Cesko-Slovenska Pediatrie最新文献

The authors present their experience with surgery of deformities of the chest wall in childhood. In the course of 1986 to 1992 they operated 93 children with the diagnosis of pectus excavatum. This number comprised 66 boys and 27 girls. The mean age of the operated children was 10.5 years. During the same period 17 patients (12 boys and 5 girls) were operated on account of pectus carinatum. The mean age of the latter group of patients was 13.5 years. 23% of the patients with a pectus excavatum had before operation mild scoliosis, two patients suffered from severe scoliosis. 76 patients after operation of pectus excavatum were followed up for more than one year after operation. In 44 patients the result was excellent (58%), in 31 patients the result was good. One patient developed a relapse. Fifteen patients after operation for pectus carinatum were followed up for more than one year. In 12 patients (80%) the result of the operation is excellent, in three patients (20%) the result is good. From the group as a whole seven patients had dehiscence of the wound after surgery, four patients developed a seroma in the surgical wound, three patients developed pneumothorax after operation and in one instance an abscess developed in the surgical wound. In the course of 1987 the authors changed the surgical technique in pectus excavatum from Jensen's to Holcomb jun. operation.

The participation of essential fatty acids and their derivatives in the blood (serum) of physiological healthy neonates (physiological pregnancy, physiological delivery) is compared with the spectrum of essential fatty acids of risk newborns (prematurity, prematurity with the tocolytic therapy and hypotrophic newborns). In the following part the presence and participation of essential fatty acids in the human maternal milk were measured. The milk of healthy mothers, of mothers with preterm delivery (37 week of gestation), of diabetic mothers were mutually compared and finally the values of mentioned essential fatty acids in formula Feminar and in the milk from the bank were established. As a consequence of our observations, they point out the absence or serious deficit of some essential fatty acids in certain groups of risk newborns as well as in the milk of diabetic mothers, of mothers with preterm delivery and in Feminar and Milk-bank. The presented facts--after their opinion--could be well judged as a rational basis for adequate nutritional therapy in risk newborns.

Leigh's syndrome--subacute necrotizing encephalomyopathy--is a serious disease of child age manifested by severe psychomotor retardation, a varied neurological symptomatology, a typically symmetrical neuropathological affection of the central nervous system in the area of the basal ganglia and a metabolic disorder affecting the energy system of cells. The authors describe the clinical course of the disease and the results of metabolic and neuropathological investigations in an infant with Leigh's syndrome and severe lactate acidosis based on deficiency of complex I activity of the respiratory chain.

In 1977-1992 chronic inflammatory bowel disease was diagnosed in the gastroenterological department at the Clinic of Pediatrics in 31 children. Idiopathic proctocolitis was diagnosed in 16 children--mean age at the time of diagnosis was 13 years and 9 months. Fifteen children were treated for the diagnosis of Crohn's disease. Their mean age was 12 years and 9 months. During the investigation period all patients were examined regularly with special attention to hepatobiliary disease. Elevated aminotransferase values were observed in four children, three of these children have had permanent elevation of aminotransferase. Percutaneous liver biopsy revealed chronic persistent or active hepatitis. The authors investigated the course of the liver disease in relation to GIT disease. In the discussion they analyze the incidence, etiopathogenesis and type of liver lesions in inflammatory bowel disease with regard to the case-histories of their three patients.

The authors describe the withdrawal syndrome of a beta-adrenolytic in neonates manifested above all 10-16 hours after delivery by alternating bradycardia and marked tachycardia independently on the infant's activity. The withdrawal syndromes correlate with the increased heart rate of the mother after delivery. The authors draw attention to the fact that the withdrawal syndrome in the neonate may develop after delivery if the mother used during pregnancy not only addictive drugs affecting the central nervous system but also drugs affecting the cardiovascular system such as the beta-adrenolytic metipranolol.

The authors investigated the development and interrelations of respiratory and biochemical parameters of normal neonates during the adaptation period from 15 minutes to the 7th day after delivery. They found that the correlations of oxygen consumption, carbon dioxide output, respiratory volume and minute ventilation are positive and independent on the time of assessment. These respiration parameters are independent on the glucose, lactate and pyruvate levels, on the respiratory quotient and pH and pCO2. The authors characterize the similarity of the trend of individual parameters and the variability of normal values.

The authors describe a case of pulmonary haemorrhage in a neonate associated with adnatal pneumonia and infection with Staphylococcus epidermidis. The authors discuss the problem of this serious complication of the neonatal period as well as the limited diagnostic and therapeutic possibilities.