摘要:

Postnatal height and weight growth were assessed in 50 children (20 boys) with Pierre Robin sequence and in 58 children (27 boys) with isolated cleft palate, born in 1967–86. The height and weight measurements from birth to 12 years were collected retrospectively from child health centers and schools. The current Finnish relative weight and SD scores for height were used for growth assessment. The birth size of children with Pierre Robin sequence did not differ from those with isolated cleft palate or from healthy children, on the basis of Finnish norms. During the first year after birth, children with Pierre Robin sequence were shorter and lighter than those with isolated cleft palate but later caught up with them and the Finnish norms. Children with Pierre Robin sequence born prematurely or with associated anomalies showed more deficient growt

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1994.tb18273.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The effect of growth hormone (GH) treatment on craniofacial development was studied in nine children exhibiting low growth velocity after bone marrow transplantation (BMT). Comparisons were made with seven BMT children who had not received GH. Two groups of age‐ and sex‐matched healthy children served as controls for the respective patient groups. After an average observation period of 3.5 years, the BMT children not treated with GH exhibited significantly reduced mandibular length and alveolar height (p<0.01). The increase in mandibular length was only 30% of that found in healthy controls. Maxillary growth was less affected by BMT treatment. In the GH treated group, no significant differences were found in craniofacial growth increments compared with controls. Although exogenous GH therapy in this group of children did not induce a catch‐up growth, it appears to have prevented further loss in growth pote

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1994.tb18274.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Children with α1‐antitrypsin deficiency, screened at birth, were followed prospectively. At 16 years of age, 150 adolescents (103 PiZ, 1 PiZ‐, 1 PiS‐, 45 PiSZ) were interviewed using a standardized questionnaire and asked to participate in an extensive lung function study including part or all of the following tests: FVC, FEV1before and 15 min after four inhaled doses of salbutamol, TLC, RV and FRC. Fifty age‐, sex‐ and height‐matched adolescents participated as controls. No significant differences in age, height or weight were found between the PiZ, PiSZ and control groups. No significant differences were found in respiratory symptoms, parental smoking history or the smoking habits of PiZ, PiSZ and control subjects. Asthma occurred in 10.7% of PiZ, 6.5% of PiSZ and 4% of control adolescents (p= 0.33). Only 3 of 100 PiZ and 1 of 45 PiSZ adolescents were smokers. No significant contribution of α1‐antitrypsin Pi‐type was found to explain the variation in lung function variables studied. We conclude that children with α1‐antitrypsin deficiency have a favourable prognosis and normal lung development up to 16 years of age. Anti‐smoking advice was found to be reasonably successful; only 3% of those answering the questionnair

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1994.tb18275.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

We evaluated gallbladder contractility in 58 colicky infants and 57 age‐matched controls. Gallbladder size was measured before and 1 h after feeding and the contraction index of the gallbladder was calculated. The results showed decreased contractility of the gallbladder in colicky infants: mean contraction index in colicky infants was 56% (95% confidence interval, 49–63%) and in controls 67% (61–73%). No difference was found in the fasting size of the gallbladder. Postprandial contraction was decreased in colicky infants examined in the evening (n= 14) compared with those examined in the morning (n= 44). Decreased contraction of the gallbladder was found in those colicky infants who presented colicky cry compared with colicky infants without symptoms at the time of examination. No structural abnormalities were found in the general abdominal survey. In conclusion, infants with colic have hypocontractility of the gallbladder. This indicates abnormal biliary tract physiology in association with infantile

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1994.tb18276.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Patients with heterozygous familial hypercholesterolaemia (FH) are at high risk for the development of coronary artery disease. Achilles tendon xanthomata are often the first clinical manifestation of FH, but are seldom palpable earlier than during the third decade. Twenty‐one FH children aged 3–18 years underwent high‐frequency ultrasound examination of the achilles tendon. Hypoechoic infiltration of the normal tendon structure was demonstrated in 8 of 21 (38%) of the FH children. The findings were similar in boys and girls. Control subjects (n= 68) aged 1–25 years had no sonographically detectable tendon abnormalities. The thickness of the achilles tendon of the FH children was (mean ±SD) 7.1 ± 1.5 mm (range 5–10 mm). The respective values for the controls were 5.8 ± 1.0 mm (3–7 mm. We conclude that ultrasound examination sensitively detects cholesterol accumulation in the achilles tendon of FH children before tendon xanthomata are clin

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1994.tb18277.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Heavy infection with the geohelminthTrichuris trichiuracauses theTrichurisdysentery syndrome (TDS). Growth retardation and anaemia are characteristic of TDS and both are associated with poor development. We have examined the growth and developmental responses to treatment in 19 children aged 27–84 months with TDS. Developmental levels (DQ) were measured with the Griffiths mental development scales. Compared with a control group matched for age, gender and neighbourhood, the TDS children initially had serious deficits in DQ (24 points,p<0.001). After a year of anthelmintic treatment, the TDS children showed improvement in locomotor development (p<0.001) compared with the controls. The TDS children also had initial deficits in height‐for‐age, weight‐for‐height, mid‐upper arm circumference and haemoglobin levels. They caught up rapidly in indices of wasting (weight‐for‐height and mid‐upper arm circumference) and showed steady improvement in height‐for‐age and haemoglobin levels. Catch‐up in height was comparable to that of children recovering from coeliac disease. The importance of continuing prevention after initial t

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1994.tb18278.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Severe infections by the geohelminthTrichuris trichiuradetrimentally affect young children's growth and development. There is concern that mild to moderate infections may affect older children's school performance and nutritional status. We therefore examined the relationship between varying intensities of infection and school achievement, attendance and nutritional status in 616 schoolchildren. A total of 409 children withTrichurisinfection of intensities greater than 1200 eggs per gram of stool (epg) were first identified, then for every 2 infected children in a class, an uninfected child was selected. After controlling for socioeconomic status, gender, age, school and the presence ofAscarisinfections, the uninfected children had higher reading and arithmetic scores than children with infections of more than 4000 epg and were taller than those with intensities greater than 2000 epg. However, there were no significant differences in spelling, school attendance and body mass index. Although a treatment trial is needed to determine causation, these results indicate that moderate levels of infection are associated with poor school achievement and growth.

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1994.tb18279.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Fifty‐three critically ill infants and children received midazolam as sedation in a regional intensive care unit. Assessment of the level of sedation was carried out at regular intervals on withdrawal of midazolam. Forty‐nine patients were fully alert within 4 h of midazolam being stopped. Four patients took from 6 h to 1 week to become fully alert. Four patients had abnormal behaviour highly suggestive of midazolam withdrawal. The onset of abnormal behaviour was within 12 h of discontinuation of midazolam. The duration of the abnormal behaviour ranged from 3 h to 1 week. One child had a paradoxical reaction to midazolam. The overall incidence of adverse effects to midazolam in the patients studied was 17%. No adverse effects were observed in infants; all adverse effects were observed in children. We have shown that it is possible to prospectively study the toxicity of sedatives in critically ill infants and child

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1994.tb18280.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

A retrospective analysis of 98 patients, less than 15 years of age, treated for caustic ingestion during 1976–1990 was performed to evaluate the modern consequences of caustic ingestion in children and to set indications for esophagoscopies and radiographic and laboratory examinations. Dishwasher detergents were ingested by 56 children. There were no lye ingestions, since lye has not been freely available in Finland since 1969. Household acetic acid (vinegar) was the most commonly (12/23) ingested acid. Primary esophagoscopy was performed in 79 of the 98 cases (80.6%). Esophageal burns were found in 20 patients. Acids caused burns more often than alkalies (9/23 (39.1%) versus 11/75 (14.7%);p= 0.011; 95% confidence intervals (CI) for the difference 5.6–43.3%) and acid burns more often developed into scars (7.4% versus 4%;p= 0.029; 95% CI for the difference 1.4–25.4%). The only esophageal stricture developed after ingestion of a Clinitest tablet. The mean time for hospitalization as a result of acid ingestion was significantly longer than after alkaline ingestion (3.2 (SD 3.5) days,n= 23 versus 1.5 (1.6) days,n= 15;p<0.05; 95% CI for the difference 0.7–2.8 days). Prolonged drooling and dysphagia (12–24h) predicted esophageal scar formation with 100% sensitivity and 90.1% specificity, but signs and symptoms did not predict esophageal burns after primary esophagoscopy. Radiographic examinations and leukocyte counts were of no value in predicting esophageal burns and scars. The panorama of caustic ingestion appears to have changed, probably due in part to the law banning sale of lye products since 1969. This type of law should be encouraged elsewhere. Acids cause even more caustic burns than alkalies. Vinegar should be regarded as a potent caustic substance and distributed in baby‐safe bottles with appropriate information on its caustic nature. As severe esophageal lesions after accidental ingestion of caustic substances are now rare in children, primary esophagoscopies and hospitalization of patients are not indicated routinely. The decision on esophagoscopy can be made on the basis of drooling and dysphagia durin

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1994.tb18281.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0803-5253    

DOI:10.1111/j.1651-2227.1994.tb18282.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY