摘要:

ABSTRACT.The vaccine response to poliovirus, diphtheria and tetanus toxoids in relation to protein intake was studied in infants, either breast‐fed or given low (1.1 g/100 ml) or conventional (1.5 g/100 ml) protein formula. Serum, salivá and faeces antibodies were measured by the enzyme‐linked immunosorbent assay. Neutralizing poliovirus antibodies were determined. The serum, saliva and faeces antibody responses in the two formula‐fed groups of infants did not differ significantly, but for the low protein formula group which had significantly higher serum neutralizing titres to poliovirus after the second vaccine dose than the conventional formula group. However, the breast‐fed group had significantly higher antibody levels than the two formula‐fed groups together: serum IgG to diphtheria toxoid (p<0.01) and serum neutralization of poliovirus (p<0.001) at 21‐40 months of age, saliva secretory IgA to tetanus (p<0.01), diphtheria toxoid (p<0.01) and poliovirus (p<0.05), as well as faecal IgM to tetanus toxoid (p<0.05) and poliovirus (p<0.01 and p<0.05) at 3 and 4 months of age. Breast‐fed infants thus showed better serum and secretory responses to peroral and parenteral vaccines than the formula‐fed, whether with a conventional or low

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11401.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.The infant mortality rate in North Rhine Westphalia (NRW), the most populous West German state, has continuously been around 10 % higher than the German national average in the post‐war period. Using white singleton data from the US 1980 National Infant Mortality Surveillance project (NIMS) and similar 1980/1981 data from NRW we compared infant mortality by birthweight and cause to describe the distribution of excess mortality in NRW. The US infant mortality rate was 8.7 deaths per 1000 live births, compared with 13.1/1000 for NRW (rate difference: 4.3/1000). Of the 4.3/1000 overall rate difference, 1.9/1000 was attributable to neonatal deaths, 2.4/1000 to postneonatal deaths. A major proportion, 2.0/1000, of the overall rate difference of 4.3/1000 was attributable to normal birthweight deaths postneonatally. 0.85/1000 of this 2.0/1000 rate difference was attributable to SIDS, 0.44/1000 to external causes and 0.42/1000 to infection

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11402.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.Postnatal changes in intracranial arterial blood flow velocity, were studied in preterm infants of less than 34 weeks of gestation. The blood flow velocity was measured in an artery on the base of the skull, using a range‐gated Doppler ultrasound velocimeter. Ten healthy infants (mean gestational age 32.5 weeks), and ten infants with transitional respiratory disease (mean gestational age 31.3 weeks) were studied at 1, 2, 5, 24 h, and 2, 3, 5 and 10 days after birth. The healthy infants showed a consistent pattern of changes on the first day, with an average reduction in mean flow velocity of 29% between 1 and 5 h. At 24 h after birth, mean flow velocity had almost returned to the level of the 1 h recording. After 24 h there was a gradual increase in systolic and mean flow velocity until 10 days, while diastolic flow velocity remained unchanged. In the infants with respiratory disease there were no systematic changes in mean flow velocity on the first day, although large individual changes were seen. After 24 h no differences were seen between the healthy infants and the infants with respiratory disease. These findings indicate a transient decrease in cerebral perfusion during early circulatory transition in healthy preterm infants, and that mild to moderate respiratory disease causes larger individual variations in intracranial blood flow velocit

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11403.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.The urinary excretion rate of creatinine was measured over 89 days in 31 infants of gestational ages 25‐34 weeks in the first week of life. Creatinine excretion was shown to have a significant positive correlation with weight and postconceptional age. Creatinine excretion factored by body weight was also positively correlated with weight and postconceptional age. Pooled analysis of published data together with our own, confirms that this correlation is important. Muscle mass was estimated from creatinine excretion rate. A regression equation was derived predicting muscle mass from birthweight and gestational age. Muscle mass increases from 12% of birthweight at 25 weeks gestation to 19% at 34 weeks and 24% at 40 weeks. This is in agreement with classic dissection studies which showed muscle mass to be 25% of body weight at ter

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11404.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.Twenty preterm infants undergoing neonatal intensive care were randomly allocated to one of two feeding regimens: human milk enriched with either human milk protein (HMP) or adapted cow's milk protein (CMP). The birthweights (1076 ± 301 g; 1031 ± 309 g) and the gestational ages (28.4 ± 1.6 weeks; 27.7 ± 2.1 weeks) were comparable. The amount of protein added to the milk was set at 0.7 g/100 ml in order to provide a total supply of 3.0‐3.5 g/kg/24 h. All infants received additional amounts of carbohydrate, calcium, phosphorous, and sodium chloride. Capillary whole blood amino acids were measured with high pressure liquid chromatography (HPLC). The amino acid levels did not differ significantly when the feeding groups were compared week by week, but the glycine/valine ratio was higher (p<0.05) in the HMP group after three weeks of fortification. Longitudinal changes after protein enrichment could be demonstrated in both groups. Alanine and threonine increased after one week (p<0.01) in both groups. Glycine in the HMP group peaked after two weeks (p<0.02), and valine in the CMP group increased (p<0.02) after one week on the feeding regimen. However, the amino acids never reached levels above those seen after a meal in normal term newborns. Other variables related to protein intake, such as protein and urea in serum, did not vary between the groups. Growth, expressed as gains in weight, length, and head circumference was poor but comparable. The quality of the protein, whether a human milk protein isolate or a cow's milk whey protein product, used for the fortification of human milk up to a protein load of 3.0‐3.5 g/kg/24 h, did not cause any alterations of significance in the amino acid profiles of periphera

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11405.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.The relation between the yellow colour of the skin as measured by the Minolta Air Shields jaundice meter and the serum bilirubin concentration was investigated in 207 mature icteric, but otherwise healthy, newborns and the relationship between the changes in the meter readings and the changes in serum bilirubin concentration was studied in 99 of the infants. Good correlation was found both between the meter readings and the serum bilirubin concentration (p=0.81), and between the changes in meter readings and the changes in serum bilirubin concentration (p=0.69). The jaundice meter proved to be effective in predicting hyperbilirubinemia defined as serum bilirubin values 175 or 225 μmol/1, and was also effective in predicting increasing or decreasing serum bilirubin concentrations by sequential meter readings. The gestational age correlated slightly but significantly with the meter readings (p=–0.15) and with the serum bilirubin concentration (p=–0.15). However, these findings did not affect the action levels for use of the jaundice meter as a screening device for hyperbilirubinemia. The postnatal age and the birthweight did not significantly influence the meter read

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11406.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.We analysed the data of difference in serum sodium (DIFNA) and glucose (DIFGLU) concentrations and difference in serum tonicity (DIFTON) following exchange transfusion (ET) with CPD blood during 122 consecutive procedures performed in 82 newborn infants. Mean (± SE) gestational age (GA) was 30.8 ± 0.45 weeks, mean birthweight was 1568.6 ± 81.4 g, and mean age at time of ET (AGEH) was 60.6 ± 4.3 h. Following the ET, mean serum sodium concentration increased in 110 cases, by 5.4 ± 0.7 mmol/1, and the mean DIFTON rose by 14.6 ± 1.46 mOsm/kg H2O. Mean DIFGLU rose in 111 cases by 3.8 ± 0.3 mmol/1. Significant correlations were found between DIFNA and AGEH (p<0.02), and between DIFTON and AGEH (p<0.02). ET performed<48 h after birth produced higher DIFTON values than later transfusions (21.2 vs. 8.2 mOsm/kg H2O, p<0.001) particularly in the VLBW infants (31.1 in28 weeks). VLBW neonates appear to be at greatest risk of developing extreme increments in serum tonicity following ET performed within the first 48 h o

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11407.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.In 1975–1987 at least 84 children developed blindness or impaired vision due to retinopathy of prematurity (ROP) in the Netherlands. Neonatal data were obtained on 74 (86%). Unexpectedly most children (40 i.e. 54%) had been in level I and II hospitals after birth. Screening for ROP had been either insufficient or not timed according to present recommendations in 33 out of 40 children in level I and II hospitals and 25 out of 34 in level III hospitals. As the number of children with ROP has not changed appreciably over the last 40 years, while birth rates in the Netherlands have steadily decreased, the incidence of blindness/impaired vision due to ROP has probably increased. In the current population at risk of ROP which differs considerably from the one during the first epidemic, the disease may not be completely preventable. We conclude that improvements in screening procedures and timely treatment are crucial in order to improve the present situatio

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11408.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.Fifty‐four neonates with congenital hypothyroidism identified by the North East and North West Thames Regional hypothyroid screening programme between January 1985 and December 1987 were investigated with radioisotope (Tc99m) and ultrasound scans of the thyroid before treatment with 1‐thyroxine was commenced. Compared with the radioisotope scans, ultrasound identified normally sited thyroid tissue in only 7 out of 10 cases, and ectopic thyroid tissue in only 5 out of 26 cases. Three out of 18 cases with no isotope uptake in the neck appeared to have normally sited tissue on ultrasound scan. We conclude that in our hands ultrasound of the neck is of only limited value in the assessment of young infants with congenital hypothyroid

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11409.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

ABSTRACT.The aim of this study was to analyze Na,Li countertransport in erythrocytes from adolescents with insulin dependent diabetes mellitus (IDDM) and to see if those with elevated values present distinct clinical features, in particular as regards arterial pressure and urinary albumin excretion (UAE). Twenty‐nine adolescents with IDDM (17 males, 12 females, mean age 15 ± 0.6 years, mean diabetes duration 11.4 ± 0.7 years) and fifteen healthy age‐matched control subjects (8 males, 7 females, age 14.5 ± 1 years) were investigated. Diabetic adolescents had a RBC Na,Li countertransport activity higher than age matched normal controls; geometric mean 283 (95% limits 259‐340) vs. 193 (169‐252) μmol/l RBC/h; p<0.01. Seven out of 29 subjects had values higher than the 95th percentile of normal subjects (Counter+). Both systolic and diastolic arterial pressures were significantly higher in Counter+ than in Counter‐ patients. No significant differences were found as regards age, body mass index, diabetes duration, HbAlc, fructosamine, serum potassium, triglycerides, creatinine clearance and UAE. The logarithm of systolic pressure was independently positively correlated with In Na,Li countertransport (r=0.38; p<0.05), In [Nai] (r=0.38; p<0.05), and In body mass index (r=0.5; p<0.01) in diabetic patients. The main finding of this study is that diabetic adolescents with a high erythrocyte Na,Li countertransport rate have an arterial pressure significantly higher than patients with normal Na,Li countertra

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1990.tb11410.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY