摘要:

ABSTRACT.Serial measurements of cerebral blood flow velocity (CBFV) were made in 29 preterm infants, using continuous wave Doppler ultrasound. CBFV was measured in both anterior cerebral arteries and quantitative measurements of CBFV were determined using the area under the velocity curve. In all ventilated infants, CBFV increased significantly during the first 6 hours of life and continued to increase until 16 hours of age. Thereafter, CBFV remained relatively constant. This increase in CBFV was primarily the result of increased diastolic flow. Three infants who had evidence of intraventricular haemorrhage on cranial ultrasound, had similar CBFV compared with the infants with no evidence of haemorrhage. Two infants died and both demonstrated areas of periventricular leukomalacia at autopsy. These infants had a prolonged period of low CBFV. These measurements provide normal data for ventilated, preterm infants. As previously suggested in term infants, the initial rise in CBFV may be secondary to closure of the ductus although a generalized decrease in peripheral vascular resistance could also be a contributing factor. Fluctuations in CBFV rather than individual readings are probably more important in the genesis of IVH. An episode of significantly reduced CBFV is a poor prognostic sign.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10720.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.Cerebral blood flow (CBF00) was investigated in 24 preterm infants (mean 30.8 weeks of gestational age) by use of intravenous 133‐Xe clearance technique while screening simultaneously for low blood glucose after birth (mean 3 hours). CBF was significantly increased in 10 infants with blood glucose lower than 1.7 mmol/l compared to normoglycaemic infants and tended to decrease rapidly after treatment. Nine of the 10 hypoglycaemic infants were monitored for cerebral function. Well defined visual evoked cortical potentials were elicit‐able in all and the aEEG was not less active during the hypoglycaemic episode. Therefore, it is suggested that compensatory increase of CBF may have supported the cerebral metabolism during uncomplicated hypoglycae

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10721.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.In a population of vaginally born low‐risk preterm infants fetal acidosis (scalp pH<7.20) was found in 50% (6 out of 12) of infants of 29–33 weeks' gestational age (Group I) and in 9% (2 of 22) infants of 34–36 weeks' gestational age (Group II). At 6–7 years of age the children underwent a neurodevelopmental examination including a Griffith test. Five out of 6 Group I infants with fetal acidosis and 10 out of 20 Group II infants without fetal acidosis had minor or moderate neurodevelopmental problems. On the Griffith test Group II infants scored below Group I with more coordination and fine motor problems on the tested subscales. Fetal acidosis was more common in very preterm infants but cannot be used per se as a reliable indicator of long‐ter

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10722.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.The metabolic response to different levels of human milk protein intake was studied in 23 appropriate (AGA) and 19 small for gestational age (SGA) infants of very low birthweight (VLBW) on the eighth day of life. The infants received from birth, either fresh preterm human milk or human milk fortified with lyophilized human milk (6 g per 100 ml). Thus, the protein intake ranged from 1.98 to 3.28 g/kg/d in the AGA‐ and from 1.94 to 3.34 g/kg/d in the SGA‐infants. Alpha‐amino‐nitrogen and bile acid concentrations in serum and total‐ as well as alpha‐amino‐nitrogen excretion in the urine were measured. When the protein intake was less than 2.5 g/kg/d no differences between the groups could be found in any of the parameters directly related to nitrogen metabolism, but a significantly higher concentration of bile acids in serum was found in the SGA‐infants. On protein intakes of more than 2.5 g/kg/d the SGA‐infants responded with higher alpha‐amino‐nitrogen as well as total bile acids concentrations in the serum and also with higher excretions of total‐ as well as alpha‐amino‐nitrogen in the urine when compared to the AGA‐infants. The differences between the groups became more pronounced with an increasing protein intake. The data suggest that on the eighth day of life SGA‐infants are more sensitive to an excessive protein intake than AGA‐infants. Hepatocellular dysfunctions as a result of intrauterine growth retardation seems to be an important factor in this special metabolic situation. Bile acid concentration in the serum can be used as a good marker to detect this. The observed differences in the metabolic capacity to handle protein between AGA‐ and SGA‐infants on the eighth day of life have to be considered in the n

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10723.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.Thirty‐two large‐for‐gestational‐age (LGA) infants and 46 appropriate‐for‐gestational‐age (AGA) infants used as controls, were investigated. LGA and AGA infants did not differ regarding instrumental deliveries or asphyxia. The infants were examined on the 1st and 5th days after birth with a standardized neurological assessment. The LGA infants showed a significantly delayed neurological adaptation with fewer optimal responses on day one as compared to the AGA infants. These differences were not observed on day five. There were no neurological differences between prenatally and postnatally detected LGA infants. No significant differences were observed regarding parity on maternal complications, neonatal course, and neurological scores of th

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10724.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.The electrocardiograms of 421 healthy fullterm and premature newborns, recorded on the fifth day of life, were evaluated for possible systematic differences related to gestational age. All newborns were appropriate for gestational age and were divided into four groups according to birthweight. As birthweight increased, we noted: (a) a progressive rightward shifting of the QRS axis in the frontal plane; (b) an increase in the amplitude mainly of the precordial R and S waves reflecting the right ventricle and both ventricles combined, whereas a less significant increase or even a decrease was noted in the R and S waves reflecting the left ventricle; (c) a more frequent occurrence of diphasic and positive T waves in the right precordial leads; and (d) a prolongation in the duration of the P wave and the QRS complex. These findings reflect both an increase in total myocardial mass as well as a progressive right ventricular predominance, as birthweight or gestational age increases. Practical implications for electrocardiographic identification of cardiac hypertrophy in newborns of different gestational age are discussed.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10725.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.A prospective study to assess whether milk IgA antibodies againstEscherichia coliheat labile‐toxin protect breast‐fed children against labile toxin‐induced gastroenteritis was carried out among infants of a marginal urban area in Guatemala. One hundred and thirty children were kept under surveillance for diarrhea by periodic home visits. Stool specimens were collected from each child routinely every 2‐3 weeks and during diarrheal episodes, to study the excretion of labile toxin‐producingEscherichia coli.Milk samples from the children's mothers were obtained concomitantly with the fecal specimens of the infants to be analyzed for anti‐labile toxin antibodies. Twenty infections by heat‐labile toxin‐producingEscherichia colias a sole agent were documented among breast‐fed infants. Nine of these infections resulted in gastroenteritis, while the remaining 11 were asymptomatic. At the time of infection children who became sick were ingesting breast milk with significantly (p=0.028) lower titers of antilabile toxin IgA than those who remained healthy. Only one of the 8 infected children receiving breast milk with high titers (≥256) of anti labile toxin IgA developed diarrhea, compared to 8 of the 12 subjects being fed milk with low titers (≤64) (p=0.025). This is the first report documenting protection by IgA antibodies in milk against labile toxin‐induced gastroenteritis in infe

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10726.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.A cohort of 1749 newborns in the municipality of Odense were followed prospectively for the development of cow's milk allergy (CMA) during their first year of life. Altogether 39 fulfilled the criteria for CMA (2.2%). Out of the 39 infants, 17 developed symptoms of CMA during breast‐feeding, in all cases before the age of 3 months. Nine of these were solely breast‐fed at the time of diagnosis, giving a one year incidence of CMA in exclusively breastfed infants of 0.5% (9/1 749) in a study population with a frequency of exclusive breast‐feeding of 52% at 3 months of age. None of the infants had signs of CMA in the neonatal period. Review of records from the newborn nursery revealed that all 9 infants had been exposed to cow's milk formula in amounts corresponding to approximately 0.4‐3.0 g of Beta‐lactoglobulin (BLG) during the first three days of life. Human milk samples were analyzed by enzyme‐linked immunosorbent assay (ELISA) for the content of bovine BLG. Detectable amounts (0.5–45 ng/ml) were found in 3/9 samples of human milk against which the infants reacted clinically. Analysis of the size distribution by high pressure liquid gel permeation chromatography in combination with ELISA indicated a molecular weight of BLG corresponding to that of monomeric BLG (18 kD). Possibly early inadvertent and occasional exposure to cow's milk proteins may initiate sensitization in predisposed neonates. Subsequent exposure to minute amounts of bovine milk proteins in human milk may act as booster doses eliciting aller

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10727.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.Eighteen newborn infants, gestational age between 36 and 42 weeks with birth asphyxia were compared with 23 normal newborn infants to determine serum cortisol and dehydroepiandrosterone sulfate levels in cord blood and in venous blood samples collected 12–18 hours after birth. Both groups were similar in gestational age, birthweight, proportion of small for gestational age and large for gestational age infants, proportion of infants delivered by cesarean section with and without labor, and proportion of mothers with pre‐eclampsia. There was no antenatal exposure to corticosteroid. The asphyxiated newborn infants had a significantly higher mean cord serum level of cortisol, and a significantly lower mean cord serum level of dehydroepiandrosterone sulfate than the control group. Mean serum cortisol and dehydroepiandrosterone sulfate levels collected 12–18 hours after birth were similar between both groups. It is suggested that elevated cord serum level of cortisol is related to birth asphyxia stress stimulating the adrenal definitive zone, and the low cord serum level of dehydroepiandrosterone sulfate is secondary to a transient hypoxemic‐ischemic insult to the adrenal fet

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10728.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.We investigated the influence of human growth hormone (hGH) on mitogen‐stimulated lymphoproliferation, in vitro IgM production, serum levels of immunoglobulins, somatomedin‐C (Sm‐C) values and serum growth‐promoting activity (Thymidine Activity, TA) in 18 short children, aged between 6.6–14.5 years, undergoing a 3‐month course of hGH therapy. Blood was collected the day before treatment (Group A), on the 5th day after patients were administered hGH daily (0.1 U/kg) i.m. for 4 days (Group B), after a 3‐month course of hGH injected three times weekly, and finally before (Group C) and 24 h after an extra injection (Group D). In vitro IgM production from the patients' unstimulated lymphocytes decreased from 277±41 (Group A) to 168±38 (Group B), to 119±43 (Group C) and then to 119±28 ng/ml (Group D) (p<0.05). Using PWM‐stimulated lymphocytes in vitro IgM production decreased from 2015±464 (Group A) to 1116±316 (Group B), then to 511±170 (Group C) and 968±295 ng/ml (Group D) (p<0.02). The variation of this decrease could be correlated with the variation of growth velocity during treatment (r=0.619,p<0.05). In contrast, no significant changes were found following therapy either in serum levels of IgA, IgE, IgG, IgM, Sm‐C and TA, or in phytohemagglutinin, concanavalin A and pokeweed mitogen‐stimulated lymphoproliferation. Our data suggest that there is some relationship between growth h

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10729.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY