Investigation of the transport of trace elements across barriers in humans: studies of placental and mammary transfer

The barrier function of the human mammary gland for selected trace elements was evaluated by analysing 27 maternal sera and corresponding colostrum samples for 14 trace elements. To investigate the impact of the human placenta at the end of gestation on the transfer of 17 trace elements from the mother to the baby, 29 maternal and corresponding umbilical cord sera (UCS) were studied. The uptake of trace elements from the UCS by the fetus was investigated in nine pairs of arterial and venous UCS. In colostrum, the concentration of Cu was 19%, of Se 47%, of Co 80%, of Mg 146%, of Ca 222%, of Sn 228%, of Mn 275%, of Mo 814%, and of Zn 1470% of that of the maternal sera. For Cd and Pb the corresponding values were 200% and 325%, respectively. These data show that the mammary gland can exert an activating as well as an inhibiting effect on the trace element transfer. A concentration gradient mode of action for the transfer of Li, Mo and Sr could be found. In UCS the concentration of Cu was 20%, of Se 55%, of Co 60%, of Sn 85%, of Mo 100%, of Mg 105%, of Ca 120%, of Zn 148%, and of Mn 150% of that of the maternal sera. The corresponding values for Cd were 66% and for Pb 50%. Conclusions: These findings indicate that the placenta can exhibit an activation or inhibition on transfer as well as a gradient mode of action as for Mo, Cs, Li and Sr. The uptake of essential trace elements from venous UCS by the unborn ranged from 2.5% for Ca to 16.7% for Mo. Both the placenta and the mammary gland can exert an activating, inhibiting or gradient mode of action for selected trace elements, the biological impact of which needs to be further elucidated.     

Determination of central hemodynamics parameters in children by a mechanocardiographic method

Comparative analysis of the data obtained during measurements of the central hemodynamic parameters by means of mechanorheo- and echocardiography revealed coincidence of the mechano- and echocardiography data in 88.57% of cases, of the mechano- and rheography data in 100%, and of the data obtained with the aid of all the three methods in 90.9% of cases. Out of 8 cases of non-coincidence of the mechano- and echography data, prolapse of the mitral cusps occurred in 5 cases. It is concluded, that to measure the central hemodynamic parameters, any of the methods under study can be used.     

Psychopathology among Offspring of Parents with Substance Abuse and/or Anxiety Disorders: A High–risk Study

This paper reports the results of a high–risk study of children under age 18 of parents who served as probands in a family study of comorbidity of substance abuse and anxiety disorders. There was a strong degree of specificity of familial aggregation of both the anxiety disorders and substance disorders. Rates of conduct disorder and depression were elevated among offspring of all affected parents. Inclusion of co-parent disorders in the evaluation of familial transmission in the present study strengthened the findings regarding the specificity of transmission of the anxiety disorders and the links between both parental substance abuse and antisocial personality with child conduct disorder.     

Developmental Disturbance of the Cerebral Cortex of Mouse Offspring from Dams Treated with Ochratoxin A during Pregnancy

Abstract This study was designed to elucidate long-term pathological effects of ochratoxin A, one of the food contaminating mycotoxins, on the developing brain in mice. A single intraperitoneal injection of ochratoxin A at a dose of 2 or 3 mg/kg was given to pregnant mice on day 10 of gestation. They were allowed to give birth and the offspring were examined 6 weeks after birth. Their body weight, brain weight, brain size, thickness and cell packing density of dorsal neocortex in histological sections were examined. Growth of basal dendrites of pyramidal neurons in the layer V of dorsal neocortex was also examined with Golgi-Cox specimens in terms of number of dendrites directly arising from the perikaryon, number of endings of dendrites, branching index (No. of endings/No. of arisings), mean distance from the perikaryon to the tips of dendrites, and number of intersections of dendrites with the zonal boundaries.
Significant changes were found in brain weight, anteroposterior length of cerebrum, mean distance from the perikaryon to the tips of dendrites and number of intersections of dendrites with the zonal boundaries. These parameters can be recommended as sensitive ones in order to estimate rather weak effects of cytotoxic chemical agents exposed in utero on the development of cerebral cortex.     

Cause od death statistics and death certificate documentation. 1. Historical development of cause of death statistics of fetal death, infants and children and current regulations in the GDR

After having described the beginnings of documentation and statistics of causes of death of newborns and children the development of this branch of medical statistics in the GDR and the introduction of a special death certificate in 1961 is dealt with. To help obstetricians, perinatologists and pediatrists to tackle the problem of documentation of the causes of death of stillborns and newborns the 9th revision of ICD, the nowadays valid death certificate and special rules of signing are explained to avoid mistakes, which are often met with in the daily practice.     

The changing picture of hepatitis A in the United States

PURPOSE OF REVIEW: Hepatitis A causes approximately half of the cases of viral hepatitis in the United States. Since 1999, routine hepatitis A immunization of children in areas of the United States with high rates of hepatitis A has been recommended. RECENT FINDINGS: There has been an increasing appreciation of the role of young children with asymptomatic or inapparent infection as the community reservoir of hepatitis A virus. Epidemiologic studies have demonstrated striking geographic variations in the incidence of hepatitis A in the United States. On the basis of this understanding, recommendations for control of hepatitis A were updated in 1999 to include routine vaccination of children living in states, counties, and communities with high rates of hepatitis A. Routine hepatitis A vaccination of children in areas with high rates of hepatitis A is a cost-effective strategy to reduce the incidence of hepatitis A. SUMMARY: Improved understanding of the epidemiology and transmission of hepatitis A combined with the availability of effective hepatitis A vaccines have dramatically reduced the burden of hepatitis A in the United States.     

Family factors affecting child development

In a large, geographically defined population of children a number of family factors in addition to social class, determined by the father's occupation, were recorded by health visitors and school nurses with routine responsibility for these children. The quality of the children in normal schools was assessed in terms of nonverbal IQ and height at the ages of 5 and 10 years, and of behavior as reported by the teacher at the age of 10 years. By analysis of variance the sum of the independent effects of the other family factors greatly outweighed that of occupational social class, except in the case of the IQ at 10 years. The most important of the other family factors was the quality of the mother's care of her child during the first 3 years of life.     

Early diagnosis and prognosis of bacterial tubulo-interstitial nephritis in children]

The authors provide the data of a prospective follow-up of children with diseases of the urinary system organs. Analysis was made of the role of endogenous and exogenous factors in the formation of abacterial and bacterial tubulointerstitial nephritis (TIN) in children with predisposing conditions. It has been established that progression of the tubulointerstitial process can be seen in patients infected with causative agents capable of intracellular parasitizing and persistence in the body. Depending on the intensity of membranopathological and immune disorders the clinicopathogenetic manifestations of different stages of TIN are described in detail. It is shown that there is a possibility of early diagnosis of the bacterial stage of the disease on the basis of detecting the persistent microflora according to an assay of the antilysozyme activity of the causative agent and the urine content of beta-lysines in urine. The authors base the necessity of the preventive treatment of children with predisposing conditions and abacterial TIN to avert the formation and progression of bacterial TIN by means of agents that may prevent the persistence of causative agents and raising the efficacy of antiinfectious defence of the macroorganism.     

Recommendations for respiratory support in the newborn

The recommendations included in this document will be part a series of updated reviews of the literature on respiratory support in the newborn infant. These recommendations are structured into twelve modules, with modules 4, 5, and 6 presented here. Each module is the result of a consensus process of all members of the Surfactant and Respiratory Group of the Spanish Society of Neonatology. They represent a summary of the published papers on each specific topic, and of the clinical experience of each one of the members of the group. Each module includes a summary of the scientific evidence available, graded into 4 levels of recommendations.     

Kinetics of circulating corticosterone in infant rats

Corticosterone plays an important role in the regulation of postnatal development in the rat. Basal concentrations of plasma corticosterone increase markedly during the 3rd wk of life. To date, however, the physiologic bases of this increase have remained unclear. To understand the determinants of circulating concentrations of corticosterone during this period, the plasma half-life of disappearance at steady state (t1/2), the apparent volume of distribution, and metabolic clearance rate were determined after injection of a tracer dose of 3H-corticosterone in rats at 12, 16, and 22 days of age. The t1/2 for total plasma corticosterone decreased with increasing age. The volume of distribution decreased even more steeply and, consequently, the MCR displayed a highly significant decline between 12 and 22 days of age. As plasma concentrations of corticosteroid-binding globulin are known to increase markedly during this period, the t1/2 of protein-bound corticosterone was measured and that of free corticosterone was computed. At all ages the t1/2 of bound corticosterone was less than that of free corticosterone. Protein binding of the injected 3H-corticosterone increased significantly with development. Thus, increased binding of corticosterone is associated with decreased t1/2. The increasing association of corticosterone with corticosteroid-binding globulin during this developmental period is the most likely explanation for the steep decline of volume of distribution and thus of the metabolic clearance rate for corticosterone. The latter provides, for the first time, an understanding of the basis of the developmental increase in plasma concentrations of corticosterone.     

Glucose and galactose infusions in newborns of diabetic and healthy mothers.

The changes of insulin, blood sugars, lactate and free fatty acid levels were studied in 12 newborns of diabetic mothers and in 21 newborns of healthy mothers in the course of intravenous infusions of glucose and galactose at a dose of 0.5 g.kg-1.h-1. During glucose infusion a striking increase of insulin levels took place, which was higher in the infants of diabetic mothers. Galactose administration caused only a mild insulinemia increase in the 1st h of infusion. In the infants of healthy mothers blood glucose increased during the 1 st h of infusion but decreased afterwards. In the infants of diabetic mothers the increase lasted for the whole time of infusion. The decrease of free fatty acid levels was present in the course of infusions of both sugars. The results show that galactose is quickly metabolized by the newborn and provokes minimal stimulation of the insular apparatus.     

ASSESSMENT OF PULMONARY AND INTRATHYMIC HEMOSIDERIN DEPOSITION IN SUDDEN INFANT DEATH SYNDROME

The aim of this study was to stain lung and thymus gland sections that had been taken from infants who had died of sudden infant death syndrome SIDS for interstitial hemosiderin and to compare the results with those obtained for controls. There were two groups of SIDS infants, one with, and a second group without, histories of apparent life-threatening events ALTEs . No significant difference in numbers of cases with interstitial hemosiderin deposition was found between SIDS infants with histories of ALTEs n 4 of 12, 33.3 , SIDS infants without histories of ALTEs n 4 of 22, 18.2 , and controls n 4 of 24, 16.7 . However, if four of the control cases with histories of previous chest trauma were excluded, there was a significantly greater number of cases with pulmonary interstitial hemosiderin in the SIDS infants with histories of ALTEs compared with the subgroup of control infants with no previous chest trauma n 1 of 20, 5 P .05 . No relationship could be established between the timing of the ALTEs, the type of resuscitation or age of the infant at death, and the presence of hemosiderin. None of the sections of thymus gland stained positively for hemosiderin. Positive staining for pulmonary interstitial hemosiderin, therefore, differentiated a group of SIDS infants with histories of previous ALTEs from a subgroup of control infants with no histories of previous chest trauma. However, pulmonary interstitial hemosiderin staining could not be used with certainty to confirm or exclude previous ALTEs in individual SIDS cases as not every SIDS case with a history of an ALTE stained for pulmonary interstitial hemosiderin. In addition, positive staining occurred for SIDS infants without histories of ALTEs and also for control infants who died of other causes.     

The role of estrogens in the pathogenesis of bladder dysfunction of the hyperreflexia type and vesico-ureteral reflux in children

Patients with the uninhibited urinary bladder of the hyperreflexia type and the vesicoureteral reflux were subjected to multimodality examinations which included excretory urography, retrograde cystometry, cystography, profilometry of the ureterovesical anastomosis, cytologic investigation of estrogenic saturation, determination of the concentration of follicle-stimulating hormone of the pituitary and estradiol by means of radioimmunoassay. As many as 56 girls aged 4 to 15 years underwent examination. It has been demonstrated that dysfunction of the urinary bladder of the hyperreflexia type is of crucial role as an active mechanism of extra-vesicalization of the intra-vesical part of the ureter, associated with its antireflux function distress.     

A 50-year overview of perinatal medicine.

Infant mortality in 1990 was approximately one-tenth that of 1950 in most of the industrialized countries of the world. The forces of change included the social-political climate, advent of neonatal intensive care, better insight into nutritional requirements of preterm infants and application of basic science to the study of events around the time of birth, and illnesses of the neonate. Attention has been paid to the advantages of human milk for the newborn infant, the importance of maternal bonding and involvement of both parents in care of the infant. Prenatal diagnosis, with option of abortion, has reduced the prevalence of some serious disorders of the fetus.     

Prophylaxis of recurrent acute otitis media and middle-ear effusion. Comparison of amoxicillin with sulfamethoxazole and trimethoprim

We compared the efficacy of amoxicillin with that of the combination drug sulfamethoxazole and trimethoprim in reducing recurrences of acute otitis media (AOM) in a single-blind, randomized, placebo-controlled trial involving 96 children. Each of the children had had three or more episodes of AOM in the preceding 6 months, and 97% (93/96) of them still had unilateral or bilateral effusion at the beginning of the study. During the 6-month study period, 9 (27%) of 33 of the children in the amoxicillin group developed 9 episodes of AOM, 9 (27%) of 33 of the children in the sulfamethoxazole and trimethoprim group experienced 11 episodes of AOM, and 19 (63%) of 30 of the children in the placebo group developed 25 episodes. Young age and day-care attendance characterized children for whom prophylaxis was more efficacious. Overall persistence of middle-ear effusion was shorter in treated children only as a consequence of the reduced number of new episodes of AOM.     

中国11市17256例胎龄25~40周双胎儿出生体重曲线及地区差异特征北大核心CSCD

目的研制胎龄25~40周双胎儿出生体重曲线,并探讨其地区差异特征。方法在中国11市(海口、广州、柳州、桂林、泉州、深圳、重庆、成都、长沙、宁波、连云港)选择年分娩量7000例以上的11家妇幼保健院,纳入其2017年1月1日至2020年12月31日分娩的全部活产双胎儿进行出生体重曲线研制。结果纳入了上述11市合计17256例胎龄25~40周双胎儿进行研究,建立了中国11市合计及各市双胎儿出生体重第3~97百分位数参考值,并绘制了出生体重百分位曲线图。柳州市双胎儿出生体重曲线水平低于11市合计双胎儿;宁波市双胎儿出生体重曲线水平高于11市合计双胎儿;连云港市双胎儿出生体重曲线水平明显高于11市合计双胎儿;其他8个城市双胎儿出生体重曲线水平与11市合计双胎儿曲线水平基本一致。结论制定了中国11市合计及各市双胎儿出生体重第3~97百分位数参考值,可作为该区域双胎儿宫内生长评价的参考标准。部分城市双胎儿宫内生长水平与中国11市合计的水平存在差异。[中国当代儿科杂志,2022,24(8):899-907]     

不同术式治疗冠状沟型尿道下裂的临床分析

目的 比较MAGPI术、Duckett 术、Snodgross术、Mathieu术4种术式一期治疗阴茎冠状沟型尿道下裂的优缺点,以提高一期治疗阴茎远端型尿道下裂的临床疗效.方法 回顾性分析我们采取4种术式治疗的86例阴茎远端型尿道下裂患儿临床资料.结果 MAGPI术成功率高,远期外观不理想,Duckett术并发症的发生率19.23%,Snodgross术并发症的发生率7.69%,mathieu术并发症的发生率7.69%.结论 尿道下裂4种术式各有优缺点,具体应用宜根据临床病例选择,其中mathieu术较常用.     

大剂量氨甲喋呤两种用药方式的肝脏毒性比较

为探讨大剂量氨甲喋呤对肝脏的毒副作用与给药方式的关系，本文作者将41例已确诊为急性淋巴细胞白血病的患儿随机地分为两组，分别利用两种不同的投药方式应用HDMTX。方法一为HDMJX总量的1／3在30分钟内静脉注射，余量在10～12，小时内静脉滴注，滴注MTX后24小时用CF解救。方法二为HDMTX总量的1／10在30分钟内静脉注射，余量在6小时内静脉滴注，HDMTX静脉注射用药后36小时用CF解救。通过对用药前后患儿的血sGPT的对比来判断MTX对肝脏的毒性。对比结果（P＜0．05）提示方法一所至肝脏毒性大于方法二。     

A prospective study of toddlers with ASD: short-term diagnostic and cognitive outcomes

Background:  Despite recent increases in the number of toddlers referred for a differential diagnosis of autism spectrum disorders (ASD), knowledge of short-term stability of the early diagnosis as well as cognitive outcomes in this cohort is still limited.
Method:  Cognitive, social, and communication skills of 89 clinic-referred toddlers were assessed at the average age of 21.5 (SD = 4.9) months, and reassessed at 46.9 (SD = 7.7) months. Groups with stable and unstable diagnostic presentation were identified and compared on their profile of cognitive and social-communicative skills obtained at the time of initial diagnosis.
Results:  Stability of the ASD diagnosis was 100%; diagnosis of autism was stable in 74% of cases as compared to 83% and 81% in PDD-NOS and Non-ASD groups, respectively. Worsening of social disability symptoms resulting in autism diagnosis was noted in 17% of toddlers initially diagnosed with PDD-NOS and in 19% of toddlers with initial diagnosis of non-ASD disorder. However, marked improvement was noted in approximately 1/4 of children initially presenting with autism, warranting diagnostic reassignment to PDD-NOS at follow-up. An analysis of developmental skills profiles suggests particular relevance of the assessment of verbal and nonverbal communication skills to diagnostic differentiation between subtypes within ASD in the second year of life.
Conclusions:  Stability of ASD diagnosis in toddlers is high, though marked changes in severity of symptoms is to be expected in a minority of cases. Simultaneous consideration of cognitive, social, and communication skills profiles enhances accuracy of diagnostic classification and prediction of outcome.