Pulmonary function at school-age in surfactant-treated preterm infants.

A follow-up study was conducted in 40 children who had been enrolled in a prospective randomized study of exogenous surfactant therapy for respiratory distress syndrome (RDS) (n = 22; S) or placebo (n = 18; P) to determine long-term pulmonary sequelae of surfactant treatment in premature infants with RDS. At follow-up, mean (SD) age was 6.63 (0.18) and 6.55 (0.23) years for S and P, respectively. Complete lung function tests (LFT) were attempted in all patients. Satisfactory data were obtained in 17/22 surfactant-treated and in 12/18 control children. There was no significant difference between groups for any of the parameters measured. Mean (SD) functional residual capacity (FRC) was 92% (16%) and 90% (21%) predicted, mean (SD) airway resistance (R(aw,exp)) was 122% (25%) and 127% (61%), and mean (SD) forced expiratory volume in 1 s (FEV1) was 104% (12%) and 99% (17%) predicted for S and P. Only maximal expiratory flow at 25% vital capacity (L/s) was significantly below the predicted range in S and P groups, with 74% (23%) and 77% (28%), respectively. To test bronchial hyperreactivity, a simple standardized running test was performed: 4 children in S and 5 in P showed a significant response as defined by clinical airway obstruction or changes in FEV1 and/or R(aw), with no significant difference between groups. Although we found no major abnormalities in lung function and no difference between S and P at early school-age, lack of cooperation during lung function tests makes further follow-up necessary.

[Babesiosis--a dangerous infection for splenectomized children and adults]. / Babesiose--eine bedrohliche Infektion für splenektomierte Kinder und Erwachsene.

Babesiosis is a world-wide distributed protozoal zoonosis, and Babesia spp. are the most ubiquitous of the blood parasites of mammals, except the trypanosomes. The tick-transmitted protozoa infect various vertebrate reservoir hosts, like rodents, cattle and horses. Approximately 100 million cattle is exposed to the disease. In tropical and subtropical regions the infection causes considerable losses in livestock industry, but clinical cases of human babesiosis in these areas have not certainly been identified. In 1957, the first case of human babesiosis in an asplenic Yugoslav farmer was reported (35). Hitherto, hundreds of cases of human babesiosis in adults and children from Europe and the U.S., with a broad range of clinical presentations, have been published (3, 4, 38). Most of the patients suffer from mild to moderate symptoms, whereas in asplenic individuals a fatal course of the infection prevails. Tick-bites in areas where human babesiosis occurs--mainly parts of Europe and the USA--can result in a deadly illness for persons without a spleen. The effect of treatment in splenectomized patients and when treatment is delayed, still is poor.

[Toxocariasis--a neglected ubiquitous helminthiasis in children and adolescents]. / Toxocariasis--eine vernachlässigte ubiquitäre Helminthose bei Kindern und Jugendlichen.

More than 40 years ago, Toxocara ssp. was identified as the cause of larva migrans visceralis and ocular larva migrans, which mainly affect infants and children. Although widespread in most parts of the world, the parasitic disease is rarely diagnosed in Germany. Focusing on clinical and pathophysiological similarities with allergic asthma of childhood, the main epidemiological, clinical, therapeutical, and pathophysiological aspects of toxocariasis will be reviewed in the following survey.

[Seizures and hyponatremia in a newborn infant]. / Krampfanfälle und Hyponatriämie bei einem Neugeborenen.

A three days old mature female newborn presented with seizures. The diagnostic data revealed a hyponatraemia (113 mmol/l) as pathogenic origin. Further causes of convulsions could be excluded. Administering saline solution (0.9%) intravenously the plasma sodium level reached normal ranges within 36 hours. We propose that an excessive enteral administration of glucose solution during the first three days of life must have led to dilutional hyponatraemia. This suggestion is in accordance with observations in older children presenting with similar symptoms.