摘要:

Twenty‐four children, previously investigated at 3–12 months of age for refusal to eat during at least four weeks with no apparent medical cause, were followed up prospectively and reinvestigated at four years of age. Comparisons were made with 38 controls, selected from the same child health care districts. Information was obtained from parental interviews, medical records and assessments by a speech therapist. At four years of age, 17 of the 24 children with early refusal to eat (71%) were reported by the parents to still have feeding problems and 10 (42%) were reported as hyperactive. Compared to the controls, the children with early refusal to eat seemed to have an equally good prognosis with respect to health, growth and development, but were at risk of later problems with their eating patterns and behavi

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12303.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Three preterm infants born at 26–30 weeks' gestation who died between 103 and 266 days after birth were found to have elevated hepatic glycogen levels. Kinetic analysis of the hepatic microsomal glucose‐6‐phosphatase system demonstrated that one infant had abnormally low levels of activity of the glucose‐6‐phosphatase enzyme (partial type 1 a glycogen storage disease) and two had deficiencies of T2, a microsomal phosphate/pyrophosphate transport protein (type lc glycogen storage disease). In all three cases glycogen storage disease was not suspected prior to death even though both hypo‐ and hyperglycaemic episodes were recorded in the first 15 days after birth indicating that they had somewhat disordered blood glucose regulation. In the infant with low glucose‐6‐phosphatase enzyme activity, abnormal development of the glucose‐6‐phosphatase enzyme cannot be ruled out. This is the first description of abnormalities in the glucose‐6‐phosphatase sy

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12304.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

We investigated the intestinal absorption of the macromolecule human ot‐lactalbumin during and after an episode of acute gastroenteritis in children. Twenty children were studied in the acute phase and 17 excreted rotavirus. Eleven children were studied again 5–8 weeks later (convalescent phase). Human α‐lactalbumin serum concentrations in the acute phase were similar but in the convalescent phase they were significantly (p<0.001) higher than those in the reference children. The serum concentrations were also higher in the convalescent than in the acute phase (p= 0.021). This study suggests that there is an increased absorption of proteins from the gut into the circulation 5–8 weeks after rotavirus gastroe

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12305.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

A survey of the incidence of coeliac disease was carried out by asking all 43 paediatric departments in Sweden to report the number of children born between 1978 and 1987 in whom coeliac disease had been diagnosed. Thirty‐four departments representing a population of 7.18 million reported 1944 cases of coeliac disease among 804935 children born between 1978 and 1987. The cumulative incidence of coeliac disease was 1.7 per 1000 live births in children born between 1978 and 1982 and doubled to 3.5 per 1000 live births in children born after 1982. The highest incidence was found in the southern and south‐eastern regions of the country. The observed increase may have been influenced by changes in infant feeding practices such as the postponed age of introduction of gluten from four to six months of age and an increase in gluten content of proprietary baby fo

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12306.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Humoral immune factors related to type 1 diabetes have been investigated in children with coeliac disease. Anti‐insulin (IAAb), immunoglobulin (αIgAb), islet cell (ICA) and glucagon autoantibodies were examined in 15 children with coeliac disease at diagnosis (group 1), in 15 children with coeliac disease following a gluten‐free diet (group 2) and in 30 control patients (groups 3 and 4). IAAb were present in 27% of group 1 and in 20% of group 2 patients and αIgAb were significantly increased in group 1 and 2 patients; two patients in group 2 were positive for ICA; none of the coeliac disease patients were positive for anti‐glucagon antibodies. The levels of anti‐gliadin antibodies in group 1 were positively correlated with those of αIgAb. Coeliac disease‐related HLA antigens were not correlated with antibody presence. The presence of diabetes‐related humoral immune factors in coeliac disease raises the question as to whether or not they are predictive of subclinical pancreatic damage or whether they are simply indicators of a more general autoim

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12307.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Lactose malabsorption was investigated in 169 Chinese children aged between two and 16 years using the breath hydrogen test. The challenge was either lactose solution (1 g/kg) or cow's milk (10 ml/kg). Overall, 68% of the children showed a significant increase in breath hydrogen following the lactose challenge while only 17% showed an increase after the cow's milk challenge and 13% after both challenges. The number of malabsorbers increased significantly (p<0.001) with age and no associated gastrointestinal symptoms or signs were found in any of the children following the challenges, suggesting a gradual and partial loss of intestinal lactase activity. We conclude that the prevalence of lactose malabsorption in Hong Kong children is very high using the standard lactose tolerance test but when a more realistic amount of lactose and a natural medium such as a glass of milk is used as the challenge, the number of malabsorbers becomes small and clinically insignificant.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12308.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

A prospective and cross‐sectional study was carried out in various communities in Kwara State, Nigeria, to access the status and implications of urinary schistosomiasis among schoolchildren. Of 425 pupils examined in nine communities, 193 (45.4%) were infected. Infection rates for boys (44.7%) and girls (47.9%) were not significantly different (p>0.5). Children between 11 and 13 years of age had the highest incidence rates (33.6%). However, the percentage of children (25.9%) excreting at least 1000 eggs per 10 ml of urine sample during their first decade of life was significantly higher (p<0.01) than for older pupils. The health implications of schistosomiasis acquired early in life, as in this study, are highlighted in the discussio

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12309.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In a modified, double‐blind controlled study, 163 prepubertal boys (aged 1.8–13.0 years) with bilateral and 94 (aged 1.5–13.1 years) with unilateral cryptorchidism were allocated to treatment with either human chorionic gonadotropin (im), gonadotrophin releasing hormone (intranasally) or placebo (intranasally). In individuals with the bilateral condition treatment with human chorionic gonadotrophin resulted in complete descent of both testes in 23% of patients. Treatment with human chorionic gonadotrophin in unilateral cryptorchidism resulted in complete descent in 19% of patients; all results were significantly better than those obtained with gonadotrophin releasing hormone or placebo. Linear and logistic regression analysis of the results obtained by treatment of bilateral disease showed that all treatments were more successful the younger the age of the boys. The data indicated that bilateral and unilateral cryptorchidism respond differently to hormonal treatment. We suggest that human chorionic gonadotrophin should be the first choice of treatment for prepubertal boys older than one

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12310.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

We studied respiratory patterns and transcutaneous gas pressures in two infants with Arnold‐Chiari type II malformation referred to us due to repeated episodes of stridor and cyanosis. During both active and quiet sleep, respiration was irregular and absent or inverse thoracic breathing movements and frequent decreases in oxygen saturation to below 80% were observed. When breathing air with 2% CO2or when given acetazolamide 10 mg/kg, chest wall movements normalized and oxygenation increased to near normal levels. After three months of treatment with acetazolamide 20 mg/kg/24 h no further episodes of hypoventilation or hypoxemia were observed and further treatment could be discontinued. We conclude that stimulation of respiration by CO2or by acetazolamide appears to recruit chest wall muscles and promote upper airway patency in Arnold‐Chiari malformation. A treatment trial with acetazolamide seems justifiable in these infants when respiratory problems are pres

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12311.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

We studied seven children with congenital myotonic dystrophy, aged 2.1–8.3 years, and the results of computed tomography and magnetic resonance imaging of the brain were analyzed and neurological development was assessed from the neonatal period. We found that ventricular dilatation that had been seen on the first day of life in two of three infants had not progressed in sequential follow‐up computed tomography scans taken at intervals of one to six years. Also, in T2‐weighted magnetic resonance imagings, areas of periventricular hyperintensity were identified in all children, as well as areas of subcortical hyperintensity in one child. Further, an asphyxial episode had occurred at birth in five patients and the extent of the periventricular hyperintensity was found to correlate significantly with Apgar scores, indicating that the degree of perinatal asphyxia that had occurred was responsible for the abnormalities uncovered by the magnetic resonance imagings. However, there was no correlation between the neurodevelopmental outcome and the extent of the periventricular hyperintensity or ventriculomegaly. Therefore, in patients with congenital myotonic dystrophy, a neonatal episode of asphyxia can be responsible for a finding of periventricular hyperintensity, but it is unlikely that an integral part of the mental retardation is attributable to brain damage due to perinatal asp

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1992.tb12312.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY