摘要:

A new methodology for evaluation of weight in relation to length normalized for sex and gestational age (leanness/fatness) in the newborn infant is presented. Using standard deviation scores (SDS) for weight and length in a linear regression model, a new continuous variable called LEANSDS has been constructed with intercept = zero, regression coefficient = 0.7152, SD = 0.6988 andr2=0.51, irrespective of gender and gestational age within the range 34–43 weeks’gestation. The model is based on the Swedish 1986 Medical Birth Register and was tested on the 1985 year cohort. The reference material consisted of live‐born, singleton infants considered “healthy”. This new variable is independent of length. A chart is presented which simplifies visual evaluation. Using — 2 SD as the cut‐off limit, approximately one‐third of light‐for‐dates infants are also lean, while two‐thirds of the lean infants are not light for dates. Proportions of “not healthy” live‐born infants and still births are given. Using another method, based on weight and length, and with some approximations needed for calculation of a comparable BW/BLSDS, the correlation was 0.9974, but this calculation is more elaborate and the comparable chart more complex. This method reveals the influence of gestational age on the relationship between weight and length, indicating a “prenatal puberty”. Empirically, the logarithmic relationship found between weight and length indicates a ponderal index exponent of 2.4–2.5 instead of 3. LEANSDS, with its continuous nature, also gives the degree of deviation in each individual and in groups of infants, and can be added together and further a

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12691.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

A follow‐up study of 69 premature infants showed that at a mean age of 11.4 years they had a cumulative incidence of allergic symptoms similar to that reported in unselected series. The 38 premature infants fed exclusively with human milk to the age of four months had more allergic symptoms than the 31 premature infants fed with adapted cow's milk formula from birth (mean number of symptoms 1.6 versus 0.6,p =0.0025). The excess of symptoms was mostly cutaneous, and often associated with a specific food. In logistic regression models, the only variable with a statistically significant association (standardized odds ratio 3.15, 95% confidence interval 1.12–8.8,p =0.03) with symptomatic allergy was the type of feed. The frequency of positive skin prick tests and the mean levels of serum IgE and antibodies to cow's milk were similar in the two groups. We infer that food allergy was more common in the group fed with human m

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12692.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Liver size and midclavicular line were measured by clinical and sonographic methods in 145 normal Chinese neonates with gestational ages of 34–42 weeks. The liver span, measured by clinical methods with percussion and percussion/palpation methods, correlated well with that measured by sonography (r= 0.73 andr= 0.76, respectively) for the entire sample. The liver spans (mean ± SD) obtained by sonography were 4.24 ± 0.63 cm and 4.58 ± 0.56 cm in the preterm and term neonates, respectively. The liver span (sonography) and the distance of the liver edge below the right costal margin were weakly related in the term neonates (r= 0.36), but unrelated in the preterm neonates. We conclude that the liver span is a better estimate of liver size than the distance below the right coastal margin in normal neonates. We also found that the mean liver span is approximately 1 cm smaller in Chinese neonates than in Western neon

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12693.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Lipid emulsion (Intralipid) causes free radical‐mediated damage to human cells in vitro. Incubation with 0.44% Intralipid for 17 h caused 40.3 ± 3.8% haemolysis in adult human erythrocytes and 26.5 ± 8.1 % in erythrocytes from term newborns (p =0.0001). In adult erythrocytes mean corpuscular volume increased 68.7 ± 8.20%, and in newborn erythrocytes 54.8 ± 10.4% (p= 0.0012). Initial concentrations of reduced glutathione in adult and newborn erythrocytes were 65.1 ± 2.5 and 62.1 ± 4.0 mg/dl, respectively (ns); after incubation, glutathione concentrations were 21.0 ± 4.0 and in 25.7 ± 5.2 mg/dl in adult and newborn erythrocytes, respectively (p =0.0004). After incubation the concentrations of thiobarbituric acid reactive material and conjugated dienes in newborn erythrocytes (2.8 ± 0.2 μM and 0.223 ± 0.019 OD 233, respectively) were higher than those of adult erythrocytes (2.1 ± 0.4 μM and 0.138 ± 0.012 OD 233) (p =0.0001). In both adult and newborn erythrocytes, the effects of Intralipid were significantly inhibited by 0.6 mM desferoxamine or 8 mM sodium etidronate. Despite higher susceptibility to lipid peroxidation of the cell membrane, newborn erythrocytes are more resistant than adult erythrocytes to free radical‐mediated effects such as depletion of intracellular glutathione, cell swelli

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12694.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Tumor necrosis factor (TNF‐alpha) has been implicated as a principal mediator in the pathogenesis of septic shock. TNF‐alpha was measured by immunoradiometric assay in serum samples from 23 full‐term infants with sepsis (15 with severe infection and 8 with septic shock) and in 20 healthy full‐term newborns. Serum TNF‐alpha levels were significantly higher in the group with sepsis, at the time of admission to the neonatal intensive care unit, than in the healthy neonates. The highest TNF levels were found in those newborns with septic shock, particularly in those who died. Although the method is far too slow for any clinical routine work, our results suggest that the presence of elevated serum TNF‐alpha levels could be considered a sensitive and specific test for predicting septic shock and its clini

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12695.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

In a prospective study, 91 episodes of fever in neutropenic children with cancer were evaluated. Fifteen episodes were septicemias, verified by a positive blood culture, 62 were fevers of unknown origin, 6 were focal infections and 8 were of other etiologies (i.e. drug fevers and viral infections). Serum antibody responses to bacteria were measured in paired sera by an enzyme immunoassay method. Bacterial infection was demonstrated serologically in 20% of documented septicemias, in 35% of fevers of unknown origin and occasionally in the other groups. Tests were available and found positive in the fever of unknown origin group forStaphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella (Branhamella) catarrhalisand enterobacteria. Some had multiple etiology. In conclusion, bacterial serology is a promising method of identifying bacterial etiology in fever of otherwise unknown origin in neutropenic children with cancer.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12696.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Sixty‐one children were treated in hospital from 1981 to 1982 because of both radiologically and microbiologically verified viral or bacterial pneumonia. The chest radiographs were interpreted by two radiologists, not familiar with the clinical data, on two occasions three years apart, and only those patients with a definite alveolar (n= 27) or interstitial (n= 34) pneumonia at both evaluations were included in the present analysis. In addition, all patients had viral (n= 20), mixed viral‐bacterial (n =21) or bacterial (n= 20) infections diagnosed by viral or bacterial antibody or antigen assays. Viral infection alone was seen in 7 (26%), mixed viral‐bacterial infection in 8 (30%) and bacterial infection alone in 12 (44%) of the 27 patients with alveolar pneumonia. The respective figures were 13 (38%), 13 (38%) and 8 (24%) for the 34 patients with interstitial pneumonia. C‐reactive protein concentration was greater than 40 mg/l (a screening limit for viral and bacterial infections) in 15 (56%) of the patients with alveolar and in 11 (32%) of the patients with interstitial pneumonia. Thus 74% of the patients with alveolar and 62% with interstitial pneumonia had bacterial infection, either alone or as a mixed viral‐bacterial infection. Our results suggest that the presence of an alveolar infiltrate in a chest radiograph is a specific but insensitive indicator of bacterial pneumonia. We conclude that patients with alveolar pneumonia should be treated with antibiotics. In patients with interstitial pneumonia, however, both viral and bacterial aetiology are possible. In those, the decision concerning antibiotic treatment should be based on clinical and laboratory

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12697.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

A cephalometric study was performed in 19 patients with Turner's syndrome, aged 8.7–16.5 years. A lateral roentgencephalogram was taken before and after two years of treatment with biosynthetic growth hormone in a dose of 24 IU/m2/week. During two years of growth hormone treatment, the mandibular length increased mainly due to vertical growth. The initially posteriorly rotated mandible showed an anterior rotation, although the normal position was not reached. The other linear measurements and angles did not change during treatment. No indications were found for an increase in the disproportionate growth or for excessive chin growth as a sign of acromegaly during growth hormone treatment. In conclusion, growth hormone treatment in patients with Turner's syndrome resulted in an increase in mandibular length, mainly due to vertical growth of the ramus and in the anterior rotation of the mandibl

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12698.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

A retrospective study was performed in 32 children with hemophagocytic lymphohistiocytosis, 16 of whom had affected siblings. Altogether 22 of these children, of whom the majority (13/22) were familial cases, had clinical or laboratory signs of infection. Laboratory analysis demonstrated Epstein‐Barr virus in five children, cytomegalovirus in three and human parvovirus in two. Two siblings with onset of familial hemophagocytic lymphohistiocytosis within one month of each other, both of whom demonstrated serological indications of a recent human parvoviral infection at onset, are described. It is concluded that a viral infection cannot serve as the sole criterion for distinguishing a virus‐associated hemophagocytic syndrome as an entity separate from familial hemophagocytic lymphohistiocytosis. Instead, it is suggested that viral infections may elicit a bout of the familial hemophagocytic lymphohistiocytosis disorder in genetically predisposed individu

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12699.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Renal function was evaluated in 12 children (aged 2.5–17.5 years) who received ifosfamide as part of their chemotherapy for different malignancies. A blood and urine analysis evaluating renal glomerular and tubular function and an isotopic determination of glomerular filtration were carried out four months or later after treatment had been stopped. Three patients had several biochemical abnormalities suggesting a significant degree of proximal renal dysfunction (increased urinary excretion of calcium, glucose, beta2‐microglobulin, amino acids (three patients) and decreased tubular reabsorption of phosphate (one patient)). The tubular dysfunction in these patients was associated with a diminished glomerular filtration. These patients could be characterized by their younger age at treatment and a higher dose of ifosfamide received if calculated per kg body wei

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1993.tb12700.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY