[The effect of giving a copy of the discharge letter to parents]. / Effekten af kopi af epikrise til foraeldre.

The purpose of this study was to evaluate the effect of giving parents a copy of the discharge letter (DL) concerning the hospitalization of their child. Questionnaires were sent to parents, general practitioners (GP) and health visitors (HV). Sixty-one per cent of the parents and 64% of the GPs and HVs returned the questionnaires. Seventy-seven per cent of the responding parents had received the discharge letter within a week after the discharge, and 64% of the parents understood the DL without difficulties. The majority regarded it as an improvement of the service to the families.

Atypical metachromatic leukodystrophy? Problems with the biochemical diagnosis.

A 3 1/2-year-old slightly retarded boy with marked deficiency of arylsulfatase A (ASA) activity in leucocytes and fibroblasts and almost no cerebroside sulfatase (CS) activity in fibroblasts was tested with the sulfatide-loading test. On this test his fibroblasts showed impaired degradation. A pathological excretion of sulfatides was seen in his urine. Nerve conduction velocity, visual evoked potential, auditory brain stem evoked response, and somatosensory evoked potential were all normal. His father and older brother had similarly low levels of ASA in leucocytes and fibroblasts and 1.7-2% residual CS activity in fibroblasts. Although both were clinically normal, their fibroblasts accumulated increased amounts of sulfatides when challenged in the sulfatide-loading test. In this family, this test thus will be of no value in prenatal diagnosis to discriminate among low ASA fetuses with pseudoarylsulfatase A deficiency and fetuses with this unusual ASA deficiency variant.

The value of the micromethod erythrocyte sedimentation rate in the diagnosis of infections in newborns.

200 newborns, gestational age between 27 and 43 weeks (mean 39 weeks) and a birth weight between 900 and 4600 g (mean 2600 g) were studied. 18 patients had severe infections, 20 topical infections, 11 had signs of infection but negative microbiological cultures, 26 had positive cultures but no clinical signs of infection, and 125 patients had no sign of infection at all. In the group without infection (125 patients), the micromethod erythrocyte sedimentation rate (MESR) raised slowly from 2 mm/h at birth (95% upper limit 8 mm/h) to 4 mm/h 8 days after delivery. The MESR of the patients with respiratory distress, asphyxia, intubated children and patients with umbilical catheter, who had no infection, did not differ from other patients in this group. In patients with focal and general infections, rapidly rising MESR within wide limits was observed. Thus, in the individual newborn a high MESR supports the diagnosis of severe infection, whereas a low MESR does not exclude this diagnosis.