Ocular palsies in children with diabetes mellitus.

The findings in three children with ocular palsies are reported in this paper. Two had insulin-requiring diabetes and one demonstrated only an abnormal I.V. glucose tolerance test. In the first patient the condition resolved in four weeks; in the second it had not fully resolved after 21 months, and in the third patient surgery was required for correction after seven months. We suggest that any child who develops a sudden ocular palsy should be examined for diabetes mellitus.

Once daily subcutaneous growth hormone-releasing hormone therapy accelerates growth in growth hormone-deficient children during the first year of therapy. Geref International Study Group.

The efficacy and safety of 1 yr of GH-releasing hormone [GHRH-(1-29)] therapy in GH-deficient children were determined. One hundred and ten previously untreated prepubertal GH-deficient children were treated for up to 1 yr in a multicenter, open label study with 30 micrograms/kg GHRH-(1-29)/day, sc, given at bedtime. Eighty-six of the 110 patients were eligible for efficacy analysis. The main outcome measures, monitored every 3-6 months, were linear growth enhancement (height velocity), bone age progression, and safety measures including clinical chemistry. The mean height velocity for the group increased from 4.1 +/- 0.9 cm/yr at baseline to 8.0 +/- 1.5 and 7.2 +/- 1.3 cm/yr after 6 and 12 months of therapy, respectively. At 6 months, 74% of the children were considered to have a good response to GHRH. The ratio of the change in bone age to height age was not significantly different from unity at 12 months (1.04 +/- 0.58; P = 0.63). No adverse changes in general biochemical or hormonal analyses were noted. No change in fasting glucose concentration or excessive generation of insulin-like growth factor I occurred, and overall GHRH was well tolerated. We conclude that GHRH administered as a once daily dose of 30 micrograms/kg GHRH.(1-29), s.c., was effective in increasing height velocity in GH-deficient children.

Combined chronic toxicity/carcinogenicity study of the fungicide trimorphamide in rats.

Trimorphamide, a new fungicide, was fed over 2 years to groups of 50 male and 50 female rats at dietary levels of 0, 67, 330 and 665 mg/kg. No adverse effects on mortality, haematology, urinalysis, organ weights, incidence and severity of tumors were observed. Isolated observations of abnormalities in blood chemistry suggested the possibility of certain renal damage in the highest dosage group; however, the clinical significance of these findings is dubious. According to the results of the present study, 67 mg/kg in the diet can be considered as the "no observed effect level".

Glucose disappearance in infants of diabetic mothers. I. Relationship to maternal glucose tolerance and insulin production.

Glucose disappearance and insulin response were determined in mother--infant pairs of normal, gestational diabetic and diabetic pregnancies following an intravenous glucose load. Mothers were studied in the third trimester of pregnancy and at least 6 wk postpartum. Significant differences were present in glucose disappearance and insulin response in both gestational diabetic and diabetic mothers during pregnancy compared with the control group. Infants were studied within 4 h of birth while fasting, and glucose and insulin levels followed through the first 3 days of life. Neonatal hypoglycemia did not occur and glucose disappearance (KT) was not different among the three groups. There was no correlation between maternal glucose tolerance or insulin production and that of their infants. The only distinguishing factor among the infants was higher insulin production in infants of diabetic mothers during the 60-min intravenous glucose tolerance test which persisted up to 4 h following the infusion. It is concluded that factors other than the degree of maternal glucose tolerance are responsible for the development of neonatal hypoglycemia in infants of diabetic mothers, most notably control of maternal diabetes, the amount of glucose infused immediately before delivery and neonatal glucose production.

Growth during and after a trial of growth hormone releasing hormone 1-29 in children with idiopathic short stature or growth hormone neurosecretory dysfunction.

The growth promoting effects of once nightly subcutaneous injections of growth hormone releasing hormone (GHRH) 1-29 (30 microg/kg) for 6 months were studied in 16 slowly growing prepubertal children with idiopathic short stature (ISS; Group 1) and 8 similar children with growth hormone neurosecretory dysfunction (GHND; Group 2). Each child underwent endogenous growth hormone evaluation using both pharmacological and physiological testing; each had stimulated values > 10 microg/l and were subsequently placed into one of two groups based on pooled 12-hour overnight GH of < or > or = 3 microg/l. Each patient was followed every three months for one year. There were no significant differences in the two groups throughout the study with the exception of the endogenous GH levels. Both groups responded to GHRH therapy with similar significant increases in their rates of growth. Although a subset of patients (6 of 21) continued to grow at a rate significantly greater than the pre-therapy rate of growth, overall rates of growth were not significantly different from the pre-therapy growth rates 6 months following the discontinuation of GHRH treatment. We conclude that GHRH 1-29, given in the doses provided, leads to similar changes in growth rates in short, slowly growing children who are GH sufficient and those with GHND. Despite prior reports to the contrary, GHND patients do not experience a sustained increased in growth rate upon discontinuation of GHRH.

Neonatal genital reconstruction.

It is evident from studies of boys who suffered a surgical catastrophe at a young age and were then assigned a female sex role that cultural and environmental influence are a potent determinant of a child's gender identity. It is imperative that parents have their child's sex assignment firmly fixed in their minds as early as possible. Early surgical correction of a child with ambiguous genitalia to conform to the sex of assignment will serve greatly to reinforce appropriate behavior in the parent. Such surgical intervention for diagnostic and reconstructive purposes is both desirable and safe in the first weeks of life.

Problems in the care of the infant diabetic patient.

The unique problems of three infants who developed diabetes mellitus at 13 months of age or younger are discussed. These problems include: the administration of small doses of insulin; the difficulty in attaining control; and the evaluation of urinary sugar content. Suggestions for care are made.

[Prophylactic administration of selected antibiotics in hospitals in the Slovak Republic]. / Profylaktické podávanie vybraných antibiotík v nemocniciach Slovenskej republiky.

Over a period of ten years prophylactic administration of selected antibiotics was evaluated three times (in 1973, 1983, and in 1988) in the same ten hospitals of the Slovak Republic. The study was focused on the use of gentamicin (GEN), cotrimoxasol (COT) and cephalosporins (CEP). Prophylactic administration of antibiotics was found to be increasing. GEN is being given less frequently, while CEP are administered more often, which is considered to be a positive trend. The period of prophylactic administration of antibiotics is still inadequately long with an average of 10.7 days. Evaluation of antibiotic administration showed that antibacterial substances have the highest rate of prophylactic administration in patients with oncologic diseases, followed by patients with diseases of the urinogenital system. A positive development was recorded in the perinatal period with a decreasing trend in the prophylactic administration of antibiotics.

[Analysis of the use of gentamicin, cotrimoxazole and cephalosporin in selected hospitals]. / Analýza pouzívania gentamicínu, kotrimoxazolu a cefalosporínov vo vybraných nemocniciach.

The authors investigated the administration of monitored antibiotics, i.e. gentamicin, cephalosporins and cotrimoxazol, as well as of other so-called not monitored antibiotics. The investigation was made in the same 10 hospitals in the Slovak Republic three times in the course of 15 years, i.e. in 1978, 1983 and for the last time in 1988. It was revealed that the number of therapeutic administrations of the monitored antibacterial substances in increasing. The excessive gentamicin administration persists in particular on neonatal, premature-infant and surgical departments. The authors evaluate as a positive feature that the structure of administered antibiotics changes, i.e. the amount of gentamicin administration is declining and the cephalosporin administration has a rising trend. The investigated antibiotics were administered for an average period of 10.6 days which is too long, in particular in gentamicin where the period was as long as 9.2 days. The investigated antibiotics were administered most frequently in diseases of the airways and in diseases of the urinary and genital system.

[Comparison of basic physical measurements in Czech and Slovak children and adolescents]. / Srovnání základních telesných rozmeru ceských a slovenských detí a mládeze.

The authors compared the Slovak and Czech part of the IVth nation-wide anthropological survey of children and youth from birth to the age of 18 years and evaluated the revealed differences in height, body weight, head and chest circumferences. The results confirm the assumed further approximation of growth values of the two child populations and the gradual equalization recorded in particular in the youngest age groups.