摘要:

Respiratory distress syndrome in preterm infants can be treated successfully by endotracheal administration of a bovine surfactant preparation (SF‐RI 1). Before the routine use of xenogenic surfactant preparations can be recommended, their immunogenicity as well as their in‐vivo and in‐vitro immunomodulatory activity have to be investigated. High titers of anti‐surfactant antibodies were detected by a sensitive ELISA after immunizing rats, rabbits and mice with SF‐RI 1. Repeated endotracheal administration of SF‐RI 1 resulted in a humoral antibody response in three out of eight rabbits. After treatment of 34 preterm infants with SF‐RI 1 (50‐200 mg/kg), a humoral immune response to SF‐RI 1 could not be detected. In‐vitro restimulation of peripheral blood lymphocytes with SF‐RI 1 after primary in‐vivo administration did not result in cell proliferation as measured by3H‐thymidine incorporation. SF‐RI 1 did not stimulate peripheral blood lymphocytes of neonates in vitro. The mitogenic response of these cells to stimulation with PHA, ConA or PWM was heavily impaired in the presence of SF‐RI 1 concentrations increasing from 0.04 to 4 mg/ml. These data indicate that SF‐RI 1 is immunogenic and that it may have an influence on l

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12254.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The effect of endotracheal suctioning on cerebral haemodynamics was investigated in 29 newborn infants with a mean gestational age of 31 weeks (range 25‐40 weeks). Prior to one of two suctioning procedures, the inspiratory fraction of oxygen was increased by 10%. Brain oxygenation and total haemoglobin concentration were estimated continuously by near infrared spectroscopy. Mean arterial blood pressure, arterial blood oxygen saturation and carbon dioxide tension were recorded simultaneously. Brain oxygenation decreased in parallel with arterial oxygen saturation during suctioning. Preoxygenation ameliorated the decrease in brain oxygenation and arterial oxygen saturation whereas there was no benefit with regard to the changes in total haemoglobin concentration, carbon dioxide tension or mean arterial pressure. Changes in total haemoglobin concentration were related closely to concomitant changes in carbon dioxide tension (p<0.0001) but unrelated to changes in mean arterial pressure or arterial oxygen saturation. Our findings suggest that cerebral blood volume may react to changes in carbon dioxide tension during endotracheal suctioning in mechanically ventilated neonates. Apparently, preoxygenation prior to suctioning does not ameliorate the stress in normoxic infant

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12255.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Using the original diagnostic criteria of the European Society for Paediatric Gastroenterology and Nutrition for symptomatic coeliac disease in children, we found an average incidence rate by birth of 0.10 per 1000 live births in a demographically homogeneous Danish population over a 15‐year period. This incidence rate by birth is the lowest described in an epidemiological study in contrast with rates of 0.33 to 8 per 1000 live births found in other western countries. This difference may be explained by the different diagnostic criteria used for coeliac disease. Another contributing factor may be a late and gradual introduction of gluten‐containing cereals into the diet of Danish infa

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12256.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

We analyzed the results of 607 small bowel biopsies performed over a seven‐year period: 284 biopsies were obtained using a fiberendoscope and 323 biopsies using a Watson capsule. Three to six specimens were removed during endoscopy. The biopsy fragments obtained with the fiberendoscope were deeper than those obtained with the Watson capsule (p<0.0001) and were more often located in the duodenum (p<0.0001). The failure rate of the fiberendoscope biopsies (1%) was lower than for the Watson capsule biopsies (9%) (p<0.0001). Multiple biopsies increased the diagnostic value of fiberendoscopy which was 95% versus 85% for Watson capsule. The mean duration of the endoscopic procedure recorded in 30 children was 6.5 min for four to six samples, i. e. 1.5 min per biopsy specimen. Fiberendoscopy appears to be an efficient and safe method for performing small bowel biopsies in infants and childre

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12257.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The present study demonstrates that renal tubular unresponsiveness to aldosterone, without associated hyperkalaemia, is present in children with acute pyelonephritis. We studied 32 children with a diagnosis of acute pyelonephritis established by high fever, flank pain/tenderness, increased blood levels of C‐reactive protein and significantEscherichia coligrowth in the urine culture. Renal tubular function tests and determinations of plasma renin activity and aldosterone concentration were performed at diagnosis (study 1), after three days of iv gentamycin (study 2) and after 21 days of antibiotic therapy (study 3). Findings were compared to those present in 32 normal children of similar age. Despite normal plasma potassium concentration, fractional potassium excretion and transtubular potassium concentration gradient were significantly decreased in studies 1 and 2, becoming normal in study 3. Decreased renal potassium excretion coexisted with increased values for plasma renin activity and aldosterone concentration. In study 3 these hormones remained elevated only in patients with scarred kidneys. The functional alteration present in acute pyelonephritis may be directly caused by the interstitial inflammation or be mediated by someE. coliendotoxi

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12258.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The risk of cerebral palsy in connection with intrauterine growth retardation has been analysed in a case‐control study. The case series comprised 519 children with cerebral palsy born in 1967‐1982 in the west health‐care region of Sweden and the control series 445 children born during the same years in the same region. The risk of cerebral palsy in small‐for‐gestational‐age infants was significantly increased in term and moderately preterm infants. The highest proportion among infants with cerebral palsy born at term was found in tetraplegia, followed by diplegia and dyskinetic cerebral palsy. It was concluded that small for gestational age on the one hand reflects early prenatal brain damage, and on the other mediates prenatal risk factors compatible with foetal deprivation of supply and also potentiates adverse effects of birth asphyxia and neona

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12259.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

We present an anonymous questionnaire inquiry involving 334 primary schoolteachers in the Randers area with the purpose of elucidating teachers' knowledge about asthma. To a series of statements about asthma, the teachers answered yes, no or don't know. A limited knowledge of different aspects of asthma in children was found, although 57% had asthma children in their classes. Specially limited was knowledge about medical treatment. Five percent had received proper instruction about asthma and had a significantly better knowledge of medical treatment (p<0.001‐0.05). Only 57% knew that wheezing after physical exertion is a strong indicator of asthma and only 33% knew that exertion in cold weather increases the risk of an attack. It is recommended that instruction in children's diseases, especially asthma, is introduced in teacher training college

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12260.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

A comprehensive prospective longitudinal study of health, development and social adjustment from the age of four to 18 years has been carried out in Uppsala, Sweden. This report presents the accumulated psychosocial burden up to 18 years of age for all 1715 children born in 1965 and resident in Uppsala from age 10 to 18 years. The psychosocial burden up to 18 years of age was assessed through analysis of records and register information from school health services, authorities for care of the handicapped, the Department of Child Psychiatry, social agencies and legal authorities. The analysis showed that 11.8% of the adolescents had a severe psychosocial burden up to the age of 18 years which could hamper their future life as adults. It was possible to categorize the whole birth cohort into one subgroup without manifest psychosocial problems and five different subgroups with serious problems: the six groups (severe mental or physical handicap, antisocial behaviour, psychiatric problems, social support, multiple problems, “normal”) had specific profiles concerning sex distribution, symptoms, social background, utilization of care services and delinque

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12261.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The study comprised all 1715 children born in 1965 and resident in Uppsala at age 10 and 18 years. Data were collected through teacher interviews and analysis of school health records in grade 3 at the age of 10 years. The psychosocial burden up to the age of 18 years was assessed on the basis of all registered contacts with official institutions outside school (authorities for care of the handicapped, Department of Child Psychiatry, social agencies, legal authorities). Approximately 12% of the adolescents were clearly in a situation of manifest psychosocial risk on the threshold of adult life. These adolescents were assigned to five mutually exclusive problem groups comprising different sex distribution, symptoms and utilization of institutional care. The analysis of the relationship between data from grade 3 and the psychosocial burden up to 18 years of age showed that the information available to the school did not permit reasonably secure predictions of the child's psychosocial situation at the end of adolescence. Observations in school of pre‐adolescent children cannot be used as a basis for risk‐group strategies aiming at concentrating early treatment measures and resources to a restricted number of children at risk. However, the prognosis is apparently serious for a limited number of 10‐year‐olds with serious problems in

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12262.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Greek immigrant children (GI) belonging to the second generation of immigrants in Sweden have been compared with Swedish children.(S) and Greek children in Greece (G) regarding energy and nutrient intake. Twenty‐four‐hour recalls were obtained in the homes of the families. The mean energy intake was the same in all three groups and met the Swedish Nutrition Recommendations. The energy distribution for protein, carbohydrates and fat was also similar. The fat intake was far above the recommended level in all groups. The GI and the G group had a significantly higher mean daily intake of monounsaturated fatty acids than the S group (p<0.05 andp<0.001, respectively). Children aged four to eight years in the GI group had a significantly higher nutrient density of retinol, vitamin D, riboflavin, vitamin B6, calcium, iron, magnesium and sucrose compared to the G group, but compared to the S group they had a lower nutrient density of retinol, vitamin D, ascorbic acid, niacin, vitamin B12 and selen. The GI children consumed more milk than the G children but as much as the S children and they had started to use enriched low‐fat milk in Sweden. In conclusion, the food quality in the GI group was better than in the G group and much the same as in the S group, and, with few exceptions, it met the Swedish Nutrition Recommenda

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12263.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY