MATERNAL and INFANTILE INFECTION WITH CHLAMYDIA IN A SWEDISH POPULATION

Abstract. Persson, K., Rönnerstam, R., Svanberg, L. and Holmberg, L. (Departments of Clinical Virology, Ophthalmology, Gynaecology and Paediatrics, University of Lund, Malmö General Hospital, Sweden). Maternal and infantile infection with chlamydia in a Swedish population. Acta Paediatr Scand, 70:101, 1981.– Chlamydia trachomatis was isolated from 2.4% of 1328 puerperal women. The frequency was highest in the age group below 20 years and thereafter decreased with increasing age. Chlamydial conjunctivitis was confirmed in 0.4% of the infants. Two additional cases of conjunctivitis occurred among the exposed infants but chlamydia cultures were not obtained. In a separate oph-thalmological material of neonatal conjunctivitis a third of the cases developing within the first month of life was associated with chlamydia. The early and sharp incidence peak for chlamydial conjunctivitis suggested that transmission occurred at delivery. No cases of chlamydial pneumonia were noted. Peroral chemotherapy is recommended in infants for systemic eradication of C. trachomatis.     

CLINICAL AND IMMUNOLOGICAL ASPECTS OF FOOD ALLERGY IN CHILDHOOD

ABSTRACT. 36 children of atopic mothers (group I) and 17 children of healthy mothers (Group II) were selected for a study of the relationship between the onset of atopic symptoms and the occurrence of IgE-, IgG- and IgA-antibodies, with special regard to the development of antibodies to β-lactoglobulin (BLG) and ovomucoid (OM). Atopic symptoms developed in 50 % of the children in group I and in no one of group II. The cord serum IgE concentrations were shown to be predictive of subsequent development of atopic symptoms, and the levels remained higher in group I than in group II. The serum IgA concentrations were low and within normal limits in both groups and bore no relationship to atopic heredity or to later development of atopic symptoms. However, at six months of age the serum IgA levels were lower in the children of atopic mothers (p<0.1). Low titers of IgE antibodies to BLG and OM occurred in several children of Group I but seemed to have clinical significance in only a few children. IgG antibodies to BLG and OM were shown to occur frequently and in equivalent titers in cord sera and maternal sera indicating a transport across the placental barrier. High cord titers were found in children of group I who remained asymptomatic, indicating a possible protective function by these antibodies. The titers to BLG were higher in group I than in group II. Most titers decreased during the first months of life and then a rise occurred.     

INCIDENCE OF COELIAC DISEASE AND TRANSIENT GLUTEN INTOLERANCE IN CHILDREN IN A SWEDISH URBAN COMMUNITY

Abstract. The incidence of coeliac disease in children in the city of Malmö, South Sweden, was 1: 982 during 1966 to 1975. The diagnostic criteria were: flat intestinal mucosa on gluten-containing diet, free of symptoms, and improvement in mucosal morphology on gluten-free diet, and morphological and/or evident clinical relapse (three times) on gluten challenge. 6 (12 %) of 49 children with initially a flat mucosa still had a normal mucosa on a gluten-containing diet for two years or longer, having so-called transient gluten intolerance.     

QUANTITATIVE ASPECTS OF ROTAVIRUS EXCRETION IN CHILDHOOD DIARRHOEA

ABSTRACT. Vesikari, T., Sarkkincn, H. K. and Mäki, M. (Department of Clinical Sciences, the University of Tampere, Tampere, Finland, and the Department of Virology, University of Turku, Turku, Finland). Quantitative aspects of rotavirus excretion in childhood diarrhoea. Acta Paediatr Scand 70:717,.–The amount of rotavirus (antigen) in diarrhoea! stools was determined from serially diluted faecal specimens using a solid phase radioimmunoassay (RIA) method. The acute stage RIA titres for rotavirus antigen ranged from 1:200 to 1:200000 with a mean titre of 1:2936 in a group of 16 infants with age range 2 to 14 months and 1:4 703 in a group of 12 children aged 25 to 94 months. In the younger age-group the diarrhoea lasted longer (mean 7.8 days) than in the older children (mean 5.4 days) despite the fact that the quantity of rotavirus was similar. In most of the younger infants there was either no demonstrable rotavirus present at the time of cessation of diarrhoea, or the amount of virus was on the decrease. In contrast, among the older children there were cases with a high titre of rotavirus in the stools a few days after the diarrhoea had ceased. These children were considered as potential spreaders of rotavirus infection in the community. However, none of the long-term follow-up stool specimens, collected 28 to 47 days after the onset of diarrhoea, were positive for rotavirus RIA.     

MOTIVATION IN CHILDHOOD AUTISM: CAN THEY OR WON''T THEY?

Research in the area of motivation in autistic and other children suggests that autistic children may be capable of performing at a higher level than they typically function. This article describes research in the area of 'learned helplessness' which suggests that autistic children's handicaps may expose them to frequent failure and to an unusual level of non-contingent reinforcement which may produce a 'learned helplessness' state of extremely low motivation, with a consequent abnormally low overall functioning level. The present article also discusses research on strategies which might be employed to improve autistic children's exposure to favourable response-reinforcer contingencies. This would be expected to improve the general level of motivation in such children, with related gains in the acquisition, generalization maintenance of a broad array of target behaviours.     

ORGANOCHLORINE CONTAMINANTS IN SWEDISH HUMAN MILK FROM THE STOCKHOLM REGION

ABSTRACT. The levels of fat-soluble organochlorine contaminants in human milk in the Stockholm region are decreasing. For p, p'-DDT, p, p'-DDE, and dieldrin a reduction has taken place during the last decade, but the levels of polychlorinated biphenyls (PCBs) started declining only from about 1977. Generally, the pooled samples from the Mothers' Milk Centre in Stockholm in 1980 contained lower levels of organochlorine contaminants than the current Swedish maximum acceptable limits for milk. In 2% of the samples the total DDT levels slightly exceeded the limit of 0.05 mg DDT+DDD+DDE/kg. Milk from three mothers was analysed during the nursing of two or three consecutive infants. In each case, the levels of organochlorine contaminants declined.     

ANTITHROMBIN IN INFANCY AND CHILDHOOD

ABSTRACT: Teger-Nilsson, A-C. (Department of Clinical Chemistry, Department of Pediatrics, and Department of Blood Coagulation Research, Karolinska sjukhuset, Stockholm). Antithrombin in infancy and childhood. Acta Pediatr Scand, 64:624, 1975.–Anti-thrombin III was measured immunologically, and antithrombin activity was measured with aid of a new synthetic tripeptide substrate for serine proteases in plasma of healthy infants and children, 0–14 years of age. Both methods gave decreased values in the youngest infants as compared with adults. The antithrombin increased with age and reached adult values about 6 months of age. In infants up to one month of age, antithrombin III measured immunologically was significantly lower than antithrombin activity, whereas there was no difference between the antithrombin methods in the higher ages. Antithrombin III concentration and antithrombin activity as measured were poorly correlated.     

COMMUNICATION BEHAVIORS IN AUTISM AND DEVELOPMENTAL LANGUAGE DELAY

The communicative behavior of autistic and developmental language delay (DLD) children matched for nonverbal mental age and mean length of utterance (MLU) was compared to that of normally-developing (ND) 2-yr-olds. Autistic children were less able than other children to respond correctly to language or gestures used to direct their attention, used attention directing (pointing, showing) less frequently, and produced more echolalic speech when making requests. DLD and ND children differed only in number of pronouns used while requesting. Attention-directing gestures were associated with receptive and expressive language abilities for autistic, DLD and normal children.     

HANDEDNESS IN SWEDISH 10-YEAR-OLDS. SOME BACKGROUND AND ASSOCIATED FACTORS

Forty-five left-handed and 46 right-handed 10-year-old children were subjected to a limited set of neurological tests and a square tracing task. 'Pathological' handedness was diagnosed in cases showing poor performance with the non-preferred hand on the squares task. The frequency of left-handedness in the population was estimated at 9.2%. The boy : girl ratio was 1.6:1. 'Pathological' handedness was twice as common among left-handers as among right-handers. Neurological dysfunction was more common in 'pathological' handers, especially left-handers. Reduced pre-. peri- and neonatal optimality was seen in boys with 'pathological handedness'. School achievement problems and behaviour problems were much more common in left-handed boys than in other study groups. The results lend partial support for the extended pathological left-handedness model recently hypothesized by Bishop, but it is suggested that left-handedness in boys is more often a symptom of pathological shift of handedness than is left-handedness in girls.     

HEREDITARY MOTOR AND SENSORY NEUROPATHIES IN SWEDISH CHILDREN

ABSTRACT. Clinical, neurophysiological and laboratory data are given for 32 children (30 kinships) considered to represent hereditary motor and sensory neurophaties (HMSN) of neuronal-axonal types. In 25 families (27 cases) one of the parents was found to be affected. In one both parents were normal. The mode of inheritance in the 27 patients with familial neuronal-axonal HMSN was concluded to be autosomal dominant HMSN II (Lambert type). The disability was mild to moderate and, on an average, less pronounced than in de- and remyelinating types of HMSN. Seven out of 27 were early toe-walkers of the secondary type. Cavus feet were noted in 25, hand atrophies in eight and mild scoliosis in five. Sensory complaints were recorded in 21. The nerve conduction velocities (NCV_m and NCV_s) of children and parents were slightly subnormal in a few. EMG proved to be the most important parameter for identifying subclinically affected parents.     

ASYMPTOMATIC DIABETES IN CHILDHOOD AND ADOLESCENCE

Abstract. An account is given of the present conception of asymptomatic (chemical) diabetes in the pediatric age group, which also has been named MODY (maturity-onset type of diabetes of young people). Long-term studies show that about 10% will eventually decompensate to overt diabetes. In contrast to classical juvenile-onset type of diabetes the inheritance of MODY seems to be autosomal dominant in many cases. Some authors have suggested that insulin resistance exists in non-obese patients with asymptomatic diabetes, but this view is not supported by observations of the author. Obese patients should reduce their body fat, but other therapeutic approaches are difficult to evaluate because of the normal fluctuation of the disease. There is no general agreement in the literature concerning the value of insulin treatment. The author supports the view that insulin treatment should be started in the late stages of chemical diabetes just before symptomatic disease emerges. In the long run this approach may ameliorate the condition due to the preservation of some beta-cell function for long periods. An unsettled question is whether early insulin treatment in asymptomatic diabetes will delay diabetic vascular complications.