摘要:

Prostaglandins exert significant effects on the range of cerebral blood flow autoregulation. However, the newborn exhibits a narrow cerebral blood flow autoregulatory range compared to the adult, and this apparently contributes to the susceptibility of the newborn to major perinatal complications such its intraventricular cerebral haemorrhage. Reduced vasoconstriction in response to prostaglandins due to the fewer prostaglandin receptors, especially for PGE2(EP) and PGF2α(FP), seems to contribute in part to the narrower range of cerebral blood flow autoregulation in the newborn. Evidence suggests that high levels of prostaglandins in the perinatal period are responsible for the down‐regulation of neurovascular EP and FP receptors. We review the pharmacology of prostaglandin receptors, in particular PGE2and PGF2αreceptors, their ontopeny on the neural vasculature. the perinatal regulation of their expression, and how these changes relate to the control of neural blood flow autoregulat

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1996.tb14077.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

It is now well established that oxytocin, as well as stimulating uterine contractions and milk cjection, promotes the development of maternal behaviour and also bonding between mother and offspring. In addition, oxytocin exerts by way of peripheral, circulating as well as by central, neurogenic mechanisms multiple physiological, endocrine and behavioural effects in connection with milk ejection and lactation. Some effects of oxytocin in the nipple and mammary gland appear to be exerted in close collaboration with peptides released from axon collaterals of somatosensory nerves originating in this region. The distribution of peptides localized to the somatosensory afferents in the nipple and mammary gland as well as possible effects by oxytocin and/or local neurogenic peptides in connection with milk ejection and lactation are reviewed in this paper.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1996.tb14078.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Regurgitation in infants is a common problem. Recent issues, such as the increased risk of sudden infant death in the prone sleeping position, the finding of persisting occult gastro‐oesophageal reflux with feed thickeners, and the increasing awareness of the cost‐benefit ratio of medications may challenge the currently recommended management approach. A round table was organized to elaborate on the impact of (i) the pro supine sleeping campaigns in relation to sudden infant death and (ii) advancement in medical treatment on therapeutic strategies in regurgitating infants. The participants were opinion leaders from Europe and North America (Belgium, Canada, France, UK, Italy, Switzerland and The Netherlands). The importance of parental reassurance is stressed. As a consequence of the supine sleeping campaigns aiming to decrease the incidence of sudden infant death syndrome, the “prone elevated sleeping position” is no longer advised as a first‐line therapeutic approach, although it is still recommended in “complicated reflux”. It is emphasized that milk thickeners are an adequate therapeutic tool for regurgitation, but not in reflux disease. According to the literature, the efficacy of (alginate‐) antacids, although very popular in some countries, is questionable. These recommendations will be of interest to first‐line paediatricians, since about 40% of their patients, according to the literature, present because

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1996.tb14079.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1996.tb14080.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

In developing countries, maternal infections during lactation are common. In this study, we evaluated the effect of acute maternal postpartum infection on the composition of colostrum and early milk with special emphasis on milk proteins and trace elements. The study was carried out in two maternity hospitals in Lima, Peru. Subjects were normally nourished women (body mass index (BMI)>20.0) who intended to exclusively breastfeed their child and who had fever and clinical symptoms of infection within the first 48 h postpartum (n= 34). Non‐ill women of similar characteristics were selected as controls (n= 23). Blood and milk samples were taken on days 1 and 14 postpartum. An acute phase response was confirmed by significantly increased serum levels of C‐reactive protein in infected women. Serum zinc levels increased significantly from day 1 to day 14, but were not affected by infection. Serum copper levels were significantly higher in ill women than in non‐ill women on day 1. All participating women were breastfeeding on day 14. Whey protein levels, the whey/casein ratio and total protein levels decreased significantly with time, but were not affected by infection. There were no differences in milk iron or copper levels with time or infection. Milk zinc levels decreased significantly with time, but were not affected by infection. Maternal infection during the early postpartum period does not appear to adversely affect the initiation of lactation or milk protein and trace element con

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1996.tb14081.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1996.tb14082.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

It is widely believed that cow's milk proteins ingested by the mother, in particular β‐lactoglobulin ([β‐LG), can pass into breast milk and thus sensitize predisposed infants. However, studies to evaluate bovine β‐LG in human milk have given conflicting results. The aim of this study was to analyse the correlation between the amount of cow's milk in the mother's diet and the presence of bovine β‐LG in breast milk. Human milk samples from 14 healthy non‐atopic women on diets with different cow's milk contents were examined. The total concentration of bovine β‐LG or β‐LG immuno‐like proteins (β‐LGIP) was determined by enzyme‐linked immunosorbent assay (ELISA). Two separation procedures utilizing ELISA plates and an affinity chromatography column were set up to identify the human whey components recognized by the anti‐β‐LG antibodies. β‐LGIP reactivities of milk from three groups on different diets were not significantly different. After splitting the antigen antibody complexes, three main protein components, human lactoferrin, human β‐casein and human α‐lactalbumin, were identified. This study would suggest that, at least in healthy subjects, false‐positive results in ELISA determinations of bovine β‐LG in human milk might be due to cross‐reactions between polyc

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1996.tb14083.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The hypothesis was tested that in young children when admitted to the hospital for acute illness, vasoactive hormone levels are raised. The plasma concentration of arginine vasopressin (AVP) and plasma renin activity (PRA) were measured in 103 acutely ill infants and children admitted to the hospital. Compared to 31 control children with elective surgery, plasma AVP and PRA levels were significantly elevated and plasma osmolality reduced in acute illness, indicating non‐osmotic, cardiovascular AVP release. AVP and PRA elevations were found to be independent of the underlying diseases (e.g. respiratory infections, gastroenteritis, bacterial infections and the viral syndrome). Since cardiovascular AVP activation bears the risk of hyponatraemia in the case of hypotonic fluid therapy, initial fluid management should be performed with solutions containing half‐normal or normal saline in acutely ill child

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1996.tb14084.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

In patients with cystic fibrosis, infection withPseudomonas cepaciais associated with poor outcomes. However, the epidemiology ofBurkholderia cepaciais still unclear. The aim of this study was to investigate the epidemiology ofBurkholderia (Pseudoomonas) cepaciacolonization among cystic fibrosis patients attending the Verona CF Centre, a large specialized unit to which patients from different parts of Italy are admitted. We used a genome finger‐printing system to analyse the nucleotidic structure ofB. cepaciaisolates from 60 colonized cystic fibrosis patients. Forty‐two different finger‐printing patterns were identified. Thirty‐two patients were colonized by individualB. cepaciastrains (53.3%). The remaining 28 subjects were divided into 10 different subgroups, each exhibiting a distinct strain ofB. cepacia(46.7%). Nevertheless, direct, person‐to‐person transmission was evident in only 10 cases (16.7%). The stability, up to 12 months, of theB. cepaciacolonizing strain was documented in 36 individuals. Consistent with other reports, risk ofB. cepaciatransmission between cystic fibrosis patients through intimacy or nosocomial contact was found in our study. However, besides low contagiousness, our data suggest that the environmental reservoir ofB. cepaciaoutside the hospital seems to play an important role inB. cepaciainfection of our cystic fibrosis

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1996.tb14085.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Although anti‐glutamic acid decarboxylase antibodies (GADAb) have been reported to be a useful diagnostic and predictive marker of insulin‐dependent diabetes mellitus (IDDM, type 1 DM) in Caucasians, a precise analysis of GADAb in Japanese children has not been reported. We examined the clinical significance and time course of GADAb in Japanese IDDM children, who have different genetic backgrounds from Caucasians. Twenty‐three of 34 (67.6%) sera from recent‐onset (<6 months) IDDM, and 16 of 49 (32.7%) sera from long‐standing (≥2 years) IDDM patients were positive for GADAb. This prevalence of GADAb in IDDM patients was significantly higher than in normal controls and the other groups including non‐insulin‐dependent DM. autoimmune thyroid disease and congenital hypothyroidism, and was also significantly higher in recent‐onset than in longstanding IDDM. Time course analysis suggested that autoimmune response against GAD could follow different courses in individual cases after the initiation of insulin therapy. The incidence of GADAb was significantly higher in females than in males in the older age group (11 15 years). Other clinical features including residual pancreatic β‐cell function after diagnosis were demonstrated to be similar between GADAb‐positive and ‐negative patients. In conclusion, this study using the newly established radioimmunoassay (RIA) for GADAb revealed a high prevalence of autoimmune reactivity to GAD in Japanese IDDM children. These results, using this RIA procedure, might assist in laying the groundwork for future trials of immunomodulation t

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1996.tb14086.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY