摘要:

The precision of the Ballard scale for assessing gestational age (GA) was evaluated in a consecutive sample of 227 preterm and/or low‐birth‐weight neonates. Each newborn was rated independently by two neonatologists and the difference in GA estimation between them was computed. The estimated precision was not high, the 95% tolerance interval estimate being as large as 7.4 weeks. The precision of the neurologic and physical parts of the scale was poorer than that of the complete scale (95% of differences less than 10.5 and 9.2 weeks respectively), and more influenced by the type of delivery. These findings are not unexpected from statistical theory, and cast doubts on the use of only the physical part of the Ballard scale in assessing GA, since greater accuracy could be accompanied by reduced precis

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12181.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The prognosis of allergic rhinitis was studied in 154 children aged 3‐17 years at diagnosis by means of a detailed questionnaire administered 8‐11 years later. The symptoms had completely disappeared in only 15 (10%) patients. The conjunctival symptoms, however, had disappeared or were controlled successfully by topical drug therapy in almost all, and 77 (50%) were managing without medication for allergic rhinitis. Twenty‐five (23%) of the 110 children with seasonal allergic rhinitis had a perennial disease at follow‐up, in contrast to seven (16%) of 44 with perennial allergic rhinitis originally who had only seasonal symptoms at follow‐up. Asthma or wheezing had developed in 29 cases (19%) and was more common (p<0.01) among those with perennial allergic rhinitis (15 of 44) than among those with seasonal allergic rhinitis (14 of 110). No significant association was found between age at onset of symptoms, family history of atopic disease or type of treatment for allergic rhinitis and allergic rhinitis still present at follow‐up or development of asthma during the observa

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12182.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In a retrospective study, clinical risk factors of the neonatal period were correlated with the severity of regressed retinopathy of prematurity (ROP) in a population of preterm infants (bw<1500 g and or gestational age<33 weeks). At the age of 5‐11 years 134 out of 528 preterm born infants (25.4%) were found to be under ophthalmic care. Reliable information on eye fundus status could be obtained in 105 of them. Regressed ROP was found in 61, the moderate form in 48 (9.1 %) and the severe form in 13 (2.5%) patients. Twelve patients (2.3%) had visual acuity of<0.3 on the worst eye and two (0.4%) of these patients were blind from ROP. Twenty‐four clinical factors of the newborn period were correlated with the severity of regressed ROP. The results suggest that long oxygen exposure in combination with other factors interfering with retinal vasotonus are associated with the degree of the disease develo

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12183.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Total casein subunits as well as whey proteins were quantitated in human milk samples during lactation. Two independent methods were used: precipitation at pH 4.3 in the presence of Ca2+followed by Kjeldahl analysis and polyacrylamide gradient gel electrophoresis (PAGGE) followed by densitometric scanning. Both methods yielded similar results: casein synthesis is low or absent in early lactation, then increases rapidly and subsequently decreases. The concentration of whey proteins decreases from early lactation and continues to fall. These changes result in a whey protein/casein ratio of about 90: 10 in early lactation, 60: 40 in mature milk and 50: 50 in late lactation. These observations indicate that the synthesis and/or secretion of caseins and whey proteins is regulated by different mechanisms. In addition, the relative proportion of the different β‐ andk‐casein subunits was found to vary throughout lacta

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12184.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Previous studies have suggested local production of IgG4 in human colostrum and mature milk. We extended these observations to examine all IgG subclasses in mammary secretions and in saliva, a mucosal secretion. In human colostrum and milk, the geometric mean percentages of IgG contributed by IgG2 were 44% and 43%, respectively, and by IgG4, 6% in both. These percentages are significantly increased compared to the contributions in matched plasma, 29% for IgG2 and 2% for IgG4. The contribution of IgG1 (47%) and IgG3 (<4%) were decreased compared to plasma which contained 64% IgG1 and 6% IgG3. Similarly, in salivary secretions the percentages of IgG contributed by IgG2 and IgG4 were increased compared to serum while the percentage of IgG1 was decreased. IgG3 was not measurable in any saliva specimen by the technique used. These data demonstrate that IgG subclass distribution in two separate mucosal secretions is uniquely different from that in matching plasma or serum.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12185.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The development of the infant faecal flora was studied over the first three months of life in infants receiving breast milk, a modern adapted formula and adaptations of this formula. Breast‐fed infants developed a flora rich inBifidobacteriumsp. Facultative anaerobes were ubiquitous, but in relatively small numbers within the diet group. Other obligate anaerobes, such asClostridiumsp. andBacteroidessp. were rarely isolated. Standard formula produced a flora rich in bifidobacteria, but the growth of facultative organisms was not suppressed by this diet.Clostridiumsp. andBacteroidessp. were more common in this feeding group. After the addition of lactoferrin at 10 mg/100 ml to the formula diet, a flora similar to that of the standard formula‐fed babies was achieved. Lactoferrin at 100 mg/100 ml was able to establish a “bifidus flora” in half of the babies given this formula, but only at age three months.Clostridiumsp. andBacteroidessp. were common faecal isolates from babies receiving both the lactoferri

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12186.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Monoclonal antibodies and flow cytometry are now used routinely in the diagnosis of many malignant diseases and primary and secondary immunodeficiency states. Technical advances have improved the identification of blood lymphocyte subsets and reliable normal values are now obtainable. Such values have been reported for adults but not for children. We report both absolute and percentage normal values for lymphocytes and their subsets in infants and children of different ages. Our findings show that the absolute and percentage values for most lymphocyte markers differ substantially not only between children and adults, but also between children from different age groups. In infants, erythroid cell contamination of Ficoll gradient‐density isolated mononuclear cells must be removed to obtain reliable flow cytometry value

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12187.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Seven patients with chronic benign granulocytopenia and nine patients with congenital agranulocytosis, received consecutive seven‐day courses of recombinant human granulocyte‐colony stimulating factor at a starting dose of 50 μg/m2/day, subcutaneously. If there was no response the doses were increased to 300 μg/m2. All patients with chronic benign granulocytopenia responded rapidly at the minimum dose within 1–3 days after administration. By contrast, only three of the nine patients with congenital agranulocytosis responded within 1–7 days at this dose. Four patients with congenital agranulocytosis showed a response between days 7–19 at a dose of granulocyte‐colony‐stimulating factor 100‐200 μg/m2but in the remaining two cases no response was obtained. The administration of granulocyte‐colony‐stimulating factor was shown to be safe and effective also in reducing infectious episodes in these patients. Previously it was reported that granulocyte‐colony‐stimulating factor 10–30 μg/kg/day was effective for patients with congenital agranulocytosis. These results indicate that patients with congenital agranulocytosis may require much higher doses of recombinant human granulocyte‐colony‐stimulating factor than patients with chronic benign granulocytopenia and that the response to ordinary doses of recombinant human granulocyte‐colony‐stimulating factor may be useful in differentiating between chronic benign granulocyt

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12188.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In this study we investigated the presence of gastroesophageal reflux in children with recurrent abdominal pain and its possible relationship to food intolerance‐associated duodenal inflammation. Twenty‐four‐hour intra‐esophageal pH monitoring, an endoscopic duodenal biopsy and a small bowel51Cr‐EDTA permeability test were performed in 25 children with recurrent abdominal pain. In 14 cases (56%) the pH monitoring was abnormal, pointing to the presence of pathological gastroesophageal reflux. Treatment of gastroesophageal reflux in the latter patients resulted in resolution or improvement of abdominal pain in 10 cases (71%). Gastroesophageal reflux did not appear to be associated with either intestinal permeability to51Cr‐EDTA or duodenal biopsy findings. We conclude that pathological gastroesophageal reflex is a frequent finding in children with recurrent abdominal pain, that it is unrelated to duodenal inflammation and that there might be a causal relationship between pathological gastroesophageal reflux and recurrent abdominal pain

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12189.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Rapid diagnosis of tuberculosis is essential, and therefore we use a polymerase chain reaction. In this report, we describe two cases of tuberculous lymphadenitis in childhood. Although histopathological findings were not specific for tuberculosis in both cases, distinct positive bands were amplified. For DNA diagnosis of tuberculosis, a lysis method of extracting chromosomal DNA from lipid‐rich cell walls of mycobacteria is of critical importance. We made use of a simple lysozyme‐proteinase K treatment for biopsied tissues. Although this extraction procedure was less efficient than those reported previously, it was considered sufficient for detecting mycobacterial DNA with the use of a highly sensitive polymerase chain reaction. We conclude that DNA amplification in combination with lysozyme lysis can be used routinely in clinical laboratories as a rapid and sensitive test for the diagnosis of tuberculo

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12190.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY