Cesko-Slovenska Pediatrie最新文献

The authors present an account on hitherto little used electrophysiological methods for the evaluation of the functional state of the brain and on the possibility to use the results of these examinations for prognostic purposes in therapeutic care of patients with impaired consciousness. They recommend the use of a mobile technique capable to ensure EEG monitoring, examination of the basic modalities of evoked potentials (visual, auditory and somatosensory) at the bedside. The practical results of these examinations are demonstrated on case-histories of patients treated at intensive care units for neonates. The asset is the relatively reliable evaluation of the actual condition of the brain and the possibility to assess the most probable development of the patient's clinical condition.

The fundus of the eye was examined in 302 children and adolescents with insulin dependent diabetes (mean age 14.2 years, SD 3.60, mean duration of diabetes 6.4 years, SD 3.83) by prolonged chromato-ophthalmoscopy and the finding was classified according to the authors' own extended classification of diabetic retinopathy. In 295 patients the authors assessed the mean value of glycosylated protein during the period of 3-6 months before assessment of the retina. When these values were compared with the retinal findings, a statistically highly significant relationship of retinopathy and the glucose compensation of diabetes was found (p < 0.001). The increase of the mean glycoprotein value during adolescence, as compared with the prepubertal period, was also statistically significant, while adolescents without retinopathy had lower mean glycoprotein values as compared with the group as a whole.

This is an analysis of 102 cases of SIDS from retrospective studies in the Zilina and Senica districts. The incidence of SIDS in the Zilina district was 2.04/1000 (period 1969-1978) and 1.04/1000 (period 1980-1984). The incidence of SIDS in the Senica district was 0.82/1000 (period 1979-1990). According to preliminary results of the epidemiological study of SIDS in Slovakia (1991) the incidence is only 0.89/1000 which amounts, however, to 23.1% of the post-neonatal mortality. In the investigation nine indicators were evaluated: age at the time of death, morbidity before death, place of death, education of mother, position of infant at time of death, birth weight succession of child in family. The assembled results were compared with data in the literature. Because of similar results it is assumed that the following risk factors participate in the incidence of SIDS: age (2-4 months), time between midnight and 6 a.m., low socio-economic status of family, lower education of mother, incidence of SIDS in the family, short interval between childbirths, prone position during sleep, succession of child in family (third or subsequent), effect of smoking. The investigation did not confirm as risk factors a lower birth weight and inadequate postnatal adaptation. In the conclusions some possible ways of prevention are outlined.

Examination of glomerular erythrocyturia which proved useful in the differential diagnosis of haematuria faces in practice two serious problems--the necessity to examine fresh urine and differences as regards the interpretation of criteria of glomerular erythrocyturia (from 10 to 80%). The authors examined therefore the morphology of erythrocytes in urine of 65 children with different causes of haematuria, incl. 35 patients with different forms of glomerulonephritis. They found that adding 25 mg thimerasol to 10 ml urine preserves urinary elements, incl. morphologically altered red cells for a period of 72 hours or longer. This makes it possible to examine the red cells under a phase microscope after dealing with ambulatory patients. Among various morphological forms of red cells in urine of 31 patients with glomerulonephritis in urine acanthocytes were found in a concentration above 5%, and in the majority above 20%. Acanthocyturia above 5% was not present only in 4 patients with glomerulonephritis, whereby all four suffered from mild erythrocyturia. The authors consider therefore acanthocyturia above 5% as the most reliable evidence of glomerulonephritis, in case of erythrocyturia above 10 Ery in the visual field. The criteria of acanthocyturia in children are thus lower than in adults.

The author presents sonomorphological characteristics of retroperitoneal neuroblastoma, nephroblastoma, non-Hodgkin lymphoma and M. Hodgkin abdominis, hepatoblastoma and hepatocellular carcinoma at the time when the diagnosis was established. The objective of the investigation was to increase the sensitivity and specificity of ultrasonic diagnosis of the mentioned malignant tumours of the abdomen and retroperitoneum during the first sonographic examination.

The authors examined the level of the atrio-natriuretic factor (ANF) in 7 infants with inborn heart disease at the age of 3 weeks to 5.5 months. As controls they examined 9 convalescent infants aged 1-10 months. Congenital heart disease was confirmed by clinical methods (ECG and X-ray) and echocardiographically (one-dimensional, two-dimensional and pulsed Doppler echocardiography, 5MHz probe, Kontron Co.). Although a small group is involved, elevated ANF values were recorded in infants with inborn heart disease, as compared with controls.

The submitted paper, based on the authors' experience, summarizes basic findings pertaining to isolated proteinuria. In addition to a simple classification the authors outline in a diagram the differential diagnostic procedure in patients with isolated proteinuria.