborn of that species. This applies for the normal infant born at term and there is consequently general agreement that human milk is the most appropriate nutritional regimen for the full‐term infant. While there is agreement when the full‐term infant is concerned, this is not the case for the preterm infant whose requirements have not yet been fully determined. It has been during the late 1970s that the more common survival of infants around 1000 g at birth has been possible. It is clear, that when deciding on an optimal diet for these infants one cannot generalize and speak about an appropriate diet for “all” preterm infants but growth rate and stage of biochemical development of the particular preterm infant in question, must be considered as well. The metabolic immaturities and the time of their maturation are important when nutritional regimens of the infants are planned. During the first four to six weeks of life, depending on maturity at birth, when both amino acid synthesizing and degradating capacities are not yet fully developed, a compromise must be made, between estimated protein requirement and actual intake, in order to avoid metabolic imbalances, which may be deleterious for later intellectual performance. During this period the mothers expressed breast milk should be preferred and pooled donor milk should be added only when the mother is not providing enough. A total intake of 185 to 200 ml per kg per day should be given. When biochemical maturity of the infants has been achieved, protein intake may be increased somewhat as a supplement to breast milk. If human milk is not available and proprietary formula must be used for feeding preterm infants it must be kept in mind that formulas with a protein composition similar to that found in human milk cause less metabolic stress than do those with a protein and amino acid composition more like

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1982.tb09588.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1982.tb09651.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

The purpose of this study was to find an answer to the question of why whooping cough cases occur in Finland in spite of the high acceptance rate of DPT vaccine.To this end agglutinins 1,2 and 3 were determined in children vaccinated in 1962–1976 with vaccine A, manufactured by the National Public Health Institute, Helsinki. The amount of agglutinins 1 and 2 was unmeasurable, while an agglutinin 3 titre of±40 was obtained in 9/14(64%). This vaccine contains strain no. 18 530, which is serotype 1.2.3.Vaccine B from the same manufacturer contains strains 18 530 and 1 772, both of which are serotype 1.2.3. In children vaccinated with vaccine B since 1976 the agglutinin 1 titre was±20 in 14/18 (78%) cases. A similar titre of agglutinin 2 was obtained in 14/19 (74%) of cases and of agglutinin 3 in 5/19 (26%). A titre of±40 was obtained for agglutinin 1 in 4/18(22%) cases, for agglutinin 2 in 5/19 (26%) cases and for agglutinin 3 in 14/19 (74%) cases.Of the Bordetella pertussis strains isolated during two whooping cough epidemics in 1976–1977, 83 were serotyped. All these strains were serotype 1.2.The whooping cough attack rate was estimated in 242 incompletely and 44 completely vaccinated children during the epidemics in question. Of the incompletely vaccinated children 188/242(78%) contracted whooping cough and 54/242(22%) remained healthy. Of the completely vaccinated children 17/44(38%) contracted whooping cough and 27/44(62%) remained h

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1982.tb09618.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Heird, W. C., Dell, R. B. and Winters, R. W. (Department of Pediatrics and Institute of Human Nutrition, Columbia University College of Physicians&Surgeons, New York). Food and metabolism in infancy. Acta Paediatr Scand, Suppl. 299: 24, 1982.—Published plasma amino acid data from normally‐growing term and preterm infants fed varying quantities of protein as well as proteins of varying quality were examined in an effort to assess the efficacy of these data as indicators of the adequacy and/or inadequacy of protein intake. Although the absolute plasma concentrations of most amino acids vary considerably, all sets of data from term infants, with exception of those from infants fed inadequate protein or inordinately large quantities of protein, when expressed as the ratio of TEAA/TAA and ind. EAA/TEAA, are remarkably similar. Despite variations in absolute plasma amino acid concentrations of as much as 60 %, for example, fasting and postprandial TEAA/TAA and ind. EAA/TEAA ratios are similar. The plasma TEAA/TAA ratio of infants fed a low protein intake (1.1 g/kgd) is low but this ratio is similar in plasma of infants fed either 3.0‐3.5 g/kgd or 9 g/kgd. Ind. EAA/TEAA ratios, on the other hand, are the same in plasma of infants fed either 1.1 or 3.0‐3.5 g/k ‐ d but some are dramatically higher in plasma of infants fed a protein intake of 9.0 g/kgd. Although ind. EAA/TEAA ratios vary somewhat as a function of the quality of protein intake, this variation is not nearly as great as that of the intake ratios. Finally, the relatively constant plasma ratios of TEAA/TAA and ind. EAA/TEAA are remarkably similar to those of the tissue deposited during normal growth. These observations support the hypothesis that the various enteric, hepatic and other mechanisms which determine the amino acid composition of plasma have as their target these relationships among various amino acids rather than absolute plasma concentrations of the various amino acids. If so, it follows that maintenance of these relationships may be an important factor for optimal protein synthesis. If these hypotheses prove to be correct, an appropriate criteria for efficacy of alternative feeding regimens chosen for the infant who is not or cannot be breast fed is whether or not this regimen overwhelms the mechanisms responsible for maintaining these apparent relationships among the amino acids

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1982.tb09623.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1982.tb09652.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY