Monatsschrift fur Kinderheilkunde最新文献

In 184 children and juvenile with type I respiratory allergies the AAT-content in serum was measured by the rocket technique. The results do show neither disease--nor agedependant changes. The mean of the total was 283 mg%. This value does agree very well with the normal values reported in literature. In 5 patients however (2,71%) of the total collective an intermediary AAT-deficiency was found. This frequency though lies within the percentage of occurrence in non-selected patients. The individual analysis of these cases did not give any valid connection to history, age, lung function, immunoglobulins and course of disease. On the basis of the demonstrated results it can be said, that the determination of AAT in serum patients with type-I-allergy is of no practical diagnostic value.

A comparative review of the various properties of human breast milk and cows' milk is presented. The advantages of breast feeding are emphasized. The recommendations of the ESPGAN and other international organizations for the formulation of artificial feeds are discussed.

Since 1972, the treatment of diabetic coma, ketoacidotic or hyperosmolar, with regular infusions of low doses of insulin, is a well-established form of therapy. Pediatricians all over the world apply this regimen regularly since 1975. In contrast to this there is the regime of intravenous or intramuscular application of high doses of insulin. To control the effectivity of these two methods, we compared two approximately identical groups of patients and analysed 17 different parameters. The patients of the low dose insulin infusion regimen needed less insulin, potassium and bicarbonate and reached earlier a bloodglucose level of 300 mg/dl. They also had a rapid and uneventful restoration of their electrolyte metabolism. Hypoglycaemia did not occur. There was no significant hypokalaemia or hypernatraemia. In contrast to this, the conventionally treated group showed much more complications. The hospital stay and the daily requirement of insulin was significantly higher. We believe that the low dose infusion regimen of insulin is a safe and easy therapeutic method. It surely is an alternative way for treating diabetic coma.

Growth and development of 172 infants with low birth weight (82 AFD, 90 SFD) were controlled within the first year of life. Head growth of AFD infants kept within normal limits during the whole time. The head circumference of the SFD infants was smaller within the first two months, from the third month onwards there was no signficant difference between AFD and SFD infants. The difference in body weight between AFD and SFD was significant up to the fifth month. Psychomotor development was within normal limits in 165 of the 172 infants, seven children developed signs of cerebral palsy. The incidence of spastic diplegia in infants with a birth weight below 1500 gm was 2.4%. The favourable outcome seems to be at least partially due to the early high caloric feeding.

The tubeless pancreas-function test with fluorescein dilaurate, which is based on the saponification of the test substance by pancreas-specific arylesterases, and which has proved itself in adults, was given to children for the first time. After reduction of the size of the test dose and the amount of liquid to be drunk, there were no difficulties in carrying out the test. Elimination of the fluorescein released from the flourescein dilaurate and excreted via the kidneys was clearly less in patients with cystic fibrosis than in normal subjects. Thus, the test in its modified form for children can provide adequate differentiation between normal and pathological pancreas function.