摘要:

ABSTRACT.Twenty‐four infants, 32 weeks of gestation or less, were studied with continuous recording of amplitude integrated electroencephalogram (aEEG) and repeated Doppler ultrasound determination of the mean blood flow velocity in the internal carotid artery (cMFV). The recording was started after the initiation of mechanical ventilation for respiratory distress. Of twelve infants receiving blood or albumin transfusion to expand the intravascular volume and in whom adequate data were available, both mean arterial blood pressure and cMFV increased in eight, and cMFV but not blood pressure in further two. In the present circumstances we consider the cMFV increases to represent true increases in cerebral blood flow. aEEG burst rate increased distinctly in five of the twelve infants during or immediately following transfusion, but did only approach the level of the four non‐transfused infants after several hours, indicating a dysfunction of neural tissue not readily reversible by improved blood f

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10756.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.A total of 576 transcutaneous bilirubin measurements were performed on 336 Japanese full‐term breast‐fed newborn infants during the first twelve days of life. Our present study revealed that transcutaneous bilirubin measurements obtained from the forehead, chest, and sternum correlated well with serum bilirubin concentrations measured by AO bilirubinometer (0.910–0.922,p<0.001,n=576). The 95% confidence lmits were ±3.04 mg/dl for the forehead, ±2.85 mg/dl for the chest, and ±2.84 mg/dl for the sternum readings. The overall mean of values from the forehead, chest and sternum, when compared with individual means, was found to correlate better with serum bilirubin concentrations (r=0.930,p<0.001,n=576) and improve the 95% confidence limits to ±2.68 mg/dl. These results demonstrated that the accuracy and reliability of TcB measurement could be increased further with multiple site measurement. The study clearly indicates that transcutaneous bilirubinometry is useful for clinical screening of serum bilirubin levels in Japanese full‐term newb

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10757.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.Transcutaneous bilirubinometry using the Minolta Airshield TcB was performed on 40 preterm VLBW Chinese infants during the first 7 days of life; altogether 614 observations were made on the forehead and sternum, respectively. A positive correlation between the TcB index and plasma bilirubin concentration was obtained on the forehead and sternum. Positive plasma bilirubin‐TcB index correlations were also observed for each individual day. The plasma bilirubin‐TcB index (forehead) regressions were fairly similar for the individual days and the combined overall regression except for 2 days (days 5 and 7). A slight improvement was observed when only bilirubin concentrations ≤200 μmol/l were evaluated. The intercepts were however different for individual days requiring correction factors to the combined overall regression intercept if the regression is to be used for the respective days. However, the plasma bilirubin‐TcB index (sternum) regression for the individual days were significantly different one from another, and from the overall combined plasma bilirubin‐TcB index (sternum) regression. This significant difference was still observed when only plasma bilirubin concentrations ≤200 μmol/l were evaluated. Hence, transcutaneous bilirubinometry has major limitations in preterm

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10758.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.The lactulose hydrogen breath‐test provides a non‐invasive measure of mouth to caecum transit‐time. Its use, particularly in children has not been thoroughly investigated. We have studied the effects on transit time of altering the lactulose concentration of the test solution, and of administering it in a liquid nutrient preparation. Concentration markedly affected transit‐time; studies with an isotonic solution may be least affected by delayed gastric emptying, and so may reflect small bowel transit‐time. Day‐to‐day variation was large, and was not reduced by altering lactulose concentration, or by using the liquid nutrient based test solution. There was no correlation between age and

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10759.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.We measured levels of cow's milk‐specific (CM) antibodies of immunoglobulin classes G, A and M by enzyme‐linked immunosorbent assay in plasma of 198 healthy infants; a variable number of samples taken at birth and at ages of 2, 4, 6, 9, 12 and 28 months were available (altogether 765 samples). The rise in the level of IgG CM antibodies was highest and most rapid in infants exposed to CM formula before the age of 1 month. The level fell by 9 months, but rose again by 12 months. This second rise was attributed to the introduction of dairy milk. Partially breast‐fed and fully weaned infants had similar levels of IgG CM antibodies. The levels of IgG CM antibodies were unaffected by the infants' own atopy, their heredity for atopy, and the umbilical serum level of IgG CM antibodies. IgA and IgM CM antibodies were absent at birth. Their levels increased similarly in exclusively breast‐fed infants and infants fed CM formula. We conclude that plasma IgG antibodies to cow's milk are increased by early weaning and by consumption of unmodified cow's milk. Production of plasma IgA and IgM antibodies to cow's milk is stimulated even during exclusive breast

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10760.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.During a ten year period, March 1976‐February 1986, 83 non‐selected consecutive cases of sudden unexpected death in infants, between one week and one year of age, were examined at the Department of Forensic Medicine in Stockholm. Forty‐three deaths (52%) were classified as typical or possible cases of Sudden Infant Death Syndrome (SIDS), 35 (42%) as non‐violent non‐SIDS cases and 5 (6%) as non‐natural deaths. Cardiovascular disease, including myocarditis, was found in 21 (25%) instances, infections with inflammatory manifestations in various organs outside the heart in 12 (14%) and miscellaneous, non‐violent causes of death in 2 (2%) cases. The male: female ratio was 1.15:1 for SIDS and 1.30:1 for non‐SIDS cases. A peak of incidence was found for SIDS cases in infants between two and four months of age, while non‐SIDS victims tended to be somewhat older. Ninety‐five percent of the SIDS fatalities occurred during the winter months (October‐April) as compared to 71% of the non‐SIDS cases. Outdoor temperature below the annual mean of 5.9°C in combination with a sudden decrease in temperature was associated with sudden deaths, particularly SIDS. Thirty‐three percent of the SIDS victims died in their cribs compared to 51% of the non‐SIDS cases. Corresponding figures for deaths outdoors in a pram were 33% and 11%, respectively. Fourteen percent of the infants in both groups died while in bed with one of the parents. Ninety‐five percent of the SIDS victims were previously healthy, but in 9% one or more periods of abnormal breathing had been noted. The corresponding figures for non‐SIDS were 70% and 3%, respectively. Among the cases of non‐natural deaths was one infant who died of heroi

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10761.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.The prevalence of asthma among 10527 children aged 7–16 years was investigated in 1985. Children were assigned to the asthma group when replies to a questionnaire stated that at least two of four stipulated symptoms had been experienced in the preceding year. A validation study, comprising exploration of medical history, pulmonary auscultation and physiological tests (spirometry and methacholine inhalation challenge) was performed in 73 children. The overall prevalence of asthma was 4%. The most common symptom‐inducing factors were physical exertion, upper respiratory tract infection, contact with animals and tobacco smoke. The methacholine test had limited value as a diagnostic aid, being positive in only 25% of children with a clear history of ast

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10762.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.In a survey of asthma among schoolchildren, a questionnaire was sent to the parents of 10 527 children aged 7–16 years. A group of 420 children with asthma was thereafter identified. Their asthma symptoms had caused little absence from school (none in the past 6 months in 60% of the group, and>5 days in only 13%). During the preceding year 40% of the group had had more than 10 days of restricted physical activity due to asthma. Severe symptoms due to undertreatment were uncommon. Although 68 children were receiving no medication, most of them appeared to have only mild symptoms, and the parents requested aerosol inhaler in only ten cases. Symptoms at school were usually related to sporting activities. In 40% of the total asthma group the symptoms were unknown to the school health service before the survey. Dissatisfaction with the service was expressed by 24% of the parents of asthmatic childre

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10763.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.One hundred and twenty‐two children between 1 1/2 and 14 years of age with symptoms suggesting tonsillar obstruction have been investigated. Each patient's history was analysed and the symptoms scored according to their incidence and severity. In addition, the size of the tonsils was evaluated. Eighty‐five patients were chosen for tonsillectomy. The children with signs and symptoms of tonsillar obstruction improved greatly immediately after tonsillectomy. Severe symptoms of obstruction were observed in children with nearly normal tonsil size, as well as in those with very large tonsils. It is therefore just as important to obtain a careful history as it is to evaluate the size of the tonsils before deciding about surg

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10764.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACT.The entire population of cystic fibrosis (CF) patients in Denmark diagnosed in the period January 1, 1945, to June 30,1985, comprised 514 persons of whom 62 were diagnosed at autopsy. Of the remaining 452 patients, 372 were probands and 80 were secondary cases. The effect of a centralized treatment on the prognosis was evaluated using a Cox's regression model. Furthermore an incidence analysis was performed using probands including autopsies. Centrab'zed treatment had a significantly beneficial effect on the prognosis (p=0.02), the death intensity (hazard rate) being decreased by a factor of 0.60. It was calculated that at present 1 out of 4760 newborn Danes may be diagnosed as suffering from CF before the age of 15 years, and 3% of the Danish population are heterozygotes for CF.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1988.tb10765.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY