RESUMO
To provide normative data, we measured anogenital distances in 115 infants of 25 to 42 weeks gestational age and 10 pregnant women, including anus to fourchette (AF), anus to base of the clitoris (AC), and fourchette to base of the clitoris (FC). All infant measurements showed positive and significant correlations with body surface area, weight, length, and gestational age (P less than 0.001). However, the anogenital ratio (AF/AC) followed a normal distribution and did not correlate with any of the anthropometric variables or age. Mean (+/- SD) value in infants was 0.37 +/- 0.07, and in adults, 0.36 +/- 0.07. An anogenital ratio greater than 0.50 falls outside the 95% confidence limits, suggests labioscrotal fusion, and indicates a need for further evaluation. Because it is independent of body size and gestational age, the anogenital ratio should be useful in diagnosing androgen-induced labioscrotal fusion in both premature and full-term female infants.
Assuntos
Canal Anal/anatomia & histologia , Virilismo/diagnóstico , Vulva/anatomia & histologia , Adulto , Antropometria/métodos , Clitóris/anatomia & histologia , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Períneo/anatomia & histologia , Gravidez , Valores de Referência , Virilismo/patologiaRESUMO
To establish normal values for gastric secretory function in preterm infants, we studied 34 healthy preterm infants once a week during hospitalization. Basal acid output, pentagastrin-stimulated acid output, fasting serum gastrin, and fasting serum pancreatic polypeptide were measured during each study. Basal acid output at 1 week of age was 12 mumol/kg/hr, increasing over the first 4 weeks to 30 mumol/kg/hr. Administration of pentagastrin 6 micrograms/kg subcutaneously increased acid output in all age groups. Pentagastrin-stimulated acid output at 1 week was 21 mumol/kg/hr, increasing over the first 4 weeks to 44 mumol/kg/hr. Acid secretion did not change significantly over the next 4 to 6 weeks. Fasting serum gastrin concentration was stable over the first 6 weeks of life, but doubled during the end of the second month. Pancreatic polypeptide was found at low levels throughout the study. These studies confirm that the majority of healthy preterm infants secrete acid in quantity sufficient to maintain the gastric pH less than or equal to 4, providing a barrier to bacteria and protein antigens.
Assuntos
Ácido Gástrico/metabolismo , Mucosa Gástrica/metabolismo , Recém-Nascido Prematuro , Acloridria/fisiopatologia , Fatores Etários , Nutrição Enteral , Feminino , Mucosa Gástrica/efeitos dos fármacos , Gastrinas/sangue , Humanos , Concentração de Íons de Hidrogênio , Recém-Nascido , Polipeptídeo Pancreático/sangue , PentagastrinaAssuntos
Pressão Sanguínea/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Recém-Nascido de Baixo Peso , Midriáticos/efeitos adversos , Soluções Oftálmicas/efeitos adversos , Ciclopentolato/efeitos adversos , Humanos , Recém-Nascido , Fenilefrina/efeitos adversos , Pulso Arterial , Pupila/efeitos dos fármacosRESUMO
Basal acid output and meal-stimulated acid output were measured in newborn infants after nasogastric infusion of 5% glucose and elemental formula, respectively. In six older infants (age range 6 to 31 months), basal acid output was 0.067 +/- 0.017 mmol/kg/hr and maximal acid output was 0.200 +/- 0.028 mmol/kg/hr. Meal-stimulated acid output in four of six older infants was 0.149 +/- 0.038 mmol/kg/hr. In eight healthy newborn infants basal acid output was 0.038 +/- 0.008 mmol/kg/hr; meal-stimulated acid output was 0.064 +/- 0.011 mmol/kg/hr (P less than 0.01). The time course of the secretory response to the elemental formula was as described previously after a protein meal in adults: the rate of acid secretion increased after 20 minutes and remained greater than the basal rate through the remainder of the 90 minute test period. These results demonstrate that in human newborn infants a mixed meal containing protein hydrolysate induces an acid secretory response that is qualitatively similar to but weaker than the response in older infants and adults.