摘要:

ABSTRACT.Some autonomic nervous reflexes often tested in adult medicine have been studied in 21 preterm infants (25‐37 gestational weeks). The aim was to develop such tests for preterm infants and see if there were any differences in babies with recurrent apnea and bradycardia and babies who had been exposed to sympathicolytic drugs before birth. To test sympathetic nervous activity the peripheral vascular resistance was measured before and during 45° of head‐up tilting. To test parasympathetic nervous activity the degree of bradycardia was measured in response to cold face test (application of an ice‐cube on the fore‐head) and laryngeal stimulation with saline. Finally the heart rate changes after a sudden noise (85 dB) were studied as an indicator of both sympathetic and vagal activity. The peripheral resistance was found to be relatively low in these preterm infants, particularly in some infants tested at the postnatal age of about two months. Heart rate and mean blood pressure did not change during tilting, while the peripheral resistance increased significantly mainly due to lowered limb blood flow. The median decrease of the heart rate during the cold face test was 20.0% and during laryngcal receptor stimulation 23.7%. The sudden noise usually caused a biphasic heart rate response. An autonomic nervous reflex score was calculated and found to be negative (parasympathetic) in infants with recurrent prolonged apnea and bradycardia and positive in infants with clinical signs of increased sympathetic nervous

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11546.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.Plasma samples obtained at birth from 70 very low birth weight (VLBW) infants (gestational age 24 to 34 weeks) and from 20 term infants were analysed for concentrations of 12 different proteins. The plasma concentrations of albumin, transthyretin (TTR), retinol‐binding protein (RBP), vitamin D‐binding protein, apolipoprotein A I, fibronectin, orosomucoid and α1‐antichymotrypsin were significantly lower in the VLBW infants than in the term infants, whereas the values of α‐fetoprotein (AFP) were significantly higher in the VLBW infants. No differences were found between the two groups for apolipoprotein A II, apolipoprotein B and transferrin. Birth asphyxia and sex had no influence on the measured plasma protein concentrations. The plasma concentrations of apolipoprotein A I and A II were significantly lower in small‐forgestational age (SGA), VLBW infants compared with appropriate‐for‐gestational age (AGA), VLBW infants. Possible acute inflammation (defined as raised concentrations of orosomucoid or α1‐antichymotrypsin) was associated with significantly higher values of vitamin D‐binding protein in both VLBW and term infants, suggesting that this protein may act as an acute phase protei

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11547.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.Urea concentrations in serum and urine were measured in 28 growing, very low birth weight, appropriate‐for‐gestational age infants fed varying human milk protein intakes (range 1.7 to 3.9 g/kg/day). We found a high correlation between serum urea values at the end of the study and mean protein intake (r3=0.85,p<0.001) and between urinary urea concentrations in eight‐hour urine collections and protein intake (r3=0.81,p<0.001). All serum and urine urea values were below 1.6 and 18 mmol/l, respectively, at protein intakes less than 3 g/kg/day. Higher protein intakes caused higher serum and urinary urea concentrations. We also found a strong correlation between the individual serum and urinary urea values at the end of the study (r3=0.90,p<0.001). The presented data are consistent with the growth data previously reported and indicate that inadequate or excessive protein intakes can be detected by measurement of urea concentrations in serum and/or urine. If urine urea samples alone can be used for estimating optimal protein intake, painful blood sampling procedures could be obv

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11548.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.Late metabolic acidosis was observed in a term baby boy with renal tubular acidosis type 4 who received two cow's milk formulas in succession. Suboptimal mineral composition of the formulas turned out to be an important risk factor for the development of late metabolic acidosis.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11549.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.We have studied the effects on lung volume, respiratory mechanics and ventilation during the first hours after instillation of 60 mg/kg of human surfactant into the trachea of 4 very preterm, newborn infants with severe IRDS under mechanical ventilation. Measurements were made with a “face‐out” body plethysmograph and a modified nitrogen wash‐out method. In addition to a transient decrease in total and alveolar ventilation immediately after the instillation we found an immediate rise in lung volume, but respiratory compliance decreased. These changes lasted less than two hours. Oxygen requirements fell in 3 out of 4 infants. The changes in lung volume and compliance are explained in terms of changes in the shape of the static recoil pressure characteristics of the diseased lungs after treatment. Mechanisms behind the short duration are sought in mode of instillation, dosage, age at treatment, and severity of

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11550.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.Birth asphyxia often leads to left ventricular myocardial dysfunction. To assess the effect of myocardial dysfunction on cerebral perfusion, we evaluated cardiac output and cerebral blood flow velocity in the anterior cerebral and internal carotid arteries in 20 asphyxiated term newborn infants during the first 4 days of life using 2‐dimensional/pulsed Doppler ultrasound. In 8 infants with myocardial dysfunction cardiac output was reduced on days 1 and 2 and within normal limits thereafter. In these infants changes in mean cerebral blood flow velocity and pulsatility index were passively related to changes in mean arterial pressure and cardiac output. In 12 infants without myocardial dysfunction a stable cerebral blood flow velocity pattern was found, which was unaffected by changes in mean arterial pressure. We conclude that infants presenting with a reduced cardiac output after deliveries associated with severe asphyxia may be at risk for additional ischemic or hemorrhagic cerebral damage because of lack of autoregulatio

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11551.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.Phosphate metabolism was studied in twenty‐one preterm infants with idiopathic respiratory distress syndrome during and after oxygen (O2) therapy using a hood. Plasma, red cell inorganic phosphate (Pi) and the red cell concentrations of organic phosphate metabolites ATP and 2, 3‐diphosphoglycerate were significantly lower in the sick infants when compared to controls of similar age and birthweight, and remained low even 24 h after cessation of therapy. Plasma cortisol levels were elevated at the onset of the disease and decreased to almost control levels by the end of O2therapy while the values of plasma calcitonin did not show any difference from controls. Plasma creatinine phosphokinase and blood lactic acid levels followed the pattern of the control group with a small increase at the beginning of the study and decreasing thereafter. Several factors may be implicated in the cause of hypophosphatemia in these infants such as inadequate feeding, acidosis and hypercortisolaemia due to stress leading to phosphatu

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11552.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.Serum thyroglobulin was determined in 68 newborn infants with positive screening tests for congenital hypothyroidism. In 38 infants the diagnosis was confirmed (patients), but the remaining 30 were euthyroid at follow‐up (controls). The mean thyroglobulin concentration at the age of 2 weeks did not differ significantly between the patients and the controls (179 vs. 125 μg/l). Thyroid scintigraphy was performed in 15 patients. All seven with thyroid aplasia, based on99mTc pertechnetate scintigraphy, had measurable thyroglobulin (>2 μg/l) and thyroid hormones in their serum. This indicates that total absence of thyroid tissue is very rare in Swedish patients with congenital hypothyroidism. Scintigraphy based on99mTc does not permit detection of small amounts of thyroid tissue. The neonatal concentrations of thyroglobulin did not correlate with the results of Griffiths test at 3 years and are therefore not useful for prognosis of psychomotor development. We conclude that neonatal measurement of thyroglobulin is of limited value in the follow‐up of patients with congenital hypothyro

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11553.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.Various methods are used for prediction of final height in girls with Turner's syndrome (TS), but their accuracy has not been systematically investigated or compared. We have compared predictions of final height made with the most commonly used methods in 20 Turner girls at ages 9.5–18 years. Growth standards based on growth and final height of 78 Danish Turner women were used for calculation of standard deviation scores (SDS). In order to provide the necessary basis for “index of potential height” (IPH) method, bone age development was determined from 74 X‐rays of 38 untreated Turner girls aged 5.2‐19 years. This method was further modified and improved for use in TS. Prediction methods based only on height and chronological age (CA) showed little difference from methods including bone age. The IPH method in our modification was more accurate than those of Bayley‐Pinneau and Tanner. At younger ages the IPH method showed better results when using Tanner‐Whitehouse 2 (TW2) bone age than when using Greulich‐Pyle bone age. Accuracy of predictions were considerably improved by combining methods with and without allowance for bone age. Combinations including the IPH method based on TW2 bone age appeared to be the most accurate. Predictions of final height in Turner's syndrome should therefore be made by combining the IPH method and one of the methods based o

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11554.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.Thirty‐two girls with Turner's syndrome aged 11.5‐16.7 years were treated with oxandrolone (0.125 mg/kg/day). The treatment period was scheduled to 2 years. Height velocity (HV) was expressed in Standard Deviation Scores (SDS), calculated by growth standards for untreated Danish Turner‐girls. For girls with initial bone age below 13 years HV increased significantly from a mean pretreatment value of ‐0.2 SDS (3.1 cm/year) to + 3.5 SDS (5.6 cm/year) in the 1st year of treatment and + 2.1 SDS (4.1 cm/year) in the 2nd year. Mean bone age velocity during treatment was 0.9 year/year. Twenty‐two girls have reached final height. Predictions of their final height were made by three different methods and compared to observed final height. A significant (p0.3). Side effects were seen in 16% o

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11555.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY