Assuntos
Anemia Falciforme/complicações , Temperatura Baixa/efeitos adversos , Exposição Ambiental , Doenças Vasculares/etiologia , Adolescente , Adulto , Anemia Falciforme/sangue , Estudos de Casos e Controles , Criança , Pré-Escolar , Constrição Patológica/etiologia , Hemoglobina Falciforme/análise , Humanos , Fatores de Tempo , ÁguaRESUMO
Two groups of infants, one fed whole cow milk commencing at 6 months of age (n = 69) and the other continuing to receive iron-fortified infant formula (n = 98), were closely observed over their second 6 months of life. At 12 months of age, infants fed cow milk had significantly lower mean serum ferritin levels and mean corpuscular volume, higher free erythrocyte protoporphyrin values, and greater incidence of hemoglobin values less than 11 g/dl than did formula-fed infants. There were no significant differences in frequency of otitis media, wheezing episodes, nasal discharge or congestion, diaper dermatitis, constipation, guaiac-positive stools, or hospital admissions between the two groups. These data suggest that, to avoid iron deficiency, infants should continue to receive iron-fortified formula throughout the first year of life or a daily iron supplement if they are fed whole cow milk before their first birthday.
Assuntos
Alimentos Infantis , Leite , Animais , Índices de Eritrócitos , Feminino , Ferritinas/sangue , Hemoglobinas/análise , Humanos , Lactente , Deficiências de Ferro , MasculinoAssuntos
Anestesiologia/tendências , Pediatria/tendências , Criança , Humanos , Medicina , Especialização , Estados UnidosRESUMO
Serum ferritin and erythrocyte porphyrin concentrations were measured in seven Peruvian infants, who ranged in age from 7.5-12.0 months (mean: 9.3 months), who had been exclusively breast-fed all their lives. No infant had evidence of iron deficiency as reflected by a reduced serum ferritin, or an increased erythrocyte porphyrin. Mean serum ferritin and erythrocyte porphyrin values in these seven infants were similar to those of 40 nonanemic, noniron-deficient U.S. infants who ranged in age from 9 to 12 months, on a mixed diet. These findings illustrate that exclusively breast-feeding an infant for at least 9 months of life meets the iron requirements of the full-term infant.
PIP: Exclusively breastfed infants have been known to maintain a state of iron sufficiency until at least 6 months of age. Introduction of solid foods while breastfeeding has been associated with the development of iron deficiency in infants. This study evaluates the iron status of 7 Peruvian Quechua Indian infants who were exclusively breastfed for periods of 7.5-12 months of age. Capillary blood samples were collected and centrifuged. Nonhemolyzed samples were brought to the U.S. for determination of serum ferritin concentration and erythrocyte porphyrin. Serum ferritin was determined by radioimmunoassay while erythrocyte porphyrin values were measured using a fluorometric procedure in a front-faced fluorometer. 40 nonanemic U.S. infants aged 9-12 months who had been fed on a mixed diet served as a comparison group for serum ferritin values. All serum ferritin values of the 7 infants were in the normal range ( 10 ng/ml), and the mean value for the group was similar to that of their American counterparts. Although the population in this study is small, the subjects represent a larger number of exclusively breastfed infants for prolonged periods of time and for whom serum ferritin values are available. This study suggests that exclusive breastfeeding is sufficient to maintain adequate iron nutrition for most of the 1st year of life.
Assuntos
Aleitamento Materno , Ferro/sangue , Eritrócitos/análise , Ferritinas/sangue , Humanos , Lactente , Peru , Porfirinas/sangueRESUMO
We evaluated the use of dexamethasone in the management of acute laryngotracheobronchitis (croup). Thirty patients, ranging in age from eight to 60 months, were evaluated in a prospective, double-blind study. Patients received dexamethasone, 0.3 mg/kg at the time of admission and a similar dose 2 hours later, and were compared with a placebo group receiving saline. Sixteen patients received dexamethasone and 14 patients received the placebo. Severity of each group was scored by a standardized system. Patients receiving dexamethasone had a mean admission score of 8.46 points; patients receiving placebo, 8.14. Twenty-four hours after admission the patients in the treatment group had a mean score of 1.19 as contrasted with a score of 5.58 for the placebo group (P less than 0.01). We concluded that dexamethasone when administered in adequate dosage by an intramuscular route hastens the recovery of infants and children with acute uncomplicated croup.
Assuntos
Crupe/tratamento farmacológico , Dexametasona/uso terapêutico , Laringite/tratamento farmacológico , Pré-Escolar , Ensaios Clínicos como Assunto , Método Duplo-Cego , Humanos , Lactente , Placebos , Estudos ProspectivosRESUMO
Red cell free erythrocyte porphyrin determinations were performed on cord blood specimens from 236 term infants and on capillary blood specimens from 63 preterm infants weighing less than 1,500 gm, during the first week of life. These results were contrasted with those obtained from 398 normal infants and children ages 1 to 6 years. The mean FEP value for the infants was significantly higher than that observed in the normal control subjects. In 10.5% of the term infants and 15.9% of the preterm infants, values in excess of 120 microgram/dl RBCs, the highest value recorded in the normal subjects, were observed. Elevations in FEP values were not related to either blood lead concentration or hematocrit levels in the infants. Infants with elevated FEP values were found to have lower serum iron and transferrin saturation values than did infants with low FEP values. These findings suggest that elevations in cord blood FEP values may indicate a state of relative iron deficiency present at birth.
Assuntos
Eritrócitos/metabolismo , Porfirinas/sangue , Capilares , Criança , Pré-Escolar , Ferritinas/sangue , Sangue Fetal , Hematócrito , Humanos , Lactente , Recém-Nascido , Ferro/sangue , Chumbo/sangue , Transferrina/metabolismoRESUMO
To test the hypothesis that iron deficiency in infants and children is associated with behavioral alterations, 24 infants with iron deficienty anemia, ages 9 to 26 months, were randomly assigned to a treatment and control group. Bayley Scales of Infant Development were administered before treatment with intramuscular iron or placebo; the test was readministered in five to eight days. Children treated with iron showed a significant increase in their scores on the Mental Development Index averaging a mean gain of 13.6 points in a mean time of 6.8 days. The treated group was found to become more alert and responsive and demonstrated improvement in tests of gross and fine motor coordination. These findings support the hypothesis that iron deficiency in infants produced developmental alterations and that these changes are rapidly reversible with iron therapy.
Assuntos
Anemia Hipocrômica/tratamento farmacológico , Desenvolvimento Infantil , Ferro/uso terapêutico , Anemia Hipocrômica/psicologia , Comportamento Infantil , Pré-Escolar , Ensaios Clínicos como Assunto , Cognição , Feminino , Humanos , Lactente , Masculino , Processos Mentais , Destreza Motora , PlacebosRESUMO
Marked platelet hyperaggregability to adenosine diphosphate, epinephrine, and collagen was demonstrated in two children with vitamin E deficiency, with complete reversal following E supplementation. No clinical thrombotic tendency was observed during the E-deficient state. The action of vitamin E in the schema of platelet arachidonate peroxidation appears to be at the step of phosphilpase A activation, or the conversion of arachidonic acid into the cyclic endoperoxides, since the peroxidation product malonaldehyde was increased during the E-deficient state with normalization following E sufficiency.
Assuntos
Agregação Plaquetária , Deficiência de Vitamina D/sangue , Vitamina E/uso terapêutico , Difosfato de Adenosina/farmacologia , Ácidos Araquidônicos/metabolismo , Plaquetas/fisiopatologia , Colágeno/farmacologia , Ativação Enzimática/efeitos dos fármacos , Epinefrina/farmacologia , Feminino , Humanos , Lactente , Fosfolipases/metabolismo , Agregação Plaquetária/efeitos dos fármacos , Deficiência de Vitamina D/tratamento farmacológico , Vitamina E/farmacologiaAssuntos
Recém-Nascido Prematuro , Complexo Ferro-Dextran/uso terapêutico , Vitamina E/administração & dosagem , Interações Medicamentosas , Hemólise , Humanos , Recém-Nascido , Injeções Intramusculares , Vitamina E/sangue , Vitamina E/uso terapêutico , Deficiência de Vitamina E/prevenção & controleRESUMO
Exchange transfusions within the first 8 hours of life, as an adjunct to conventional therapy, were evaluated in two groups of infants: (1) infants with birth weights of less than 1,250 gm without severe respiratory distress and (2) infants of any birth weight with evidence of severe respiratory distress syndrome. A total of 63 infants were studied in Group 1. Infants who received an exchange transfusion had a survival rate of 86% as contrasted with a survival rate of 57% in the control group (p less than 0.01). A total of 82 infants were studied in Group 2. Infants who received an exchange transfusion had a 59% survival rate as compared with a 39% survival rate for the control group (p less than 0.04). The mechanism by which early exchange transfusion improves survival rate is unknown.
Assuntos
Peso ao Nascer , Transfusão Total , Doenças do Prematuro/terapia , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , Dióxido de Carbono/sangue , Hematócrito , Hemoglobinometria , Humanos , Hiperbilirrubinemia/terapia , Recém-Nascido , Doenças do Prematuro/sangue , Doenças do Prematuro/mortalidade , Oxigênio/sangue , Síndrome do Desconforto Respiratório do Recém-Nascido/sangue , Síndrome do Desconforto Respiratório do Recém-Nascido/mortalidadeRESUMO
Exchange transfusion, as a form of therapy, was contrasted with the use of fresh frozen plasma or conventional supportive care alone in the management of 19 infants with birth weights of less than 1,000 gm, without severe respiratory distress, and in the management of 82 infants, birth weights less than 2,000 gm, with severe respiratory distress whose disease manifested itself within the first 24 hours of life. Survival for more than five days was similar, regardless of therapy, in infants weighing less than 1,000 gm without severe RDS. In contrast, the use of exchange transfusion significantly decreased the case fatality rate of infants with severe RDS. In the groups receiving exchange transfusion, the mortality rate was 41%, whereas the groups receiving either plasma or supportive care alone the mortality was 80%. Study of coagulation factors and red cell concentrations of fetal hemoglobin and of 2,3-DPG failed to demonstrate any relationship between either improvement in coagulation or oxygen unloading and the improved survival of infants receiving exchange transfusion. Following exchange transfusion there was a significant decrease in the ratio of FIO2 to PaO2, suggesting that pulmonary perfusion and/or ventilation was improved by the procedure.
Assuntos
Peso ao Nascer , Transfusão Total , Doenças do Prematuro/terapia , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , Acidose Respiratória/terapia , Gasometria , Ácidos Difosfoglicéricos/análise , Eritrócitos/análise , Congelamento , Humanos , Doença da Membrana Hialina/terapia , Hipóxia/terapia , Recém-Nascido , Doenças do Prematuro/mortalidade , Plasma , Respiração com Pressão Positiva , Síndrome do Desconforto Respiratório do Recém-Nascido/mortalidade , Tromboplastina/análiseRESUMO
Inability to absorb oral iron is believed to be an extremely rare cause of therapeutic failure in the treatment of iron deficiency anemia. Six patients who had failed to respond to oral iron therapy were studied by a simple oral absorption test and contrasted with 25 patients with untreated iron deficiency anemia and 10 normal subjects. All six of the patients who were therapeutic failures demonstrated impaired iron absorption in the absence of other clinical evidence of gastrointestinal disease. In the 25 newly diagnosed patients with iron deficiency. 24 demonstrated elevated iron absorptions while 10 ironreplete normal subjects had minimal elevations in their serum iron values following the administration of the test dose of 1 mg of elemental iron per kilogram. When the therapeutic failures were treated with parenteral iron, all had a therapeutic response. In addition, after treatment the impaired absorption of iron improved transiently. All children who absorbed iron readily responded to oral iron therapy.
Assuntos
Anemia Hipocrômica/metabolismo , Ferro/metabolismo , Síndromes de Malabsorção/etiologia , Administração Oral , Anemia Hipocrômica/tratamento farmacológico , Criança , Humanos , Absorção Intestinal , Ferro/administração & dosagem , Ferro/uso terapêuticoRESUMO
Cord blood samples from ten term infants were fractionated into populations of young and old erythrocytes and compared with cells prepared in a similar fashion from eight normal adults. The old cell fraction from the newborn infants had very low phosphofructokinase activity and did not display the usual decline of activity of the enzymes phosphoglycerate kinase and enolase. In addition, the old cells from the newborn infants demonstrated impaired glucose consumption, which, upon analysis of the pattern of glycolytic intermediates, appeared to be a result of the phosphofructokinase deficiency. These findings suggest that cells produced earlier in gestation possess the developmental characteristics of fetal blood to a more significant degree and that these biochemical alterations may produce functional impairment.
Assuntos
Envelhecimento Eritrocítico , Eritrócitos/enzimologia , Recém-Nascido , Fosfofrutoquinase-1/sangue , Fosfoglicerato Quinase/sangue , Fosfopiruvato Hidratase/sangue , Adulto , Glicemia , Fracionamento Celular , Ensaios Enzimáticos Clínicos , Sangue Fetal/enzimologia , Glicóis/sangue , Hexoquinase/sangue , Humanos , Técnicas In Vitro , Fosfofrutoquinase-1/deficiênciaRESUMO
Chronic iron deficiency in rats resulted in decreased MAO activity both in vitro and in vivo. Since MAO is an important enzyme in inactivation of catecholamines, urinary excretion of DA, NE, E, MN-NMN, and VMA was measured in 24-hour samples from 11 iron-deficient children before and after treatment with intramuscular iron. Pretreatment NE excretion was abnormally high and returned to normal (P=0.001) within one week of therapy. VMA excretion also was higher before than after treatment (P greater than 0.05), but most values were within the normal range for healthy children of comparable size. There was no significant difference between DA, E, and MN-NMN excretion before and after iron therapy. Anemic, non-iron-deficient children had normal urinary NE, E, and VMA excretion before and after transfusion. These findings suggest that the irritability, lack of attentiveness, and low performance scores of iron-deficient children may be related to alterations in catecholamine metabolic pathways secondary to dependence of MAO on adequate iron stores.