Plasma concentrations of carbohydrates and sugar alcohols in term newborns after milk feeding.

Nonglucose carbohydrates such as galactose, mannose, and inositol play a clinically important role in fetal and neonatal nutrition, though little is known about their metabolism in the neonate. The aim of this study was to determine whether postprandial changes in plasma carbohydrate and sugar alcohol concentrations are affected by clinical variables such as postnatal age (PNA), milk type, feeding volume, or feeding duration in term newborns. Neonates (n = 26) taking intermittent enteral feedings were enrolled. Blood samples were obtained at baseline (immediately before the start of a feeding) and at 2-3 subsequent time points up to 110 min. Postprandial rise was only observed for plasma glucose concentrations [Glu] and plasma galactose concentrations [Gal] and clinical variables did not predict this change. Despite equimolar delivery in milk, the median of [Glu] rise minus [Gal] rise from baseline to second postprandial plasma sample was 674 microM (-38, 3333 microM; p < 0.0001), reflecting efficient hepatic first-pass metabolism of galactose. A significant PNA effect on [Gal] was observed such that for each day PNA there was an 18% decrease in [Gal] (p = 0.03). [Gal] are a function of PNA, suggesting maintenance of a significant ductus venosus shunt in term infants.

Primary Sjögren syndrome in the paediatric age: a multicentre survey.

UNLABELLED: Primary Sjögren syndrome (SS) is very rare in childhood. We collected a series of primary paediatric SS cases from different centres. A data collection form was prepared and sent to rheumatologists who were willing to participate. Data on 40 cases of primary SS with onset before the 16th birthday were collected. Almost all patients (35/40) were females, age at onset varied from 9.3 to 12.4 years (mean 10.7 years). Signs and symptoms at disease onset were mainly recurrent parotid swelling followed by sicca symptoms. Abnormal laboratory tests were found in the majority of cases. Regarding treatment, 22 patients were treated at some time with oral corticosteroids, seven with non-steroidal anti-inflammatory drugs, and five with hydroxychloroquine; two patients needed cyclosporine and one cyclophosphamide. Follow-up varied from 0 to 7.5 years from onset, without major complications in the majority of patients. CONCLUSION: recurrent parotid swelling is a common feature of primary Sjögren syndrome in childhood and often occurs as a presenting feature. Sicca symptoms may be rarer.

One year experience at the Emergency Unit of the Children's Hospital of Parma.

The objective of the study was to analyse the activity of the Paediatric Emergency Unit (PEU) of the Children's Hospital in Parma, Italy, in the first year of its functioning. To this aim, the child's chronological age, place of origin (town or province), ethnic group, cause of consultation, time and date of admission, diagnosis and final destination were retrospectively collected from the clinical notes of all children who attended PEU from 1st. 10.1998 to 30th. 09.1999. During the period of this study 8,564 medical consultations (57% of users were male) were carried out by the Paediatricians on duty in the EU of The Children's Hospital. The average age of the patients was 3.9 +/- 3.5 years. Only 7% of patients passed through the General Emergency Department of the same Hospital. The peak period of consultations was found to be in February. The number of daily attendances progressively increased from Monday to Sunday according to a r of 0.59 (p<0.02) with a peak during the weekend. The most frequent causes for attendance concerned infections in the upper respiratory tract (36%), gastroenteritis (22%) and injuries (12%). Attendance, consultation and discharge procedures were covered at an average interval of 36.1 +/- 15.6 minutes (median 30 min.). Seventy per cent of the patients were discharged, 56.7% were males. Fourteen per cent of the rest were admitted for a short period of observation in the beds of the PEU and 16% in beds of specialised wards in the PD. Eighty per cent of admissions at the PEU lasted less than 48 hours. The analysis of the data collected at the PEU of our PD during the first year of its activity highlights the huge amount of work carried out by the Paediatricians on duty. To solve the abnormal admittance to a PEU, a complete reorganization of the Family Paediatricians network has to be hoped for. Special attention must also be addressed to the users of a PEU in order to reduce their attendance. To reach this target a continuous health education and information program for the general population and first-time parents has to be planned. Beyond these considerations, there is not doubt that a PEU requires a specific medical and nursing staff in order to prevent the service becoming ineffective.

Voluntary discontinuance of seven years successful insulin prophylaxis produced shortly overt diabetes in a first-degree relative of a diabetic child at high risk for type 1 diabetes.

This is the story of a nondiabetic first-degree relative of a child with Type 1 Diabetes who was screened for Type 1 diabetes and was found to be at high risk being positive for genetic, immunologic and metabolic markers. He accepted to be treated with low-dose subcutaneous insulin and for 7 years he has been living in subclinical prediabetes state. At the beginning of eighth year, he voluntary discontinued the preventive insulin therapy and after 18 months clinically overt diabetes appeared.