A longitudinal cohort study on the prevalence of Helicobacter pylori antibodies in Swedish children and adolescents

The aim of this study was to monitor the Helicobacter pylori antibody seroprevalence of an asymptomatic cohort between the ages of 4 and 18 y. The H. pylori antibody titres in a longitudinally followed cohort of 168 native Swedish children (born between 1972 and 1974) were established at 4, 8, 12, 16, and 18 y of age. Seventeen children (10.1%) were found positive on at least one occasion when a paediatric cut-off was applied. Five children (3.0%) reached levels considered positive in adults. The seroprevalence at 4 y of age was 4.0%, at 8 y 2.5%, at 12 y 4.9%, at 16 y 5.3%, and at 18 y 6.3%. The difference in serological titres between the age groups was not significant. A change from negative to positive after the age of 4 took place in 5 of the cases. Spontaneous seroreversion appeared in 5 cases.

CONCLUSION

Our findings showed no significant differences among the various age groups. Seventeen of the 168 children (10.1%) had been infected at some time, the prevalence ranging from 2.5% to 6.3%. Seroconversion and seroreversion occurred infrequently between the ages of 4 and 18 y.

Acute myocardial infarction in middle-aged women: narrations from the patients and their partners during rehabilitation

The purpose of this study was to examine the meaning of lived experiences after an acute myocardial infarction (AMI) and being a partner to an afflicted woman, as it is narrated during rehabilitation. Nine women and their partners narrated their experiences three and twelve months after AMI. The interview texts were transcribed and then interpreted, using a phenomenological-hermeneutic method inspired by the philosophy of Ricoeur. The result showed that their experiences of the illness contained two themes: 'rehabilitation needed' and 'loss of freedom' which contains eight sub-themes; 'adapting to it', 'struggling against it', 'living as normally as possible', 'having insight into how it can be', 'feeling guilty and ashamed about being weak', 'withholding feelings', 'feeling useless', and 'feeling fatigued and losing strength'. After further interpretation, the themes gave a deeper meaning of living with AMI and how it affects women and their partners. The women conceded that they felt distressed and vulnerable but struggled against the fear the illness means. The partner's role appears to be one of trying to adapt to the women's experiences of the illness. That the women withheld their feelings and did not talk about them indicates a lack of communication between the couples. As coronary care nurses often come very close both to the afflicted persons and the relatives they fill an important function in each patient's recovery. The nurses could help and prepare the patients and their relatives to understand better such feelings and reactions as could appear after discharge from hospital.

Iron status of children in southern Sweden: effects of cow's milk and follow-on formula

AIM

The objective of the study was to investigate iron status in children in relation to intake of cow's milk and follow-on formula.

METHODS

In all, 367 healthy 2.5-y-old children were enrolled in the study. The amounts of cow's milk and formula consumed were recorded. B-haemoglobin, S-ferritin, S-iron, total iron binding capacity and mean corpuscular volume were analysed.

RESULTS

Seven percent of the children had iron deficiency anaemia (Hb <110g/l) and 10% had S-ferritin < 12 microg/l. Furthermore, 10% of the children were iron deficient, with or without anaemia. Children with iron deficiency had a higher intake of cow's milk (382 ml, 95% confidence interval (CI) 294-496, vs. 257 ml, CI 232-272, p < 0.0001), and fewer consumed follow-on formula (11% vs. 43%, p= 0.0002) compared to those with sufficient iron.

CONCLUSION

Iron deficiency is still common during childhood in Sweden. Intake of cow's milk is significantly higher in children with iron deficiency. In contrast, iron deficiency is less frequent among those consuming follow-on

[The AD-drops can be replaced by D-drops]

Since 1932, when vitamin A and D supplementation, in the form of cod liver oil, was introduced in Sweden, rickets has been a rare diagnosis among Swedish infants. In 1978, the National Board of Health and Welfare issued recommendations of daily supplementation with 300 micrograms (1000 IU) of vitamin A and 10 micrograms (400 IU) of vitamin D. This has recently been under review by the Paediatric Committee on Nutrition and Health, of the Swedish Paediatric Association and the National Food Administration, who concluded that there is no reason to retain vitamin A supplementation, but that vitamin D supplementation should continue to be recommended at the same daily dose (400 IU).

[Recommendations for prevention of iron deficiency. Delay cow's milk intake as a beverage to infants until 10-12 months of age!]

Breast-feeding is to be encouraged during the first six months of life. Iron deficiency is extremely rare in exclusively breast-fed infants during this period. Any cow-milk based formula used should be iron-fortified. During the second half of infancy, the iron content of weaning foods is important in preventing iron deficiency. Indeed, owing to the low iron content of dairy products, it is hard to compose a weaning diet sufficiently rich in iron to meet the demands of rapidly growing infants, if it is to include substantial amounts of cow milk, sour milk or yoghurt. Accordingly, the Paediatric Committee on Nutrition and Health, of the Swedish Paediatric Association and the National Food Administration, recommend delaying the introduction of cow's milk and cow-milk products until the infant is 10-12 months of age. Until then, breast-feeding, and the use of iron-fortified formula or gruel with modified protein and sodium content are encouraged; iron-fortified porridges of softer consistency can be prepared to circumvent the need of extra fluids, or porridge can be served with breast milk or iron-fortified formula; small amounts of milk may be used for cooking purposes.

Ultrasound measurements of subcutaneous adipose tissue in infants are reproducible

BACKGROUND

The purpose of this study was to evaluate the ultrasound technique for measuring subcutaneous adipose tissue in infants.

METHODS

Twenty infants were investigated at 3, 6, and 12 months of age. All measurements were made by the same investigator in triplicate on the left side of the body at the triceps and subscapular anatomic landmarks and at the abdomen and thigh. An ultrasound system equipped with a linear 7.0-MHz transducer was used.

RESULTS

The intraclass correlation coefficients were 0.88 to 0.99. Random errors ranged from 0.01 to 0.19 mm. For log-transformed values, the random error ranged from 2.4% to 5.7%.

CONCLUSIONS

Measurements of subcutaneous fat in infants using ultrasound are reproducible when performed by the same observer.

Nebulization of drugs in a nasal CPAP system

Aerosolized drugs have been used in infants for the treatment of respiratory distress syndrome and bronchopulmonary dysplasia (beta-agonists, steroids and surfactant) and bronchiolitis due to respiratory syncytial virus (epinephrine and ribavirin). Controlled clinical trials have, however, produced conflicting results, probably due in part to problems with the transportation of the aerosol from the nebulizer to the bronchioli. We have modified a nasal continuous positive airway pressure (CPAP) system permitting an aerosol to flow through a canal to the nasal prongs and into the airways of the infant. It has been used successfully for the administration of epinephrine, salbutamol, budesonide, acetylcysteine, natural surfactant and ribavirin to sick infants. The modified nasal CPAP system is a simple, safe, cost-efficient and baby-friendly system for respiratory support and drug treatment, which can be used in future trials of aerosolized drugs.

Prevalence of IgA-antigliadin antibodies and IgA-antiendomysium antibodies related to celiac disease in children with Down syndrome

OBJECTIVE

This study was undertaken to investigate the prevalence of celiac disease in children and adolescents with Down syndrome.

MATERIAL AND METHODS

Forty-three children and adolescents with Down syndrome were screened for IgA-antigliadin antibodies (AGA) and IgA-antiendomysium antibodies (EMA). Patients found to be either AGA- or EMA-positive were investigated further with intestinal biopsy.

RESULTS

None of the 43 patients had known celiac disease at entry into the study; 37% (16/43) were found to have AGA levels above normal, and 16% (7/43) to be EMA-positive. Of the 15 patients who underwent biopsy, 8 manifested villous atrophy. Villous atrophy was present in all 7 of the EMA-positive patients, whereas the villi were normal in 7 of the 13 AGA-positive patients who underwent biopsy.

CONCLUSIONS

EMA is a good immunologic marker for use in screening for celiac disease, and screening is justified in patients with Down syndrome.

The influence of dietary nucleotides on erythrocyte membrane fatty acids and plasma lipids in preterm infants

OBJECTIVE

The objective of this study was to evaluate whether a regular formula for premature infants supplemented with nucleotides has any influence on plasma lipids and erythrocyte membrane fatty acids.

METHODS

Preterm infants fed either human milk supplemented with human milk protein (HM, n = 14), nucleotide-supplemented preterm formula (NF, n = 13), or a regular preterm formula (F, n = 13) were included in the study. The NF was supplemented with 18.2 mg cytidine monophosphate/l (CMP), 7.0 mg uridine monophosphate/l (UMP), 6.4 mg adenosine monophosphate/l (AMP), 3.0 mg inosine monophosphate/l (IMP) and 3.0 mg guanosine monophosphate/l (GMP).

RESULTS

There were significantly higher concentrations of triglycerides (TG) in infants fed NF compared to those fed F (191.42 +/- 79.58 vs 108.21 +/- 43.73, p < 0.001, mean +/- SD lipid concentrations, mg/100 ml plasma). Infants fed F had significantly lower concentrations of total cholesterol (94.34 +/- 11.71 vs 115.69 +/- 39.29, p < 0.01) and TG in plasma (108.21 +/- 43.73 vs 172.27 +/- 68.19, p < 0.001, mean +/- SD lipid concentrations, mg/100 ml plasma) when compared to HM-fed infants. There were no significant differences in any of the erythrocyte membrane fatty acids and total long-chain polyunsaturated fatty acids (LC-PUFA) between NF and F during the study period (6 weeks). Furthermore, total LC-PUFA and docosahexaenoic acid (DHA) concentrations in red blood cell were not significantly different when infants fed NF were compared to those fed HM. In contrast, however, infants fed F had significantly lower concentrations of total n-3 LC-PUFA (p < 0.01) and DHA (p < 0.01) than those found in HM-fed infants.

CONCLUSIONS

These results do not suggest an effect of nucleotides on the red blood cell LC-PUFA profile in preterm infants. However, the nucleotides may increase the concentrations of triglycerides in plasma.

Oral findings in a group of newborn Swedish children

Oral examinations were performed of 1021 newborn Swedish children, of whom 101 were re-examined after 2-3 or 4-5 months. The most common findings, registered in 74.9% of the children, were of oral mucosal cysts situated either palatally or on the alveolar ridges. The majority of the palatal cysts disappeared shortly after birth, and some alveolar cysts appeared after birth. Ankyloglossia was found in 2.5% of the children, and Fordyce spots in 1.0%. No natal teeth were found. The upper labial frenum was attached to the crest of the alveolar ridge in 76.7% of the children, palatally in 16.7% and buccally in 6.7%. The relationship of the alveolar ridges was recorded: the anterior segment of the mandibular ridge was distal to the maxillary in 99% of cases, and, posteriorly, the mandibular ridges were lingual to the maxillary in 97.6%. An open bite was found in 39.8% of the children.

Visual functions in a Swedish population of dyslexic and normally reading children

Eighty-six 9-year old dyslexic children were carefully matched to controls with regard to age, sex, class in school, and intelligence and thorough visual functions tests and eye examinations were performed. As a group the dyslexic pupils exhibited a lower distance as well as near visual acuity both with monocular and binocular viewing. Furthermore, the dyslexic pupils had a lower contrast sensitivity at the lower and higher spatial frequencies. These differences were all statistically significant. However, no statistically significant differences between the two groups could be observed regarding refractive errors or contrast sensitivity in the middle spatial frequency range. Although some eyes were amblyopic, any severe eye anomalies or diseases were not found in any of the investigated children.

Structure and composition of proteoglycans from human annulus fibrosus

Proteoglycans were extracted from ground human lumbar annuli fibrosi with 4M guanidinium chloride and purified by means of associative equilibrium density gradient centrifugation. The proteoglycan preparations contained chondroitin sulphate, keratan sulphate and hyaluronic acid, but no dermatan sulphate. Degradation experiments suggested that the proteoglycans contain three regions: a chondroitin sulphate-rich region, a keratan sulphate-rich region and a region that binds to hyaluronic acid, thus allowing proteoglycan aggregates to be formed. The keratan sulphate-rich region seemed to be more prominent than in bovine hyaline cartilage proteoglycans. The model for the structure of bovine hyaline cartilage proteoglycans, Hascall and Heinegård, seems to be applicable to the proteoglycans from human annulus fibrosus. The amino acid composition of annulus fibrosus proteoglycans is very similar to that of bovine hyaline cartilage proteoglycans.

Kinetics of proteoglycans and cells in growth plate of normal, diabetic, and malnourished rats

The metabolism of proteoglycans in normal growth plate and the changes in growth plate morphology induced by diabetes and malnutrition were studied in rats. The proteoglycans had a significantly faster turnover (half-life measured with [35S]sulfate labeling: 25-30 h) than the cells in the growth plate. Morphometric studies showed significant reductions of cell number, zone height, and [3H]thymidine incorporation in growth plates from rats with untreated streptozotocin-induced diabetes compared to normal rats. Similar, although less pronounced alterations were observed in malnourished, nondiabetic rats. Disaggregation and degradation of proteoglycans are probably necessary prerequisites for calcification. Our data indicate that the proteoglycans are in a dynamic state of rapid biosynthesis and degradation throughout the growth plate with a shift in the balance at the calcification front toward less synthesis and more degradation.