Protein nutrition, faecal flora and iron metabolism: the role of milk-based formulae

This paper explores the role of milk-based formulae in achieving four aspects of nutritional health in infants and toddlers: in the suckling, to mimic the amino acid metabolism and the faecal flora of a breast-fed baby; in the weanling, to achieve adequate protein intakes in later infancy and beyond and to achieve satisfactory haemoglobin concentrations in the early toddler years. Milk-based formulae have two roles in infant nutrition: as so-called breast milk substitutes and as a safety net during the weaning period; the latter role may be the more important.     

PAROXYSMAL TACHYCARDIA IN INFANCY AND CHILDHOOD I. Paroxysmal Supraventricular Tachycardia

A 1 to 30 year follow-up study of 54 infants and children with paroxysmal supraventricular tachycardia is presented. In 28 cases the first attack occurred in infancy, and in 18 of these already in the first months of life. Nine patients had organic heart disease. The WPW syndrome was diagnosed in 30 cases. When first seen, most of the infants presented signs of incipient or manifest congestive heart failure, which was very unusual in the children, most of whom had only minor symptoms. Four children had experienced brief syncopes during attacks. Digitalis was effective against congestive heart failure and, when continued, may have prevented failure during subsequent attacks. Whether digitalis and other anti-arrhythmic agents facilitated conversion to sinus rhythm could not be established in this study. Vagal stimulation was only rarely effective. Preventive treatment with digitalis or other antiarrhythmic drugs seemed to have little if any effect on the frequency of recurrent attacks. Out of 23 infants who were followed for at least 5 years, 17 had been free from attacks during the last 3 years and 13 of these had had their last attack before the age of 6 months. Out of 23 children followed for 5 years or more, only 3 had been free from recurrences during the last 3 years. Patients with the WPW-syndrome had a somewhat higher incidence of recurrent attacks.     

A comparison of idiopathic hypersomnia and narcolepsy-cataplexy using self report measures and sleep diary data.

Eighteen patients with idiopathic hypersomnia (IH) were compared with 50 patients with the narcoleptic syndrome of cataplexy and daytime sleepiness (NLS) using self report questionnaires and a diary of sleep/wake patterns. The IH group reported more consolidated nocturnal sleep, a lower propensity to nap, greater refreshment after naps, and a greater improvement in excessive daytime sleepiness since onset than the NLS group. In IH, the onset of excessive daytime sleepiness was predominantly associated with familial inheritance or a viral illness. Two variable--number of reported awakenings during nocturnal sleep and the reported change in sleepiness since onset--provided maximum discrimination between the IH and NLS groups. Confusional arousals, extended naps or nocturnal sleep, autonomic nervous system dysfunction, low ratings of medication effectiveness, or side effects of medication were not associated differentially with either IH or NLS.     

Factors determining the persistence of phantom pain in the amputee

Forty-six amputees were interviewed one month and thirteen months after amputation of an arm or leg.Complaints of persisting pain in a phantom limb were found to be significantly correlated with rigid and/or compulsively self-reliant personality, many people at home, illness of over 1 year's duration prior to amputation, persisting illness with threat to life or limb after amputation, pain in stump during first month after operation, pain in phantom limb during the same period, stump complications persisting at 13 months, and unemployment or retirement at 13 months after amputation.It is concluded that it may be possible to predict, at the time of amputation, which patients are likely to have problems with persisting pain in a phantom limb. Two illustrative case examples are described and the possible aetiological and therapeutic implications of the findings are discussed.     

Myasthenia gravis in the dog

An account is given of four cases of myasthenia gravis in the dog. All animals showed fatigue, and considerably reduced tolerance to exercise. Recovery followed rest or treatment with neostigmine. Three animals, two of which are still alive, had dilatation of the oesophagus. The fourth eventually died from an aortic body tumour. The occurrence of myasthenia in the dog may be of value in elucidating the cause of the disease in man.     

Supersensitivity of salivation in response to pilocarpine after withdrawal of chronically administered hyoscine in the mouse

1. The duration of the effect of a single large dose of hyoscine, in reducing the salivary response of mice to pilocarpine, was established as less than 66 hours.2. Supersensitivity was observed, after daily oral dosing with hyoscine, in the increased salivation of mice in response to pilocarpine injected at least 66 h after withdrawing hyoscine.3. The minimum duration of pretreatment with hyoscine that resulted in supersensitivity was 5 days. The daily dose was more effective if divided.4. The period after withdrawal for which supersensitivity could be detected was 6 days.5. The maximum salivary response to pilocarpine was increased by chronic hyoscine pretreatment.6. The antagonism of a single dose of hyoscine to pilocarpine salivation, as expressed by the dose-ratio of pilocarpine, was not altered by chronic hyoscine pre-treatment.