SOCIAL ADJUSTMENT AND FUNCTIONING OF CHRONICALLY ILL AND IMPARED CHILDREN AND ADOLESCENTS

A cluster sample of 532 children aged 8 to 19 years with certain impairments were compared to a matched sample of 316 healthy children of the same age. Almost half (46 %) of the impaired had a disability, which was mostly in the domain of body disposition ability (in 88 %), behaviour (63 %) and situational functioning (54 %). In the controls, where 12 % had some kind of disability, the corresponding figures were 13 %, 11 % and 15 %. The most disabling conditions were CP (67 % handicapped), MBD (52 %) and epilepsy (42 %). The most frequent non-compènsated handicaps were those of occupation (44 % of impaired), mobility (31 %) and social integration (22 %). More than one handicap was associated most frequently with CP (76 %) and with epilepsy (36 %). Neurological impairments are more disabling and handicapping than non-neurological ones, with the exception of mobility and occupation handicaps in asthmatics.     

HEIGHT AND WEIGHT OF SCHOOL CHILDREN AND ADOLESCENT GIRLS AND BOYS IN OSLO 1970

ABSTRACT: Brundtland, G. H., Liestö1, K. and Wallöe, L. (Oslo City Health Department and Departments of Physics and Physiology, University of Oslo). Height and weight of school children and adolescent girls and boys in Oslo 1970. Acta Paediatr Scand, 64:565, 1975.–Height and weight measurements of the school children of Oslo in 1970 (aged 7 to 19 years) are reported. Weights show considerably skewed distributions with long tails towards higher weights. Weight percentiles are calculated by interpolation in the empirical distributions. Percentiles and tables for both sexes, showing height for age, weight for height and weight for age, are presented. A comparison with existing Norwegian data from Sundal, 1956, Bergen shows that the application of statistics based on normal distribution for weight, has introduced considerable error in these percentiles. Oslo children in 1970 are taller by 5–6 cm at age eighteen, than USA (Iowa) standards and 4–5 cm taller compared to Tanner's English percentiles. Oslo children are also taller than Swedish children, and have reached a stature higher than found in any other comparable study.     

PHYSICAL EXERCISE AND JUVENILE DIABETES—SUMMARY AND CONCLUSIONS

Abstract. Larsson, Y. (Department of Pediatrics, University Hospital, Linköping, Sweden). Physical exercise and juvenile diabetes.—Summary and conclusions. Acta Paediatr Scand, Suppl. 283: 120, 1980.—The various metabolic effects of physical exercise in ketotic diabetics, non-ketotic diabetics and non-diabetics are summarized. A favorable metabolic effect is only observed during optimal insulin administration, while in ketotic diabetics exercise may aggravate the metabolic situation. The use of exercise as a tool in the routine treatment of young diabetics is described. Activity-produced hypoglycemia should be prevented through an adequate food intake and through patient education. Regular exercise may postpone the appearance of diabetic microangiopathy.     

ABETALIPOPROTEINEMIA TREATED WITH PARENTERAL AND ORAL VITAMINS A AND E, AND WITH MEDIUM CHAIN TRIGLYCERIDES

ABSTRACT. An 11-year-old girl with abetalipoproteinemia was treated with parenteral vitamin A and vitamin E for two and a half years. Some improvement in neurological and visual deficits was noted. On changing to oral vitamin E and later with addition of medium chain triglycerides (MCT) to the diet, a considerable improvement in her general wellbeing, neuromuscular lesions and ophthalmological symptoms was noted. This regimen is being adhered to for five and a half years. The condition is stable with no further improvement.     

MECONIUM ILEUS AND INTESTINAL ATRESIA IN FETUSES AND NEONATES

A collaborative study was performed to determine the different types and mechanisms of intestinal abnormalities during gestation. Cases had to fulfill one or more of the following three criteria: (1) meconium ileus, (2) intestinal stenosis or atresia, and (3) meconium peritonitis. Esophageal atresia, anorectal atresia, and abdominal wall defects were excluded. One hundred two cases were reviewed from the autopsies of 42 induced abortions, 22 stillborns, and the surgical findings in 38 neonates. Meconium ileus was detected mainly during the second trimester (28/38), and was associated with cystic fibrosis (15), fetal blood deglutition (4), infection (6), or multiple abnormalities (10), in which three chromosomal aberrations were found. Intestinal stenosis or atresia was more commonly detected during the third trimester of gestation (46/56). Sixteen of the 30 duodenal malformations were associated with trisomy 21, whereas in the 26 small intestinal atresias, signs of distress or ischemia were most frequently detected. Only 8 of 25 meconium peritonitis cases were isolated. A total of 20 cystic fibrosis cases could be proved. In this series, functional abnormalities were observed predominantly in the second trimester and associated mainly with cystic fibrosis or amniotic fluid abnormalities. Anatomic lesions were commonly detected later on and associated with ischemic conditions, chromosomal aberrations, and even cystic fibrosis.     

MATERNAL CARETAKING AND PLAY WITH FULL-TERM AND PREMATURE INFANTS

The contribution of past psychological experiences of the mother and medical complications of the infant to differences in caretaking of pre- and full-term infants are examined. Twenty full- and 20 pre-term matched mother-infant dyads were studied during a feed and play 1, 2 and 3 months after the expected date of birth. Full-term infants were more active than pre-terms at 4 weeks only. Mother of pre-terms showed differences in their interactions at all times. Interactions were related to maternal experiences in full-term infants only. Degree of neonatal illness was correlated with behavioral disorganization of premature infants, leading to differences in caretaking style.     

LOCALIZATION AND FUNCTIONS OF SP-A AND SP-D AT MUCOSAL SURFACES

Pulmonary surfactant protein A (SP-A) and D (SP-D), members of the collectin family, are implicated in innate host defense of the lung. Collectins consist of a collagen-like domain and a carbohydrate recognition domain. SP-A and SP-D recognize and interact with glycoconjugates on the surface of microorganisms. They protect the lung by interacting with a wide variety of potential pathogens, including viruses, bacteria, and fungi. This may result in enhanced killing and/or clearance by phagocytes. Although most extensively studied in the lung, both SP-A and SP-D, or proteins closely resembling SP-A and SPD, are found in a number of other sites in the body and therefore may play a protective role at other sites than the lung. SP-A and SP-D protein and/or mRNA have been detected at various sites of the body: the respiratory tract, the gastrointestinal tract, the middle ear, and in the peritoneal cavity. The presence of SP-A and SP-D at these mucosal surfaces, in close contact with numerous potentially harmful microorganisms, supports a role for these "lung"-collectins in innate mucosal defense. SP-A and SP-D may be important molecules in a threefold innate defense, particularly in the neonatal period between maternally acquired immunity and a fully developed adaptive immune system; the time interval between first exposure to a pathogen and generation of specific antibodies; and states of impaired immune function.     

RELATIONSHIP BETWEEN HAEMOGLOBIN AND SERUM TESTOSTERONE IN NORMAL CHILDREN AND ADOLESCENTS AND IN BOYS WITH DELAYED PUBERTY

ABSTRACT. The concentrations of haemoglobin and of serum testosterone were measured in 215 normal children and adolescents aged 7–20 years, and in 8 boys with constitutional delayed puberty. From the age of 14 years onward haemoglobin and testosterone rose in normal boys and differed significantly from the stable levels observed in prepubertal children and pubertal girls. In the entire series of normal boys ( n = 118, age 7–20 years) concentrations of haemoglobin and testosterone were found to be closely correlated ( r =0.73, p <0.001). These results provide further evidence for a major role of testosterone in the control of erythropoiesis. Therefore, this correlation suggests the use of serum testosterone determination for the proper selection of haemoglobin reference ranges in boys. The respective reference ranges of haemoglobin corresponding to testosterone levels at 0 and 30 nmol/1 were 120.5–148.5 and 143.5–171.5 g/1 (95% confidence limits). Boys with delayed puberty were found to have significantly reduced median values of haemoglobin and testosterone for their chronological age, and 6 of the 8 boys investigated were truly anaemic on this background. Nevertheless, their haemoglobin concentration did appear appropriate as judged from their testosterone levels. This observation supports the idea that the selection of the relevant reference range for haemoglobin in boys should depend on the state of physical development as expressed by serum testosterone.     

ORGAN-SPECIFIC ANTIBODIES IN HEALTHY AND DIABETIC CHILDREN AND YOUNG ADULTS

ABSTRACT. 160 children and young adults (aged 7-21 years) and 84 diabetics (aged 2-19 years) were screened for thyroglobulin (TgA), thyroid microsomal (MsA), smooth muscle (SMA), parietal cell (PCA), reticulin (RA), glomerular (GIA) and mitochondrial (MA) antibodies. The diabetics were also screened for islet cell antibodies (ICA). The overall incidence of other antibodies than ICA at the lowest serum titre studied was 18.1 percent for healthy children and 30.9% for diabetic children. The elevation in diabetics is significant ( p <0.01). Females were overrepresented in both groups and had the highest titres of antibodies. The age group 10-14-years was observed to be a special time at which antibody titres became positive. As compared with the controls, diabetics exhibited increased incidence of MsA (4.4 and 11.9% respectively, p <0.001), PCA (5.0 and 10.7% respectively, p <0.05) and RA (3.8 and 9.5% respectively, p <0.05). The presence of ICA or the duration of diabetes showed no correlation with other autoantibodies. The results indicate that autoantibodies at a low titre are a common phenomenon. Diabetics seem to be susceptible to react against their own tissue, which is probably associated with their increased frequency of autoimmune diseases.     

CALCIUM AND PHOSPHORUS CONTENT OF TRANSITIONAL AND MATURE HUMAN MILK

Abstract. Barltrop, D. and Hillier, R. (Paediatric Unit, St. Mary's Hospital Medical School, London, England). Calcium and phosphorus content of transitional and mature human milk. Acta Paediatr Scand 63: 347, 1974.–The mineral content of breast milk is known to vary but the significance of this for the newborn is unknown. The calcium and phosphorus content of breast milk from 58 nursing mothers has been determined at intervals up to 6 weeks post partum . The plasma calcium and phosphorus content of 15 of the infants aged 6 days was also measured. The calcium and phosphorus content of transitional milk increased during the first 6 days of lactation without significant alteration in Ca/P ratio. No relationship between milk composition and infant plasma chemistry could be demonstrated at the 6th day. The data suggest that milk Ca/P ratios are of less significance for neonatal calcium homeostasis at low as opposed to high mineral loads.