The significance of a high plasma ammonia value

At a tertiary referral centre, just over 50% of patients with plasma ammonia values over 200 micro mol/l had inborn errors of metabolism. To distinguish artefactual high values from those requiring treatment, the measurement should be repeated immediately if the result is above 200 micro mol/l and at lower concentrations if the patient is encephalopathic.     

Acute polyvisceral lupus erythematosus in a young 12-year-old girl. The value of plasma exchange

The authors report on the case of a 12 year old girl, presenting with severe systemic lupus erythematosus. Skin, joints and kidney were involved. The treatment associated steroids, plasma exchanges and cyclophosphamide. Remission has been obtained and remains one year later.     

Prognostic value of creatine kinase BB-isoenzyme in high risk newborn infants.

Serum creatine kinase BB-isoenzyme (CK-BB) activity was studied on the first day of life in 31 acutely asphyxiated infants, 70 infants born after high risk pregnancies (pre-eclampsia or intrauterine growth retardation, or both), and 47 very low birthweight infants. Neuro-developmental evaluation was carried out at 2.2-2.5 years. Eight infants died with, and eight without, hypoxic-ischaemic lesions of the brain, 14 had cerebral palsy, 16 had mild motor impairment, six had developmental delay without motor impairment, and 96 were normal at follow up. Infants who died with brain injury had significantly higher CK-BB activity than infants with normal outcomes (geometric mean 12 U/l); the mean difference was 82 U/l with a 95% confidence interval from 31 to 219 U/l. CK-BB in infants with cerebral palsy and mild motor impairment (geometric means 12 and 15 U/l, respectively) were similar to controls. CK-BB activity after birth is predictive of neonatal death but not of neurological damage in survivors.     

川崎病患儿血浆前白蛋白的变化及其意义

目的 观察川崎病病程中急性时相蛋白包括前白蛋白(prealbumin,PA)的变化并探讨其意义.方法 回顾总结45例川崎病患儿资料,测定患儿血浆中PA和其他炎症指标,并对其在病程中的变化进行比较分析.结果 总计45例患儿纳入研究,其中男34例,女11例;发病年龄3个月到6岁1个月,其中5岁以下41例(91.1%),占绝大多数.退热前和退热后患儿血浆PA含量分别为(32.5±28.6)mg/L、(201.5±77.3)mg/L;退热前息儿血浆PA的含量较正常参考值明显下降,退热后PA则明显回升.结论 急性负性时相蛋白PA在川崎病病程中有明显的变化;PA和CRP一样可以作为监测川崎病病情变化的重要指标.     

The significance of elevated CSF lactate.

The final diagnosis of 158 patients who had a cerebrospinal fluid (CSF) lactate concentration greater than 2 mmol/l was ascertained. The conditions included seizures, inflammatory changes, and proven metabolic disorders. For the diagnosis of congenital lactic acidoses, CSF lactate should ideally be measured in a seizure free patient after any acute illness.     

Macrolipodystrophy. The value of soft-tissue radiography

Macrodystrophia lipomatosa is the hypertrophy of a limb or of a limb-segment due to fatty infiltration. X-ray examination of the soft tissues which reveals the presence of fat, most often allows the easy distinction of this disorder from other causes of localized hypertrophy.     

肺炎患儿空腹血糖变化的临床探讨

目的 探讨血糖检测对小儿急性肺炎的临床意义.方法 观察139例急性小儿肺炎及33例正常对照组血糖变化情况,分析血糖变化与病情严重程度的关系.结果 重症肺炎组患儿血糖7.11±2.58 mmol/L,显著高于普通肺炎组(5.49±1.12 mmol/L)及正常对照组(5.41±0.38 mmol/L);高血糖组肺炎患儿中重症肺炎占的比例显著高于正常血糖组.结论 高血糖是反映急性小儿肺炎病情严重程度的重要的临床指标之一.     

血前降钙素在新生儿败血症中的应用价值探讨

目的探讨血清前降钙素(PCT)检测在新生儿败血症中的应用价值.方法对58例疑似新生儿败血症患儿采用半定量固相免疫测定法测定血清PCT水平,PCT水平分为＜0.5 ng/ml,0.5～2.0ng/ml,2.0～＜10.0 ng/ml和≥10 ng/ml4个等级,血清PCT＞0.5ng/ml为阳性阈值.结果败血症组PCT阳性44例,阳性率75.9%,对照组仅1例阳性,阳性率5.5%,两组有显著差异.结论血清PCT是新生儿败血症的重要诊断标准,可作为败血症预后判断及治疗监测的指标.     

The significance of multiple trauma in children.

Accident-related injuries, mainly traffic-connected, are the most serious threat to health and most-frequent cause of death in the pediatric age group. Usually these are multi-system injuries. While the total number of accidents has decreased over the last 20 years, traffic accidents have become more serious. Conventional prognostic scores are not applicable in children with multiple injuries because of their essential pathophysiologic differences with adults. The Pediatric Trauma Score closes this gap. It is simple to use and provides high reliability.