摘要:

ABSTRACT.The paper discusses the possibility of detecting newly introduced teratogenic agents by a population surveillance of congenital malformations. In practice, only outbreaks of previously rare malformations or combinations of malformations can be detected by such systems. The most important aspect of malformation surveillance is therefore a detailed reporting of malformations whereas statistical techniques play a minor role. For ongoing surveillance, a high ascertainment level is less important than speed and amount of detail. For studies of longtime changes in malformation rates, ascertainment must be as complete as possible. Such changes have been identified repeatedly, but are usually explained by changes in diagnosis, ascertainment or population characteristics.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11122.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11123.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT.The serum concentrations of selected trace elements and proteins in cord blood from 17 new‐bom infants whose mothers were habitual smokers were compared with values from 22 infants of non‐smoking mothers. All the mothers were healthy with normal pregnancies and deliveries. Cigarette smoke exposure was verified by determinations of nicotine, cotinine and thiocyanate concentrations in cord blood. Infants of smoking mothers had a slightly lower mean birth weight (3490±430 g) than control infants (3780±460 g). Infants of smokers had lower serum iron (p=0.05) and prealbumin (p≤0.05), but higher serum copper (p≤0.05) and ceruloplasmin (p≤0.01) levels than the controls. Infants of smoking mothers tended to have higher levels of the acute‐phase reactants alpha‐2‐macroglobulin and orosomucoid, but lower levels of albumin, transferrin and retinol‐binding‐protein, although differences were not stat

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11124.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT.Seven very low birthweight (VLBW) infants, small for gestational age (SGA), with moderate intrauterine growth retardation and 7 VLBW‐infants, appropriate for gestational age (AGA), fed breast milk fortified with 6 g freeze‐dried human milk per 100 ml were studied on the 8th, 21st and 42nd days of life. The protein intake on the study days varied between 2.68 and 3.61 g/kg/day in the SGA‐ and 2.69 and 3.75 g/kg/day in the AGA‐infants. Serum concentrations of total bile acids (BA) and the renal excretion of total nitrogen (TN) as well as alpha‐amino‐nitrogen (AAN) were measured in all infants on each study day. On the 8th day of life a mean protein intake of 3.2 g/kg/day resulted in higher serum concentrations of BA as well as in a higher renal excretion of TN and AAN in the SGA‐infants when compared to the AGA‐infants. On the 21st day of life these differences were smaller and only the serum concentration of BA and the renal excretion of AAN were still significantly higher in the SGA‐infants. On the 42nd day of life only the serum concentrations of total BA were elevated in the SGA‐infants when compared to that in the AGA‐infants. The observed metabolic differences between moderately SGA‐ and AGA‐infants related to protein and bile acid metabolism diminished during the first weeks of life. The present data suggest that when nutritional management of VLBW‐infants is planned, differences in metabolic capacities must be considered and protein intake should be increased with caution and in accordance to the individual metabolic situation of the infants dur

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11125.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT.Bowel frequency was recorded, on a diary sheet basis, in 662 children from six Italian cities. There is a wide interindividual variability, showing a sharp decrease with age; we report the distribution of the percentiles in the different age groups. Among infants, the breast‐fed ones pass significantly more stools than the formula‐

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11126.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT.During seven epidemics of rotavirus from 1978 to 1987, 575 children younger than 3 years were admitted to hospital with acute gastroenteritis. The management before and during hospitalization, the status on admission and the outcome are reviewed. The mean age of the patients rose significantly during the study period, with the proportion younger than 12 months decreasing from 50 to 26%. Mild to moderate iso‐osmolal dehydration was found in most cases, both hypematraemia and hyponatremia were rare. The home management had usually consisted of fasting except for “clear fluids”. Oral rehydration and rapid feeding in hospital according to modem principles accelerated weight gain, shortened the duration of diarrhoea and the hospital stay and reduced the requirement for intravenous fluid therapy. This experience, together with the current rarity of acute gastroenteritis in young infants and of delay in recovery, suggests that oral rehydration and realimentation should be more extensively used in general pra

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11127.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT.A semistructured personal interview was performed with 29 carriers of hemophilia A or B, 1–5 years after a pregnancy in which prenatal diagnosis (PND) was performed by fetal blood sampling. Fetal blood sampling by fetoscopy was significantly more often reported by the women to be more trying than expected than was ultrasound‐guided heart puncture. Of 29 women 13 were classified as having experienced the PND process (amniocentesis and fetal blood sampling) as distressing, having had mental or psychosomatic symptoms associated with it. All of the women who had abortion/miscarriage after PND reported a very high frequency of psychological sequelae during the 6 months that followed PND. Of 22 women who continued their pregnancy with a healthy fetus after PND 8 experienced the period until delivery as trying and felt that their emotional and somatic status influenced their daily life activities. This was particularly common among women who after fetoscopy received routine profylactic terbutalin treatment and had continuous sickleave until the 36th gestational week. 17/29 would consider going through PND in the future. Qualified psychological assistance must be offered both before and after

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11128.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT.Intestinal hypomotiHty is a common late complication in infants with acute diarrhoeal disease in Pakistan. Among the infants admitted to our gastrointestinal unit with a history of acute diarrhoea, 35% developed abdominal distension and 12% developed the full clinical picture of paralytic ileus. The infants with ileus were treated with decompression and total parenteral nutrition; in this group the mortality rate was 25%. We compared 30 infants who developed ileus (group A) with an age‐matched control group of infants (group B) who were admitted because of acute diarrhoea but did not develop ileus. The use of antimotility drugs was significantly more frequent in group A. Serum‐K was not different in group A (3.92±0.22 mmol/1) and group B (4.32±0.18 mmol/l). However, there were more patients who had serum‐K below 3 mmol/l in group A (8/30) than in group B (5/30). We conclude that the use of antimotility drugs predisposes to the development of ileus in infants with acute diarrhoea. Hypokalemia may contribute to ileus in a few cases but is generally not a prere

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11129.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT.Four neonates who presented with coma secondary to hyperammonaemia resulting in central respiratory failure were treated with peritoneal dialysis for between 16 and 120 hours. Underlying diseases were maple‐syrup‐urine disease, propionic acidaemia and citrullinaemia in two patients. Clinical improvement was observed in three patients within 16 to 72 hours after institution of peritoneal dialysis. Biochemical analysis revealed a rapid reduction in plasma concentrations of leucine, isoleucine and valine as well as their alpha‐keto‐analogues in the infant suffering from maple‐syrup‐urine disease. Correction of ammonia, glycine, alanine and propionic acid concentrations was observed in the infant with propionic acidaemia 24–72 hours after institution of peritoneal dialysis. Severe hyperammonaemia (1000–2500 μmol/1) in two infants with citrullinaemia before peritoneal dialysis was treated successfully in one infant; whereas the second infant showed no clinical improvement despite amelioration of biochemical parameters. Glucose‐absorption from peritoneal dialysis solution was in the range

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11130.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT.The renal function in a group of diabetic children (n=29; age: 4–17 yr; IDDM duration: 1.5–13 yr) was studied with a 3 year interval. At the first evaluation glomerular filtration rate (GFR) as assessed by inulin clearance was significantly increased compared to control values (167±32 vs. 124±18 ml/min/1.73 m2;p≤0.01). Eighteen out of 29 children exhibited a glomerular hyperfiltration (GFR ≥ 160). Three years later mean GFR was identical (169±25 ml/min/1.73 m2) and 16 children were hyperfiltrating. Among them, 11 have had a persisting glomerular hyperfiltration over the 3‐year period. Renal plasma flow (RPF) was positively correlated to GFR (r=0.7;p≤0.01) and remained elevated at both evaluations (794±163 and 812±157 ml/min/1.73 m2,p≤0.01 vs. control values). When the children were separated into 3 groups according to IDDM duration no significant differences were observed in the results for GFR and RPF. Mean urinary albumin excretion was comparable at the 3‐year interval, and not significantly different from the control values (5.2±3.7 and 8.2±6.6 respectively vs. 8.65±4 |ig/min). None of the children demonstrated a persistent microalbuminuria. This study reveals a high proportion of diabetic children with a persisting glomerular hyperfiltration, without any other symmptom of incipiens nephropathy. If elevated GFR plays an important role in the development of diabetic nephropathy, this study emphasizes the value of regular evaluation of renal functi

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1989.tb11131.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY