摘要:

Growth velocity and serum aminoterminal propeptide of type III procollagen (P‐III‐NP) were evaluated in 11 girls (age 3.8–8.5 years) with central precocious puberty during luteinizing hormone releasing hormone (LH‐RH) analogue treatment (D‐Trp6‐LH‐RH, 60 μg/kg im for 28 days,n = 7;D‐ser(TBU)6‐LH‐RH, 1600 μg/day intranasally,n =4). Before treatment, growth velocity (10.2 ± 1.9 cm/ year) and P‐III‐NP concentrations (12.8 ± 4.3 μg/l) were in the pubertal range. During therapy, growth velocity significantly decreased to the prepubertal levels. P‐III‐NP concentrations decreased significantly after six months of therapy (7.9 ± 3.7 μg/l,p<0.001). Three girls with low growth velocity (<4 cm/year), stimulated growth hormone peak<10 μg/l, and altered 12‐h nocturnal growth hormone secretion at 12 and/or 18 months of treatment, had a more marked decrease in P‐III‐NP concentrations (patient 3: −65.9%; patient 5: −58.7%; patient 10: −61.0%) after 6 months of therapy. Our results suggest that LH‐RH analogue treatment in central precocious puberty may impair growth. In these cases, measurement of serum P‐III‐NP

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12656.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

An acute thrombocytopenic purpura developed shortly after measles‐mumps‐rubella vaccination in 23 of approximately 700 000 children immunized over a period of seven years. The mean interval from inoculation to the onset of purpura was 19 days. Bone marrow aspirates obtained from 13 patients showed increased or normal amounts of megakaryocytes. Platelet survival time was markedly shortened in the two patients studied. Fifteen patients recovered (the platelet count exceeded 100 x 109/1) in one month, five in two months and two in six months. Increase in platelet‐associated immunoglobulin was detected in 10 of 15 patients. Circulating antiplatelet autoantibodies (AAb) against glycoprotein IIb/IIIa were detected in 5 of 15 patients. The findings are compatible with an autoimmune mechanism triggered by immune response to measles‐mumps‐rubella vaccination. As evaluated by the clinical course and the presence of AAb, post‐vaccination thrombocytopenic purpura appears to be indistinguishable from childhood acute idiopathic thrombocytope

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12657.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

We evaluated 91 episodes of fever in 46 profoundly neutropenic children with cancer, in a search for any symptom, sign or laboratory test that would serve to identify patients with septicemia and differentiate them from those in no immediate need of prompt antimicrobial therapy. Seventeen episodes (19%) were bacteremias, 59 (64%) were suspected septic infections, 9 (10%) were focal bacterial infections and 6 (7%) proved not to be bacterial infections. We were unable to detect any parameter, either on admission or after two days of antimicrobial therapy (except for blood culture findings), that would be helpful in differentiating bacteremia from an episode not of bacterial origin. We focused on serum levels of C reactive protein and found them unreliable on an individual level. Prompt institution of antimicrobial therapy at the occurrence of fever results in low mortality, but does not allow assignment of cases to different categories.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12658.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The differences between parents' assessments of their child's handicap and professionals' assessment of disabilities were studied in 486 Nordic children with myelomeningocele aged 4–18 years. Although disability and handicap are conceptually different, agreement between the parents' assessments of the handicap and the degree of disability according to Lorber's classification was found in 51% of cases. The parents' assessments showed close agreement with overall disability according to Lagergren's method in 45% of cases. The factors most strongly associated with parental assessment of the handicap were the child's motor disability, intellectual functioning, faecal and urinary incontinence and the parents' inclination to feel inadequate with respect to the child's needs. Data from professional assessment of disabilities alone are of limited value in understanding the impact of disabilities on the daily life of a chil

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12659.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

A common breast‐feeding problem is when the infant “places its tongue in its palate” and has difficulties in attaching to its mother's nipple. The aim of this study was to document the position of the tongue in the mouth cavity during rooting reflexes elicited in newborn infants before the first suckle. Eleven healthy, full‐term infants were videotaped 101 ± 31 min after birth during an evoked distinct rooting reflex before the first suckle. The videotaped rooting reflex was analyzed in detail concerning the degree of turning of the head, mouth opening and position of the tongue, in pictures that were “frozen” at specific intervals. “Licking movements” preceded and followed the rooting reflex in the alert infants. In 10 of the 11 infants the tongue was placed in the bottom of the mouth cavity during a distinct rooting reflex (p=<0.05). It is suggested that forcing the infant to the breast might abolish the rooting reflex and disturb placement of the tongue. A healthy infant should have the opportunity of showing hunger and optimal reflexes, and attach to its mother's

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12660.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Breast milk samples from three groups of Brazilian women were evaluated: G1, mothers delivering term babies of low birth weight (n=16); G2, mothers delivering preterm babies of appropriate birth weight (n = 20); G3, mothers delivering term babies of appropriate birth weight (n =30). Milk samples were obtained at 48 h and on the 7th, 15th, 30th and 60th days after delivery and they were analyzed for lysozyme and total IgA levels and for the presence of specific antibodies against Poliovirus types I, II, III, Rotavirus, Herpes simplex virus, Varicella zoster and Cytomegalovirus. The groups were not statistically different in relation to mother's age, parity, type of delivery or socio‐economic levels. IgA levels were higher in both low‐birth‐weight groups (G1&G2) compared to the control group (G3) throughout the study period. Lysozyme levels decreased up to the 15th day, increasing thereafter up to the 60th day in all groups. Specific antibodies were detected throughout the study period, with no differences among groups. We conclude that breast milk composition of mothers delivering low‐birth‐weight babies (G1&G2) was similar despite the different gestati

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12661.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Urinary nitrite excretion, an index of L‐arginine‐dependent nitric oxide formation, was quantified daily for two weeks, in very low‐birth‐weight (<1500 g) premature infants. A transient 52%) reduction in nitrite excretion was noted on the day of transfusions (54±10 versus 26±6 μmol/mmol creatinine, before and during transfusion, respectively,n = 24, p<0.02). Indomethacin administration in six infants was associated with a dramatic increase in nitrite excretion from a basal median value of 3 to 76 μmol/mmol creatinine (p<0.05). Nitrite excretion returned to baseline on day 3 after indomethacin administration. In two infants who received indomethacin and transfusions on the same day, the stimulatory effect on nitrite excretion by indomethacin overwhelmed any depressive effect of transfusions. These results suggest that L‐arginine utilization is influenced by common therapeutic strategies in these high

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12662.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

To verify the diagnosis of coeliac disease in childhood, three consecutive small intestinal biopsies are performed under fluoroscopic control. To assess the amount of radiation dose absorbed during biopsy, dose measurements were performed both in patients and in a phantom model. These measurements were used for a theoretical assessment of cancer risk and shortening of life due to radiation exposure. The cancer excess lifetime mortality risk (CELMR) was 0.001, i.e. 1 case per 1000 children with a diagnosis of coeliac disease. The loss of life expectancy after three small intestinal biopsies in childhood was approximately 15% of the risk due to lifetime exposure to natural background radiation. These results should be compared with the reported increased risk of malignancy for undiagnosed coeliac disease in adult age. Although the exccss risk of the biopsies was small, all efforts should be made to use a technique and equipment giving the least radiation dose.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12663.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12664.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12665.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY