摘要:

The literature concerning efficacy and side effects of pertussis vaccines is reviewed. With few exceptions, most vaccines induce a protective immunity lasting for 2 to 5 years. The large‐scale use of pertussis vaccines has markedly contributed to the decrease in pertussis morbidity in small children but in some countries the incidence has increased in older children. Not even countries with immunisation rates of 90–95 % have managed to eradicate pertussis or prevent disease in infants below the age of immunisation. The pertussis‐associated mortality is currently very low in the industrialised countries and no differences can be discerned when countries with high, low and zero immunisation rates are compared. Local and benign systemic reactions are commonly seen after immunisation. The vaccines also sometimes cause convulsions, a shock‐like state and, rarely, serious neurological re

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1984.tb09949.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

The effects of breast and bottle‐feeding on serum immunoglobulin levels and specific antibody responses have been examined in 30 infants on five occasions from 6 days until 9 months of age. No significant differences were found on any sample occasion between the two feeding groups in total immunoglobulin levels of G, M and A classes or in class‐specific antibody responses to tetanus toxoid vaccine. This suggests that the capacity of the two groups to make serum antibodies develops similarly. Concentrations of antibodies to commensalEscherichia coli‘O’lipopolysaccharide antigens, however, were significantly greater in the bottle‐fed group, and it is suggested that this difference is due to an increase in the exposure of the systemic immune system to these gut antigens in the bottle‐fed infants. There are several possible explanations for this increased exposure and the resulting effects on the infants’immune system. These experiments also illustrate a possible role of breast milk in stimulating the

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1984.tb09950.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

From a population‐based series of 773 patients with cerebral palsy (CP) born in 1959–78, an analysis was made of the epidemiological trends over this period of 20 years, divided into five 4‐year periods with emphasis on the last two. After a significantly decreasing incidence of CP in the first three periods (1959–70) from 1.9 to 1.4 per thousand, there was a significant increase in the last two periods, reaching 2.0 per thousand in the period 1975–78. Both the decreasing trend in the earlier periods and the increasing trend in the more recent ones were mainly referrable to spastic/ataxic diplegia in preterm CP, and to dyskinetic syndromes in CP infants born at term. With respect to pathogenesis, the corresponding changes in CP incidence were mainly accounted for by the group with potential perinatal risk factors. When analysed on the basis of surviving babies in birth‐weight‐specific groups, the incidence of CP in 1971–78 was found to have increased in all groups, but this was only statistically significant in the low birth weight group of 2 000–2 500 g. Changing trends in incidences ran parallel with a steadily progressive decline in perinatal mortality through all five periods. A considerable and cumulative net gain of surviving non‐CP children was continuously achieved; this was also true for 1970–78, in spite of an increasing CP morbidity during these la

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1984.tb09951.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

The acute circulatory effects of asthma have been studied in two groups of children, having an average age of 13.2 and 14.7 years, respectively. Asthma was provoked by exercise (EIA group) and histamine inhalation (HIA group). The latter group was also studied after subsequent inhalation of a β2receptor agonist. Cardiac output was measured by dye dilution and intraarterial blood pressure was recorded. During attacks of asthma cardiac output and heart rate increased in both groups (p>0.05). The stroke volume decreased in the EIA group (p<0.01) but remained unchanged in the HIA group. The systemic vascular resistance (SVR) did not change. After salbutamol inhalation, the cardiac output and stroke volume increased and the SVR decreased (allp<0.05). The hemodynamic response during exercise was normal. Thus asthmatic children have normal cardiovascular function during moderate asthma. The decrease in stroke volume in the EIA group depended presumably on the preceding exercise test. The response to the β2‐stimulation was similar to that seen in healthy adu

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1984.tb09952.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

148 newborns of non‐atopic and 329 newborns of atopic parents were included in a five‐year follow‐up study of atopic diseases. The prevalence of atopic diseases at five years of age is compared to environmental factors, which may be involved in the development of atopic diseases. There was no significant correlation between the development of atopic disease and the following factors: the nature of the immediate environment (industrial, agricultural, rural, urban, arboreal, lake‐district); building materials, heating systems and general state of repair of the houses, including its interior decoration; the presence of pets, plants, humidifiers or cigarette smoke. There was, however, one exception: in both family groups the avoidance of woollen garments and bed clothes before the outbreak of atopic symptoms was associated with the increased prevalence of asthma, allergic rhinitis and atopic dermatitis. The cause of this association remained uncertain. Children with atopic diathesis are known to frequently display skin intolerance to wool. Therefore, wool avoidance in a family may only indicate that the child was potentially atopic. Atopic children suffered from ear infections and vomiting more often than control children. The incidence of ear infections was also increased amongst children with a positive family history of atopy, even if no atopic disease was diagnosed in the child himself. Although breast fed infants tended to have less infectious diseases than those weaned early, ear infections were equally common in all feeding groups. This is further evidence, that in part of the cases of recurrent ear infections, atopy should be considered as a possible etiologic

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1984.tb09953.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

In order to assess the safety and stability of a parenteral fat emulsion (Intralipid8) in total parenteral nutrition (TPN), 29 infants were infused Vamin glucose and Dextrose electrolyte solution as well as one of two isocaloric regimens; either 25 % Dextrose (Group I) or 10 % Intralipid (Group II). Regular biochemical monitoring was performed in all cases and no infants became lipaemic nor developed abnormally high levels of total free fatty acid. Eight infants died and only those who had received fat emulsion had lipid staining material distending the pulmonary vessels. One infant having low infusion rates of Intralipid had massive fat accumulation in the lungs, but biochemistry during life had been normal. We speculate that in ill infants the emulsion becomes less stable and agglomeration of fat particles occurs which are then fully filtered out by the lungs before metabolism of the exogenous fat can occur.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1984.tb09954.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

The lungs of 22 low‐birth‐weight infants were investigated, mean gestational age 29 weeks (range 25 to 35). Thirteen of the 22 newborns had been treated with Intralipid®–10 % for an average of 20 days (range 3 hours to 75 days). The mean maximum rate of fat infusion was 2.0 g/kg/day (range 0.5 to 3.6). Nine of the 22 newborns had been fed formula and given supplemental amounts of amino acids and glucose intravenously, but no Intralipid. The lungs were fixated in situ immediately after death with glutaraldehyde. Neither in the Intralipid group nor in the non‐Intralipid controls was intravascular fat accumulation identified, either by light microscopy or by electron microscopy. It is speculated that an agglomeration of lipoprotein globules to larger stainable lipid droplets cannot take place in the short interval between the actual time of death and the time of fixation of the lung tissue. Thus, fat globules found in lungs of premature infants and described as fat embolism might have been post mortem a

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1984.tb09955.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

The functional capability of antigen‐stimulated breast milk cells to produce an immunologic mediator was examined. Colostrum and comparison peripheral blood samples were obtained from ten women, two to four days postpartum, and supernatants from PPD‐stimulated mononuclear cell cultures were assayed for the lymphokine, monocyte chemotactic factor. Five of the ten women studied had a history of a positive tuberculin skin test and one had received BCG immunization. Peripheral blood lymphocyte cultures and colostrum cell cultures from four of these six women produced monocyte chemotactic factor. These results demonstrated the functional capability of antigen‐stimulated colostra! cells to produce immunologic medi

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1984.tb09956.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

The contents of iron, copper, zinc, calcium and magnesium were determined in human milk samples from 18 Ethiopian and 23 Swedish women. The Ethiopian women belonged to two groups with different socio‐economic situations, a non‐privileged and a privileged group. Both groups had an excessively high dietary iron intake–20 to 30 times that of the Swedish women–from the iron‐rich traditional diet. In spite of this, the mean concentrations of iron in the milk, as well as of zinc and magnesium, were similar in all three groups. The mean copper concentration, however, was significantly lower in the Ethiopian than in the Swedish milk samples, the lowest mean value occurring in the privileged group. In contrast, a significantly higher mean calcium concentration was found in milk samples from the Ethiopian women than from the Swedish, the highest mean concentration being noted in the non‐privileged group. The levels of minerals in breast milk showed no correlation to the birth weight of the infants or the length of gestation. Our data suggest that an excessively high dietary iron intake does not increase the breast milk content of iron in mothers with a good iron status. The reasons for the differences in the content of copper between the Ethiopian and Swedish milk samples are unclear. The higher calcium content in milk from the Ethiopian mothers, despite a low dietary calcium intake may be a result of an increased endogenous cholecalciferol synthesis due to greater exposure

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1984.tb09957.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

53 Nigerian infants with neonatal meningitis were prospectively studied. The striking features were: (a) the higher predisposition (26.7‐fold) of LBW infants to developing meningitis than has been previously reported in the literature; (b) the predominant role ofE. coliandStaphylococcus aureus; and (c) the rarity of salmonella organisms and the conspicuous absence of group B streptococcus as aetiological pathogens. The outcome was related to the age of onset and type of micro‐organism. The presence of neurological signs, particularly nuchal rigidity and bulging anterior fontanelle, carried a poor prognosis. The overall mortality was 3

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1984.tb09958.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY