The Association Between Vitamin D Status and Recurrent Wheezing

Objective

To investigate association between vitamin D status and recurrent wheezing in infants.

Methods

Thirty infants with recurrent wheezing and 45 healthy, similar aged infants without any history of acute or chronic illness were included in the study. The clinical features of infants were recorded and serum 25-hydroxyvitamin D [25(OH)D] levels were measured. Data analysis was performed using SPSS 13 package program.

Results

The mean value of 25 (OH) D vitamin levels were 22.1?±?8.9 IU/L and 18.8?±?11 IU/L for the control and recurrent attack group respectively. Seventy-three percent of subjects with recurrent wheezing had vitamin D levels in the deficient range (<20 ng/ml) and 48.9 % had vitamin D levels under?<?20 ng/ml in the control group. The percentage of insufficient vitamin D levels (<30 ng/ml) were 90 and 77.8 for the patient and control group respectively. Eight patients had extremely deficient vitamin D (<10 ng/ml) levels. There was no statistical significance between the groups in terms of the distribution of 25 (OH)D level.

Conclusions

The present study did not demonstrate significant association between vitamin D status and recurrent wheezing in the infants.     

Vitamin D Status of Hong Kong Chinese Infants

ABSTRACT. Vitamin D deficiency is a common nutritional problem of weaning infants in many parts of the world. Hong Kong infants, who are fed with traditional rice-based weaning foods and live in crowded high rise fiats, might be expected to suffer from this nutritional problem. Yet a study of 150 bottle fed infants revealed that the vitamin D intake from fortified milk and cereals was more than half of the recommended amount throughout the first 18 months and that the serum 25-OH vitamin D concentration of the infants at 18 months was normal. The effect of sunlight was also evident.     

伴喘鸣的婴儿肺炎其TFV环变化及临床意义

目的了解伴喘鸣的肺炎婴儿其潮气流速容量（ＴＦＶ）环形态及相关参数的变化,为临床判断此类患儿病情及观察疗效寻找敏感的指标。方法５０例肺炎婴儿,其中伴喘鸣者２７例,应用森迪２６００儿童肺功能仪测定患儿安静睡眠状态下的ＴＦＶ环及相关参数。１３例喘鸣阳性患儿在喘鸣消失后复查,比较喘鸣阳性与阴性、喘鸣发作期与恢复期ＴＦＶ环及相关参数的变化。结果喘鸣阳性患儿,ＴＦＶ环呼气高峰前移,呼气曲线降枝呈“波谷”样凹向容量轴,喘鸣消失后,降枝呈弓背向上的抬高。喘鸣阴性患儿ＴＦＶ环呈“梭形”％ＶＰＦ、Ｔｐ／Ｔｅ、２５／ＰＦ及５０／ＰＦ在喘鸣阳性与阴性两组间差异显著。结论ＴＦＶ环形态及％ＶＰＦ、Ｔｐ／Ｔｅ、２５／ＰＦ及５０／ＰＦ可做为反映婴儿下气道阻塞性疾患的可靠指标。     

Vitamin D Supplementation in Infants With Chronic Congestive Heart Failure

Increased circulating proinflammatory cytokines may contribute to the pathogenesis of congestive heart failure (CHF). In vitro studies have suggested that vitamin D suppresses proinflammatory cytokines and increases anti-inflammatory cytokines. The aim of this work was to evaluate the effect of vitamin D supplementation on renin-angiotensin system cytokines as well as different clinical, biochemical, and echocardiographic variables in infants with chronic CHF. This was a double-blind, placebo-controlled intervention study and included 80 infants with CHF. The intervention consisted of either giving Vitamin D(3) oral drops (group I) or placebo oral drops (group II). In both study groups, baseline 25-hydroxyvitamin D [25(OH)D] concentrations were below the lower end of the reference range. After 12 weeks of intervention, vitamin D supplementation for group I infants caused significant improvement of HF score, left-ventricular (LV) end-diastolic diameter, LV end-systolic diameter, LV ejection fraction%, and myocardial performance index together with markedly increased serum 25(OH)D and interleukin (IL)-10 and decreased PTH, IL-6, and TNF-α compared with the placebo group; these differences were statistically significant (p < 0.001). Vitamin D supplementation has great benefits as an anti-inflammatory agent in infants with CHF. It helps acceleration of the clinical improvement and cytokine profile balance.     

Risk of Wheezing Attacks in Infants With Transient Tachypnea Newborns

Background:

The most common reason of respiratory distress in the newborn is transient tachypnea of the newborn (TTN). There are some reports saying that TTN is associated with increased frequencies of wheezing attacks.

Objectives:

The aims of this study were to determine the risk factors associated with TTN and to determine the association between TTN and the development of wheezing syndromes in early life.

Materials and Methods:

In a historical cohort study, we recorded the characteristics of 70 infants born at the Shohadaye Kargar Hospital in Yazd between March 2005 and March 2009 and who were hospitalized because of TTN in the neonatal intensive-care unit. We called their parents at least four years after the infants were discharged from the hospital and asked about any wheezing attacks. Seventy other infants with no health problems during the newborn period were included in the study as the control group.

Results:

The rate of wheezing attacks in newborns with TTN was more than patients with no TTN diagnosis (P = 0.014). TTN was found to be an independent risk factor for later wheezing attacks (relative risk [RR] = 2.8).

Conclusions:

The most obvious finding of this study was that TTN was an independent risk factor for wheezing attacks. So long-term medical care is suggested for these patients who may be at risk, because TTN may not be as transient as has been previously thought.     

维生素D缺乏与小婴儿毛细支气管炎发病的关系

目的 研究VitD缺乏与小婴儿毛细支气管炎以及免疫力低下的关系.方法 选择毛细支气管炎患儿60例,随机分为VitD治疗组和非VitD治疗组.以同期收治的普通肺炎患儿30例(肺炎组)作为对照.应用生化法检测血钙及血磷水平,全血干化学免疫浓缩法检测血清AKP水平,ELISA法检测血清25-(OH)D3水平,免疫透射比浊法测定血清IgA水平;同时记录患儿临床症状的缓解时间以及住院天数.结果 1.VitD治疗组喘憋消失时间、住院时间均较非VitD治疗组减少,二组比较差异均有统计学意义(Pa<0.05).VitD治疗组转入ICU比率显著低于非VitD治疗组(P<0.05);VitD治疗组28例(93.3%)痊愈,非VitD治疗组21例(70%)痊愈,二组比较差异有统计学意义(P<0.05).2.毛细支气管炎组与肺炎组血清25-(OH)D3、AKP、IgA水平比较差异均有统计学意义(Pa<0.01).3.毛细支气管炎患儿治疗前后血清AKP、25-(OH)D3及IgA水平差异均有统计学意义(Pa<0.01).4.毛细支气管炎患儿血清IgA水平与 25-(OH)D3水平呈正相关(r=0.61,P<0.05).结论 VitD缺乏与小婴儿毛细支气管炎发病及免疫力低下密切相关.在毛细支气管炎的治疗过程中,补充VitD可及时缓解临床喘憋症状,且明显缩短其病程;VitD缺乏可能是毛细支气管炎的潜在病因.     

婴儿维生素K缺乏症

近20年来,全球各地相继报道了许多有关婴儿维生素K(VitK)缺乏出血及相关研究进展,认为VitK缺乏症是世界婴儿出血和死亡的重要原因。VitK缺乏可发生任何部位的出血,但最严重的是颅内出血,VitK缺乏是婴儿颅内出血的主要原因。该病发病急,病死率和致残率高,严重危害婴儿健康。1995     

转录因子T-bet和GATA-3对婴幼儿喘息性支气管炎的免疫调控作用

目的探讨转录因子T-bet和GATA-3对小儿喘息性支气管炎的免疫调控作用。方法对32例喘息性支气管炎(喘支组)和30例正常儿童(对照组)抽取抗凝静脉血5 mL,Ficoll分离外周血淋巴细胞,以终质量浓度为100 mg/L的植物血凝素(PHA)刺激48 h,采用酶联免疫吸附法(ELISA)检测培养上清液干扰素-γ(IFN-γ)和白细胞介素-4(IL-4)水平,用逆转录聚合酶链式反应(RT-PCR)检测淋巴细胞T-bet、GATA-3的mRNA表达水平。结果喘支组淋巴细胞培养上清液IFN-γ水平[(528±164)ng/L]低于对照组[(870±203)ng/L](P<0.05),而IL-4水平[(106±29)ng/L]明显高于对照组[(47±15)ng/L](P<0.01);喘支组和对照组淋巴细胞T-bet mRNA水平分别为(0.11±0.03)(、0.17±0.03),GATA-3 mRNA分别为(0.54±0.09)、(0.41±0.07),提示喘支组T-bet mRNA表达较对照组减少(P<0.05),而GATA-3 mRNA明显高于对照组(P<0.01);喘支组IFN-γ水平与T-bet mRNA表达I、L-4与GATA-3 mRNA表达均呈正相关(r=0.57,0.60 P均<0.01);IFN-γ与IL-4水平、T-bet mRNA与GATA-3 mRNA表达均呈负相关(r=-0.38,-0.46 P均<0.05)。结论1.喘支组患儿淋巴细胞合成IL-4水平增高,IFN-γ减少,存在以Th2细胞过度分化为特征的T辅助细胞分化失衡。2.喘支组患儿T细胞分化失衡受到核转录因子T-bet和GATA-3的调控,T-bet表达减少可能是一重要因素。     

Different Skeletal Phenotypes in a Mother and Two Daughters with Short Stature Homeobox-Containing Haploinsufficiency

Haploinsufficiency of the short stature homeobox-containing (SHOX) gene causes Turner skeletal features such as short metacarpals, cubitus valgus, and Madelung deformity. We report the clinical findings of a Japanese family consisting of two daughters with SHOX haploinsufficiency (46, X, del(X) (p.22.3)) and their mother with 45,X [9]/ 46, X, del(X) (p22.3) [11] karyotype. Physical and auxological examinations revealed a mesomelic appearance, cubitus valgus, a short neck and short stature in the daughters, but on the other hand, only a short neck and short stature in the mother. Radiological studies indicated markedly curved radii in the daughters, but only mild curvature of the radii in the mother. Regular menstruation had taken place since the age of 12 yr in the elder daughter, but the mother had irregular menstruation and she had received fertility treatment for pregnancy. The different skeletal phenotypes of the mother and her daughters with SHOX haploinsufficiency might be due to the mild gonadal estrogen deficiency found in the mother, which was caused by mosaic Turner syndrome, and the phenotypic variability of SHOX haploinsufficiency.     

Two Cases of Pseudohypoparathyroidism Type Ia in Duozygotic Twins with Different Phenotypes

Pseudohypoparathyroidism (PHP) type Ia is characterized by hypocalcemia due to PTH resistance and by features of Albright’s hereditary osteodystrophy, including short stature, obesity, subcutaneous calcification and brachydactyly. A wide variety of clinical and biochemical manifestations have been reported. We report two cases of PHP type Ia in duozygotic twins with different phenotypes. The proband was a 10-yr-old girl. She showed subcutaneous ossification, shortening of the metacarpal bone, short stature, obesity and round face. She had normocalcemia (8.9 mg/dl), high-normal phosphate (5.0 mg/dl) and increased levels of serum intact PTH (152 pg/ml) and TSH (9.17 μIU/ml) levels. Her twin younger brother had atypical Albright’s hereditary osteodystrophy with only mild obesity and subcutaneous calcifications, but he showed a low level of serum calcium (7.0 mg/dl) and high levels of serum phosphate (7.6 mg/dl), intact PTH (377 pg/ml) and TSH (6.9 μIU/ml). We diagnosed them as having PHP type Ia on the basis of clinical and biochemical findings, Ellsworth-Howard test and family history. There is considerable variability in clinical and biochemical features of PHP type Ia even among affected duozygotic twins. The differences of intrauterine environment and growth history cannot account for the variable phenotypes of PHP type Ia. Even if a patient shows no AHO features, examination of all family members should be undertaken.     

Two Live-Born Infants with Trisomy 22

The autopsy findings and karyotypes of two live-born fetuses with full trisomy 22 are discussed. Confined placental mosaicism was documented in one of the two cases. Confined placental mosaicism may play a role in the intrauterine survival of some trisomy 22 conceptions.