RESUMEN
Plasma concentrations of copper and zinc and leucocyte concentrations of zinc were measured in mothers during later pregnancy, at delivery, and 8-10 weeks after birth, and plasma concentrations of copper and zinc were measured in their infants at delivery and 8-10 weeks after birth. The 145 infants were either breast fed or fed one of two milk formulas supplying copper at different concentrations. None of the infants achieved the minimum copper intakes recommended by the World Health Organisation (WHO). At 2 months of age there were no major differences in growth or health detected in infants fed the different copper intakes. Infant birth weight correlated well with the ratio of maternal venous plasma zinc:maternal leucocyte zinc at delivery. Maternal venous plasma copper and zinc concentrations at birth correlated with umbilical venous plasma copper and zinc concentrations. Infants fed the higher copper content formulas had a low mean plasma zinc concentration without a significant increase in the mean plasma copper concentration. The present WHO recommendations regarding minimum copper intakes for infants fed formulas cannot be achieved with currently available formulas and are probably wrong.
Asunto(s)
Cobre/administración & dosificación , Dieta , Alimentos Infantiles , Recién Nacido/sangre , Lactancia Materna , Cobre/sangre , Femenino , Sangre Fetal/análisis , Humanos , Recién Nacido de Bajo Peso/sangre , Recién Nacido/crecimiento & desarrollo , Leucocitos/análisis , Masculino , Embarazo , Zinc/sangreRESUMEN
Forty-two children aged one to sixteen years with persistent and severe hypertension were investigated by renal vein renin measurements. There were no serious complications in the 49 procedures performed and technical failure occurred on three occasions. Arteriography was performed in 35. Asymmetrical renin release was found in 22 patients and of these 15 underwent surgery. This was successful in 12 patients (80%) who became normotensive. Ten had unilateral disease (100% cure rate) but only 2 (40%) with bilateral disease became normotensive. Renal vein renin studies combined with arteriography have a useful role in the investigation and management of childhood hypertension.
Asunto(s)
Hipertensión/sangre , Renina/sangre , Adolescente , Angiografía , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Venas RenalesRESUMEN
Throughout 1981 and 1982 all deaths of infants aged 8-365 days (post-perinatal infant mortality, PPIM) in Scotland were studied. During this period there were 135 250 live births and 1533 infant deaths (infant mortality rate 11.3), including 763 PPIM deaths (5.6 per 1000 live births). These 763 deaths fell into three main categories: birth-determined (329), accident or acquired disease (65), and cot deaths (369). Birth-determined deaths included 109 preterm, 199 congenital disorders, and 21 miscellaneous deaths. 61 of the cot deaths were fully explained on necropsy, in 141 an associated finding which might or might not be relevant was found, and in the remaining 167 no explanation was found. The cot death rate was 2.7 per 1000 live births overall (3.3 for boys, 2.1 for girls), and more second-born than first-born children died (approximately 3:2). Excluding "explained" cot deaths the rate was 2.3 per 1000 live births.
Asunto(s)
Mortalidad Infantil , Muerte Súbita del Lactante/epidemiología , Accidentes , Anomalías Congénitas/mortalidad , Femenino , Humanos , Lactante , Recién Nacido de Bajo Peso , Recién Nacido , Masculino , EscociaRESUMEN
Post-perinatal infant mortality (PPIM; deaths from the 8th day to the end of the 1st year of life) was studied in Glasgow over the 3-year period 1979-81. The 244 deaths were divided into three main categories--those determined at birth, those due to accidents and acquired disease, and cot deaths. 50% of deaths were determined at birth, and of these 46% were due to prematurity and 49% to congenital disorder. Cot deaths accounted for 44% of the total (88% of deaths not determined at birth) and a definite cause could be identified in only 10% of these. The PPIM rate was 6.1 per 1000 livebirths, a significant part of the infant mortality rate of 12.6. The significance of these findings is discussed in relation to the possible reduction of these figures.
Asunto(s)
Mortalidad Infantil , Enfermedades del Recién Nacido/mortalidad , Traumatismos del Nacimiento/mortalidad , Anomalías Congénitas/mortalidad , Femenino , Humanos , Lactante , Recién Nacido , Enfermedades del Prematuro/mortalidad , Masculino , Escocia , Muerte Súbita del LactanteRESUMEN
As judged by admissions to a children's hospital, the prevalence of Asian rickets in Glasgow increased from 1960 to 1973 and then decreased gradually. 400 children born of Indian or Pakistani parents (200 in 1974 and 200 in 1979), from two schools, were examined for clinical, biochemical, and radiological evidence of vitamin-D deficiency. In 1974 there were 10 children with florid rickets and 15 with subclinical rickets, whereas in 1979 no child had florid rickets and only 9 had subclinical rickets. Most Asian children now receive vitamin-D supplements. In the short term, general practitioners, physicians, and obstetricians in the United Kingdom must try to ensure vitamin D supplementation not only by children but also by young adults (aged 13-18 years) of Asian origin. A particular target should be pregnant Asian women, to prevent osteomalacia, fetal hypovitaminosis, and congenital rickets. The long-term answer to Asian probably lies in health education and a change towards the Western diet and life-style.
Asunto(s)
Raquitismo/epidemiología , Adolescente , Niño , Preescolar , Femenino , Educación en Salud , Humanos , India/etnología , Masculino , Intercambio Materno-Fetal , Pakistán/etnología , Embarazo , Raquitismo/prevención & control , Escocia , Vitamina D/administración & dosificaciónRESUMEN
In neonates, thrombosis beginning in small renal veins and progressing to larger veins is best termed renal venous thrombosis (RVT) since the renal vein is not usually concerned. RVT occurs dominantly in the new-born and affects males more often than females (2:1). Hyperosmolality, maternal prediabetes and angiocardiography contribute to the occurrence or RVT. Early signs and symptoms are largely non-specific with the most reliable being the presence of haematuria (49%) or a palpably enlarged and hard kidney (60%). A falling platelet count, raised FDP level of falling plasminogen level support the diagnosis in 90% of cases. Radiology and nephrosonography are very useful in establishing the presence or absence and functional state of the kidneys. Therapy consists of the maintenance of homeostasis, minimization of spread, correction of uraemia and prevention of renal hypertension from a contracted functionless kidney by elective nephrectomy after 4--6 months. Heparin therapy and peritoneal dialysis have greatly improved the outlook in bilateral cases.
Asunto(s)
Venas Renales , Trombosis/diagnóstico , Diagnóstico Diferencial , Femenino , Heparina/uso terapéutico , Humanos , Lactante , Recién Nacido , Riñón/irrigación sanguínea , Masculino , Nefrectomía , Concentración Osmolar , Pronóstico , Trombosis/fisiopatología , Trombosis/terapia , Ultrasonografía , Urografía , Vénulas , Equilibrio HidroelectrolíticoRESUMEN
200 Asian 300 African, Chinese, or Scottish children were examined for clinical, biochemical, and radiological evidence of vitamin-D deficiency. Among the Asians there were 10 with florid rickets and 15 with subclinical rickets. Among the African, Chinese, and Scottish children there were no cases of florid rickets and only 7 cases of subclinical rickets (3 African, 3 Chinese, and 1 Scottish). Loss of metaphyseal definition is considered to be the radiological pattern of minimal active rickets and metaphyseal bands to represent the healing stage. Serum 25-hydroxycholecalciferol concentrations were low in clinical and subclinical minimal active rickets although there was some overlap with the wide range found in the "normal" group. Elevated serum-alkaline-phosphatase levels alone should not be regarded as indicating vitamin-D deficiency. The continuing prevalence of rickets in Asian children and in particular among schoolchildren warrants immediate action, which is long overdue.
Asunto(s)
Raquitismo/epidemiología , África/etnología , Fosfatasa Alcalina/sangre , Calcio/sangre , Niño , Fenómenos Fisiológicos Nutricionales Infantiles , Preescolar , Emigración e Inmigración , Ergocalciferoles/administración & dosificación , Ergocalciferoles/uso terapéutico , Femenino , Hong Kong/etnología , Humanos , Hidroxicolecalciferoles/sangre , India/etnología , Lactante , Inyecciones Intramusculares , Masculino , Fosfatos/sangre , Radiografía , Raquitismo/sangre , Raquitismo/tratamiento farmacológico , Escocia , Vitamina D/administración & dosificación , Muñeca/diagnóstico por imagenRESUMEN
This article is meant to serve as a simple introduction to diagnostic ultrasound, explaining the nature of sonar and the basic equipment for its production and use. A scans, B scans, time-position scans, and Doppler-shift techniques are described, with some examples of the clinical applications of each. Some recent innovations such as scan conversion to improve gray scaling and electrocardiographically triggered cardiac sector scans are mentioned. The limitations of the technique are indicated, with measures that can be adopted to reduce them. The safety of the procedure is emphasized, with its freedom from the known biological effects of ionizing radiation.